I made this mango and banana smoothie for our afternoon snack, Josh loved it!
Mango and Banana Smoothie:
-Frozen mango cubes
-banana
-blueberry yogurt
-milk
-some crushed ice
Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts
September 04, 2015
August 28, 2015
August 13, 2015
Doctor's appointment 8/12/2015
June 05, 2014
风疹块的起因
风疹块的起因？了解风疹块的起因吗？下面是关于风疹块的起因的解答。寻麻疹的病因复杂，尤其是慢性寻麻疹不易找到病因，除和各种致敏原有关外，与个人的敏感性素质及遗传等因素也有密切的关系，常见的诱因有：(一)食物以鱼、虾、蟹、蛋、牛奶、肉类等动物性蛋白质最常见，尤其是在一次大量进食蛋白质饮食和酗酒后，发生的蛋白胨性寻麻疹，其次某些植物也可致敏。(二)药物如青霉素、痢特灵、血清、疫苗等可由变态反应引起，另一些药物如吗啡、阿托品、阿司匹林等为组胺释放剂，可直接刺激肥大细胞释放组胺，引起寻麻疹。
(三)吸入物花粉、动物皮屑、羽毛、灰尘、某些气体及真菌孢子等。(四)感染包括细菌、真菌、病毒、原虫、寄生虫等感染，这些感染可能通过传染物的抗原作
用或改变了机体的应激状态，引起I型或III型变态反应。(五)昆虫叮咬如虱、跳蚤叮咬皮肤及黄蜂、蜜蜂、毛虫的毒刺刺入皮肤，引起变态反应。(六)物理
及化学因素如冷、热、日光和机械性刺激、摩擦压迫和某些化学物质的刺激，引起变态反应或非变态反应性寻麻疹。(七)内分泌和代谢障碍及胃肠功能失调均可诱
发本病，尤其是慢性寻麻疹。(八)内脏疾病如红斑性狼疮、淋巴瘤及某些肿瘤、风湿热等
可为寻麻疹的病因。(九)遗传因素如家族性寒冷性寻麻疹、遗传性家族性寻麻疹综合症和遗传因素有关。(十)精神因素精神紧张、感情冲动可引起乙酰胆碱释
放，增强血管通透性而发生寻麻疹。寻麻疹的发病机理可分为变态反应和非变态反应两种，前者主要是由于I型变态反应引起，少数是II型或III型反应，此型
的抗体IgE和血管周围肥大细胞、血中嗜碱性粒细胞相结合。当抗原再次侵入后，在这些细胞表面发生抗原抗体反应，引起肥大细胞膜本身及其一系列生物物理及
生物化学的变化，促使胞浆中的颗粒脱出，同时释放出各种药理性活性介质，如组胺、5-羟色胺、肝素、前列腺素、
乙酰胆碱、溶酶体酶、纤维蛋白溶酶、补体、各种激肽和慢性反应物质等，引起毛细血管扩张、血管通透性增加、平滑肌痉挛、腺体分泌增多，产生皮肤粘膜、消化
道和呼吸道的各种症状。非变态反应性寻麻疹是由于某些物质如细菌酶素、蛇毒、蛋白胨、某些药物直接刺激肥大细胞释放组胺，引起红斑、风团。【临床表现】常
突然发病，先感皮肤瘙痒，很快出现大小不等、形态不一、鲜红色或苍白色风团。散在性分布亦可融合成片，风团可局限也可泛发全身，数分钟或数小时后消退不留痕迹，但新风团又陆续出现，此起彼落，消化道受累可出现恶心、呕吐、腹痛、腹泻，喉头及支气管受累可发生喉头水肿，出现胸闷、
气急、呼吸困难甚至窒息，症状在数日至2~3周内消退者称为急性寻麻疹；若反复发作，病程达1~2月，大多找不出原因，顽固性难治者称为慢性寻麻疹。除以
上两型外，还有几种特殊型寻麻疹：(一)皮肤划痕症又称人工寻麻疹，手抓或钝器划其皮肤后，该处出现暂时性红色条状隆起。(二)血管性水肿又称巨大性寻麻
疹。发生在眼睑、口唇、包皮、外阴等
组织松弛部位，突然发生的局限性肿胀，边缘不清，持续1~2日自行消退，常反复发作。(三)压迫性寻麻疹皮肤受压4~6小时后，局部发生深在性肿
胀，8~12小时后消退，多发生在臀部、腰部、足背等受压部位。(四)日光性寻麻疹暴晒日光或紫外线后，在照光部位出现风团，并有瘙痒和针刺感。(五)寒
冷性寻麻疹分家族性和获得性两型。前者少见，为常染色体显性遗传，从婴儿开始持续终生。后者开始于儿童或成人，在气温骤降或接触冷水冷风时，在皮肤露出部
位出现风团，持续半小时至3~4小时，冰块试验和被动转移试验阳性，多见于女性青年。(六)胆碱能性寻麻疹在运动、重劳动、受热、饮酒或情绪紧张时，胆碱
能神经发生冲动而释放乙酰胆碱，作用于肥大细胞而发生直径2~3mm小风团，不融合，半小时至1小时内消退，除掌拓外，皮疹可泛发全身，以青年人多见。
(七)血清病性寻麻疹注射血清、疫苗或药物后除皮肤出现风团外，可有发热、关节痛、淋巴结肿大，有的可出现蛋白尿、管型尿。
October 17, 2013
Breast Cancer Risk in American Women
Breast Cancer Risk in American Women
Key Points
- Based on current breast cancer incidence rates, experts estimate that about one out of every eight women born today will be diagnosed with breast cancer at some time during her life.
- The strongest risk factor for breast cancer is age. A woman’s risk of developing this disease increases as she gets older.
- Other factors can also increase a woman’s risk of developing breast cancer, including inherited changes in certain genes, a personal or family history of breast cancer, having dense breasts, beginning to menstruate before age 12, starting menopause after age 55, having a first full-term pregnancy after age 30, never having been pregnant, obesity after menopause, and alcohol use.
Based on current incidence rates, 12.4 percent of women born in the United States today will develop breast cancer at some time during their lives (1). This estimate, from the most recent SEER Cancer Statistics Review (a report published annually by the National Cancer Institute’s [NCI] Surveillance, Epidemiology, and End Results [SEER] Program), is based on breast cancer statistics for the years 2007 through 2009.
What is the average American woman’s risk of developing breast cancer during her lifetime?
This estimate means that, if the current incidence rate stays the same, a woman born today has about a 1 in 8 chance of being diagnosed with breast cancer at some time during her life. On the other hand, the chance that she will never have breast cancer is 87.6 percent, or about 7 in 8.
In the 1970s, the lifetime risk of being diagnosed with breast cancer in the United States was just under 10 percent (or about 1 in 10).
The last five annual SEER reports show the following estimates of lifetime risk of breast cancer, all very close to a lifetime risk of 1 in 8:
- 12.7 percent for 2001 through 2003
- 12.3 percent for 2002 through 2004
- 12.0 percent for 2003 through 2005
- 12.1 percent for 2004 through 2006
- 12.4 percent for 2005 through 2007
What is the average American woman’s risk of being diagnosed with breast cancer at different ages?
Many women are more interested in the risk of being diagnosed with breast cancer at specific ages or over specific time periods than in the risk of being diagnosed at some point during their lifetime. Estimates by decade of life are also less affected by changes in incidence and mortality rates than longer-term estimates. The SEER report estimates the risk of developing breast cancer in 10-year age intervals (1). According to the current report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is as follows:
- Age 30 . . . . . . 0.44 percent (or 1 in 227)
- Age 40 . . . . . . 1.47 percent (or 1 in 68)
- Age 50 . . . . . . 2.38 percent (or 1 in 42)
- Age 60 . . . . . . 3.56 percent (or 1 in 28)
- Age 70 . . . . . . 3.82 percent (or 1 in 26)
For more information about risk of breast cancer at specific ages and for specific time periods, see Table 4.18 in the SEER report.What factors increase a woman’s risk of breast cancer?
The strongest risk factor for breast cancer is age. A woman’s risk of developing this disease increases as she gets older. The risk of breast cancer, however, is not the same for all women in a given age group. Research has shown that women with the following risk factors have an increased chance of developing breast cancer.
- Genetic alterations (changes): Inherited changes in certain genes (including BRCA1, BRCA2, and others) increase the risk of breast cancer. These changes are estimated to account for no more than about 10 percent of all breast cancers. However, women who carry changes in these genes have a much higher risk of breast cancer than women who do not carry these changes.
- Mammographic breast density: The glandular (milk-producing) and connective tissue of the breast are mammographically dense—that is, they appear white on a mammogram. In contrast, fatty tissue of the breast is not mammographically dense and appears dark. Women who have a high percentage of breast tissue that appears dense on a mammogram have a higher risk of breast cancer than women of similar age who have little or no dense breast tissue. In general, younger women have denser breasts than older women. As a woman ages, the amount of glandular tissue normally decreases and the amount of fatty tissue increases. Abnormalities, such as tumors, in dense breasts can be more difficult to detect on a mammogram because tumors often also appear white.
- Family history: A woman’s chance of developing breast cancer increases if her mother, sister, and/or daughter have been diagnosed with the disease, especially if they were diagnosed before age 50. Having a close male blood relative with breast cancer also increases a woman's risk of developing the disease.
- Personal history of breast cancer: Women who have had breast cancer are more likely to develop a second breast cancer.
- Certain breast changes found on biopsy: Looking at breast tissue under a microscope allows doctors to determine whether a suspicious finding (one detected by a mammogram, for example) represents cancer or another type of breast change. Most breast changes turn out not to be cancer, but some may increase the risk of developing breast cancer. Changes that are associated with an increased risk of breast cancer include atypical hyperplasia (a noncancerous condition in which cells have abnormal features and are increased in number), lobular carcinoma in situ (LCIS) (abnormal cells are found in the lobules of the breast), and ductal carcinoma in situ (DCIS; abnormal cells are found in the lining of breast ducts). Because some cases of DCIS will eventually become cancer, this type of breast change is actively treated. Women with atypical hyperplasia or LCIS are usually monitored carefully and not actively treated. In addition, women who have had two or more breast biopsies for other noncancerous conditions also have an increased risk of developing breast cancer. This increased risk is due to the conditions that led to the biopsies and not to the biopsy procedures themselves.
- Radiation therapy: Women who had radiation therapy to the chest (including the breasts) before age 30 have an increased risk of developing breast cancer throughout their lives. This includes women treated for Hodgkin lymphoma. Studies show that the younger a woman was when she received treatment, the higher her risk of developing breast cancer later in life.
- Alcohol: Studies indicate that the more alcohol a woman drinks, the greater her risk of breast cancer.
- Reproductive and menstrual history: Women who had their first menstrual period before age 12 or who went through menopause after age 55 have an increased risk of developing breast cancer. Women who had their first full-term pregnancy after age 30 or who have never had a full-term pregnancy are also at increased risk of breast cancer.
- Long-term use of menopausal hormone therapy: Women who used combined estrogen and progestin menopausal hormone therapy for more than 5 years have an increased chance of developing breast cancer.
- DES (diethylstilbestrol): The drug DES was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took DES during pregnancy have a slightly increased risk of breast cancer. Women who were exposed to DES in utero—that is, whose mothers took DES while they were pregnant—may have a slightly increased risk of breast cancer after age 40.
- Body weight: Studies have found that among postmenopausal women who have not used menopausal hormone therapy, the chance of getting breast cancer is higher in women who are overweight or obese than in women of a healthy weight.
- Physical activity level: Women who are physically inactive throughout life may have an increased risk of breast cancer.
- Race: In the United States, breast cancer is diagnosed more often in white women than in African American/black, Hispanic/Latina, Asian/Pacific Islander, or American Indian/Alaska Native women.
Selected References
- Howlader N, Noone AM, Krapcho M, et. al. (eds). SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, 2012. Retrieved September 7, 2012.
http://www.cancer.gov/cancertopics/factsheet/detection/probability-breast-cancer
August 17, 2013
味精的危害
味精的危害
发布时间：2010-03-08 10:18:06
●谁发现味精有害1968年，有一个美国医生在纽约一家中国餐馆吃饭之后，感到身体麻痹，从颈后部开始，一直伸延到手臂和背部、臀部，同时他感到全身软弱，心跳加速， 这些症状维持了大约两个钟头。这个医生发现他的许多朋友也是吃过中国菜之后，出现类似的不适症状。于是他写了一封信给美国一份医学学报提及此事。他的信发 表以后，陆续有许多人投函撰文说有类似的经历，有人提出那些症状可能是由味精引起。是的，中国餐馆里使用了大量味精来调味。这些症候被称为中国餐馆症。多 个医生和科学家做过试验，发现有些人吃了含有味精的食物，会产生中国餐馆症。从此，中国餐馆症令有些西方人谈虎色变。有些人对味精特别敏感，例如有些患哮 喘者吃味精后病情恶化。会出现了各种中国餐馆症，再过12～14小时之后就会有哮喘发作，有些哮喘病人因为情况严重而要送到院抢救，若得不到及时的治疗， 就可能死亡。澳洲医生也曾经医治过一些哮喘病人，就是这样以急性病入院的。中国餐馆症以及中国餐馆哮喘症，与食用的味精的重量无关；无论是每日吃6克，还 是1.5克，都可能出现这种味精症候群。
●谁证实味精有害
急性味精中毒的症状是面部充血、热辣辣或烧灼的感觉、舌根肿胀；心跳反常或加速、晕眩、头痛、偏头痛、颈部僵硬，肌肉收缩、作呕、失眠、肠胃不适；皮肤刺痛、颈痛、臂痛、胸痛；上肢酸软、情绪低落；哮喘恶化、咳嗽等。而慢性味精中毒会导致下列情况发生：
①妨碍胎儿发育，令后代畸形。
美国科学家在1965年一次兔子实验里，把兔子分为四群。第一群兔子10雌4雄，所有的雌兔一连27天吃了每公斤体重25毫克的味精，而雄兔不吃。后 来雌兔怀孕；两只雌兔子宫里有变质胎儿，后来小产，产下畸形死胎；另外两只后来怀孕，正常生产，但小兔四肢有多种畸形残缺、生长迟缓。
第二群兔子4雌2雄，全部吃了每公斤体重25毫克的味精。有两只雌兔怀孕，产生畸形小兔，出生后不久都死掉，骨骼变形，多个器官萎缩。
第三群兔子6雌1雄，全部吃了每公斤体重25毫克的味精。雄兔睾丸萎缩，雌兔产下的小兔身体全部多重残缺。第四群兔子6雌8雄，作为对照；由于不吃味精而没有以上情形。
②破坏遗传因子、影响生殖力，而且幼年时看不出来。
美国科学家在1970年及1971年，和1975年的三次小鼠实验中发现，如果母鼠吃了味精，那么产下的幼鼠长大后纷纷内分泌失调。这三次实验又发 现，小鼠出生后不久一连10天用皮下注射法打进相当于每公斤体重2.2～4.2克的味精，后来在40日大时杀死剖尸检验，结果发现这些小鼠体重减少、睾丸 及卵巢坏死，肾上腺及甲状腺重量减少，前大脑垂体内的生长激素及促黄体发生素水平下降。结果两性的老鼠长大后生殖都有问题：雌鼠怀孕较少，产生的小老鼠体 积特别小；雄鼠能育性亦大减。
③加重过敏性鼻炎、加重过敏性哮喘。
中国医生发现，许多过敏性鼻炎、过敏性哮喘的病人，在停止食用味精之后，其症状不治而愈。
④导致肥胖症。
美国科学家在1970年的一次实验中，一群老鼠在出世后开头10天用皮下注射方式把味精打进体内，结果长大后纷纷痴肥——附睾脂肪垫重量增加，细胞体积增 大，脂肪质细胞数目下降。此外，这群老鼠长大后与对照的另一群比较，体内较大型的细胞对于肾上腺素的脂解作用反应特别差，但是对胰岛素的抗脂解作用反应却 特别厉害。负责研究的专家认为味精造成肥胖症，原因是味精改变了细胞对肾上腺素及胰岛素的反应，令在脂肪质里的脂类成分增加。
美国科学家在1974年的一次实验中，发现幼年老鼠长期吃了含1％～2％味精的食物之后，断奶时体重比对照那一群较高。在1997年的一次实验中，一 组老鼠在出世后开头10天用腹膜注射法打进相当于每公斤体重4克的味精，结果发现长大后生长畸形、内分泌反常、行为反常，其中大部分尾部自动裂开，全部明 显又矮又痴肥，雌鼠比对照的另一群卵巢小、子宫小、脑下垂体小。另一组老鼠同样在出世后开头10天打进了同样分量的味精，但分5次注射，结果上述典型的味 精遗害轻微很多。
⑤造成永久性脑部创伤。
美国科学家在1970年的一次老鼠实验里，把65只10～12日大的老鼠，一次性喂食不同分量的味精，包括每公斤体重0.5克、0.75克、1.0 克、2.0克，其中有10只没有吃味精，作为对照。喂食后3～6小时，所有的老鼠用灌注法杀死，结果发现吃过味精的54只老鼠之中，有51只老鼠的脑神经 细胞纷纷坏死，而坏死的比率正好跟味精服量成正比。该次实验还发现，若味精与糖精同吃，脑部受损加倍严重。
英国科学家在1970年做实验，把6只9～10日大的老鼠口服相当于每公斤体重2克的10%味精溶液，结果也出现了典型的那种味精造成的脑部创伤。
瑞典科学家在1971年的一次实验里，把一群出生后3～10日的老鼠，使用皮下注射法注入相当于每公斤体重2～4克的味精。另一群成年老鼠，使用腹膜 注射方法注入相当于每公斤体重6～10克味精。注射后72小时，把全部老鼠杀死，用显微镜观察脑组织，结果发现注射过味精的老鼠，有95％下丘脑弓形细胞 核受到损毁。美国有两位科学家，在一次恒河猴的味精实验之后说：“这些猴幼时脑细胞有小部分受损，完全没有征象显示出来，证明脑部受创伤是一个微妙的过 程，人类婴儿在平日的环境里若受同样伤害，很可能没有人看得出来。”换句话说，儿童被喂以含味精的食物，脑部可能正在不断受创伤，而父母一直不会察觉。
⑥破坏视网膜，影响视力。
在1960年的一次实验里，美国科学家用腹膜注射的方法，把味精打进幼年老鼠体内，分量为每公斤体重3.2克，结果发现那些老鼠视网膜中毒受损。
在1967年的一次实验里，美国科学家在一群老鼠出生后1～10日，用肠道外注射法把相当于每公斤体重2.2～4.2克的味精10次打进体内，结果视网膜全部毁坏。
在1969年一次实验里，一些1～10日大的老鼠被一次皮下注射每公斤体重4克的味精，然后分别在30分钟到48小时之后被杀，结果发现视网膜严重损毁——处处有神经枝状突起，还有神经细胞逐渐坏死。
⑦造成恶心以及呕吐。
在1944年的一次实验里，美国科学家用静脉注射方法，把酪朊水解产物或人造氨基酸混合液，打进狗群体内，结果狗群纷纷恶心及呕吐。
在1947年，美国医生用谷氨酸钠盐来医治尿毒症，把血液里的氨含量水平降低，结果发现受治疗的人，用静脉注射方法打进了38克之后，17人中有11人呕吐。
⑧味精含钠离子量大约是13％，身体吸收太多钠离子可能导致高血压症。美国科学家在1962年一次实验里，使用静脉注射方法把大量味精打进兔子体内，结果 兔子纷纷产生心肌损害，并证明这是由于味精，促使动脉紧张所造成的结果。他们把割出的心脏单独研究，发现大量味精令心脏运动减缓，令心脏收缩幅度增加，令 冠状脉管受压缩，很大量的味精会令心脏停止活动。
⑨味精在高温之下会形成致癌物质。
西方及亚洲的许多医生都大声疾呼，指出给幼童吃含有味精的食物可能极端危险。新加坡大学小儿科系主任说：“这样做很危险，因为味精是一种神经的传导物，吃 进体内之后，变成了一种物质，把一个神经细胞的刺激传送到另一个，于是因而造成中国餐馆症，令一些人感到晕眩、面部发红、呼吸紧促、感到灾难临头。”他还 说：“我见过婴儿患肿瘤，当时唯一可以解释该症的线索，就是该婴儿吃了超级市场买来的婴儿食品，里面含有大量味精。”日本科学家最近也做过研究，发现味精 在高温之下会形成所谓的致癌物质。
⑩造成猝死。
1971年，日本国家卫生研究所选用小鸡做了实验，给予含2.6％味精的溶液，结果三日之内，小鸡大部分死掉，而尸体内的心脏、气囊、肝部、肌肉及其他内 脏部位都发现大量白色物质沉淀其中。据该次研究的报告，小鸡死前一天或半天之内拒绝进食，“站在那里，双眼闭合，然后倒在地上，软弱地啼叫，脚部关节僵 硬，想站起来但失去平衡。”当地中学生也做了同样的实验，亦发现喂以2.6％味精溶液的小鸡，在19日内死亡。
然而我国人每年味精的消费量大约是100万吨，也就是10亿公斤。请问我国13亿人口，每人每年要消费多少味精？如果每人每年要消费769克味精，那么每人每天要消费多少味精？告诉你，我国人每人每天要消费2克味精，已经超过所谓的最高安全使用量1.6克/每人每天。
●一些科学家不断发明新的添加剂，而另外一些科学家也在不断揭露添加剂的危害。你说你听谁的？我说还是听你的。如果你，或者你的父母，以及你的儿女，不怕吃了味精而发生以下情况，那么你就尽管吃：
①不怕胎儿畸形。
②不怕阳痿或者阴痿。
③不怕加重过敏性鼻炎、加重过敏性哮喘。
④不怕肥胖症。
⑤不怕造成永久性脑部创伤，而学习吃力。
⑥不怕得近视眼。
⑦不怕胃气下降而造成恶心呕吐。
⑧不怕得高血压症。
⑨不怕得癌症。
⑩不怕猝死。
其实，许多病人的胃气非常难以提升，许多阳痿或者阴痿病人非常难于壮阳，许多过敏性鼻炎、过敏性哮喘病人非常难于抗过敏，许多肥胖病人非常难于减肥， 许多低智商病人非常难于聪明，许多小孩子得了近视眼而非常难于矫正，许多高血压病人非常难于降压，许多癌病人非常难于控制，许多人非常容易发生猝死等等， 仅仅在于他们不断地吃味精。
http://www.cbd5gourmet.com/jiankangcontent.php?aid=86
January 07, 2011
Headaches in Children
http://www.hmc.psu.edu/childrens/healthinfo/h/headache.htm
Headaches in Children
What is it?
A headache is, quite simply, a pain in the head. Headaches in children can range from mild to severe.
Who gets it?
Most children get headaches at one time or another.
What causes it?
The most common cause of headaches in children is the same for adults' tension. Tension headaches are caused by muscle tension in the neck, shoulders, and head. Muscle tension is caused by remaining in one position for a long period of time, such as when playing a video game or sitting at a computer. It can also be caused by stress, such as from school or social situations. Another common cause of headache is fever or congestion from a common cold or other viral infection. Headaches in children can also be caused by problems with the eyes, nose, throat, teeth, and ears; coughing; hunger; medication; and overexertion. However, headaches can also be caused by very serious illnesses. A bacterial or fungal infection of the membrane (meninges) that surrounds the brain and spinal cord, called meningitis, causes severe headache. Severe, recurring headaches can be caused by migraines or a brain tumor. Migraines occur when the arteries in the brain narrow, then widen. Because migraine headaches tend to run in families, there appears to be a genetic link. Headaches that follow a blow to the head, especially when accompanied by loss of consciousness, disorientation, or vomiting, can indicate concussion or other serious brain injury.
What are the symptoms?
Mild to moderate headaches in very young children are often difficult to pinpoint because they are unable to explain what they are feeling. They may simply act irritable. Young children with severe headaches may act extremely irritable, cry, and even vomit. Children older than 10 are more likely to get tension headaches. This type of headache is described as feeling as though a tight band is encircling the head. Your child may also say his or her neck muscles feel sore or tight. Tension headaches develop during the day and get worse as the day goes on. A headache caused by sinus congestion occurs on only one side of the head, with the pain centered across the forehead, down toward the nose, and near the eye. Headache caused by vision problems is usually accompanied by a feeling of eye strain, and is often worse after using the eyes, such as when reading. It is not unusual for a child with a cold and fever to have a mild to moderate headache that goes away as the fever goes down. However, excruciating headache pain with high fever, lethargy, and stiff neck, is a sign of meningitis or other infection of the meninges.
Meningitis is a life-threatening illness that must be treated immediately. Migraine headaches begin as pain in a localized area, such as around one eye or temple. The pain gradually spreads down one side, or to both sides. As the migraine develops, any movement or sound can cause more severe, throbbing pain. These headaches often have a trigger, such as changes in the hormonal cycle (in girls), certain foods or smells, or physical exertion. A child may have some indication that the migraine is coming, called an aura. Common auras include unique smells, visual disturbances, or odd feelings. Other characteristics of a migraine include sensitivity to light and sound and nausea and/or vomiting. A migraine headache can last for anywhere from a few hours to a few days. Migraines can be complicated by other symptoms, such numbness or paralysis on one side of the body, severe pain at the back of the head accompanied by weakness and loss of coordination, noticeable confusion and lethargy, and severe eye pain with eye muscle paralysis. Cluster headaches are a severe type of migraine headache that occur several times in one day and can last for several hours. They are accompanied by nasal congestion, runny nose, and crying.
Headaches caused by brain tumor or brain infection can range from mild to severe, and often occur intermittently without any obvious reason. With a brain tumor, the child may begin to experience weakness on one side of the body, vision problems, convulsions, speech and learning problems, and vomiting, and the headaches may become more severe each time they occur. These headaches are usually worse in the morning and get better as the day goes on. Medication usually doesn't help. Headaches that follow a blow to the head occur suddenly and can be accompanied by nausea, vomiting, disorientation, pupils that are unresponsive to light, loss of consciousness, and personality changes.
How is it diagnosed?
First your doctor will try to determine the cause of the headache. He or she will do this by listening to your and your child's description of the symptoms, by performing a thorough physical examination, and by asking questions about your child's daily life at home and school. Doctors classify headaches as acute, acute recurrent, chronic recurrent, and chronic progressive. An acute headache occurs suddenly, but lasts for a short time. An acute recurrent headache lasts for a short time, but occurs frequently. A chronic recurrent headache lasts for a longer period of time, and occurs frequently. A chronic progressive headache tends to become more severe each time it occurs. This is the most serious type of headache because it may be a sign of a brain tumor or infection. To diagnose the type of headache your child has, your doctor may ask you to keep a diary of when and how often the headaches occur, your child's activities when each headache occurs, and patterns of rest and diet. When tension headaches occur more than fifteen times per month, they are considered chronic tension headaches. Children with these types of headaches may also need to be examined for signs of depression or anxiety. Blood tests may also be ordered to check for any underlying illness.
Sinus-related headaches are indicated when the child's headaches are located around the eye and nasal area, and when the child has a history of upper respiratory infections with the headaches. These are commonly diagnosed through an x-ray of the sinuses. If the headache seems to be vision-related, your doctor will refer you to an ophthalmologist or optometrist for an eye examination. If symptoms point to meningitis, or other bacterial or fungal infections that inflame the meninges, the doctor will hospitalize the child to perform a lumbar puncture, or spinal tap, to check the spinal fluid for signs of infection. He or she will test your child's ability to bend at the neck and place the chin on the chest, as well as general strength and reflexes.
Migraine headaches are usually easy to diagnose because they have such unique symptoms. Children with migraines are frequently treated by a pediatric neurologist, a specialist in the area of the nervous system. A headache diary, mentioned earlier, is especially useful in diagnosing migraines. The doctor may try treating the headaches with migraine medications. If these medications help, then migraine is the probable cause. However, your doctor may also order a magnetic resonance imaging (MRI) or computed tomography (CT) scan. Both are painless procedures that provide the doctor with an image of your child's brain. MRI and CT scans are also used to diagnose brain tumors, brain infections, and brain injuries.
What is the treatment?
Treatment depends upon the cause of the headache. Tension headaches are treated by identifying the source of the tension and trying to prevent or avoid the tension. Once a tension headache begins, an over-the-counter acetaminophen or ibuprofen can provide quick relief. It is extremely important to follow the dosage instructions for your child's age and weight. Healthcare professionals do not recommend giving aspirin to children or teenagers because it has been associated with a life-threatening disorder called Reye's syndrome. Acetaminophen or ibuprofen is also effective for illness-related headaches. In addition, you might try placing a cool washcloth on your child's forehead. Sinus headaches are treated with medications to relieve sinus congestion. Surgery is only considered in severe cases. Vision-related headaches usually stop once the vision problem is treated, usually with glasses or contact lenses. Infections of the tissues surrounding the brain, such as meningitis, are treated with antibiotics. Children with migraines feel better if they lie down in a darkened room and sleep. Your child will also be taught to avoid his or her migraine triggers. These might be certain foods that include nitrates, monosodium glutamate (MSG), and caffeine; strong perfumes; lack of sleep; or hunger. Children with a pattern of recurring migraines are treated with preventive medications, taken on a daily basis, or medications taken at the onset of the migraine. A concussion is a bruise to the brain, and usually heals on its own with time. However, if the child has lost consciousness, he or she will need to be observed for a few days, usually in a the hospital, to make sure there is no lasting injury.
Self-care tips
Headaches in children can have many causes, and are frequently a symptom of some other condition. For this reason, it's important to contact your doctor whenever your child has headaches with no obvious cause such as a cold, lack of rest, or hunger, or if your child begins to have a pattern of recurring headaches. In general, plenty of rest and good nutrition will go far to prevent many acute headaches. Encourage your child not to be an over-achiever and to recognize when it's time to take a break from an intense activity, such as sports, studying, or video and computer games.
--------------------------------------------------------------------------------
This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.
Headaches in Children
What is it?
A headache is, quite simply, a pain in the head. Headaches in children can range from mild to severe.
Who gets it?
Most children get headaches at one time or another.
What causes it?
The most common cause of headaches in children is the same for adults' tension. Tension headaches are caused by muscle tension in the neck, shoulders, and head. Muscle tension is caused by remaining in one position for a long period of time, such as when playing a video game or sitting at a computer. It can also be caused by stress, such as from school or social situations. Another common cause of headache is fever or congestion from a common cold or other viral infection. Headaches in children can also be caused by problems with the eyes, nose, throat, teeth, and ears; coughing; hunger; medication; and overexertion. However, headaches can also be caused by very serious illnesses. A bacterial or fungal infection of the membrane (meninges) that surrounds the brain and spinal cord, called meningitis, causes severe headache. Severe, recurring headaches can be caused by migraines or a brain tumor. Migraines occur when the arteries in the brain narrow, then widen. Because migraine headaches tend to run in families, there appears to be a genetic link. Headaches that follow a blow to the head, especially when accompanied by loss of consciousness, disorientation, or vomiting, can indicate concussion or other serious brain injury.
What are the symptoms?
Mild to moderate headaches in very young children are often difficult to pinpoint because they are unable to explain what they are feeling. They may simply act irritable. Young children with severe headaches may act extremely irritable, cry, and even vomit. Children older than 10 are more likely to get tension headaches. This type of headache is described as feeling as though a tight band is encircling the head. Your child may also say his or her neck muscles feel sore or tight. Tension headaches develop during the day and get worse as the day goes on. A headache caused by sinus congestion occurs on only one side of the head, with the pain centered across the forehead, down toward the nose, and near the eye. Headache caused by vision problems is usually accompanied by a feeling of eye strain, and is often worse after using the eyes, such as when reading. It is not unusual for a child with a cold and fever to have a mild to moderate headache that goes away as the fever goes down. However, excruciating headache pain with high fever, lethargy, and stiff neck, is a sign of meningitis or other infection of the meninges.
Meningitis is a life-threatening illness that must be treated immediately. Migraine headaches begin as pain in a localized area, such as around one eye or temple. The pain gradually spreads down one side, or to both sides. As the migraine develops, any movement or sound can cause more severe, throbbing pain. These headaches often have a trigger, such as changes in the hormonal cycle (in girls), certain foods or smells, or physical exertion. A child may have some indication that the migraine is coming, called an aura. Common auras include unique smells, visual disturbances, or odd feelings. Other characteristics of a migraine include sensitivity to light and sound and nausea and/or vomiting. A migraine headache can last for anywhere from a few hours to a few days. Migraines can be complicated by other symptoms, such numbness or paralysis on one side of the body, severe pain at the back of the head accompanied by weakness and loss of coordination, noticeable confusion and lethargy, and severe eye pain with eye muscle paralysis. Cluster headaches are a severe type of migraine headache that occur several times in one day and can last for several hours. They are accompanied by nasal congestion, runny nose, and crying.
Headaches caused by brain tumor or brain infection can range from mild to severe, and often occur intermittently without any obvious reason. With a brain tumor, the child may begin to experience weakness on one side of the body, vision problems, convulsions, speech and learning problems, and vomiting, and the headaches may become more severe each time they occur. These headaches are usually worse in the morning and get better as the day goes on. Medication usually doesn't help. Headaches that follow a blow to the head occur suddenly and can be accompanied by nausea, vomiting, disorientation, pupils that are unresponsive to light, loss of consciousness, and personality changes.
How is it diagnosed?
First your doctor will try to determine the cause of the headache. He or she will do this by listening to your and your child's description of the symptoms, by performing a thorough physical examination, and by asking questions about your child's daily life at home and school. Doctors classify headaches as acute, acute recurrent, chronic recurrent, and chronic progressive. An acute headache occurs suddenly, but lasts for a short time. An acute recurrent headache lasts for a short time, but occurs frequently. A chronic recurrent headache lasts for a longer period of time, and occurs frequently. A chronic progressive headache tends to become more severe each time it occurs. This is the most serious type of headache because it may be a sign of a brain tumor or infection. To diagnose the type of headache your child has, your doctor may ask you to keep a diary of when and how often the headaches occur, your child's activities when each headache occurs, and patterns of rest and diet. When tension headaches occur more than fifteen times per month, they are considered chronic tension headaches. Children with these types of headaches may also need to be examined for signs of depression or anxiety. Blood tests may also be ordered to check for any underlying illness.
Sinus-related headaches are indicated when the child's headaches are located around the eye and nasal area, and when the child has a history of upper respiratory infections with the headaches. These are commonly diagnosed through an x-ray of the sinuses. If the headache seems to be vision-related, your doctor will refer you to an ophthalmologist or optometrist for an eye examination. If symptoms point to meningitis, or other bacterial or fungal infections that inflame the meninges, the doctor will hospitalize the child to perform a lumbar puncture, or spinal tap, to check the spinal fluid for signs of infection. He or she will test your child's ability to bend at the neck and place the chin on the chest, as well as general strength and reflexes.
Migraine headaches are usually easy to diagnose because they have such unique symptoms. Children with migraines are frequently treated by a pediatric neurologist, a specialist in the area of the nervous system. A headache diary, mentioned earlier, is especially useful in diagnosing migraines. The doctor may try treating the headaches with migraine medications. If these medications help, then migraine is the probable cause. However, your doctor may also order a magnetic resonance imaging (MRI) or computed tomography (CT) scan. Both are painless procedures that provide the doctor with an image of your child's brain. MRI and CT scans are also used to diagnose brain tumors, brain infections, and brain injuries.
What is the treatment?
Treatment depends upon the cause of the headache. Tension headaches are treated by identifying the source of the tension and trying to prevent or avoid the tension. Once a tension headache begins, an over-the-counter acetaminophen or ibuprofen can provide quick relief. It is extremely important to follow the dosage instructions for your child's age and weight. Healthcare professionals do not recommend giving aspirin to children or teenagers because it has been associated with a life-threatening disorder called Reye's syndrome. Acetaminophen or ibuprofen is also effective for illness-related headaches. In addition, you might try placing a cool washcloth on your child's forehead. Sinus headaches are treated with medications to relieve sinus congestion. Surgery is only considered in severe cases. Vision-related headaches usually stop once the vision problem is treated, usually with glasses or contact lenses. Infections of the tissues surrounding the brain, such as meningitis, are treated with antibiotics. Children with migraines feel better if they lie down in a darkened room and sleep. Your child will also be taught to avoid his or her migraine triggers. These might be certain foods that include nitrates, monosodium glutamate (MSG), and caffeine; strong perfumes; lack of sleep; or hunger. Children with a pattern of recurring migraines are treated with preventive medications, taken on a daily basis, or medications taken at the onset of the migraine. A concussion is a bruise to the brain, and usually heals on its own with time. However, if the child has lost consciousness, he or she will need to be observed for a few days, usually in a the hospital, to make sure there is no lasting injury.
Self-care tips
Headaches in children can have many causes, and are frequently a symptom of some other condition. For this reason, it's important to contact your doctor whenever your child has headaches with no obvious cause such as a cold, lack of rest, or hunger, or if your child begins to have a pattern of recurring headaches. In general, plenty of rest and good nutrition will go far to prevent many acute headaches. Encourage your child not to be an over-achiever and to recognize when it's time to take a break from an intense activity, such as sports, studying, or video and computer games.
--------------------------------------------------------------------------------
This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.
December 08, 2010
7 Deadly Symptoms You Should Never Ignore - The DR. OZ Show
Deadly Symptom: Sudden and Increasing Pain in the Upper Right of Your Stomach
The Condition: Gallstones
The gallbladder is one of the body’s smallest organs. Located right below the liver, it collects bile, necessary for the digestion of fat, and releases it into the small intestine. When excess cholesterol is present in bile, stones can begin to form in the gallbladder – leading to excruciating pain, infection and other complications. Infection can spread to the liver or pancreas and can be deadly if left untreated. When infection occurs or, in more extreme cases, when the gallbladder bursts, surgery is necessary. Seek immediate help if you feel this pain, which can be accompanied by a fever. Click here to learn more about keeping your gallbladder healthy.
Deadly Symptom: Blurred, Shaded or Double Vision
The Condition: Diabetes
Aging can cause vision changes, but these symptoms are distinct. Diabetes is the leading cause of blindness in people ages 20 to 74. Uncontrolled blood sugar levels can damage all the blood vessels in the body, including those in the eye. Damaged vessels can not deliver blood to the eye. As new vessels begin to replace the damaged ones, they begin to crowd your field of vision, shading it like the branches of a tree. These new vessels can also hemorrhage. If you notice blurred, shaded or double vision, go to your doctor immediately. These symptoms are reversible and further damage is avoidable if you get your sugar levels under control.
Deadly Symptom: A Persistent Headache
The Condition: Cerebral Aneurysm
People who have had an aneurysm have described the pain as the “worst headache of their life.” An aneurysm is a ballooning of the blood vessel. If you feel an intense headache, it could mean that a blood vessel has ruptured, which is fatal 40% of the time. If you have high blood pressure, you are at increased risk for a cerebral aneurysm. If you are menopausal, the drop in estrogen is also a risk factor.
Seek help immediately if you feel this pain or any of these warning symptoms:
Pain above or behind the eye
Neck pain
Numbness on one side of the face
Deadly Symptom: A Leg Cramp That Won’t Go Away
The Condition: Deep Vein Thrombosis
A cramp, pain or tenderness in the leg can be a symptom of deep vein thrombosis (DVT). This pain is a sign that there is a clot in the leg, which can travel to your lungs, where it can block an artery. If this happens, it can stop your heart and you could die in minutes. Symptoms include pain or swelling in the calf, pain behind the knee, or pain or tenderness in the thigh.
DVT is most likely to occur after sitting for long periods of time, especially during air travel. Other risk factors include family history, and taking estrogen medication like the pill or hormone replacements, as side effects already include blood clots. DVT is preventable; get up or move as often as possible, especially when on a plane (and avoid alcohol when flying). Click here to learn more about how estrogen medications put you at increased risk for DVT.
Deadly Symptom: Bleeding Gums
The Condition: Leukemia
In a healthy person, the blood components operate normally: red blood cells deliver oxygen, white blood cells fight infection, and platelets clot the blood. But in a person with leukemia, or cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system, there is an elevated number of abnormal white blood cells that don’t function properly. As a result, there aren’t as many platelets and blood does not clot as it should. People with leukemia will bleed and bruise more easily. Other symptoms include nosebleeds, fever, night sweats, and weakness or fatigue. A doctor can diagnose leukemia with a blood test.
Deadly Symptom: Shortness of Breath
The Condition: Asthma
An asthma attack is caused by the tightening of the muscles around your airways, inflammation of the lining of the airways, and thick and excess mucus production. A combination of all three will give rise to asthma symptoms including shortness of breath, which means that less air is getting to your lungs. At a critical level, this can stop your heart. If you experience asthma symptoms, talk to your doctor and avoid asthma triggers like allergens, pet dander, cold weather or emotional upset.
__________________________________________
http://www.doctoroz.com/videos/7-deadly-symptoms-you-should-never-ignore
The Condition: Gallstones
The gallbladder is one of the body’s smallest organs. Located right below the liver, it collects bile, necessary for the digestion of fat, and releases it into the small intestine. When excess cholesterol is present in bile, stones can begin to form in the gallbladder – leading to excruciating pain, infection and other complications. Infection can spread to the liver or pancreas and can be deadly if left untreated. When infection occurs or, in more extreme cases, when the gallbladder bursts, surgery is necessary. Seek immediate help if you feel this pain, which can be accompanied by a fever. Click here to learn more about keeping your gallbladder healthy.
Deadly Symptom: Blurred, Shaded or Double Vision
The Condition: Diabetes
Aging can cause vision changes, but these symptoms are distinct. Diabetes is the leading cause of blindness in people ages 20 to 74. Uncontrolled blood sugar levels can damage all the blood vessels in the body, including those in the eye. Damaged vessels can not deliver blood to the eye. As new vessels begin to replace the damaged ones, they begin to crowd your field of vision, shading it like the branches of a tree. These new vessels can also hemorrhage. If you notice blurred, shaded or double vision, go to your doctor immediately. These symptoms are reversible and further damage is avoidable if you get your sugar levels under control.
Deadly Symptom: A Persistent Headache
The Condition: Cerebral Aneurysm
People who have had an aneurysm have described the pain as the “worst headache of their life.” An aneurysm is a ballooning of the blood vessel. If you feel an intense headache, it could mean that a blood vessel has ruptured, which is fatal 40% of the time. If you have high blood pressure, you are at increased risk for a cerebral aneurysm. If you are menopausal, the drop in estrogen is also a risk factor.
Seek help immediately if you feel this pain or any of these warning symptoms:
Pain above or behind the eye
Neck pain
Numbness on one side of the face
Deadly Symptom: A Leg Cramp That Won’t Go Away
The Condition: Deep Vein Thrombosis
A cramp, pain or tenderness in the leg can be a symptom of deep vein thrombosis (DVT). This pain is a sign that there is a clot in the leg, which can travel to your lungs, where it can block an artery. If this happens, it can stop your heart and you could die in minutes. Symptoms include pain or swelling in the calf, pain behind the knee, or pain or tenderness in the thigh.
DVT is most likely to occur after sitting for long periods of time, especially during air travel. Other risk factors include family history, and taking estrogen medication like the pill or hormone replacements, as side effects already include blood clots. DVT is preventable; get up or move as often as possible, especially when on a plane (and avoid alcohol when flying). Click here to learn more about how estrogen medications put you at increased risk for DVT.
Deadly Symptom: Bleeding Gums
The Condition: Leukemia
In a healthy person, the blood components operate normally: red blood cells deliver oxygen, white blood cells fight infection, and platelets clot the blood. But in a person with leukemia, or cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system, there is an elevated number of abnormal white blood cells that don’t function properly. As a result, there aren’t as many platelets and blood does not clot as it should. People with leukemia will bleed and bruise more easily. Other symptoms include nosebleeds, fever, night sweats, and weakness or fatigue. A doctor can diagnose leukemia with a blood test.
Deadly Symptom: Shortness of Breath
The Condition: Asthma
An asthma attack is caused by the tightening of the muscles around your airways, inflammation of the lining of the airways, and thick and excess mucus production. A combination of all three will give rise to asthma symptoms including shortness of breath, which means that less air is getting to your lungs. At a critical level, this can stop your heart. If you experience asthma symptoms, talk to your doctor and avoid asthma triggers like allergens, pet dander, cold weather or emotional upset.
__________________________________________
http://www.doctoroz.com/videos/7-deadly-symptoms-you-should-never-ignore
September 27, 2010
6 biggest lies about food busted
The other day while I was making zucchini bread, I cracked an egg and dumped it right down the drain. Total mistake. (With a baby who still wakes up multiple times a night, I’m still a little sleep deprived.) There was a time, however, when I intentionally washed egg yolks down the drain—and used only the whites—because I thought that egg yolks were bad for my heart. Joyce Hendley tackles this food myth and 12 others in the September/October issue of EatingWell Magazine.
Here are the details of why you should go ahead and eat the yolks, plus highlights of other food myths that just won’t die.
Myth 1: Eggs are bad for your heart.
The Truth: Eggs do contain a substantial amount of cholesterol in their yolks—about 211 mg per large egg. And yes, cholesterol is the fatty stuff in our blood that contributes to clogged arteries and heart attacks. But labeling eggs as “bad for your heart” is connecting the wrong dots, experts say. “Epidemiologic studies show that most healthy people can eat an egg a day without problems,” says Penny Kris-Etherton, Ph.D., R.D., distinguished professor of nutrition at Penn State University. For most of us the cholesterol we eat doesn’t have a huge impact on raising our blood cholesterol; the body simply compensates by manufacturing less cholesterol itself. Saturated and trans fats have much greater impact on raising blood cholesterol. And a large egg contains only 2 grams of saturated fat and no trans fats. The American Heart Association recommends limiting cholesterol intake to less than 300 mg daily—less than 200 mg if you have a history of heart problems or diabetes or are over 55 (women) or 45 (men). “That works out to less than an egg a day for this population—more like two eggs over the course of the week,” notes Kris-Etherton.
Related: Two Dozen Easy, Healthy Egg Recipes
Myth 2: High-Fructose Corn Syrup (HFCS) is worse for you than sugar.
The Truth: The idea that high-fructose corn syrup is any more harmful to your health than sugar is “one of those urban myths that sounds right but is basically wrong,” according to the Center for Science in the Public Interest, a health advocacy group. The composition of high-fructose corn syrup is almost identical to table sugar or sucrose (55 percent fructose, 45 percent glucose and 50:50, respectively). Calorie-wise, HFCS is a dead ringer for sucrose. Studies show that HFCS and sucrose have very similar effects on blood levels of insulin, glucose, triglycerides and satiety hormones. In short, it seems to be no worse—but also no better—than sucrose, or table sugar. This controversy, say researchers, is distracting us from the more important issue: we’re eating too much of all sorts of sugars, from HFCS and sucrose to honey and molasses. The American Heart Association recently recommended that women consume no more than 100 calories a day in added sugars [6 teaspoons]; men, 150 calories [9 teaspoons].
Related: Delicious Desserts with Surprisingly Low Added Sugars
Myth 3: A raw-food diet provides enzymes that are essential to healthy digestion.
The Truth: “Raw foods are unprocessed so nothing’s taken away; you don’t get the nutrient losses that come with cooking,” says Brenda Davis, R.D., co-author of Becoming Raw: The Essential Guide to Raw Vegan Diets (Book Publishing, 2010). But the claim by some raw-food advocates that eating raw boosts digestion by preserving “vital” plant enzymes, Davis explains, just doesn’t hold water. “Those enzymes are made for the survival of plants; for human health, they are not essential.” What about the claim by some raw-foodistas that our bodies have a limited lifetime supply of enzymes—and that by eating more foods with their enzymes intact, we’ll be able to spare our bodies from using up their supply? “The reality is that you don’t really have a finite number of enzymes; you’ll continue to make enzymes as long as you live,” says Davis. Enzymes are so vital to life, she adds, “the human body is actually quite efficient at producing them.”
Myth 4: Your body can’t use the protein from beans unless you eat them with rice.
The Truth: Proteins—which our bodies need to make everything from new muscle to hormones—are made up of different combinations of 20 amino acids. Thing is, our bodies can make only 11 of these amino acids; we must get the other nine from food. Animal-based protein-rich foods like eggs and meat provide all nine of these “essential” amino acids, but nearly all plant foods are low in at least one. Experts used to say that to get what your body needs to make proteins, you should pair plant-based foods with complementary sets of amino acids—like rice and beans. Now they know that you don’t have to eat those foods at the same meal. “If you get a variety of foods throughout the day, they all go into the ‘basket’ of amino acids that are available for the body to use,” says Winston J. Craig, Ph.D., R.D., nutrition department chair at Andrews University in Berrien Springs, Michigan.
Related: Cheap, Quick Dinners Using Canned Beans
Myth 5: Microwaving zaps nutrients.
The Truth: This is misguided thinking, says Carol Byrd-Bredbenner, Ph.D., R.D., professor of nutrition at Rutgers University in New Brunswick, New Jersey. Whether you’re using a microwave, a charcoal grill or a solar-heated stove, “it’s the heat and the amount of time you’re cooking that affect nutrient losses, not the cooking method,” she says. “The longer and hotter you cook a food, the more you’ll lose certain heat- and water-sensitive nutrients, especially vitamin C and thiamin [a B vitamin].” Because microwave cooking often cooks foods more quickly, it can actually help to minimize nutrient losses.
Related: How to Cook 20 Vegetables
Myth 6: Radiation from microwaves creates dangerous compounds in your food.
The Truth: “Radiation” might connote images of nuclear plants, but it simply refers to energy that travels in waves and spreads out as it goes. Microwaves, radio waves and the energy waves that we perceive as visual light all are forms of radiation. So, too, are X-rays and gamma rays—which do pose health concerns. But the microwaves used to cook foods are many, many times weaker than X-rays and gamma rays, says Robert Brackett, Ph.D., director of the National Center for Food Safety and Technology at the Illinois Institute of Technology. And the types of changes that occur in microwaved food as it cooks are “from heat generated inside the food, not the microwaves themselves,” says Brackett. “Microwave cooking is really no different from any other cooking method that applies heat to food.” That said, microwaving in some plastics may leach compounds into your food, so take care to use only microwave-safe containers.
What food myth are you sick of hearing people defend?
By Nicci Micco
http://shine.yahoo.com/channel/food/6-biggest-lies-about-food-busted-2391419
Here are the details of why you should go ahead and eat the yolks, plus highlights of other food myths that just won’t die.
Myth 1: Eggs are bad for your heart.
The Truth: Eggs do contain a substantial amount of cholesterol in their yolks—about 211 mg per large egg. And yes, cholesterol is the fatty stuff in our blood that contributes to clogged arteries and heart attacks. But labeling eggs as “bad for your heart” is connecting the wrong dots, experts say. “Epidemiologic studies show that most healthy people can eat an egg a day without problems,” says Penny Kris-Etherton, Ph.D., R.D., distinguished professor of nutrition at Penn State University. For most of us the cholesterol we eat doesn’t have a huge impact on raising our blood cholesterol; the body simply compensates by manufacturing less cholesterol itself. Saturated and trans fats have much greater impact on raising blood cholesterol. And a large egg contains only 2 grams of saturated fat and no trans fats. The American Heart Association recommends limiting cholesterol intake to less than 300 mg daily—less than 200 mg if you have a history of heart problems or diabetes or are over 55 (women) or 45 (men). “That works out to less than an egg a day for this population—more like two eggs over the course of the week,” notes Kris-Etherton.
Related: Two Dozen Easy, Healthy Egg Recipes
Myth 2: High-Fructose Corn Syrup (HFCS) is worse for you than sugar.
The Truth: The idea that high-fructose corn syrup is any more harmful to your health than sugar is “one of those urban myths that sounds right but is basically wrong,” according to the Center for Science in the Public Interest, a health advocacy group. The composition of high-fructose corn syrup is almost identical to table sugar or sucrose (55 percent fructose, 45 percent glucose and 50:50, respectively). Calorie-wise, HFCS is a dead ringer for sucrose. Studies show that HFCS and sucrose have very similar effects on blood levels of insulin, glucose, triglycerides and satiety hormones. In short, it seems to be no worse—but also no better—than sucrose, or table sugar. This controversy, say researchers, is distracting us from the more important issue: we’re eating too much of all sorts of sugars, from HFCS and sucrose to honey and molasses. The American Heart Association recently recommended that women consume no more than 100 calories a day in added sugars [6 teaspoons]; men, 150 calories [9 teaspoons].
Related: Delicious Desserts with Surprisingly Low Added Sugars
Myth 3: A raw-food diet provides enzymes that are essential to healthy digestion.
The Truth: “Raw foods are unprocessed so nothing’s taken away; you don’t get the nutrient losses that come with cooking,” says Brenda Davis, R.D., co-author of Becoming Raw: The Essential Guide to Raw Vegan Diets (Book Publishing, 2010). But the claim by some raw-food advocates that eating raw boosts digestion by preserving “vital” plant enzymes, Davis explains, just doesn’t hold water. “Those enzymes are made for the survival of plants; for human health, they are not essential.” What about the claim by some raw-foodistas that our bodies have a limited lifetime supply of enzymes—and that by eating more foods with their enzymes intact, we’ll be able to spare our bodies from using up their supply? “The reality is that you don’t really have a finite number of enzymes; you’ll continue to make enzymes as long as you live,” says Davis. Enzymes are so vital to life, she adds, “the human body is actually quite efficient at producing them.”
Myth 4: Your body can’t use the protein from beans unless you eat them with rice.
The Truth: Proteins—which our bodies need to make everything from new muscle to hormones—are made up of different combinations of 20 amino acids. Thing is, our bodies can make only 11 of these amino acids; we must get the other nine from food. Animal-based protein-rich foods like eggs and meat provide all nine of these “essential” amino acids, but nearly all plant foods are low in at least one. Experts used to say that to get what your body needs to make proteins, you should pair plant-based foods with complementary sets of amino acids—like rice and beans. Now they know that you don’t have to eat those foods at the same meal. “If you get a variety of foods throughout the day, they all go into the ‘basket’ of amino acids that are available for the body to use,” says Winston J. Craig, Ph.D., R.D., nutrition department chair at Andrews University in Berrien Springs, Michigan.
Related: Cheap, Quick Dinners Using Canned Beans
Myth 5: Microwaving zaps nutrients.
The Truth: This is misguided thinking, says Carol Byrd-Bredbenner, Ph.D., R.D., professor of nutrition at Rutgers University in New Brunswick, New Jersey. Whether you’re using a microwave, a charcoal grill or a solar-heated stove, “it’s the heat and the amount of time you’re cooking that affect nutrient losses, not the cooking method,” she says. “The longer and hotter you cook a food, the more you’ll lose certain heat- and water-sensitive nutrients, especially vitamin C and thiamin [a B vitamin].” Because microwave cooking often cooks foods more quickly, it can actually help to minimize nutrient losses.
Related: How to Cook 20 Vegetables
Myth 6: Radiation from microwaves creates dangerous compounds in your food.
The Truth: “Radiation” might connote images of nuclear plants, but it simply refers to energy that travels in waves and spreads out as it goes. Microwaves, radio waves and the energy waves that we perceive as visual light all are forms of radiation. So, too, are X-rays and gamma rays—which do pose health concerns. But the microwaves used to cook foods are many, many times weaker than X-rays and gamma rays, says Robert Brackett, Ph.D., director of the National Center for Food Safety and Technology at the Illinois Institute of Technology. And the types of changes that occur in microwaved food as it cooks are “from heat generated inside the food, not the microwaves themselves,” says Brackett. “Microwave cooking is really no different from any other cooking method that applies heat to food.” That said, microwaving in some plastics may leach compounds into your food, so take care to use only microwave-safe containers.
What food myth are you sick of hearing people defend?
By Nicci Micco
http://shine.yahoo.com/channel/food/6-biggest-lies-about-food-busted-2391419
September 21, 2010
Which plastic bottles are safe to re-use?
Which plastic bottles are safe to re-use?
Canada's ban on plastic baby bottles containing the chemical bisphenol A - the first clampdown of its type - has reawakened the debate on what plastics are safe.
Bisphenol A, or BPA, is used to make polycarbonate plastic, a clear shatter-resistant material, in products ranging from plastic baby and water bottles to sports safety equipment and medical devices.
The jury is still out on how dangerous BPA is. It's in the dock because it mimics estrogen, the female hormone, and may cause neural and behavioural problems in fetuses, infants and children. Given that these plastics can all be replaced by something else, the Canadian government has decided better safe than sorry.
What is not in dispute is that BPA is enterning the human body. In a 2007 study by the Centers for Disease Control and Prevention, 93% of Americans were found to have BPA in their urine.
The reason is that contrary to what we've often been told, plastic does not last for ever. The chemicals can start leaching out as the plastic gets older and/or is and washed and/or heated repeatedly. Warning signs on bottles include cracks or cloudiness in the plastic.
How safe are your plastic bottles? You can check the plastic in your bottle by looking at the labelling on the bottom. There should be the name of the type of plastic (eg PET) and/or a number.
The two categories which are most dangerous are probably number 3 (Vinyl/PVC: polyvinylchloride) and number 6 (PS: polystyrene) both can leach cancer-causing chemicals.
PET or PETE (polyethylene terephthalate) is number 1. It's fine for one-off use but may leach cancer-causing chemical and endocrine-disruptors as it degrades. Whether these are in dangerous quantities or not is not clear. To be on the safe side, the general advice is not to reuse PET bottles.
Category 7 is miscellaneous and may include bisephonal A. All tin can linings include BPA. But Tetrapak type 'brick' cartons do not.
Safer plastics include: number 2 - HDPE (high-density polyethylene; number 4 - LDPE (low-density polyethylene); and number 5 - PP (polypropylene)
http://www.malehealth.co.uk/environment/19389-which-plastic-bottles-are-safe-re-use
_________________________________________________________
All plastics, when subjected to heat over extended periods of time can leach into the liquids they contain. By reading the codes imprinted on the plastics, you can, however, winnow the good from the bad. The following tend to be the most stable:
1: PETE (polyethylene teraphthalate)
2: HDPE (high-density polyethylene)
The next few are somewhat stable, but not quite as safe as the top two:
4: LDPE (low-density polyethylene)
5: PP (polypropylene)
The last three should be avoided at all costs:
3: PVC (polyvinyl chloride) - can leach phthalates
6: PS (polystyrene) - can leach styrene, a neuerotoxin
7: This final number consists of both safe and dangerous plastics. It is better overall to avoid plastics bearing this code as they may contain polycarbonate, which will leach bisphenol A into liquids, which is a xeno-estrogen.
_____________________________________________________
Dear EarthTalk: Are the rumors true that refilling and reusing some types of plastic bottles can cause health problems?
-- Regina Fujan, Lincoln, NE
Most types of plastic bottles are safe to reuse at least a few times if properly washed with hot soapy water. But recent revelations about chemicals in Lexan (plastic #7) bottles are enough to scare even the most committed environmentalists from reusing them (or buying them in the first place).
Chemicals May Contaminate Food and Drinks in Reused Plastic Bottles
Studies have indicated that food and drinks stored in such containers—including those ubiquitous clear Nalgene water bottles hanging from just about every hiker’s backpack—can contain trace amount of Bisphenol A (BPA), a synthetic chemical that interferes with the body’s natural hormonal messaging system.
Reused Plastic Bottles Can Leach Toxic Chemicals
The same studies found that repeated re-use of such bottles—which get dinged up through normal wear and tear and while being washed—increases the chance that chemicals will leak out of the tiny cracks and crevices that develop over time. According to the Environment California Research & Policy Center, which reviewed 130 studies on the topic, BPA has been linked to breast and uterine cancer, an increased risk of miscarriage, and decreased testosterone levels.
BPA can also wreak havoc on children’s developing systems. (Parents beware: Most baby bottles and sippy cups are made with plastics containing BPA.) Most experts agree that the amount of BPA that could leach into food and drinks through normal handling is probably very small, but there are concerns about the cumulative effect of small doses.
Even Plastic Water and Soda Bottles Should Not Be Reused
Health advocates also recommend not reusing bottles made from plastic #1 (polyethylene terephthalate, also known as PET or PETE), including most disposable water, soda and juice bottles. According to The Green Guide, such bottles may be safe for one-time use, but re-use should be avoided because studies indicate they may leach DEHP—another probable human carcinogen—when they are in less-than-perfect condition.
Millions of Plastic Bottles End Up in Landfills
The good news is that such bottles are easy to recycle; just about every municipal recycling system will take them back. But using them is nonetheless far from environmentally responsible: The nonprofit Berkeley Ecology Center found that the manufacture of plastic #1 uses large amounts of energy and resources and generates toxic emissions and pollutants that contribute to global warming. And even though PET bottles can be recycled, millions find their way into landfills every day in the U.S. alone.
Incinerating Plastic Bottles Releases Toxic Chemicals
Another bad choice for water bottles, reusable or otherwise, is plastic #3 (polyvinyl chloride/PVC), which can leach hormone-disrupting chemicals into the liquids they are storing and will release synthetic carcinogens into the environment when incinerated. Plastic #6 (polystyrene/PS), has been shown to leach styrene, a probable human carcinogen, into food and drinks as well.
Safe Reusable Bottles Do Exist
Safer choices include bottles crafted from safer HDPE (plastic #2), low-density polyethylene (LDPE, AKA plastic #4) or polypropylene (PP, or plastic #5). Aluminum bottles, such as those made by SIGG and sold in many natural food and natural product markets, and stainless steel water bottles are also safe choices and can be reused repeatedly and eventually recycled.
http://environment.about.com/od/healthenvironment/a/plastic_bottles.htm
Canada's ban on plastic baby bottles containing the chemical bisphenol A - the first clampdown of its type - has reawakened the debate on what plastics are safe.
Bisphenol A, or BPA, is used to make polycarbonate plastic, a clear shatter-resistant material, in products ranging from plastic baby and water bottles to sports safety equipment and medical devices.
The jury is still out on how dangerous BPA is. It's in the dock because it mimics estrogen, the female hormone, and may cause neural and behavioural problems in fetuses, infants and children. Given that these plastics can all be replaced by something else, the Canadian government has decided better safe than sorry.
What is not in dispute is that BPA is enterning the human body. In a 2007 study by the Centers for Disease Control and Prevention, 93% of Americans were found to have BPA in their urine.
The reason is that contrary to what we've often been told, plastic does not last for ever. The chemicals can start leaching out as the plastic gets older and/or is and washed and/or heated repeatedly. Warning signs on bottles include cracks or cloudiness in the plastic.
How safe are your plastic bottles? You can check the plastic in your bottle by looking at the labelling on the bottom. There should be the name of the type of plastic (eg PET) and/or a number.
The two categories which are most dangerous are probably number 3 (Vinyl/PVC: polyvinylchloride) and number 6 (PS: polystyrene) both can leach cancer-causing chemicals.
PET or PETE (polyethylene terephthalate) is number 1. It's fine for one-off use but may leach cancer-causing chemical and endocrine-disruptors as it degrades. Whether these are in dangerous quantities or not is not clear. To be on the safe side, the general advice is not to reuse PET bottles.
Category 7 is miscellaneous and may include bisephonal A. All tin can linings include BPA. But Tetrapak type 'brick' cartons do not.
Safer plastics include: number 2 - HDPE (high-density polyethylene; number 4 - LDPE (low-density polyethylene); and number 5 - PP (polypropylene)
http://www.malehealth.co.uk/environment/19389-which-plastic-bottles-are-safe-re-use
_________________________________________________________
All plastics, when subjected to heat over extended periods of time can leach into the liquids they contain. By reading the codes imprinted on the plastics, you can, however, winnow the good from the bad. The following tend to be the most stable:
1: PETE (polyethylene teraphthalate)
2: HDPE (high-density polyethylene)
The next few are somewhat stable, but not quite as safe as the top two:
4: LDPE (low-density polyethylene)
5: PP (polypropylene)
The last three should be avoided at all costs:
3: PVC (polyvinyl chloride) - can leach phthalates
6: PS (polystyrene) - can leach styrene, a neuerotoxin
7: This final number consists of both safe and dangerous plastics. It is better overall to avoid plastics bearing this code as they may contain polycarbonate, which will leach bisphenol A into liquids, which is a xeno-estrogen.
_____________________________________________________
Dear EarthTalk: Are the rumors true that refilling and reusing some types of plastic bottles can cause health problems?
-- Regina Fujan, Lincoln, NE
Most types of plastic bottles are safe to reuse at least a few times if properly washed with hot soapy water. But recent revelations about chemicals in Lexan (plastic #7) bottles are enough to scare even the most committed environmentalists from reusing them (or buying them in the first place).
Chemicals May Contaminate Food and Drinks in Reused Plastic Bottles
Studies have indicated that food and drinks stored in such containers—including those ubiquitous clear Nalgene water bottles hanging from just about every hiker’s backpack—can contain trace amount of Bisphenol A (BPA), a synthetic chemical that interferes with the body’s natural hormonal messaging system.
Reused Plastic Bottles Can Leach Toxic Chemicals
The same studies found that repeated re-use of such bottles—which get dinged up through normal wear and tear and while being washed—increases the chance that chemicals will leak out of the tiny cracks and crevices that develop over time. According to the Environment California Research & Policy Center, which reviewed 130 studies on the topic, BPA has been linked to breast and uterine cancer, an increased risk of miscarriage, and decreased testosterone levels.
BPA can also wreak havoc on children’s developing systems. (Parents beware: Most baby bottles and sippy cups are made with plastics containing BPA.) Most experts agree that the amount of BPA that could leach into food and drinks through normal handling is probably very small, but there are concerns about the cumulative effect of small doses.
Even Plastic Water and Soda Bottles Should Not Be Reused
Health advocates also recommend not reusing bottles made from plastic #1 (polyethylene terephthalate, also known as PET or PETE), including most disposable water, soda and juice bottles. According to The Green Guide, such bottles may be safe for one-time use, but re-use should be avoided because studies indicate they may leach DEHP—another probable human carcinogen—when they are in less-than-perfect condition.
Millions of Plastic Bottles End Up in Landfills
The good news is that such bottles are easy to recycle; just about every municipal recycling system will take them back. But using them is nonetheless far from environmentally responsible: The nonprofit Berkeley Ecology Center found that the manufacture of plastic #1 uses large amounts of energy and resources and generates toxic emissions and pollutants that contribute to global warming. And even though PET bottles can be recycled, millions find their way into landfills every day in the U.S. alone.
Incinerating Plastic Bottles Releases Toxic Chemicals
Another bad choice for water bottles, reusable or otherwise, is plastic #3 (polyvinyl chloride/PVC), which can leach hormone-disrupting chemicals into the liquids they are storing and will release synthetic carcinogens into the environment when incinerated. Plastic #6 (polystyrene/PS), has been shown to leach styrene, a probable human carcinogen, into food and drinks as well.
Safe Reusable Bottles Do Exist
Safer choices include bottles crafted from safer HDPE (plastic #2), low-density polyethylene (LDPE, AKA plastic #4) or polypropylene (PP, or plastic #5). Aluminum bottles, such as those made by SIGG and sold in many natural food and natural product markets, and stainless steel water bottles are also safe choices and can be reused repeatedly and eventually recycled.
http://environment.about.com/od/healthenvironment/a/plastic_bottles.htm
September 05, 2010
传染性单核细胞增多症
这是一种由于Epstein-Barr(EB)病毒引起的,以发热,咽炎和淋巴结肿大为特征的急性疾病.
病因学和病理生理学
EB病毒是一种分布非常广泛的疱疹病毒,其宿主局限于人类和某些灵长类的B淋巴细胞以及鼻咽细胞,在鼻咽部复制以后,病毒便传染到B淋巴细胞,并使之诱导分泌免疫球蛋白,这些免疫球蛋白中包括了一种称之为异嗜抗体的物质,这种物质对诊断很有帮助(见下文实验室检查和诊断).
被EB病毒转变的B淋巴细胞,是一种多面反应的靶细胞.体液免疫反应(异嗜性抗体的产生)是EB病毒感染后的原发反应.细胞免疫反应部分是由于CD8标记的T淋巴细胞被诱导激活,是由于原发性EB病毒感染而引起的非典型性淋巴细胞增多.因此,细胞介导的免疫反应在防止原发感染时被EB病毒转变的B淋巴细胞继续增殖,以及扭转EB病毒的多株B细胞激活反应中发挥了重要的作用.
在原发性感染以后,EB病毒仍然长期存留在宿主体内,而且间歇地从口咽部排放出来,在15%~20%健康的EB病毒血清阳性反应的成人口咽分泌物中能找到EB病毒.免疫力低下的病人(如同种器官移植的受体,受到HIV感染的人)其口咽部排毒频繁而且滴度增高.与单纯疱疹和带状疱疹病毒不同,EB病毒的反应一般呈亚临床型.
EB病毒是相对不稳定,传染性也相对较小,只有大约5%的病人有近期接触过传染性单核细胞增多症患者的接触史,对大数病人而言,潜伏期为30~50天.
本病可通过血源传染,但易感者和EB病毒健康携带者口咽接触(接吻)更为常见.后者虽然没有症状,但其口咽部不断排放病毒,在低社会经济群体和拥挤的生活环境中,年幼者受传染的机会更为多见.
EB病毒也被认为与非洲伯基特(Burkitt)淋巴病,某些免疫力低下患者(尤其是同种器官移植的受体,HIV感染者,共济失调-毛细血管扩张症患者)的B细胞肿瘤以及鼻咽癌有关(参见第139节和第87节).这些关联是由于这些患者血清中EB病毒的活力增高,而且在肿瘤活检标本中发现有EB病毒的核心抗原(EBNA)和DNA.曾经推测EB病毒是通过改变B淋巴细胞克隆,使之易于产生染色体错位,并激活单克隆或多克隆淋巴细胞增生,从而与某些B淋巴细胞性肿瘤有关.
在过去的若干年里,许多研究者发现有一种称之为"慢性疲乏综合征"的疾患,其特征为疲乏,轻度可被感觉到的功能不全,有些病例还伴有低热和淋巴结肿大(参见第287节),虽然有人猜测EB病毒与慢性疲乏综合征的发病可能有些关系,但支持这种推测的客观依据不足,因此EB病毒的特异性血清学实验对该病的诊断无意义.
偶有病例报道支持慢性EB病毒感染和一种发热,间质性肺炎,全血细胞减少和葡萄膜炎的综合征有关.这些病人应与慢性疲乏综合征相区别,因为后者没有客观的症状和体征.
流行病学
大约有50%的患儿在5岁时已有原发性EB病毒感染,大多数呈亚临床型感染.在青春期或成年人中,可能是一种亚临床型或者表现为传染性单核细胞增多症.对大学生所作的前瞻性研究发现,原发性EB病毒感染者有30%~70%产生传染性单核细胞增多症,但在和平志愿队以及招募新兵中的类似研究结果显示,高达90%的病例并无临床表现.EB病毒感染即使延迟到老年人,也会产生典型的传染性单核细胞增多症的症状.
症状和体征
患者通常可出现疲乏,发热,咽炎和淋巴结肿大四联症,或仅出现其中几项症状.病人常表现出持续多日至一周的不适,接下去便发热,咽炎和淋巴结肿大,在最初的2~3周感到最为疲乏,体温在午后或黄昏时最高,一般为39.5℃左右,少数可达40.5℃,疲乏和发热很突出(所谓伤寒样类型)时,发作和消退都比较迟缓.咽炎可以很严重,有剧痛和渗出,可与链球菌性咽炎相仿,肿大的淋巴结可累及任何一组,但通常呈对称性,以颈前和颈后淋巴结肿大最为突出,有时以单个或一组淋巴结肿大,此时异嗜抗体检查可以代替淋巴结活检或协助解决使人感到捉摸不定的病理学所见.
大约50%的病人出现脾脏肿大,在病程的第2和第3周达到最大,此时脾尖刚刚在左肋缘下面可被触及,也可出现轻度的肝肿大和肝区叩击痛,少见的症状包括斑丘疹,黄疸,眶周水肿和腭部粘膜疹.
并发症
虽然绝大多数病例最后都会痊愈,但是并发症仍然十分引人注目.
中枢神经系统并发症包括脑炎癫痫样发作,Guillain-Barré综合征,周围神经病变,无菌性脑膜炎,脊髓炎,颅神经瘫痪和精神症状.EB病毒相关性脑炎,可能伴有小脑损害的症状,也有可能是全脑性的损害,而且类似于单纯疱疹脑炎,进展迅速,但不同的是EB病毒相关性脑炎通常是自限性的.
血液学并发症包括粒细胞减少症,血小板减少症和溶血性贫血,常常呈自限性,并不需要特殊的处理.约有50%的病人伴有短暂的粒细胞减少或血小板减少,较少见的严重病例中可有继发感染或出血.由于特异性抗体的存在,可发生溶血性贫血.因脾脏肿大和包膜水肿可发生脾破裂,此时需要脾切除手术.尽管大多数病人会感到腹痛,但偶尔会有无痛性的脾破裂,此时仅表现出低血压.约半数病人曾有外伤史.
肺部并发症包括气道阻塞或间质性肺部浸润,由于咽部或气管周围淋巴结肿大可导致气管阻塞,若肾上腺皮质激素不能控制时需立即住院并可能会需要手术治疗.间质性肺炎较常见于儿科病人,通常只是X线片上有异常而缺乏临床症状.
肝脏并发症以肝功能异常为主要表现,大约95%的病人肝细胞酶增高(可达正常值的2~3倍,于病程第3~4周回到基线上来).如果出现黄疸或酶的滴度更高,则要考虑是不是其他原因引起的肝炎.
偶尔发生的散在性的势不可挡的EB病毒感染可能有相关的家族史.在某些家庭中可能会出现X连锁的淋巴细胞增殖综合征(Duncan综合征)(参见第147节),在这些家庭中,原发性EB病毒感染可伴有不能控制的淋巴细胞增殖,再生障碍性贫血或低丙种球蛋白血症.
传染性单核细胞增多症是由EB病毒感染引起的一种单核-巨噬细胞系统急性增生性传染病，小儿期常见。
一、 临床表现
1、 发热：绝大多数患儿均有不同程度发热，体温波动在38~40，热型不定，热程数日至数周甚至长达数月。发热虽高，中毒症状却较细菌性咽炎为轻。
2、 淋巴结肿大：每一病例均有，为本病特征，主要累积双侧颈部淋巴结，双侧可不对称。其他各处淋巴结也可肿大。
3、 咽颊炎：80%患儿出现咽痛或咽颊炎症状，咽充血，扁桃体肿大，可有渗出或假膜。
4、 肝脾肿大：见于70%病例，多出现于发病第一周时，可有肝功能异常，黄疸少见，重者可发生重型肝炎，肝功能衰竭。
5、 皮疹：可出现斑丘疹，多在病程第4-10天出现，应用氨苄西林钠后皮疹出现率高达90%。
二、 辅助检查
1、 血象：白细胞总数增高，以淋巴细胞为主，异常淋巴细胞10-90%，呈泡沫型，不规则型和幼稚型，发生溶血性贫血时红细胞减少，网织红细胞增加，免疫异常可导致粒细胞缺乏或血小板减少。
2、 EB病毒抗体测定：以下结果如出现一项或多项，即为本病急性感染的指征：1）抗VCA-IgM抗体滴定效价1：10或更高；2）抗VCA-IgG抗体效价在1：320或更高；3）抗EA-D抗体效价在1：10或更高；4）血清中未出现抗EBNA抗体。
3、 血清嗜异凝集反应：一般认为1：40以上即为阳性反应，1：80以上更具有价值。于起病5天后即可呈阳性反应，2-3周达高峰，可持续2-5个月。但有10%患者始终阴性，尤其是5岁以下小儿。
三、 并发症：本病为全身病毒感染性疾病，可发生多种并发症，影响预后。
1、 血液系统：可有Coomb's试验阳性的自身免疫性溶血性贫血，出现于病程的1-2周，且大多可在1个月内停止发展，另可发生粒细胞减少，嗜酸细胞增多，全血细胞减少或免疫性血小板减少性紫癜。
2、 神经系统：0.37%-7.3%患儿可出现此类合并症，症状差异很大，以横贯性脊髓病为最严重，其它如小脑病变、脑膜、脊髓、颅神经和周围神经都可能受累而出现不同的神经系统症状与体征。
3、 消化系统：肝功异常多不严重，可有黄疸，曾报告有肝坏死，自发性脾破裂，食道静脉曲张。
4、 呼吸系统：上呼吸道梗塞，扁桃体周围脓肿，咽喉部水肿，肺炎，胸膜炎或胸腔积液等。
5、 心脏：心电图非特异性T波改变或轻度传导异常，心肌炎和心包炎少见。
6、 眼部：可并发结膜炎，视神经炎，偏盲，斜视，眼睑下垂等。
7、 泌尿系统：血尿，蛋白尿，肾炎，肾病，急性肾功能衰竭等。
8、 其他：慢性疲劳综合征，中耳炎，腮腺炎等。
四、治疗
本病常为自限性，若无并发症，则大多预后良好，病程约1-2周，但也可反复，少数患者恢复缓慢，可达数周甚至数月之久。目前本病尚缺乏特异性治疗。
1、 一般治疗：急性期卧床休息2-3周，加强护理，避免严重并发症。
2、 抗病毒治疗：病毒唑10-15mg/kg.d，分2次静脉滴注，疗程5-7日；阿昔洛韦5-10mg/kg.d，溶于10%葡萄糖100ml中静点，疗程5-7日；重症可用ａ-干扰素100万μ肌注或溶于10%葡萄糖100ml中静点，疗程5-7日。
3、 对症：退热，止惊，镇静，保肝治疗。对重症并发心肌炎、严重肝炎、溶血性贫血或血小板减少性紫癜时，可短期应用激素，经济条件好者可用丙种球蛋白，400mg/kg.d，连用5天。伴发细菌感染时可使用抗生素，忌用氨苄青霉素，（因用后皮疹发生率可达95%），可选用青霉素。
病因学和病理生理学
EB病毒是一种分布非常广泛的疱疹病毒,其宿主局限于人类和某些灵长类的B淋巴细胞以及鼻咽细胞,在鼻咽部复制以后,病毒便传染到B淋巴细胞,并使之诱导分泌免疫球蛋白,这些免疫球蛋白中包括了一种称之为异嗜抗体的物质,这种物质对诊断很有帮助(见下文实验室检查和诊断).
被EB病毒转变的B淋巴细胞,是一种多面反应的靶细胞.体液免疫反应(异嗜性抗体的产生)是EB病毒感染后的原发反应.细胞免疫反应部分是由于CD8标记的T淋巴细胞被诱导激活,是由于原发性EB病毒感染而引起的非典型性淋巴细胞增多.因此,细胞介导的免疫反应在防止原发感染时被EB病毒转变的B淋巴细胞继续增殖,以及扭转EB病毒的多株B细胞激活反应中发挥了重要的作用.
在原发性感染以后,EB病毒仍然长期存留在宿主体内,而且间歇地从口咽部排放出来,在15%~20%健康的EB病毒血清阳性反应的成人口咽分泌物中能找到EB病毒.免疫力低下的病人(如同种器官移植的受体,受到HIV感染的人)其口咽部排毒频繁而且滴度增高.与单纯疱疹和带状疱疹病毒不同,EB病毒的反应一般呈亚临床型.
EB病毒是相对不稳定,传染性也相对较小,只有大约5%的病人有近期接触过传染性单核细胞增多症患者的接触史,对大数病人而言,潜伏期为30~50天.
本病可通过血源传染,但易感者和EB病毒健康携带者口咽接触(接吻)更为常见.后者虽然没有症状,但其口咽部不断排放病毒,在低社会经济群体和拥挤的生活环境中,年幼者受传染的机会更为多见.
EB病毒也被认为与非洲伯基特(Burkitt)淋巴病,某些免疫力低下患者(尤其是同种器官移植的受体,HIV感染者,共济失调-毛细血管扩张症患者)的B细胞肿瘤以及鼻咽癌有关(参见第139节和第87节).这些关联是由于这些患者血清中EB病毒的活力增高,而且在肿瘤活检标本中发现有EB病毒的核心抗原(EBNA)和DNA.曾经推测EB病毒是通过改变B淋巴细胞克隆,使之易于产生染色体错位,并激活单克隆或多克隆淋巴细胞增生,从而与某些B淋巴细胞性肿瘤有关.
在过去的若干年里,许多研究者发现有一种称之为"慢性疲乏综合征"的疾患,其特征为疲乏,轻度可被感觉到的功能不全,有些病例还伴有低热和淋巴结肿大(参见第287节),虽然有人猜测EB病毒与慢性疲乏综合征的发病可能有些关系,但支持这种推测的客观依据不足,因此EB病毒的特异性血清学实验对该病的诊断无意义.
偶有病例报道支持慢性EB病毒感染和一种发热,间质性肺炎,全血细胞减少和葡萄膜炎的综合征有关.这些病人应与慢性疲乏综合征相区别,因为后者没有客观的症状和体征.
流行病学
大约有50%的患儿在5岁时已有原发性EB病毒感染,大多数呈亚临床型感染.在青春期或成年人中,可能是一种亚临床型或者表现为传染性单核细胞增多症.对大学生所作的前瞻性研究发现,原发性EB病毒感染者有30%~70%产生传染性单核细胞增多症,但在和平志愿队以及招募新兵中的类似研究结果显示,高达90%的病例并无临床表现.EB病毒感染即使延迟到老年人,也会产生典型的传染性单核细胞增多症的症状.
症状和体征
患者通常可出现疲乏,发热,咽炎和淋巴结肿大四联症,或仅出现其中几项症状.病人常表现出持续多日至一周的不适,接下去便发热,咽炎和淋巴结肿大,在最初的2~3周感到最为疲乏,体温在午后或黄昏时最高,一般为39.5℃左右,少数可达40.5℃,疲乏和发热很突出(所谓伤寒样类型)时,发作和消退都比较迟缓.咽炎可以很严重,有剧痛和渗出,可与链球菌性咽炎相仿,肿大的淋巴结可累及任何一组,但通常呈对称性,以颈前和颈后淋巴结肿大最为突出,有时以单个或一组淋巴结肿大,此时异嗜抗体检查可以代替淋巴结活检或协助解决使人感到捉摸不定的病理学所见.
大约50%的病人出现脾脏肿大,在病程的第2和第3周达到最大,此时脾尖刚刚在左肋缘下面可被触及,也可出现轻度的肝肿大和肝区叩击痛,少见的症状包括斑丘疹,黄疸,眶周水肿和腭部粘膜疹.
并发症
虽然绝大多数病例最后都会痊愈,但是并发症仍然十分引人注目.
中枢神经系统并发症包括脑炎癫痫样发作,Guillain-Barré综合征,周围神经病变,无菌性脑膜炎,脊髓炎,颅神经瘫痪和精神症状.EB病毒相关性脑炎,可能伴有小脑损害的症状,也有可能是全脑性的损害,而且类似于单纯疱疹脑炎,进展迅速,但不同的是EB病毒相关性脑炎通常是自限性的.
血液学并发症包括粒细胞减少症,血小板减少症和溶血性贫血,常常呈自限性,并不需要特殊的处理.约有50%的病人伴有短暂的粒细胞减少或血小板减少,较少见的严重病例中可有继发感染或出血.由于特异性抗体的存在,可发生溶血性贫血.因脾脏肿大和包膜水肿可发生脾破裂,此时需要脾切除手术.尽管大多数病人会感到腹痛,但偶尔会有无痛性的脾破裂,此时仅表现出低血压.约半数病人曾有外伤史.
肺部并发症包括气道阻塞或间质性肺部浸润,由于咽部或气管周围淋巴结肿大可导致气管阻塞,若肾上腺皮质激素不能控制时需立即住院并可能会需要手术治疗.间质性肺炎较常见于儿科病人,通常只是X线片上有异常而缺乏临床症状.
肝脏并发症以肝功能异常为主要表现,大约95%的病人肝细胞酶增高(可达正常值的2~3倍,于病程第3~4周回到基线上来).如果出现黄疸或酶的滴度更高,则要考虑是不是其他原因引起的肝炎.
偶尔发生的散在性的势不可挡的EB病毒感染可能有相关的家族史.在某些家庭中可能会出现X连锁的淋巴细胞增殖综合征(Duncan综合征)(参见第147节),在这些家庭中,原发性EB病毒感染可伴有不能控制的淋巴细胞增殖,再生障碍性贫血或低丙种球蛋白血症.
传染性单核细胞增多症是由EB病毒感染引起的一种单核-巨噬细胞系统急性增生性传染病，小儿期常见。
一、 临床表现
1、 发热：绝大多数患儿均有不同程度发热，体温波动在38~40，热型不定，热程数日至数周甚至长达数月。发热虽高，中毒症状却较细菌性咽炎为轻。
2、 淋巴结肿大：每一病例均有，为本病特征，主要累积双侧颈部淋巴结，双侧可不对称。其他各处淋巴结也可肿大。
3、 咽颊炎：80%患儿出现咽痛或咽颊炎症状，咽充血，扁桃体肿大，可有渗出或假膜。
4、 肝脾肿大：见于70%病例，多出现于发病第一周时，可有肝功能异常，黄疸少见，重者可发生重型肝炎，肝功能衰竭。
5、 皮疹：可出现斑丘疹，多在病程第4-10天出现，应用氨苄西林钠后皮疹出现率高达90%。
二、 辅助检查
1、 血象：白细胞总数增高，以淋巴细胞为主，异常淋巴细胞10-90%，呈泡沫型，不规则型和幼稚型，发生溶血性贫血时红细胞减少，网织红细胞增加，免疫异常可导致粒细胞缺乏或血小板减少。
2、 EB病毒抗体测定：以下结果如出现一项或多项，即为本病急性感染的指征：1）抗VCA-IgM抗体滴定效价1：10或更高；2）抗VCA-IgG抗体效价在1：320或更高；3）抗EA-D抗体效价在1：10或更高；4）血清中未出现抗EBNA抗体。
3、 血清嗜异凝集反应：一般认为1：40以上即为阳性反应，1：80以上更具有价值。于起病5天后即可呈阳性反应，2-3周达高峰，可持续2-5个月。但有10%患者始终阴性，尤其是5岁以下小儿。
三、 并发症：本病为全身病毒感染性疾病，可发生多种并发症，影响预后。
1、 血液系统：可有Coomb's试验阳性的自身免疫性溶血性贫血，出现于病程的1-2周，且大多可在1个月内停止发展，另可发生粒细胞减少，嗜酸细胞增多，全血细胞减少或免疫性血小板减少性紫癜。
2、 神经系统：0.37%-7.3%患儿可出现此类合并症，症状差异很大，以横贯性脊髓病为最严重，其它如小脑病变、脑膜、脊髓、颅神经和周围神经都可能受累而出现不同的神经系统症状与体征。
3、 消化系统：肝功异常多不严重，可有黄疸，曾报告有肝坏死，自发性脾破裂，食道静脉曲张。
4、 呼吸系统：上呼吸道梗塞，扁桃体周围脓肿，咽喉部水肿，肺炎，胸膜炎或胸腔积液等。
5、 心脏：心电图非特异性T波改变或轻度传导异常，心肌炎和心包炎少见。
6、 眼部：可并发结膜炎，视神经炎，偏盲，斜视，眼睑下垂等。
7、 泌尿系统：血尿，蛋白尿，肾炎，肾病，急性肾功能衰竭等。
8、 其他：慢性疲劳综合征，中耳炎，腮腺炎等。
四、治疗
本病常为自限性，若无并发症，则大多预后良好，病程约1-2周，但也可反复，少数患者恢复缓慢，可达数周甚至数月之久。目前本病尚缺乏特异性治疗。
1、 一般治疗：急性期卧床休息2-3周，加强护理，避免严重并发症。
2、 抗病毒治疗：病毒唑10-15mg/kg.d，分2次静脉滴注，疗程5-7日；阿昔洛韦5-10mg/kg.d，溶于10%葡萄糖100ml中静点，疗程5-7日；重症可用ａ-干扰素100万μ肌注或溶于10%葡萄糖100ml中静点，疗程5-7日。
3、 对症：退热，止惊，镇静，保肝治疗。对重症并发心肌炎、严重肝炎、溶血性贫血或血小板减少性紫癜时，可短期应用激素，经济条件好者可用丙种球蛋白，400mg/kg.d，连用5天。伴发细菌感染时可使用抗生素，忌用氨苄青霉素，（因用后皮疹发生率可达95%），可选用青霉素。
June 30, 2010
Tooth Extraction
Tooth Extraction
What Is It?
Tooth extraction is the removal of a tooth from its socket in the bone.
What It's Used For
If a tooth has been damaged by decay or a fracture, your dentist will try to repair it and restore it with a filling, crown or other treatment. Sometimes, though, the damage is too extensive for the tooth to be repaired. This is the most common reason for extracting a tooth.
Here are other reasons for extraction:
Some people have extra teeth that block other teeth from coming in.
People undergoing orthodontic work may need teeth extracted to create room for the teeth that are being moved into place.
People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
People receiving chemotherapy may develop infected teeth because chemotherapy weakens the immune system, increasing the risk of infection. These teeth may need to be extracted.
People receiving an organ transplant may need some teeth extracted if the teeth are at risk of becoming sources of infection after the transplant, when immunosuppressive medications are given.
Wisdom teeth, also called third molars, often are extracted either before or after they come in. They commonly come in during your late teen years or early twenties. Impacted teeth get stuck in the jaw and often need to be removed if they are decayed or cause pain. A wisdom tooth that has emerged partially may be blocked by other teeth or may not have enough room to come in completely. This can irritate the gum, causing pain and swelling, which requires the tooth to be removed.
Preparation
Your dentist or oral surgeon will ask about your medical and dental histories. He or she will take an X-ray of the area to help plan the best way to remove the tooth. If you are having all of your wisdom teeth removed, you may have a panoramic X-ray, which takes a picture of all of your teeth at once. This type of X-ray shows the relationship of your wisdom teeth to your other teeth, as well as the upper teeth's relationship to your sinuses and the lower teeth's relationship to the inferior alveolar nerve, which provides sensation to your lower jaw, lower teeth, lower lip and chin.
Some health care professionals prescribe antibiotics to be taken before and after surgery, but this varies by the dentist or oral surgeon. Antibiotics are more likely to be given to people with infection at the time of surgery or with weakened immune systems, those who will be undergoing longer surgeries, or very young or elderly people.
If you’re going to have conscious sedation or deeper anesthesia, wear clothing that has short sleeves or will allow you to roll the sleeves up easily so that an intravenous (IV) line can be placed in a vein. You will be told not to eat or drink anything for six hours before the procedure. You should also make sure you have someone available to drive you home.
How It's Done
There are two types of extractions:
A simple extraction is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions, and most can be done under a local anesthetic, with or without anti-anxiety drugs. In a simple extraction, the dentist will grasp the tooth with forceps and move the forceps back and forth to loosen the tooth before removing it. Sometimes, an instrument called a luxator, which fits between the tooth and the gum, is used to help loosen the tooth.
A surgical extraction involves teeth that cannot be seen easily in the mouth, either because they have broken off at the gum line or because they have not come in yet. Another reason for a surgical extraction is that the tooth to be removed requires a flap be cut in the gum for access to remove bone or a section of the tooth. Surgical extractions commonly are done by oral surgeons. They can be done with local anesthesia or conscious sedation. Patients with special medical conditions and young children may be given general anesthesia. In a surgical extraction, the dentist will need to make an incision in your gum to reach the tooth. In some cases, the tooth will need to be broken into sections to be removed.
If you are having teeth extracted and are receiving conscious sedation, you may be given steroids in your IV line to help reduce postoperative swelling.
If you need all four wisdom teeth removed, they usually are taken out at the same time. The top teeth usually are easier to remove than the lower ones.
Here are the types of wisdom teeth in order from easiest to remove to most complex to remove:
Erupted (already in the mouth)
Soft-tissue impacted (just under the gum)
Partial-bony impacted (partially stuck in the jaw)
Full-bony impacted (completely stuck in the jaw)
Also, if your wisdom teeth are tilted sideways, they can be harder to remove than if they are vertical.
Follow-Up
Most simple extractions do not cause much discomfort after the procedure. You may take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin and other brand names) for several days, or you may not need any pain medication.
Because surgical extractions are more complicated, they generally cause more pain after the procedure. The level of discomfort and how long you have discomfort depend on the difficulty of the extraction. Your dentist may prescribe a prescription pain medication for a few days and then suggest an NSAID. Most postsurgical pain disappears after a couple of days.
A cut in the mouth tends to bleed more than a cut on the skin because the incision cannot dry out and form a scab. So after an extraction, you'll be asked to bite on a piece of gauze for about 20 to 30 minutes to put pressure on the area and allow the blood to clot. The area may still bleed minimally for the next 24 hours or so and taper off after that. Don’t disturb the clot that forms on the wound.
You can put ice packs on your face to reduce postoperative swelling. If your jaw is sore and stiff after the swelling dissipates, try warm compresses. Eat soft foods for a few days then try other food as you feel comfortable. Rinse with warm salt water (1/2 teaspoon of salt in a cup of water) for the first few days to help keep the area clean. Most swelling and bleeding ends within one or two days of the surgery. Overall healing takes between one and two weeks.
If the extraction needs to be closed with stitches, the stitches are usually dissolvable and should disappear in one to two weeks. Rinsing with warm salt water will help the stitches to dissolve.
You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was. That causes more bleeding and can lead to a dry socket, which occurs in about 5% of all extractions. It is most common when lower back teeth are removed and happens more often in smokers and women who take birth control pills.
Risks
Infection can set in after an extraction, although you probably won't get an infection if you have a healthy immune system.
A common complication called a dry socket occurs when a blood clot doesn’t form in the hole or the blood clot prematurely breaks off or breaks down. In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.
Other potential complications include:
Accidental damage to adjacent teeth, such as fracture
An incomplete extraction, in which a tooth root remains in the jaw — Your dentist usually removes the root to prevent infection, but occasionally it is less risky to leave a small root tip in place.
A fractured jaw (a risk most often encountered in older people with osteoporosis of the jaw) caused by the pressure put on the jaw during extraction
A hole in the sinus during removal of an upper molar. A small hole will usually close up by itself in a few weeks but may require additional surgery if it doesn’t heal spontaneously.
Sustained numbness in the lower lip and chin, caused by trauma to the inferior alveolar nerve (during removal of the lower wisdom teeth). Complete healing of the nerve may take three to six months. In rare cases, the numbness, although not disfiguring, may be permanent.
When To Call a Professional
Call your dentist or oral surgeon if the swelling gets worse instead of better, or you experience fever, chills or redness in the area. If you have an infection, your dentist usually will prescribe antibiotics.
Also call your dentist or oral surgeon if the area of the extraction becomes very painful, a sign that you may have a dry socket. If the area continues to bleed after the first 24 hours, notify your oral surgeon.
©2002-2005 Aetna, Inc. All rights reserved.
Reviewed by the faculty of Columbia University College of Dental Medicine
9/14/2005
What Is It?
Tooth extraction is the removal of a tooth from its socket in the bone.
What It's Used For
If a tooth has been damaged by decay or a fracture, your dentist will try to repair it and restore it with a filling, crown or other treatment. Sometimes, though, the damage is too extensive for the tooth to be repaired. This is the most common reason for extracting a tooth.
Here are other reasons for extraction:
Some people have extra teeth that block other teeth from coming in.
People undergoing orthodontic work may need teeth extracted to create room for the teeth that are being moved into place.
People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
People receiving chemotherapy may develop infected teeth because chemotherapy weakens the immune system, increasing the risk of infection. These teeth may need to be extracted.
People receiving an organ transplant may need some teeth extracted if the teeth are at risk of becoming sources of infection after the transplant, when immunosuppressive medications are given.
Wisdom teeth, also called third molars, often are extracted either before or after they come in. They commonly come in during your late teen years or early twenties. Impacted teeth get stuck in the jaw and often need to be removed if they are decayed or cause pain. A wisdom tooth that has emerged partially may be blocked by other teeth or may not have enough room to come in completely. This can irritate the gum, causing pain and swelling, which requires the tooth to be removed.
Preparation
Your dentist or oral surgeon will ask about your medical and dental histories. He or she will take an X-ray of the area to help plan the best way to remove the tooth. If you are having all of your wisdom teeth removed, you may have a panoramic X-ray, which takes a picture of all of your teeth at once. This type of X-ray shows the relationship of your wisdom teeth to your other teeth, as well as the upper teeth's relationship to your sinuses and the lower teeth's relationship to the inferior alveolar nerve, which provides sensation to your lower jaw, lower teeth, lower lip and chin.
Some health care professionals prescribe antibiotics to be taken before and after surgery, but this varies by the dentist or oral surgeon. Antibiotics are more likely to be given to people with infection at the time of surgery or with weakened immune systems, those who will be undergoing longer surgeries, or very young or elderly people.
If you’re going to have conscious sedation or deeper anesthesia, wear clothing that has short sleeves or will allow you to roll the sleeves up easily so that an intravenous (IV) line can be placed in a vein. You will be told not to eat or drink anything for six hours before the procedure. You should also make sure you have someone available to drive you home.
How It's Done
There are two types of extractions:
A simple extraction is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions, and most can be done under a local anesthetic, with or without anti-anxiety drugs. In a simple extraction, the dentist will grasp the tooth with forceps and move the forceps back and forth to loosen the tooth before removing it. Sometimes, an instrument called a luxator, which fits between the tooth and the gum, is used to help loosen the tooth.
A surgical extraction involves teeth that cannot be seen easily in the mouth, either because they have broken off at the gum line or because they have not come in yet. Another reason for a surgical extraction is that the tooth to be removed requires a flap be cut in the gum for access to remove bone or a section of the tooth. Surgical extractions commonly are done by oral surgeons. They can be done with local anesthesia or conscious sedation. Patients with special medical conditions and young children may be given general anesthesia. In a surgical extraction, the dentist will need to make an incision in your gum to reach the tooth. In some cases, the tooth will need to be broken into sections to be removed.
If you are having teeth extracted and are receiving conscious sedation, you may be given steroids in your IV line to help reduce postoperative swelling.
If you need all four wisdom teeth removed, they usually are taken out at the same time. The top teeth usually are easier to remove than the lower ones.
Here are the types of wisdom teeth in order from easiest to remove to most complex to remove:
Erupted (already in the mouth)
Soft-tissue impacted (just under the gum)
Partial-bony impacted (partially stuck in the jaw)
Full-bony impacted (completely stuck in the jaw)
Also, if your wisdom teeth are tilted sideways, they can be harder to remove than if they are vertical.
Follow-Up
Most simple extractions do not cause much discomfort after the procedure. You may take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin and other brand names) for several days, or you may not need any pain medication.
Because surgical extractions are more complicated, they generally cause more pain after the procedure. The level of discomfort and how long you have discomfort depend on the difficulty of the extraction. Your dentist may prescribe a prescription pain medication for a few days and then suggest an NSAID. Most postsurgical pain disappears after a couple of days.
A cut in the mouth tends to bleed more than a cut on the skin because the incision cannot dry out and form a scab. So after an extraction, you'll be asked to bite on a piece of gauze for about 20 to 30 minutes to put pressure on the area and allow the blood to clot. The area may still bleed minimally for the next 24 hours or so and taper off after that. Don’t disturb the clot that forms on the wound.
You can put ice packs on your face to reduce postoperative swelling. If your jaw is sore and stiff after the swelling dissipates, try warm compresses. Eat soft foods for a few days then try other food as you feel comfortable. Rinse with warm salt water (1/2 teaspoon of salt in a cup of water) for the first few days to help keep the area clean. Most swelling and bleeding ends within one or two days of the surgery. Overall healing takes between one and two weeks.
If the extraction needs to be closed with stitches, the stitches are usually dissolvable and should disappear in one to two weeks. Rinsing with warm salt water will help the stitches to dissolve.
You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was. That causes more bleeding and can lead to a dry socket, which occurs in about 5% of all extractions. It is most common when lower back teeth are removed and happens more often in smokers and women who take birth control pills.
Risks
Infection can set in after an extraction, although you probably won't get an infection if you have a healthy immune system.
A common complication called a dry socket occurs when a blood clot doesn’t form in the hole or the blood clot prematurely breaks off or breaks down. In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.
Other potential complications include:
Accidental damage to adjacent teeth, such as fracture
An incomplete extraction, in which a tooth root remains in the jaw — Your dentist usually removes the root to prevent infection, but occasionally it is less risky to leave a small root tip in place.
A fractured jaw (a risk most often encountered in older people with osteoporosis of the jaw) caused by the pressure put on the jaw during extraction
A hole in the sinus during removal of an upper molar. A small hole will usually close up by itself in a few weeks but may require additional surgery if it doesn’t heal spontaneously.
Sustained numbness in the lower lip and chin, caused by trauma to the inferior alveolar nerve (during removal of the lower wisdom teeth). Complete healing of the nerve may take three to six months. In rare cases, the numbness, although not disfiguring, may be permanent.
When To Call a Professional
Call your dentist or oral surgeon if the swelling gets worse instead of better, or you experience fever, chills or redness in the area. If you have an infection, your dentist usually will prescribe antibiotics.
Also call your dentist or oral surgeon if the area of the extraction becomes very painful, a sign that you may have a dry socket. If the area continues to bleed after the first 24 hours, notify your oral surgeon.
©2002-2005 Aetna, Inc. All rights reserved.
Reviewed by the faculty of Columbia University College of Dental Medicine
9/14/2005
June 14, 2010
10 Small Changes with Big Health Payoffs
Does it ever feel like you have to spend hours and hours at the gym, change your diet dramatically or jump way out of your comfort zone to reap any rewards in the health department? Think again. Our experts say that these small changes can have significant health payoffs.
1. Floss more often.
According to Robert Emami, DDS, chief of staff at Dental Specialties, a multispecialty practice in Randolph, Massachusetts, a simple piece of nylon string can have dramatic effects on a woman's overall health. “Flossing is one of the easiest, quickest ways to remove bad bacteria from your body,” he says. “Plaque and bacteria are constantly building up in areas of the teeth that brushing does not get to. If plaque accumulates, it eats away the bone that holds the teeth in place.” Oral bacteria, he adds, can enter the bloodstream; studies have shown that such harmful bugs could exacerbate diabetes and hypertension, and even lead to premature births.
2. Eat every 2 to 3 hours during the day.
Think you’re a saint for going on a long hunger strike at work? If you’re imagining thinner thighs as a result, don’t. You’re likely making your metabolism crazy, says Dallas-based fitness trainer Scott Colby, and possibly setting yourself up to eat more later in the day. Colby encourages women to eat when they’re hungry, which often translates to three meals and at least two snacks per day. “This will help keep you full and satisfied and will reduce the likelihood of binge eating at the end of the day,” he says. “This is one of the best principles you can follow to blast fat and build sexy, lean muscle.”
MORE FROM WOMAN’S DAY
Everything You Need to Know About Vitamins
4 Proven Health Benefits of Marriage
3. Make your coffee at home.
If a trip to Starbucks is as much of a morning ritual as showering and blow-drying your hair, you might find this advice crazy, but health experts like Gregory J.E. Ladas, author of the book The Couch Potato Diet, say it will not only save you money but possibly hundreds of calories. When you brew your java at home, you “avoid the unhealthy temptations at coffee shops like doughnuts,” he says. And who hasn’t fallen for a sprinkle donut or a piece of fat- and calorie-laden pumpkin loaf?
4. Wear a pedometer.
Boston-based personal trainer Helena Collins calls the affordable little pedometer “the most effective fitness tool known to man”—or woman. “Becoming aware of how much you move is such motivation to move more,” she says. “Not only for you, but for your whole family. Kids love pedometers—it becomes a family challenge about movement, not exercise.” It also may be fun to track how active (or inactive) you are each day. For starters, 2,000 steps is the equivalent of one mile. To boost your physical and mental health, wear a pedometer and challenge yourself to increase your steps every day.
5. Sleep in your exercise clothes (comfortable ones).
Do you always intend to get up and go for a jog or log an hour at the gym before work but…don’t? Motivation may be your problem, and if so, Nicole Glor, an AFAA-certified personal trainer and group fitness instructor at Crunch in New York City, says that she gives her clients some unusual advice that works. “Sleep in your gym clothes and put your sneaks and sports bra by the bed,” she says. “Many of us waste too much time saying we need to work out but dread the process. Trick yourself by just getting dressed for it and not really thinking about the next step.”
6. Do your Kegels.
Experts say that as many as 1 in 4 women over the age of 18 experience episodes of involuntary leaking urine, called urinary incontinence. It’s embarrassing and frightening, but there is something you can do about it, say experts: Keep your pelvic floor muscles strong. According to a review of studies by The Cochrane Library, the pelvic-floor strengthening exercises known as Kegels were found to be an effective way to minimize urinary incontinence issues. Proof: Women who did their Kegels were between 2.5 and 7 times more likely to experience improvement than those who did not do the exercises.
Need a quick refresher course on how to do Kegels? First, to figure out which muscles need flexing, some experts suggest women insert a tampon or a clean finger into their vagina and then try to close their vaginal muscles around it. Contract these pelvic muscles and hold for about 3 seconds; repeat 10 times. Do these as often as you like, and anywhere you like—no one will know.
7. Give yourself a compliment.
The key to feeling happy, confident and proud of your body—flaws and all? According to Stacey Rosenfeld, PhD, a New York-based psychologist who specializes in issues of anxiety, depression, eating disorders and body image, the best thing you can do for yourself is to learn how to marvel at your body’s many abilities. “Focus on what your body can do, rather than on how it looks,” she says. “Too often, we pay attention to how our bodies appear, rather than what they allow us to do. Can your body dance or swim? Can you build sand castles at the beach with your kids? Does your body allow you to enjoy a hot bath or intimacy with a partner? Does your body transport you down the block or up a mountain?” Try this exercise: “Identify what you like about your body,” she says. “See if you can find 10 things you like about how you look, like the sparkle in your eyes, the strength of your calves or your hair.”
8. Get your vitamin D levels checked.
Next time you’re at the doctor’s office, request a simple blood test to evaluate your vitamin D blood levels, suggests Doreen Orion, MD, a physician in private practice in Boulder, Colorado, and the author of the memoir Queen of the Road. “We're finding that many, many women have a low level of this essential vitamin,” she says. “Low levels are correlated with all sorts of things from cancers to low energy to Alzheimer's. I've had patients who are outside all day, who still have very low levels. The fix is simple and just involves taking vitamin D for several months, then rechecking the level.”
9. Switch from instant to steel-cut oats.
If you eat oatmeal in the morning, give yourself some bonus points. The breakfast of champions, oatmeal fills you up and helps you feel satisfied longer than most breakfasts. But, to get the maximum health payoff, consider switching to steel-cut oats, says Jill Nussinow, MS, RD, a registered dietitian and the author of The Veggie Queen. “Steel-cut oats are less processed, contain more fiber and are more satisfying,” she says. “Make them in the slow cooker overnight or quickly in the pressure cooker in 5 minutes in the morning.”
10. Turn on some classical music at dinner.
“We tend to mimic the pace of the music we’re listening to,” explains David Niven, PhD, author of The 100 Simple Secrets of Healthy People. “To keep yourself from eating too fast—and too much—put on some slow music.” He cites a research study that found people who listened to fast music with meals ate, on average, five bites per minute. Those who didn’t listen to music ate four bites per minute. And the kicker: Those who listened to slow music ate just three bites per minute.
1. Floss more often.
According to Robert Emami, DDS, chief of staff at Dental Specialties, a multispecialty practice in Randolph, Massachusetts, a simple piece of nylon string can have dramatic effects on a woman's overall health. “Flossing is one of the easiest, quickest ways to remove bad bacteria from your body,” he says. “Plaque and bacteria are constantly building up in areas of the teeth that brushing does not get to. If plaque accumulates, it eats away the bone that holds the teeth in place.” Oral bacteria, he adds, can enter the bloodstream; studies have shown that such harmful bugs could exacerbate diabetes and hypertension, and even lead to premature births.
2. Eat every 2 to 3 hours during the day.
Think you’re a saint for going on a long hunger strike at work? If you’re imagining thinner thighs as a result, don’t. You’re likely making your metabolism crazy, says Dallas-based fitness trainer Scott Colby, and possibly setting yourself up to eat more later in the day. Colby encourages women to eat when they’re hungry, which often translates to three meals and at least two snacks per day. “This will help keep you full and satisfied and will reduce the likelihood of binge eating at the end of the day,” he says. “This is one of the best principles you can follow to blast fat and build sexy, lean muscle.”
MORE FROM WOMAN’S DAY
Everything You Need to Know About Vitamins
4 Proven Health Benefits of Marriage
3. Make your coffee at home.
If a trip to Starbucks is as much of a morning ritual as showering and blow-drying your hair, you might find this advice crazy, but health experts like Gregory J.E. Ladas, author of the book The Couch Potato Diet, say it will not only save you money but possibly hundreds of calories. When you brew your java at home, you “avoid the unhealthy temptations at coffee shops like doughnuts,” he says. And who hasn’t fallen for a sprinkle donut or a piece of fat- and calorie-laden pumpkin loaf?
4. Wear a pedometer.
Boston-based personal trainer Helena Collins calls the affordable little pedometer “the most effective fitness tool known to man”—or woman. “Becoming aware of how much you move is such motivation to move more,” she says. “Not only for you, but for your whole family. Kids love pedometers—it becomes a family challenge about movement, not exercise.” It also may be fun to track how active (or inactive) you are each day. For starters, 2,000 steps is the equivalent of one mile. To boost your physical and mental health, wear a pedometer and challenge yourself to increase your steps every day.
5. Sleep in your exercise clothes (comfortable ones).
Do you always intend to get up and go for a jog or log an hour at the gym before work but…don’t? Motivation may be your problem, and if so, Nicole Glor, an AFAA-certified personal trainer and group fitness instructor at Crunch in New York City, says that she gives her clients some unusual advice that works. “Sleep in your gym clothes and put your sneaks and sports bra by the bed,” she says. “Many of us waste too much time saying we need to work out but dread the process. Trick yourself by just getting dressed for it and not really thinking about the next step.”
6. Do your Kegels.
Experts say that as many as 1 in 4 women over the age of 18 experience episodes of involuntary leaking urine, called urinary incontinence. It’s embarrassing and frightening, but there is something you can do about it, say experts: Keep your pelvic floor muscles strong. According to a review of studies by The Cochrane Library, the pelvic-floor strengthening exercises known as Kegels were found to be an effective way to minimize urinary incontinence issues. Proof: Women who did their Kegels were between 2.5 and 7 times more likely to experience improvement than those who did not do the exercises.
Need a quick refresher course on how to do Kegels? First, to figure out which muscles need flexing, some experts suggest women insert a tampon or a clean finger into their vagina and then try to close their vaginal muscles around it. Contract these pelvic muscles and hold for about 3 seconds; repeat 10 times. Do these as often as you like, and anywhere you like—no one will know.
7. Give yourself a compliment.
The key to feeling happy, confident and proud of your body—flaws and all? According to Stacey Rosenfeld, PhD, a New York-based psychologist who specializes in issues of anxiety, depression, eating disorders and body image, the best thing you can do for yourself is to learn how to marvel at your body’s many abilities. “Focus on what your body can do, rather than on how it looks,” she says. “Too often, we pay attention to how our bodies appear, rather than what they allow us to do. Can your body dance or swim? Can you build sand castles at the beach with your kids? Does your body allow you to enjoy a hot bath or intimacy with a partner? Does your body transport you down the block or up a mountain?” Try this exercise: “Identify what you like about your body,” she says. “See if you can find 10 things you like about how you look, like the sparkle in your eyes, the strength of your calves or your hair.”
8. Get your vitamin D levels checked.
Next time you’re at the doctor’s office, request a simple blood test to evaluate your vitamin D blood levels, suggests Doreen Orion, MD, a physician in private practice in Boulder, Colorado, and the author of the memoir Queen of the Road. “We're finding that many, many women have a low level of this essential vitamin,” she says. “Low levels are correlated with all sorts of things from cancers to low energy to Alzheimer's. I've had patients who are outside all day, who still have very low levels. The fix is simple and just involves taking vitamin D for several months, then rechecking the level.”
9. Switch from instant to steel-cut oats.
If you eat oatmeal in the morning, give yourself some bonus points. The breakfast of champions, oatmeal fills you up and helps you feel satisfied longer than most breakfasts. But, to get the maximum health payoff, consider switching to steel-cut oats, says Jill Nussinow, MS, RD, a registered dietitian and the author of The Veggie Queen. “Steel-cut oats are less processed, contain more fiber and are more satisfying,” she says. “Make them in the slow cooker overnight or quickly in the pressure cooker in 5 minutes in the morning.”
10. Turn on some classical music at dinner.
“We tend to mimic the pace of the music we’re listening to,” explains David Niven, PhD, author of The 100 Simple Secrets of Healthy People. “To keep yourself from eating too fast—and too much—put on some slow music.” He cites a research study that found people who listened to fast music with meals ate, on average, five bites per minute. Those who didn’t listen to music ate four bites per minute. And the kicker: Those who listened to slow music ate just three bites per minute.
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