And treatment of aplastic anemia
DESCRIPTION
Enough of the bone marrow to peripheral blood elamanlarını which is a type of anemia usually is a slow trend. Pure red cell aplasia, erythroid elements of the construction is due to inadequate selective. May be associated with thymoma. Constitutional (Fanconi), anemia, anemia, congenital anomalies birliktedir.Aplastik Ehrlich first in 1888 by German pathologist, who died of bone marrow failure due to work on pregnant woman results have been described. Aplastic anemia in 1904, the term has been used for the first time.
The SYSTEM EFFECTS AND ORGANS
Hematologic, Lymphatic, Immune System
GENETICS
Constitutional type, is autosomal recessive.
Incidence / Prevalence
Are 500 new cases each year in the United States. Rastlanmıştır.Fransa quite common in Asia a few times also been reported as 1.5 million.
AGE AND GENDER
Acquired type, may be at any age. Constitutional type, in Childhood and Youth
Is common. Male and female ratio is equal.
Symptoms
Shortness of breath
Ecchymosis
Petechiae
Fatigue
High fever
Bleeding, menorrhagia, Fecal Occult Blood, melena, Epistaxis
Paleness
Palpitation
Progressive weakness
Flame-shaped retinal hemorrhages
Systolic ejection murmur
Weight loss
Hyperpigmentation (Acquired Type) and
Constitutional
Short stature
Microcephaly
Radius and Elbaşparmak anomalies
Renal anomalies
Hypospadias
REASONS
Idiopathic (50%)
Stem Cells Plöripotent damage / destruction
Immunologic damage
Benzene, exposure to toxic substances such as inorganic arsenic
Infectious hepatitis
Radiation therapy
Drugs, particularly antibiotics, anticonvulsants, gold
Pregnancy
Inherited (constitutional)
RISK FACTORS
Viral Diseases
Exposure to toxins
Thymic tumors (red cell aplasia)
Differential Diagnosis
Other causes of pancytopenia
Myelodysplastic Disease
Acute Leukemia
Hairy Cell Leukemia
Systemic lupus erythematosus
Disseminated Infection
Hypersplenism
Temporary Eritroblastopenisi Childhood
LABORATORY
Pancytopenia
Anemia
Leukopenia
Neutropenia
Thrombocytopenia
Elongation of bleeding time
Decreased reticulocytes
Increased serum iron, depending on the transfusion of
Total Iron Binding Capacity to normal
The mean erythrocyte volume (MCV> 104) limit the increase
Hematuria
Increase in fetal hemoglobin (FA)
In special cases, increased chromosomal fractures (constitutional)
Pathological findings
Normocromic Erythrocytes
Bone marrow
Increased iron stores.
Selülarite decreased (<10%)
Decreased megakaryocytes
Null decreased
Erythrocyte precursors (precursors) were decreased.
OTHER TESTS TO be
Chromosome breakage (constitutional), fetal hemoglobin
RADIOLOGY / IMAGING
Computed tomography; thymoma with areas for red cell aplasia are suspected thymus
Radiology of the hands of the radius and thumb (constitutional)
Ultrasonography; a kidney for (constitutional)
Diagnostic procedures
Bone Marrow Biopsy
MAINTENANCE / PRECAUTIONS
And treated in hospital in a specialized center.
Serious measures to support
Oxygen therapy
Good oral hygiene
Avoidance of the causative agents
All patients and their families, Human Leukocyte Antigens (HLA) Test
Transfusion support
Donors severe aplastic anemia patients and HLA-identical bone marrow transplantation.
30 55 transplantations of restricting the upper age limit for living is variable.
Not suitable donors for patients, immunosuppressive therapy: 5.Siklosporin, corticosteroids, antithymocyte globulin (ATG)
Unrelated donor transplants when other treatments have failed
Thymectomy for thymoma
If less serious, androgen therapy
Neutropenic patients should be isolated.
A balanced diet can reduce susceptibility to infections.
Possible toxic agents should be avoided.
Security measures should be used when working with radiation.
TREATMENT
Antithymocyte globulin (ATG)
This is against human T cells is enhanced horse serum containing polyclonal antibodies. To determine any hypersensitivity skin test should be done. In elderly patients and donors are given to patients who did not. Diluted in 500 ml isotonic with serum, 10-20 mg / kg dose, 4-6 hours infusion, followed by 8-14 days consecutively is given. As can be given alone may be combined with corticosteroids.
Cyclosporine
Initially 10 mg / kg, then 50-10 mg / kg / day given in the form of reducing. Blood levels are monitored, according to the normal value measurement techniques used değişir.2-three months of the application may be sufficient.
And does not respond to other treatment options for patients with less severe disease is useful. Oksimetalon-1-2 mg / kg / day given orally.
2-3 months to assess implementation of the answer is sufficient.
Prednisone (pure red blood cell aplasia)
Received immunosuppressive therapy relapses may occur after the first response. Growth hormone and bone marrow transplantation between the treatment options. Supportive therapy; red blood cell and platelet transfusions containing blood, antibiotics for infection control and to prevent the accumulation of iron chelation therapy is applied.
Children with
Pure red blood cell anemia (Diamond-Blackfan anemia) and constitutional Anemia is common in childhood.
Idiopathic Aplastic Anemia is common in adolescence. Children, Secondary Aplastic Anemia, exposed to ionizing radiation or cytotoxic chemotherapeutic agents can be seen in those treated.
In ELDERLY Many elderly people have been exposed to drugs and therefore are more open to Secondary Aplastic Anemia.
In pregnancy Pregnancy, may lead to the Aplastic Anemia.
Complications of Bleeding
Infection
Transfusion Hemosiderozu
Transfusion hepatitis
Heart failure
Acute Leukemia
Neoplasia, constitutional can cause anemia.
The course of a disease
Treatment depends on the patient's condition.
Some drugs can make aplastic anemia;
amphotericin B, sulfonamides, Phenacetin, trimetadion, klordiazepoksid, tolbutamide, tiourasil, carbamazepine, chloramphenicol, tetracycline, oksifenbutazon, arsenic, chlorpromazine, primetamin, karbimazol, asetazolamid, colchicine, penicillin, aspirin, mefenitoin, bismuth, promazin, quinacrin, methimazole, klorotiazid, dinitrofenol, ristocetin, indomethacin, phenytoin, gold, trifluoperazin, karbutamid, perchlorate, chlorpheniramine, streptomycin, fenilbutazon, primidone, meprobamat, klorpropamid, tiosiyanat, tripelenamin, benzene
Tuesday, September 7, 2010
Musculoskeletal problems
Objectives of treatment
- Spina bifida patients to physicians' involvement in children's goal to bring the level to allow optimal mobility and may cause a range of diseases is to prevent complications.
- Numerous surgeries, long hospital stay, long-term casting calls, complicated process that requires orthotic treatment and rehabilitation process of children, families and communities isolated from the psychosocial risk of inhibitor development should be remembered every moment.
- To the level of involvement of the patient, family and the child's potential should be determined according to realistic goals, long-term treatment plan should be done with the patient should be monitored and perseverance.
- Some patients schedule wheelchair ambüle prefer to be able mind should be kept in childhood, the therapeutic ambulation overall growth and development and socialization on the positive effects due to each patient the maximum ambulation in providing effort should be.
During treatment:
1. Can not be comfortable in bed, looking at the patient's care to facilitate
2. Easy to care for patients who can not sit in the seat, but to provide balance
3. Patients can live better and can sit on their hands to ensure
4. The patient can sit up well to provide
5. Ensure patients can get up to walk
6. Conducted to ensure that patients have a good walk
7. Do not wear shoes of the patient could walk well - calluses recovery - and so wound up. Patients should be evaluated in order to solve problems, contractures, deformities and instabilities were determined for each of these solutions should be sought.
Regional Issues
- Spine problems in the treatment of non-stop destination to sit and to walk is to get a balanced posture.
- The target for the treatment of hip flexor problem postürüne outcome and may cause dislocation of unilateral pelvic and leg oblikite to prevent shortening. Flexion, standing and walking postüründe biomechanical aspects requires large energy losses and minimizes the potential for mobilization of the patient. In all cases, within the possibilities of hip and knee flexion, standing crops, or be prevented by calcaneal deformity in children is very advantageous for the extension mobilization Posture should win. Posture extension during sitting and walking in children as they can use their hands free for activities of daily life, psychosocial development and gain the advantage. Is very controversial in the treatment of hip dislocation, dislocation can be neglected in many cases.
- Spina bifida patients to physicians' involvement in children's goal to bring the level to allow optimal mobility and may cause a range of diseases is to prevent complications.
- Numerous surgeries, long hospital stay, long-term casting calls, complicated process that requires orthotic treatment and rehabilitation process of children, families and communities isolated from the psychosocial risk of inhibitor development should be remembered every moment.
- To the level of involvement of the patient, family and the child's potential should be determined according to realistic goals, long-term treatment plan should be done with the patient should be monitored and perseverance.
- Some patients schedule wheelchair ambüle prefer to be able mind should be kept in childhood, the therapeutic ambulation overall growth and development and socialization on the positive effects due to each patient the maximum ambulation in providing effort should be.
During treatment:
1. Can not be comfortable in bed, looking at the patient's care to facilitate
2. Easy to care for patients who can not sit in the seat, but to provide balance
3. Patients can live better and can sit on their hands to ensure
4. The patient can sit up well to provide
5. Ensure patients can get up to walk
6. Conducted to ensure that patients have a good walk
7. Do not wear shoes of the patient could walk well - calluses recovery - and so wound up. Patients should be evaluated in order to solve problems, contractures, deformities and instabilities were determined for each of these solutions should be sought.
Regional Issues
- Spine problems in the treatment of non-stop destination to sit and to walk is to get a balanced posture.
- The target for the treatment of hip flexor problem postürüne outcome and may cause dislocation of unilateral pelvic and leg oblikite to prevent shortening. Flexion, standing and walking postüründe biomechanical aspects requires large energy losses and minimizes the potential for mobilization of the patient. In all cases, within the possibilities of hip and knee flexion, standing crops, or be prevented by calcaneal deformity in children is very advantageous for the extension mobilization Posture should win. Posture extension during sitting and walking in children as they can use their hands free for activities of daily life, psychosocial development and gain the advantage. Is very controversial in the treatment of hip dislocation, dislocation can be neglected in many cases.
Hip replacement
Your life will develop problems in the hip replacement if you do not want your time has come to mean lowering. Patients are not doctors here can be seen that timing of surgery is decided.
The most frequently asked denture construction and how much life is that age. Where the patient's personal characteristics such as age, sex, weight and decisive action level. Be carried out in good hands with the prosthesis 10 years is based on 98% of all patients. Over 65 years, female, 70 kg in six and less mobile people can handle the remainder of the life of the prosthesis can be said. In general, the hip prosthesis is made in good hands at around 20 years, completely painless and is full of hip function to obtain a life time.
The best hand made up of hip replacement surgery and postoperative care is also very important. The most important complication of these operations in the infection rate is 1-2%. (The best operating conditions). If the infection may require additional surgical procedures. In good operating condition when infection control is very good, "laminar air flow operating rooms lu understood. Is almost no risk of vascular and nerve injury.
Surface of the joint operation of both plastic and metal components are replaced. The second way to keep track of issues is in place. One of them is identified with cement polimetimetakrilat called. And another special prepared in accordance with the development of bone and bone composite prostheses are integrating with. Some cementless implants that could allow the formation of new bone on the surface of biological active substances are located. Except for osteoporosis, advanced age and advanced cementless prostheses are preferred nowadays. (Directory vice versa) after a certain period of cementless prostheses is necessary to use crutches.
Patients to walk the day after the operation, 2 days will be permitted to sit in the toilet. Average 15 days after stitches are taken and will be allowed into the bathroom. Patients with hip and knee surgery the next day from the bending and muscle strengthening exercises are initiated. To win these exercises will continue until all of hip function. Usually 6 hip function returns all week. In the presence of hip replacement patients 3-6 months after the first week of walking they can feel is pain.
The most frequently asked denture construction and how much life is that age. Where the patient's personal characteristics such as age, sex, weight and decisive action level. Be carried out in good hands with the prosthesis 10 years is based on 98% of all patients. Over 65 years, female, 70 kg in six and less mobile people can handle the remainder of the life of the prosthesis can be said. In general, the hip prosthesis is made in good hands at around 20 years, completely painless and is full of hip function to obtain a life time.
The best hand made up of hip replacement surgery and postoperative care is also very important. The most important complication of these operations in the infection rate is 1-2%. (The best operating conditions). If the infection may require additional surgical procedures. In good operating condition when infection control is very good, "laminar air flow operating rooms lu understood. Is almost no risk of vascular and nerve injury.
Surface of the joint operation of both plastic and metal components are replaced. The second way to keep track of issues is in place. One of them is identified with cement polimetimetakrilat called. And another special prepared in accordance with the development of bone and bone composite prostheses are integrating with. Some cementless implants that could allow the formation of new bone on the surface of biological active substances are located. Except for osteoporosis, advanced age and advanced cementless prostheses are preferred nowadays. (Directory vice versa) after a certain period of cementless prostheses is necessary to use crutches.
Patients to walk the day after the operation, 2 days will be permitted to sit in the toilet. Average 15 days after stitches are taken and will be allowed into the bathroom. Patients with hip and knee surgery the next day from the bending and muscle strengthening exercises are initiated. To win these exercises will continue until all of hip function. Usually 6 hip function returns all week. In the presence of hip replacement patients 3-6 months after the first week of walking they can feel is pain.
Hip calcification
Move your weight to hip joint wear and tear that the joints is among the most frequent subject. In this case, medicine, osteoarthritis, and in daily use are referred to as arthritis of the hip is the most common diseases. As with all of the joints and ball and socket hip joint are covered with cartilage. Cartilaginous structures of the two bones that pain on each other with minimal friction and allow slippage.
This cartilage degradation, erosion and in places to be lost or arthritis is called osteoarthritis. As can be seen from the outside is not such a collection of lime. In a situation like this morning when the first signs in front of groin and thigh pain and discomfort is tatafında. Pain increases with activity, decreases with rest. Many of these symptoms can be in hip disease.
Untreated pain as osteoarthritis progression over the years make it impossible to walk. Progress so that the bone around the joint will develop spines. In the meantime, completely worn out cartilage, bone to bone friction in the joint will has become. Hip movements may disappear almost completely. Weakness and failure in this case consists of more muscles.
Can be seen in families with a predisposition. But the development of overweight later in life, accident, injured cartilage is more commonly seen in people.
Diagnosed by clinical examination and careful consideration of direct x-ray examinations. Tedevi your doctor will suggest to you according to your situation.
Medical (non-surgical) therapy
If you are a non-surgical treatment in early stages of osteoarthritis and can slow the progression of your disease.
Avoid using your hips more.Make regular physical activity. Especially swimming, water aerobics, cycling center maintains muscle strength and joint range of motion helps to protect.Anti-rheumatic, anti-inflammatory drugs kulanılabilir.Sleeping at night should be sufficient.If you have more weight should be evaluatedIt is recommended to use a cane.Surgical Treatment
Develop osteoarthritis at an early age is really a difficult problem in terms of surgery. Hip arthroscopy in the early stages of disease development may be slowed. Hip arthroscopy in the center of the world very little is being done and still in its early stages and have the ability to intervene is limited.
One of the osteotomies are pre-prosthetic surgery. Osteotomy of the head or neck of the femur bone is cut redirected. With this method, the burden of the hip joint re-arranging and / or joint surface of the solid load-bearing areas are brought. This method because of advances in total hip replacement decreased popularity, although in some cases may provide unique opportunities.
The small section of the femoral head cartilage in the hip joint space (especially traumatic ones) in the period since the cartilage transplants osteoatritin hip replacement may postpone the need for the elderly. (See Education Matters - New Approaches to Articular Cartilage Problems)
Radical treatment of hip osteoarthritis is total hip replacement.
This cartilage degradation, erosion and in places to be lost or arthritis is called osteoarthritis. As can be seen from the outside is not such a collection of lime. In a situation like this morning when the first signs in front of groin and thigh pain and discomfort is tatafında. Pain increases with activity, decreases with rest. Many of these symptoms can be in hip disease.
Untreated pain as osteoarthritis progression over the years make it impossible to walk. Progress so that the bone around the joint will develop spines. In the meantime, completely worn out cartilage, bone to bone friction in the joint will has become. Hip movements may disappear almost completely. Weakness and failure in this case consists of more muscles.
Can be seen in families with a predisposition. But the development of overweight later in life, accident, injured cartilage is more commonly seen in people.
Diagnosed by clinical examination and careful consideration of direct x-ray examinations. Tedevi your doctor will suggest to you according to your situation.
Medical (non-surgical) therapy
If you are a non-surgical treatment in early stages of osteoarthritis and can slow the progression of your disease.
Avoid using your hips more.Make regular physical activity. Especially swimming, water aerobics, cycling center maintains muscle strength and joint range of motion helps to protect.Anti-rheumatic, anti-inflammatory drugs kulanılabilir.Sleeping at night should be sufficient.If you have more weight should be evaluatedIt is recommended to use a cane.Surgical Treatment
Develop osteoarthritis at an early age is really a difficult problem in terms of surgery. Hip arthroscopy in the early stages of disease development may be slowed. Hip arthroscopy in the center of the world very little is being done and still in its early stages and have the ability to intervene is limited.
One of the osteotomies are pre-prosthetic surgery. Osteotomy of the head or neck of the femur bone is cut redirected. With this method, the burden of the hip joint re-arranging and / or joint surface of the solid load-bearing areas are brought. This method because of advances in total hip replacement decreased popularity, although in some cases may provide unique opportunities.
The small section of the femoral head cartilage in the hip joint space (especially traumatic ones) in the period since the cartilage transplants osteoatritin hip replacement may postpone the need for the elderly. (See Education Matters - New Approaches to Articular Cartilage Problems)
Radical treatment of hip osteoarthritis is total hip replacement.
Gout disease
How gout is a disease?
"Disease of kings and king of diseases known as" gout disease, at least, is the subject of much research since the time of Hippocrates and is known to affect many people.
Gut, some joint pain, tenderness, redness, swelling and growing as a sudden increase in temperature, is a disease that presents with severe attacks. A joint is usually affected at a time and this joint is often as big toe joint. Knees, elbows and other joints like the wrist may also be affected. Attacks and the first attack usually occurs at a very fast during the night. It is the most painful in all types of rheumatism. Attacks may occur for the following reasons:
Too much alcohol intake
Very strict dieting and fastingMore of certain foods to be eatenReview operations (such as tooth extraction can cause even a simple attempt)Sudden, severe illness ofExtreme fatigue and worry for any reasonJoint trauma, injuryOf chemotherapyTaking diuretic drugs(Diuretics are used in high blood pressure, body fluid that provides breakthrough drugs)
Do not forget!If you are a patient and a small gout injury after trauma and healing of the joint if you expected much pain lasts longer, it might be an attack of gout.Disturb your body system which can initiate any incident gout attacks. The early findings of an acute attack of alert you, because the sooner treatment begins the more useful If.
What is the cause of gout?
Excess uric acid in our body is made up of gout. Uric acid in the blood of healthy persons as a result of various chemical processes is included as a degradation product. However, more stability of uric acid or excess production of uric acid, or less than the rate of kidney or in the body of the purines into uric acid taken in excess can be caused by certain foods. Meat, seafood and legumes are rich in purine. Alcoholic beverages also significantly increase uric acid levels. Gout is caused due to eating and drinking more than the view is not correct. Ingestion of certain foods or too much weight to be taken in patients with gout attacks may occur more frequently.
Review of the chemical processes in the body of uric acid problems may be inherited in families or as a complication of another disease can occur. This issue to the person of the mother-father, grandfather or grandmother-switches. But environmental factors may also play a role. In addition, each individual family will not see gout attacks.
Over time, uric acid in the blood leads to accumulation of excess around the joints. As a result, needle-like uric acid crystals in joints that creates conditions that can cause gout attacks. These crystals do not occur only in joints. Uric acid at the same time under the skin, ear and urinary tract as kidney stones in the tofüs as may be encountered. Tofüs small, white like a pimple.
What are the risks in the long term?
The first gout attacks do not cause permanent damage to joints and the joints will remain completely normal. In a joint gout attacks, but a continuous manner if exposed to it - this is very rare now as a result of the treatment - then add crystals of uric acid damage and may develop chronic arthritis. In mild cases the attacks are very rare, and attacks between the time periods measured in years, enters and does not develop any permanent damage.
Gout obesity, hypertension, hyperlipidemia and diabetes is closely associated with the disease. Left untreated, gout, kidney stones may occur.
How is the diagnosis of gout?
Various rheumatic diseases and treatment for gout attacks can mimic the disease was confined to the gout is crucial for the correct diagnosis. It is useful for diagnosis, medical history and physical examination.
Your doctor may want yapımasını of the following research:
Blood test. The amount of uric acid in the blood are measured. However, these results may be misleading. Because the amount of uric acid in gout patients with normal or even low levels can be in. But also in healthy people, especially in the high level of fat can be determined.Examination of synovial fluid. In joint synovial fluid can be captured by your doctor with a syringe and urate crystals under a microscope to investigate whether there is. If these crystals are detected, the diagnosis of gout is confirmed. This test is not typical, especially in gout is very useful starts. For example, rheumatoid arthritis, gout, such as sometimes it can mimic other rheumatic diseases.Direct radiographs of joints (radiograph) withdrawal. If your doctor or your joint radiography results are normal and usually helpful in diagnosis, but it happens.
Do not forget!Recurrent attacks of gout and arthritis, can cause damage to your joints. Modern treatment methods may prevent the development of arthritis.
How is gout treated?
DietDrugs: colchicine, corticosteroids, nonsteroidal anti-inflammatory drugs, probenecid, sülfinpirazonSurgery (very rare)Acute attacks of gout are treated with anti-inflammatory analgesic drugs. These drugs reduce pain and inflammation will decline. Short-term use of these drugs have to hand in gout is usually not cause significant side effects and are well tolerated. However, sometimes indigestion, stomach pain, nausea, rash, headache may develop. Asthma patients should also be careful when using this drug. Necessarily people who had previously ulcers should alert their doctor about it, so your doctor may lead to treatment is not harmful. Drugs, including aspirin and aspirin must be avoided during acute attacks.
Other drugs used in treatment of acute FMF attacks. Colchicine is very effective but often nausea, vomiting and diarrhea can lead to the development. The use of this drug by injecting görülümünü reduce these side effects. If you see fit to give your doctor colchicine, your pain until it developed side effects such as diarrhea or until it will offer two hours to take your medicine.
At the start of symptoms to get more drugs will be effective immediately. Therefore, your doctor will recommend medications, and attacks occurring at home to keep them until you get to see your doctor is helpful.
Your doctor's recommendations carefully and fully comply very quickly and successfully as gout attack can be brought under control. Toe protection is required, such as joint pain. Such as lattice structure, thus placing the joint of the foot of the blanket, blanket protection of such weight would be helpful.
Recommended for acute episodes of blood uric acid levels on the drugs had no effect. In other words, these drugs had new episodes to prevent the accumulation of uric acid in the joints or not. So if your attack tightens tofüs / or blood tests if kidney stones develop high levels of uric acid is found as, blood, your doctor may recommend medications to reduce uric acid levels. A decision to be taken in this direction, whether or not your attack requires you to take medication every day. Used as a preventative treatment for this purpose there are various medications. Examples of uric acid in the body that blocks the formation of allopurinol and probenecid may be given which allows renal excretion of uric acid. Depending on the amount of uric acid in your urine, it will choose between two types of drugs. With proper treatment, almost all cases of gout can be well under control.
Do not forget!Preventive treatment lasts a lifetime.You should get plenty of fluids.Development of preventive treatment if attacks are made, please make attacks treated separately.
DietIt was believed that much more important than the diet used, but there are effective treatments for patients with gout after what they want to eat a lot and started drinking. Cells in certain foods and uric acid concentration is greater because the cell destruction caused by the liver, kidneys, such as the consumption of offal is not appropriate. Protein containing food (particularly meat) should be eaten in moderation, these foods are consumed in certain amounts already not only for gout patients, are useful for everyone. If you have excess weight, you lose weight not only in lowering blood urate levels will be beneficial for your heart. However, strict dieting and fasting also can trigger attacks.
AlcoholTaking excessive amounts of alcoholic beverages is not the cause of gout, but it can trigger an attack. What to drink beverages, which should not be on the inside, there are many rumors, do not take them seriously. Patients with certain types of alcoholic beverages, but sometimes one has successfully claim that the attacks began. In this case, the patient is not recommended in those types of drinks.
SOME QUESTIONS and answers
Do women will get gout?
Mainly in terms of gout in men over age 40 are at risk, but the affection of all ages may apply. Very rarely, in older women after menopause may develop gout. Especially high blood pressure or heart disease can be recommended for the treatment of diuretic use in women can be seen. Storage of these drugs can cause uric acid in the body. Development of gout in young women is very rare and in this case requires special investigations.
Does gout causes severe joint disease?
In case of treatment can only be done. Attacks are acute in the beginning, the joint returns to normal status. However, the deposition of uric acid can lead to deformity and disability. Good side, this situation is preventable with proper treatment.
Is uric acid stored elsewhere joints?
Under the skin in other areas, for example, can be stored in the ears and hands on. In addition, the kidneys can be stored in our internal organs. Therefore, when evaluating a patient with gout kidney tests are needed to look at. For this, you may also need to give a urine sample.
Uric acid-lowering drugs can be harmful in the long term be?
These drugs are very reliable. Skin rash or heartburn because sometimes these drugs may need to be cut. But apart from that nothing can be taken continuously without side effects.
Uric acid crystals can cause joint disease types Is there any other?
A special type of calcium, such as uric acid crystals in the joints can be stored. Acute gout attacks may occur similar to, but in this case, rather than the knee joint is affected toe.
Gout prevalence varies from country to country?
Some races have high uric acid levels (for example, Pacific countries) are, of course, these people are more likely to gout. Rates of developing gout, even in the same country at different times may differ. For example, when the Second World War because of hunger and living conditions are very difficult period of the common representation in the European countries has decreased.
"Disease of kings and king of diseases known as" gout disease, at least, is the subject of much research since the time of Hippocrates and is known to affect many people.
Gut, some joint pain, tenderness, redness, swelling and growing as a sudden increase in temperature, is a disease that presents with severe attacks. A joint is usually affected at a time and this joint is often as big toe joint. Knees, elbows and other joints like the wrist may also be affected. Attacks and the first attack usually occurs at a very fast during the night. It is the most painful in all types of rheumatism. Attacks may occur for the following reasons:
Too much alcohol intake
Very strict dieting and fastingMore of certain foods to be eatenReview operations (such as tooth extraction can cause even a simple attempt)Sudden, severe illness ofExtreme fatigue and worry for any reasonJoint trauma, injuryOf chemotherapyTaking diuretic drugs(Diuretics are used in high blood pressure, body fluid that provides breakthrough drugs)
Do not forget!If you are a patient and a small gout injury after trauma and healing of the joint if you expected much pain lasts longer, it might be an attack of gout.Disturb your body system which can initiate any incident gout attacks. The early findings of an acute attack of alert you, because the sooner treatment begins the more useful If.
What is the cause of gout?
Excess uric acid in our body is made up of gout. Uric acid in the blood of healthy persons as a result of various chemical processes is included as a degradation product. However, more stability of uric acid or excess production of uric acid, or less than the rate of kidney or in the body of the purines into uric acid taken in excess can be caused by certain foods. Meat, seafood and legumes are rich in purine. Alcoholic beverages also significantly increase uric acid levels. Gout is caused due to eating and drinking more than the view is not correct. Ingestion of certain foods or too much weight to be taken in patients with gout attacks may occur more frequently.
Review of the chemical processes in the body of uric acid problems may be inherited in families or as a complication of another disease can occur. This issue to the person of the mother-father, grandfather or grandmother-switches. But environmental factors may also play a role. In addition, each individual family will not see gout attacks.
Over time, uric acid in the blood leads to accumulation of excess around the joints. As a result, needle-like uric acid crystals in joints that creates conditions that can cause gout attacks. These crystals do not occur only in joints. Uric acid at the same time under the skin, ear and urinary tract as kidney stones in the tofüs as may be encountered. Tofüs small, white like a pimple.
What are the risks in the long term?
The first gout attacks do not cause permanent damage to joints and the joints will remain completely normal. In a joint gout attacks, but a continuous manner if exposed to it - this is very rare now as a result of the treatment - then add crystals of uric acid damage and may develop chronic arthritis. In mild cases the attacks are very rare, and attacks between the time periods measured in years, enters and does not develop any permanent damage.
Gout obesity, hypertension, hyperlipidemia and diabetes is closely associated with the disease. Left untreated, gout, kidney stones may occur.
How is the diagnosis of gout?
Various rheumatic diseases and treatment for gout attacks can mimic the disease was confined to the gout is crucial for the correct diagnosis. It is useful for diagnosis, medical history and physical examination.
Your doctor may want yapımasını of the following research:
Blood test. The amount of uric acid in the blood are measured. However, these results may be misleading. Because the amount of uric acid in gout patients with normal or even low levels can be in. But also in healthy people, especially in the high level of fat can be determined.Examination of synovial fluid. In joint synovial fluid can be captured by your doctor with a syringe and urate crystals under a microscope to investigate whether there is. If these crystals are detected, the diagnosis of gout is confirmed. This test is not typical, especially in gout is very useful starts. For example, rheumatoid arthritis, gout, such as sometimes it can mimic other rheumatic diseases.Direct radiographs of joints (radiograph) withdrawal. If your doctor or your joint radiography results are normal and usually helpful in diagnosis, but it happens.
Do not forget!Recurrent attacks of gout and arthritis, can cause damage to your joints. Modern treatment methods may prevent the development of arthritis.
How is gout treated?
DietDrugs: colchicine, corticosteroids, nonsteroidal anti-inflammatory drugs, probenecid, sülfinpirazonSurgery (very rare)Acute attacks of gout are treated with anti-inflammatory analgesic drugs. These drugs reduce pain and inflammation will decline. Short-term use of these drugs have to hand in gout is usually not cause significant side effects and are well tolerated. However, sometimes indigestion, stomach pain, nausea, rash, headache may develop. Asthma patients should also be careful when using this drug. Necessarily people who had previously ulcers should alert their doctor about it, so your doctor may lead to treatment is not harmful. Drugs, including aspirin and aspirin must be avoided during acute attacks.
Other drugs used in treatment of acute FMF attacks. Colchicine is very effective but often nausea, vomiting and diarrhea can lead to the development. The use of this drug by injecting görülümünü reduce these side effects. If you see fit to give your doctor colchicine, your pain until it developed side effects such as diarrhea or until it will offer two hours to take your medicine.
At the start of symptoms to get more drugs will be effective immediately. Therefore, your doctor will recommend medications, and attacks occurring at home to keep them until you get to see your doctor is helpful.
Your doctor's recommendations carefully and fully comply very quickly and successfully as gout attack can be brought under control. Toe protection is required, such as joint pain. Such as lattice structure, thus placing the joint of the foot of the blanket, blanket protection of such weight would be helpful.
Recommended for acute episodes of blood uric acid levels on the drugs had no effect. In other words, these drugs had new episodes to prevent the accumulation of uric acid in the joints or not. So if your attack tightens tofüs / or blood tests if kidney stones develop high levels of uric acid is found as, blood, your doctor may recommend medications to reduce uric acid levels. A decision to be taken in this direction, whether or not your attack requires you to take medication every day. Used as a preventative treatment for this purpose there are various medications. Examples of uric acid in the body that blocks the formation of allopurinol and probenecid may be given which allows renal excretion of uric acid. Depending on the amount of uric acid in your urine, it will choose between two types of drugs. With proper treatment, almost all cases of gout can be well under control.
Do not forget!Preventive treatment lasts a lifetime.You should get plenty of fluids.Development of preventive treatment if attacks are made, please make attacks treated separately.
DietIt was believed that much more important than the diet used, but there are effective treatments for patients with gout after what they want to eat a lot and started drinking. Cells in certain foods and uric acid concentration is greater because the cell destruction caused by the liver, kidneys, such as the consumption of offal is not appropriate. Protein containing food (particularly meat) should be eaten in moderation, these foods are consumed in certain amounts already not only for gout patients, are useful for everyone. If you have excess weight, you lose weight not only in lowering blood urate levels will be beneficial for your heart. However, strict dieting and fasting also can trigger attacks.
AlcoholTaking excessive amounts of alcoholic beverages is not the cause of gout, but it can trigger an attack. What to drink beverages, which should not be on the inside, there are many rumors, do not take them seriously. Patients with certain types of alcoholic beverages, but sometimes one has successfully claim that the attacks began. In this case, the patient is not recommended in those types of drinks.
SOME QUESTIONS and answers
Do women will get gout?
Mainly in terms of gout in men over age 40 are at risk, but the affection of all ages may apply. Very rarely, in older women after menopause may develop gout. Especially high blood pressure or heart disease can be recommended for the treatment of diuretic use in women can be seen. Storage of these drugs can cause uric acid in the body. Development of gout in young women is very rare and in this case requires special investigations.
Does gout causes severe joint disease?
In case of treatment can only be done. Attacks are acute in the beginning, the joint returns to normal status. However, the deposition of uric acid can lead to deformity and disability. Good side, this situation is preventable with proper treatment.
Is uric acid stored elsewhere joints?
Under the skin in other areas, for example, can be stored in the ears and hands on. In addition, the kidneys can be stored in our internal organs. Therefore, when evaluating a patient with gout kidney tests are needed to look at. For this, you may also need to give a urine sample.
Uric acid-lowering drugs can be harmful in the long term be?
These drugs are very reliable. Skin rash or heartburn because sometimes these drugs may need to be cut. But apart from that nothing can be taken continuously without side effects.
Uric acid crystals can cause joint disease types Is there any other?
A special type of calcium, such as uric acid crystals in the joints can be stored. Acute gout attacks may occur similar to, but in this case, rather than the knee joint is affected toe.
Gout prevalence varies from country to country?
Some races have high uric acid levels (for example, Pacific countries) are, of course, these people are more likely to gout. Rates of developing gout, even in the same country at different times may differ. For example, when the Second World War because of hunger and living conditions are very difficult period of the common representation in the European countries has decreased.
How is fibromyalgia treated?
Fibromyalgia patients;1. Reduce pain and sleep medication for editing2. Muscle stretching and cardiovascular exercises to increase compliance3. Relaxation exercises to reduce muscle spasms4. To understand the disease and is useful training programs to help cope.
In some patients with very mild and treatment of fibromyalgia only to be told of the disease and may even help to resolve concerns. However, most patients will require a comprehensive treatment program planning.
drug therapy: Rheumatic diseases in the treatment of pain in fibromyalgia very often non-steroidal anti-inflammatory drugs have no place. Instead, to achieve deep sleep and to relax muscles and is more useful for pharmaceutical treatment. Most of these drugs are used to treat depression. However, the doses used in the treatment of depression in fibromyalgia is much lower than it should. Continued during the day drowsiness, constipation, dry mouth, these drugs can have side effects, such as doctors always have to be used in the control.
Physical therapy and exercise therapy: treatment of fibromyalgia is the second main objective to tense and painful muscles and cardiovascular adjustment to increase. Almost all patients can benefit from applications of heat. Most patients improve endurance, exercise program to reduce pain and aerobic exercise such as swimming and walking-cycling is greater than the benefit. However, the type of physical therapy and exercise therapy, duration, dosage, can vary from patient to patient in the control to make sure the physician is recommended.
When diagnosed patients and their relatives who need to know, although the fibromyalgia syndrome, other inflammatory rheumatic fever, such as life-threatening, injury to an illness, though pain and fatigue due impairs quality of life could work force that can be a real disease is that.
In some patients with very mild and treatment of fibromyalgia only to be told of the disease and may even help to resolve concerns. However, most patients will require a comprehensive treatment program planning.
drug therapy: Rheumatic diseases in the treatment of pain in fibromyalgia very often non-steroidal anti-inflammatory drugs have no place. Instead, to achieve deep sleep and to relax muscles and is more useful for pharmaceutical treatment. Most of these drugs are used to treat depression. However, the doses used in the treatment of depression in fibromyalgia is much lower than it should. Continued during the day drowsiness, constipation, dry mouth, these drugs can have side effects, such as doctors always have to be used in the control.
Physical therapy and exercise therapy: treatment of fibromyalgia is the second main objective to tense and painful muscles and cardiovascular adjustment to increase. Almost all patients can benefit from applications of heat. Most patients improve endurance, exercise program to reduce pain and aerobic exercise such as swimming and walking-cycling is greater than the benefit. However, the type of physical therapy and exercise therapy, duration, dosage, can vary from patient to patient in the control to make sure the physician is recommended.
When diagnosed patients and their relatives who need to know, although the fibromyalgia syndrome, other inflammatory rheumatic fever, such as life-threatening, injury to an illness, though pain and fatigue due impairs quality of life could work force that can be a real disease is that.
Gonorrhea and chlamydia
Gonorrhea and chlamydia
Gonorrhea and chlamydia:
Early symptoms of this disease are the same are often infected from sexual contact. Often the same person is both gonorrhea and chlamydia. Both should be treated so often
This disease can spread to other males
Gonorrhea and chlamydia:
Early symptoms of this disease are the same are often infected from sexual contact. Often the same person is both gonorrhea and chlamydia. Both should be treated so often
This disease can spread to other males
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