Stiff Person Syndrome (SPS) is a rare neurological disease characterized by symptoms similar to that of autoimmune disorders. Read and know more about the causes, symptoms, diagnosis and treatment of the disease.

What is Stiff Person Syndrome?

It is a nervous system disorder that results in stiffness, rigidity and spasms. It is common in both males and females and can occur at any age. However, it is rarely reported in childhood.

This condition is also known as:

• Stiffperson’s Syndrome
• Stiff-man Syndrome
• Moersch-Woltmann Syndrome

Types of Stiff Person Syndrome

The disorder is classified into two different forms:

• Stiff Baby Syndrome
• Stiff Limb Syndrome

Causes of Stiff Person Syndrome

The specific cause of this syndrome has not been established as yet. However, the following factors have been associated with increased possibilities of its occurrence:

Picture 1 – Stiff Person Syndrome

Presence of antibodies

The presence of Anti‐glutamic acid decarboxylase (GAD) antibodies has also been associated with this syndrome. These antibodies are found to be present in about 60% of the people diagnosed with the condition.

GLRA1

Another cause of SPS is mutation of GLRA1 (Glycine Receptor).

Cancerous conditions

In a few cases, the disorder has also been reported to occur in people suffering from malignant conditions like Breast cancer and Lymphoma.

Autoimmune Disorders

It is also associated with some autoimmune disorders like anemia, diabetes, vitiligo and throiditis.

Symptoms of Stiff Person Syndrome

SPS occurs in three stages –

Early Stage

In the initial stage, pain and stiffness is limited to the back. The development of sleep disorders is another typical sign of SPS arising in this phase.

Late Stage

In this stage, the pain moves further towards the proximal limb muscle. Patients experience extreme pain due to spasms during walking.

End Stage

In this final phase, patients face difficulties in performing even basic functions like eating and moving. Moreover, fractures and muscle ruptures also occur at this stage.

Some of the common signs and symptoms of SPS are:

1)    Stiffness and back pain, which occurs as a result of stiffness of the trunk muscles

2)    Spasms in muscles all over the arms and legs of patients

3)    Difficulties while walking or moving, which might lead to falls during movement

Exaggerated upright posture and stiff-legged walk are other common problems associated with this disorder. Hypertonia, hyperreflexia and rigidity of muscles are also noticed in most affected people.

Diagnosis of Stiff Person Syndrome

Various tests are available for the diagnosis of this syndrome. Proper diagnosis is necessary as some symptoms of SPS are identical to those of psychological disorders like Parkinson’s disease, Fibromyalgia or Multiple Sclerosis. Doctors generally suggest these diagnostic tests only if they note the above mentioned signs and symptoms in a patient.

Picture 2 – Stiff Person Syndrome Image

The diagnosis of SPS is mainly concerned with the conformation of anti-GAD antibodies. However, it must be noted that no anti-GAD antibodies have been found in 40% of the affected people. Some other tests performed include the hemoglobin A1C for diabetes, Muscle testing (EMG) or thyroid-stimulating hormone (TSH) for Thyroiditis.

Treatment of Stiff Person Syndrome

There is no permanent cure for this disorder. The treatment is, thus, mainly aimed at controlling the associated symptoms of SPS. Curative options involve:

Medications

Drugs like azathioprine, gabapentin, baclofen and tiagabine are typically administered to SPS patients. Most of these drugs are Benzodiazepines which work by increasing the GABA action. These drugs are also noticed to become ineffective after continuous use.

Immunoglobulin

Intravenous immunoglobulin has also showed good performance in reliving the symptoms.

Corticosteroids

In some patients, corticosteroids are also used. However, these drugs should be avoided in people suffering from diabetes.

Physical therapy

Physical therapy is also helpful in reducing the muscular problems associated with the syndrome.

Therapeutic exercises

In many cases, therapeutic exercises are also recommended by doctors. These help in fighting against muscle stiffness and spasms.

A lot of research is being done on understanding the mechanism of the disease and finding better treatment approaches for it. Most early cases of the disorder can be treated successfully in an outpatient environment. However, later cases have to be treated by a more serious approach to prevent complications. If any of your family members is exhibiting SPS symptoms, get in touch with a doctor for timely diagnosis and treatment.

References:

http://www.medicinenet.com/stiff-person_syndrome/article.htm

http://en.wikipedia.org/wiki/Stiff_person_syndrome

http://rarediseases.about.com/od/rarediseasess/a/stiffperson.htm

http://www.uptodate.com/contents/stiff-person-syndrome

Phyllodes tumor is a rare, malignant growth of the breast cancer that develops rapidly. Read further to know more about the causes, symptoms, diagnosis and treatment of this cancerous condition.

What is Phyllodes Tumor?

It is a rare tumor which arises in the connective tissue of the breast instead of the epithelial tissue. Thus, it is also referred to as “Sarcoma”. It is also known by other names like:

• Phylloides tumor
• Cystosarcoma phyllodes
• Cystosarscoma phylloides
• Giant Fibroadenomas

This breast lump can be either malignant or benign. It is an extremely rare tumor and is believed to account for 1% of all breast cancers.

Causes of Phyllodes Tumor

There are various possible causes behind the occurrence of this tumor, such as:

Picture 1 – Phyllodes tumor

• Family history
• Early menarche
• Late menopause
• Problems with hormone therapy

Research also suggests that women who become mother at an older age are more prone to this tumor. For instance, a woman becoming mother after the age of 30 is twice more susceptible than one who gives birth at the age of 25.

Symptoms of Phyllodes Tumor

The common symptoms of this condition are:

Large breast lumps

The condition is primarily characterized by the formation of large masses on the periductal stromal cells of the breast. Initially, the lump is not painful. However, patients may experience pain in the later stages as the tumor grows in size.

Redness of breast

In some patients, the skin on the affected region of the breast turns red in color.

Rapid growth of tumor

Fast growth of this tumor is another notable characteristic of this condition. On an average, this type of tumor is found to grow larger by about 2-3 cm in a span of few weeks.

Development of ulcers or wounds

In extreme cases, an ulcer or wound may develop near the affected area.

It is noteworthy that these tumors mainly occurin menopausal women. In adolescent girls, a similar disorder, Fibroadenoma, is more common.

Stages of Phyllodes Tumor

Generally, all breast cancers are classified in four stages, from stage1-4. In case of Phyllodes growths, however, the classification is entirely different. Based on whether or not they are cancerous, these growths are distinguished into:

• Benign phyllodes tumor – It is a harmless condition.
• Malignant phyllodes tumor – As the name implies, it is a cancerous condition.

The lumps are distinguished on the basis of certain features like appearance, growth of stromal cells and the presence of epithelial cells.

Diagnosis of Phyllodes Tumor

These lumps are generally confused with Fibroadenomas, which makes their diagnosis a bit complicated. Tests like Mammogram and Breast ultrasound are not helpful either in differentiating these growths. Even the needle biopsy technique is useless as it gives ineffective sample cells. It requires a surgical biopsy to get a good sample for cells that can help in the diagnosis.

Picture 2 – Phyllodes tumor Image

The various tests involved in the diagnosis of this abnormal mass are:

Physical examination of the breast

This involves detection of the lump in the breast. You can either self examine the breast by standing before a mirror or take the help of your doctor for the physical examination.

Mammogram

This test helps determine the exact location of a tumor and provides X-ray images of the breast. This tumor is manifested by some typical features, such as calcifications or development of a round mass with edges.

Ultrasound and MRI

This technique is employed to obtain sound wave images of the breast. MRI also provides further details about the tumor that helps in the surgical process.

Biopsy

This technique is used to take out sample cells from the affected part of the breast. There are two types of this process – Core Needle Biopsy and Excisional Biopsy. In Core Needle Biopsy, a needle is used to take the sample cells while in Excisional biopsy the entire tumor is removed. The sample tissue is examined for the confirmation of Phyllodes tumor. The tumor can be either benign or malignant. Each type has its unique traits. Benign tumors have distinct edges, contain epithelial cells and have stromal cells with a normal appearance. Malignant tumors, on the other hand, have edges that are not distinct. The stromal cells in these growths have an abnormal appearance. The epithelial cells, in these cancerous lumps, may be less or absent due to overgrowth of stromal cells.

Treatment of Phyllodes Tumor

The use of drugs is not much beneficial in the treatment of this type of tumor. Moreover, the effects of radiation and hormonal therapy are also limited. In case the tumor is in the benign stage, it can be removed by Lumpectomy. If the tumor is malignant, however, treatment involves use of Mastectomy. Wide local excision is another common method to treat malignant tumor.

If you suspect an abnormal lump in your breast, get in touch with your family physician on an immediate basis. Early diagnosis and treatment will help you avoid worsening of the condition and have it cured in the very early stages. With proper treatment, you can get back to health within a short time.

References:

http://en.wikipedia.org/wiki/Phyllodes_tumor

http://www.breastcancer.org/symptoms/types/phyllodes/diagnosis.jsp

http://phyllodestumor.net/

http://breastcancer.about.com/od/types/p/phyllodes_sa.htm

http://www.hopkinsmedicine.org/avon_foundation_breast_center/breast_cancers_other_conditions/phyllodes_tumors.html

Are you undergoing frequent anxiety pangs or unintentional weight loss of late? If yes, you are most probably suffering from Hashitoxicosis. Read and know more about this rare condition, including its incidence, symptoms, causes, diagnosis and treatment.

Hashitoxicosis Definition

It is a condition of the thyroid gland where affected individuals display frequent episodes of hyperthyroidism. This hyperthyroid phase is usually transient. It is generally considered to be an autoimmune condition where the thyroid gland produces increased amount of thyroid hormone. Inflammation of the thyroid gland is abrupt during this condition.

Hashitoxicosis Incidence

Picture 1 – Hashitoxicosis

It commonly affects the middle-aged population, especially women who are undergoing menopause. It may also affect children between 3 to 12 years of age.

Hashitoxicosis Symptoms

Some of the main signs and symptoms of this condition are:

Anxiety

Patients may have an unusual feeling of nervousness and restlessness, which is a very common symptom observed during this condition. They may also suffer from irritability and depression.

Panic Disorder

It is a type of anxiety disorder where patients may undergo sudden attacks of intense fear and always have a sense of some terrible event that they feel may occur soon.

Mania

It is manifested by elevated mood or energy levels. Individuals suffering from this disorder may become excited and behave in an abnormal manner.

Hyperactivity

Patients tend to be abnormally active during the transient phase of hyperthyroidism.

Weight Loss

High thyroid hormone levels in the body increase the rate at which food is metabolized, causing unintended weight loss despite increased appetite.

Weakness

Increased levels of thyroid hormone in the body may lead to chronic tiredness and listlessness.

Intolerance to heat

Hyperthyroidism can lead to increased or profuse sweating in affected people, typically accompanied by unusual heat intolerance. Patients may feel hot and sweat even during cold conditions.

Menstrual Irregularities

Women with this inflammatory thyroid condition may suffer from irregular menstrual periods and vaginal bleeding.

Mood swings

Affected patients may easily get agitated and feel stressed and impatient.

Insomnia

Hyperthyroidism can cause sleeplessness in some patients.

Tremors

Mild muscular tremors, especially in the hands and tongue, are quite apparent in affected patients.

Palpitations

Accelerated heart or pulse rate under normal conditions may occur due to shortness of breath.

Lightheadedness

It is an unpleasant sensation of dizziness that is recurrent in patients with elevated levels of thyroid hormone.

Nausea

Acute discomfort in the abdominal region generates an involuntary urge to vomit in patients.

Diarrhea

Higher levels of thyroid hormone in the body may result in Diarrhea in certain patients. Frequent bowel movements, along with abdominal cramping, may also lead to reduced appetite.

Visual distortion

During hyperthyroid phase, certain patients may complain of eye irritation or blurred vision. They may exhibit blood shot or red eyes, accompanied by intense pain and visual problems.

Loss of libido

Low thyroid hormone levels may lead to decreased sexual libido in both men and women during this condition. Such patients may have little or no interest in sexual activities.

Photophobia

In some patients, light sensitivity or intolerance may develop. Such people may suffer from extreme discomfort in eye on exposure to bright lights or glare.

Noise Sensitivity

Mild irritation or intolerance towards any form of noise or sound may cause headache and annoyance in a few patients.

Patients of this disorder may experience several symptoms that change over time and may eventually develop into Permanent Hypothyroidism.

Hashitoxicosis Causes

Causes of this specific disorder are found to be nearly similar to other Hyperthyroid conditions, leading to abnormal increase in thyroid hormone levels. Some of the main causative factors of this ailment include:

Hashimoto’s Thyroiditis

It is an autoimmune disorder that causes excess secretion of Thyroid hormone and is normally associated with this hyperthyroid phase. In this condition, the body is not able to recognize the thyroid gland and attacks it by a variety of cell-antibody-mediated immune processes. Affected patients may experience phases of hyperthyroidism before the onset of hypothyroid phase. These hyperthyroidism spells are known to cause Hashitoxicosis. Medical experts believe that a certain virus or bacterium may trigger this autoimmune response. However, this theory remains unexplained as yet.

Graves’ disease

It is another autoimmune condition where the thyroid gland becomes overactive, producing excessive amount of thyroid hormones. It causes serious hormonal imbalance where thyroid autoantibodies (TSHR-Ab), activating the TSH-receptor (TSHR) is released in excess. This further stimulates thyroid hormone synthesis and secretion. It is also manifested by intense thyroid growth.

Heredity

Genetic conditions may also lead to an abnormal secretion of thyroid hormone that is unwittingly transmitted from generation to generation.

Hashitoxicosis Diagnosis

The diagnosis of this disorder normally begins with an extensive physical examination. Physicians simply observe the major symptoms of this condition such as weight loss, high pulse rate and sluggishness. This is generally followed by few diagnostic tests in order to detect the exact condition.

Hormone test

This is a simple blood test conducted to monitor the levels of thyroid hormone. Elevated hormone levels indicate abnormality in the thyroid gland.

Antibody test

This diagnostic technique can help detect whether Hashimoto’s disease is the cause of this disorder. Increased levels of antibodies, produced in blood as a reaction to enhanced thyroid secretion, confirms the presence of this disorder.

Biopsy

Hurthle cells present in the thyroid gland undergo modification due to an over-activity of the thyroid gland. During a thyroid biopsy, physicians can determine whether the thyroid cells have enlarged in size.

Hashitoxicosis Treatment

Hyperthyroidism, if left untreated for a prolonged duration, may lead to Osteoporosis in the middle-aged population. Naturally, it requires professional medical treatment. This involves use of:

Picture 2 – Hashitoxicosis Image

Medication

Lower doses of beta-blockers or anti-thyroid drugs are usually administered to affected patients for a short duration. Some patients are also given anti-anxiety medications for the treatment of anxiety disorders, such as Benzodiazepines and anti-depressants.

Thyroidectomy

It is the total or partial removal of the thyroid gland by surgical means. It is a common procedure and is generally recommended by physicians when long-term use of medications becomes ineffective. Post-surgery however, there could be several potential complications including permanent voice change or deficiency in calcium levels.

Thyroid ablation

It is a radioactive iodine treatment that is normally conducted after complete thyroidectomy to destroy any remaining thyroid tissues. In certain cases, the entire thyroid is completely excised or ablated. Ablation usually depends on the degree of severity of the condition.

Hashitoxicosis is only a temporary inflammation of the thyroid gland that does not lead to any major complications. Patients can always go back to living a normal and healthy life by undergoing appropriate treatment procedures under an experienced health expert.

References:

http://en.wikipedia.org/wiki/Hashitoxicosis

http://elaine-moore.suite101.com/hashitoxicosis-update-a121050

http://jim-lowrance.suite101.com/conditions-related-to-hashimotos-thyroiditis-a137630

Mesenteric Ischemia is a highly discomforting abdominal condition that causes stomach pain after meals. Read and find all about the various causes, symptoms and treatment of the condition.

What is Mesenteric Ischemia?

Also known as Mesenteric Artery Ischemia, it is a condition that generally affects the small as well as the large intestines. It may give rise to various serious health conditions including bowel infarction, sepsis and even death. The disease generally affects individuals aged above 60 years.

Mesenteric Ischemia Types

The condition is categorized into different types, such as:

• Mesenteric Artery Embolism
• Mesenteric Artery Thrombosis
• Mesenteric Vein Thrombosis
• Nonocclusive Mesenteric Ischemia

Mesenteric Ischemia Causes

This condition can be both chronic and acute. Chronic means the patient is suffering from the disease for very long time periods which often causes weight loss. The main cause of development of this disease is a lack of blood flow through the arteries which prevents the intestines from receiving adequate amounts of oxygen for digestion. This can occur due to:

Picture 1 – Mesenteric Ischemia

Atherosclerosis

It is one of the most common causes of this disease. It lessens the amount of blood that flows through arteries. In healthy people, the insides of the arteries are smooth and do not obstruct proper flow of blood. With age, however, a sticky substance known as “plaque” develops in the walls of the arteries. It is formed by fats and various materials that circulate in the bloodstream. Large amounts of plaque can constrict and stiffen the arteries. This can eventually lead to reduced blood flow.

Embolus

It is a type of blood clot that may act as a causative factor for this disorder. Embolus travels to the mesenteric arteries and suddenly causes a blockage in the blood flow. These clots generally develop in the heart. They are relatively common among individuals with irregular heartbeat and heart patients.

Acute Mesenteric Ischemia may arise from various serious health disorders such as shock, chronic kidney failure, heart failure and certain medications.

Mesenteric Ischemia Risk Factors

The main risk factors of this disorder are as follows:

• Aging. It is the most important risk factor of this condition as its onset occurs after the age of 60.
• High cholesterol levels
• History of smoking
• Certain medications
• Use of illegal drugs

This condition may also arise from health disorders like:

• Congestive heart failure
• Low blood pressure
• Aortic dissection, or a breakage in the inner layer of the aorta
• Occlusion and blockage of the bowel veins
• Coagulation disorders
• Rare blood vessel disorders like Arteritits and Fibromuscular Dysplasia

Mesenteric Ischemia Signs and Symptoms

The symptoms of this condition can be differentiated into three progressive phases:

Hyper Active Phase

In this stage, severe abdominal pain and bloody stools are some of the primary symptoms displayed by patients. In most cases, the disease does not progress to an advanced phase as patients generally get better after receiving treatment at this stage.

Paralytic Phase

It is the second stage of the condition. The abdominal pain spreads to a wider area and the belly gets more and more tender. This stage also reduces bowel motility, which results in abdominal bloating. In this stage, blood is not noticed in stools any more.

Shock Phase

It is the final stage of the disease in which there is leakage of fluids through the broken colon linings. This can lead to shock as well as metabolic acidosis with low blood pressure, dehydration, confusion and rapid heart rate. Patients almost always require intensive care at this stage.

Some other symptoms associated with this disorder involve:

• Abdominal pain after meals
• Nausea
• Great fear of eating as eating causes pain
• Vomiting
• Diarrhea
• Frequent and forceful bowel movements
• Abdominal tenderness
• Fever
• Flatulence
• Constipation

Mesenteric Ischemia Diet

This disease is caused by diffuse atherosclerosis occurring in the arterial tree. Individuals having heavy, fatty meals may experience severe postprandial pain. Hence, patients suffering from chronic or acute cases of this disorder should follow a diet mainly comprising of low-fat foods and plenty of fruits and vegetables. They should also take multiple light meals instead of two or three large meals.

Mesenteric Ischemia Tests and Diagnosis

It is difficult to diagnose this condition at an early stage. The tests used for diagnosing this disorder include:

Blood Tests

Blood tests are done to see if the white blood cell count is normal and to determine the level of Lactic acid.

X-Ray

X-ray plates often fail to identify any abnormalities in the intestines of the patients.

Computed Tomography or CT Scan

The CT scan helps to determine if the arteries are damaged in any way like aortic dissection. This test diagnoses Mesenteric Ischemia by creating three-dimensional images. Other abdominal organs of the patient are also tested.

Magnetic Resonance Angiogram (MRA) Scan

MRA also helps to diagnose this condition by producing 3D images of the body vessels. However, this test is used only in case of patients who have some metal implant in their bodies such as artificial hips and pacemakers.

Mesenteric Angiography

This test is used for diagnosing acute Mesenteric Ischemia at a very early stage. X-rays are used in Angiography for studying the blood vessels. The test is known as Arteriogram when used for studying the arteries. A dye is injected into the artery o be tested through a flexible, thin tube called “catheter”. The injection is generally pushed into the groin or arm of the patient. This dye makes it possible to see the blood vessels on an x-ray plate.

Doppler Ultrasound

In this test, high-frequency sound waves are used for diagnosing the syndrome. Sound waves bounce off the blood vessels and blood cells, helping medical professionals identify any abnormality in blood flow and the structure of blood vessels. Any possible obstruction in specific arteries is also determined through this test.

Mesenteric Ischemia Differential Diagnosis

Doctors must rule out presence of other conditions that might be present with this disorder, such as:

• Abdominal Angina
• Abdominal Abscess
• Appendicitis
• Biliary Colic
• Abdominal Aortic Aneurysm
• Aortic Dissection
• Biliary Obstruction
• Cholecystitis
• Boerhaave Syndrome
• Choledocholithiasis
• Gastric Volvulus
• Intestinal Perforation
• Acute Pancreatitis
• Pneumothorax
• Septic Shock
• Esophageal Rupture
• Colonic Obstruction
• Cholangitis
• Myocardial Infarction

Physicians must also differentiate the disease from Ischemic Colitis, a health disorder considered to be less serious than the Acute Mesenteric Ischemia of small intestine – which is a life-threatening condition.

Mesenteric Ischemia Treatment and Management

Both the chronic and acute cases of this disease are treated for re-opening the blocked artery and allowing proper blood flow to the intestines. If there is a threat of permanent damage to the intestines, vascular surgeons use an emergency procedure for treating the condition. Otherwise, a routine procedure is implemented.

Chronic Mesenteric Ischemia Treatment

The main aim of treatment of this condition is to restore blood flow to the intestines. Bypass surgery is often performed for unblocking clogged arteries. Angioplasty therapy and stenting can also be used for widening the narrowed arteries and curing the disease. In some rare cases, another surgical procedure known as Trans-aortic endarterectomy is also used for the purpose. It helps remove the plaque that causes the blockage of the mesenteric artery.

Acute Mesenteric Ischemia Treatment

Acute cases of the disease require emergency treatment. Due to this reason, surgeons bypass the artery blockage or repair the damaged intestinal area by removing the blood clot through a surgery. The treatment generally includes various medications that help prevent blood clot, dilate blood vessels and dissolve clots.

If an angiography is used for the diagnosis, surgeons may remove blood clots and widen the artery with angioplasty at the same time. Angioplasty uses a balloon, inflated at a catheter end, to compress the fat deposits in order to widen the artery and allow adequate flow of blood. Sometimes, a stent (spring-like metallic coil) is placed in the artery to keep it open.

Mesenteric Ischemia Complications

This disease may lead to certain complications, which include:

Picture 2 – Mesenteric Ischemia Image

Death of the intestinal tissues

The intestinal tissue may die in case the blood flow to the intestine is completely blocked. This is a life-threatening situation that needs surgery for clearing the blockage.

Narrowing or scarring of the colon

During healing process, there is development of scar tissues which block the intestines. This occurs even if the intestines have recovered from Ischemia. In these cases, the damaged intestinal portion is removed surgically.

Mesenteric Ischemia Prognosis

In chronic cases, the prognosis is good after a successful surgery. However, patients should maintain a healthy lifestyle which includes following a low-fat diet and exercising regularly. Without lifestyle modification, the condition may arise again.

The outlook of the acute Mesenteric Ischemia is generally poor as the affected intestine often dies before the surgery is performed. However, the condition can be treated successfully with early diagnosis and proper surgery.

Mesenteric Ischemia Life-Expectancy

Acute cases of this disorder constitute the most dangerous abdominal conditions to affect elderly people. Patients of chronic forms of this disease generally have a longer life expectancy compared to those suffering from the acute type.

Mesenteric Ischemia Prevention

Know about some possible ways of preventing this condition:

• Smoking is a major risk factor of the condition. Hence, one should quit smoking to avoid this disorder. Counseling, nicotine replacement products and proper medications may also help an individual give up smoking.
• Exercising for at least 30 minutes every day can also help avoid this disease.
• Maintaining a healthy weight through regular exercise is also important. Individuals with excessive bodyweight should consult their doctors to know how they can lose weight. Eating lesser amounts of calorie-rich foods may help in weight loss.
• Following a healthy lifestyle and keeping health problems like high cholesterol, high blood pressure and diabetes in check can reduce the chances of Atherosclerosis and ultimately prevent this condition.

If left untreated, this intestinal disease can lead to life-threatening complications. Timely diagnosis, proper treatment and a healthy lifestyle allow patients to live an almost normal life.

References:

http://www.mayoclinic.com/health/intestinal-ischemia/DS00459

http://emedicine.medscape.com/article/189146-treatment

http://health.nytimes.com/health/guides/disease/mesenteric-artery-ischemia/overview.html

http://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/conditions/mesenteric_ischemia.html

Facet Syndrome (FS) is a painful condition of the back that is a common problem in patients with chronic neck and backache. Read and learn all about the causes, symptoms, diagnosis and treatment of this musculoskeletal disorder.

What is Facet Syndrome?

It is a type of pain affecting the facet joints, the synovial joints that are located in pairs on both sides of the vertebrae. These joints are covered by a thick lubricating liquid known as synovial fluid and function as hinges connecting the spinal vertebrae. Each of the joints are lined by a special membrane called synovium and also enclosed within a fibrous sac known as the joint capsule. A special type of tissue, the articular cartilage, lines the bony surfaces of the facet joints. Abnormalities occurring within various anatomical parts of facet joints may give rise to pain and thereby threaten the overall stability of the spinal column. This painful condition is referred to as Facet Syndrome or Facet Joint Syndrome.

Facet Syndrome Types

The disorder is classified into several types depending upon the location of the pain.

Picture 1 – Facet Syndrome

Lumbar Facet Syndrome

Also referred to as ‘Lumbar Facet Joint Syndrome’, it is a type of pain caused by the arthritis of facet joints in the lower back or lumbar region of the spinal cord. The pain may even stretch to the buttock as well as the upper thigh regions.

Cervical Facet Syndrome

It is characterized by the structural weakening of the vertebrae joints that are located in the cervical section of the spine around the neck. It is also known as Cervical Facet Joint Syndrome or Cervical Facet Disease. This form of osteoarthritis most frequently occurs later in life. It can cause significantly high chronic pains if ignored or left untreated.

Thoracic Facet Syndrome

It is a degenerative spinal condition which causes significant back pain as well as other health problems if left untreated. It is also called Thoracic Facet Disease. A vital responsibility of the thoracic spine vertebrae is to provide support to the ribcage. Just as the lumbar and cervical segments are meant to provide flexibility, the thoracic spine is aptly structured for providing stability. Over time, the cartilage coating on the facet joint fades away which results in arthritic pain due to bone-on-bone contact and facilitates growth of osteophytes.

Lumbosacral Facet Syndrome

It is a debilitative spinal condition that affects the lower back and the pelvis regions. If left untreated, it can lead to acute pain around the lower half of the body. Due to the flexibility and smoothness of the spine section as well as the pressure of supporting most of the body weight, Lumbosacral Facet Syndrome is quite common.

Posterior Facet Syndrome

Also referred to as Posterior Facet Disease, it is a detrimental condition of the spine which causes chronic neck and back pain. This syndrome is mostly associated with aging and is generally experienced much later in life, only after several years of wear and tear have taken its toll on spinal column.

Facet Syndrome Symptoms

It is rather difficult to exactly pinpoint the symptoms of FS due to their high similarity with effects of other major spinal conditions. The most prominent symptoms of FS or spinal arthritis include wearing away of the smooth cartilaginous lining of spinal joints. This leads to friction between the vertebral bones that can give rise to bone spurs. The lower back or lumbar and the neck or cervical areas of the spine are most susceptible to this type of bone erosion, these being the most flexible regions of the spine and enduring the maximum stress over the lifetime of a person.

Some of the other notable signs and symptoms of FS include:

• Sporadic pains
• Headaches
• A dull, deep ache
• Inflammation of the facet joints
• Difficulty in turning the neck or twisting the lower back region
• Difficulty in leaning forward
• Tenderness near the inflamed joints
• Stiffness in the neck and lower back regions after getting up in the morning

Damage or deterioration of the facet joints, due to age or any other reason, can result in acute pain. The cervical and lumbar regions are most vulnerable to this condition. FS symptoms are experienced in varying extremities, depending on the areas that are affected.

Facet Syndrome Causes

Injuries or age-related changes in the bone structure leads to swelling of bones or erosion of the cartilaginous covering of facet joints. This results in increased friction within joint space and consequently, development of painful symptoms. A degenerative disc disease may lead to reduced disc height and cause stress within the facets on the same levels. This can ultimately lead to FS.

The symptoms of FS may be produced due to age-related deterioration of cartilage that exposes small nerves lying within the joints. FS symptoms may also arise due to the formation of osteophytes or bone spurs, which are a form of bony projections developed by reduced stability of joints. In most cases, these bone spurs remain asymptomatic. However, they can also grow big enough to irritate the nearby nerve roots. This can weaken the muscles, thereby causing pain, tingling sensation and numbness.

Facet Syndrome Prevention

FS cannot be prevented under normal conditions as it occurs as a natural consequence of aging. However, even though a patient cannot prevent the predominant causes of the disorder, he or she can definitely keep his or her spine healthy by following certain regulations and avoid development of degenerative spine conditions in this way. The health of spine may also be safeguarded in the following ways:

• Maintaining a proper body weight
• Eating the right kinds of food
• Exercising regularly
• Avoidance of smoking
• Following other general healthcare tips

An FS patient may also try some gentle stretching, hot and cold therapy, physical therapy and appropriate pain-relieving medications (analgesics) to mitigate the symptoms of the disease in an effective manner. One may also try some alternate treatment methods such as yoga, acupuncture, Pilates and massage therapy to relieve the pain and keep the negative effects of FS under control.

Facet Syndrome Diagnosis

The diagnosis of FS is done only after a thorough physical examination as well as a careful study and analysis of the medical history of a patient. Additional tests and examinations may be used for ruling out the possibilities of other disorders such as a herniated or fractured disc as the source of pain. Such tests include:

• X-Ray
• CT (Computed Tomography) scans of the spine
• MRI (magnetic resonance imaging) scans

The medial branch block exam is regarded as the best diagnostic test for FS. It is conducted under the influence of X-Ray by injecting an anesthetic medicine into or close to the nerves which are connected to the facet joint. If the pain decreases considerably after a numbing medication is implemented, the patient is confirmed to be suffering from FS. If the injection does not reduce the pain, it is improbable that the facet joints are a cause for the pain in the level in which the numbing injection was administered.

Facet Joint Syndrome Treatment

While dealing with FS, doctors often recommend conservative treatment options at the initial stages of cure. These include:

• Taking pain-relieving medications
• Cold/hot therapy
• Performing some physical exercises
• Taking proper rest

The medications that are generally prescribed by doctors include NSAIDs, Opioids and Facet Joint blocks, which are anesthetic and steroidal medication injections. Patients can also try out alternative treatment options such as:

Picture 2 – Facet Syndrome Image

• Yoga
• Pilates
• Acupuncture
• Massage therapy
• Aromatherapy
• Chiropractic adjustments

In most cases, FS is easily handled by various treatment options discussed above. Doctors opt for surgery only when these treatment methods are unable to ease the pain of FS.

Facet Syndrome Prognosis

This condition is mostly kept under control by following conservative treatment procedures. In most cases, these procedures successfully help in minimizing painful symptoms. Patients can lead a healthy life albeit he or she might have to follow certain regulations, such as maintaining special postures while sitting or standing and regularly performing some exercises. In very rare cases, surgery is chosen as the treatment method. In case of surgery, prognosis varies from one patient to another.

FS frequently occurs with the onset of age as the cartilage covering of facet joints wear away with years of wearing and tearing. This causes significant pain to an individual. However, following some simple procedures can allow a person to control the pain and lead a normal life.

References:

http://www.painmd.com/types-of-pain/backspine/facet-syndrome.html

http://en.wikipedia.org/wiki/Facet_syndrome

http://www.laserspineinstitute.com/back_problems/facet_syndrome/

http://www.bonati.com/conditions/Facet-Syndrome/

http://knol.google.com/k/lumbar-facet-syndrome#

http://www.spine-health.com/conditions/arthritis/symptoms-and-diagnosis-facet-joint-problems

Pancreatic Pseudocysts are the most common types of pancreatic cystic lesions that account for around 75-80% of all abnormal masses arising in the pancreas. Read and know what a pseudocyst is as well as all about its causes, symptoms, management and treatment options.

Pancreatic Pseudocyst Definition

It is a condition marked by the development of a fluid-filled sac within the abdomen. It is generally located in the lesser sac of the abdomen and contains pancreatic enzymes, necrotic tissues and blood. It commonly develops in children after some type of abdominal trauma.

The prefix “pseudo” (meaning “false” in Greek) in the name of this disorder distinguishes these lumps from true cysts that are lined by epithelium. Pseudocysts are surrounded by granulation tissues.

Pancreatic Pseudocyst Prevalence

Picture 1 – Pancreatic Pseudocyst

The exact prevalence of this condition is not known. According to medical research, however, 60 to 85% of these cases occur due to alcohol abuse and gallstones. Men are 5 to 10 times more prone to the condition compared to women.

Pancreatic Pseudocyst Classification

There is much confusion regarding “chronic” and “acute” pseudocysts. According to experts, acute Pancreatic Pseudocysts are sacs containing pancreatic juice and lined by a granulation tissue wall. These cysts arise due to pancreatic trauma or Acute Pancreatitis. Chronic Pseudocysts are sacs filled with pancreatic juice and lined by fibrous tissues. These mainly arise due to Chronic Pancreatitis.

Pancreatic Pseudocyst Pathophysiology

Acute Pancreatitis is caused by disturbances in the functioning of the pancreatic parenchyma and ductal system. Due to this, the pancreatic enzymes are extravasated leading to the digestion of the adjoining tissues. It results in the development of fluid sacs around the pancreas that comprise of pancreatic enzymes, necrotic debris and hemolysed blood. The fluids generally accumulate in the lesser sac and form pseudocysts in the pancreas. This is known as ‘Acute Pancreatic Collection’. Some of these pancreatic collections are cured automatically as an affected individual recovers from the condition. However, many of them organize themselves and get surrounded by a solid wall of fibrosis and granulation tissue. This process continues for several weeks, finally leading to the development of Pancreatic Pseudocysts.

Pancreatic Pseudocyst Causes

Know about some of the main factors that lead to this condition:

• A severe episode of acute Pancreatitis, characterized by a sudden swelling of the pancreas, is the most common cause of this disorder.
• Swelling and inflammation, occurring due to Pancreatitis, generally damages the pancreatic ducts. This may give rise to a pseudocyst.
• Some kind of abdominal trauma, especially in children, may also result in the development of such sacs.
• Individuals suffering from Chronic Pancreatitis may also develop this condition.
• An episode of acute Pancreatitis sometimes leads to pseudocysts, especially in case of people who have experienced some penetrating trauma.

Pancreatic Pseudocyst Risk Factors

The risk factors of this condition include

• Underlying Chronic Pancreatitis
• Acute Pancreatitis
• Abdominal trauma
• Alcohol abuse

Pancreatic Pseudocyst Signs and Symptoms

The symptoms of the disorder tend to vary from one patient to another. The main signs and symptoms of the condition include:

• Abdominal Bloating
• Severe abdominal pain
• Fever
• Vomiting
• Nausea
• Weight loss
• Diarrhea
• Loss of appetite
• Jaundice or yellowing of the eyes and skin
• Tender mass in the abdomen
• Development of fluid in abdominal cavity

Pancreatic Pseudocyst Prevention

Avoiding Pancreatitis is the only way to prevent the development of these sacs. If gallstones are causing Pancreatitis, it is necessary to remove the gallbladder with an appropriate surgery (Cholecystectomy). It is important to give up drinking alcohol if alcohol abuse is the main reason behind Pancreatitis. This helps prevent future occurrence of Pseudocysts.

Pancreatic Pseudocyst Diagnosis

The chief objective of diagnosis is to determine the location, size and number of pseudocysts in the pancreas. Draining these kinds of pseudocysts increases the possibility of development of pancreatic fistula. Due to this reason, it is important to find out if the pseudocysts have any connection with the pancreatic ductal system.

Some of the diagnostic imaging tools that are commonly used for this disorder include:

Ultrasonography

It is an ultrasound based imaging technique used for detecting various diseases. In this case, however, the usefulness of Ultrasonography for understanding the state of the pancreas is often limited due to the health of patients and the experience of the operator.

Computerized Tomography

This test is perfect for both the initial assessment and the follow-up treatment of this disorder.

Magnetic resonance cholangiopancreatography (MRCP)

This test helps understand the relationship between the pseudocysts and the pancreatic ducts.

Blood Tests

The amount of different substances present in the blood can be measured by a blood test. Blood test is commonly done during the diagnosis of these cysts.

X-Ray

An X-ray examination produces images of the internal structures of the body by electromagnetic energy beams. This helps check whether any pseudocysts are present in the pancreas.

Pancreatic Pseudocyst Differential Diagnosis

The differential diagnosis for this disorder includes ruling out presence of other associated conditions, such as:

• Pancreatic Cancer
• Pancreatic Pseudoaneurysm
• Acute Pancreatitis
• Chronic Pancreatitis
• Pancreatic Necrosis
• Pancreatic Abscess

Pancreatic Pseudocyst Treatment and Management

Pseudocysts do not always require treatment as some of them heal on their own. However, an advanced stage of this pancreatic disorder requires professional medical treatment which involves surgery, gastroenterology and radiology.

Picture 2 – Pancreatic Pseudocyst Image

The condition rarely occurs during pregnancy. Its management depends on various factors.

Surgical Treatment of Pancreatic Pseudocyst

Surgery is the most common treatment option used for curing this condition. The various surgeries used for curing this disease include:

Cystgastrostomy

It connects the back wall of the stomach and the pseudocyst in such a way that the fluid in the pseudocyst can drain into the stomach.

Cystjejunostomy

In this surgery, the small intestine and the pseudocyst are connected so that the pseudocyst fluid can flow directly into the small intestine.

Cystduodenostomy

In this procedure, surgeons make a connection between the pseudocyst and the duodenum to make the fluid drain directly into the latter organ.

Drainage of Pancreatic Pseudocyst by Radiology

In this process, a radiologist inserts a thin needle into the pseudocyst with the aid of a CT X-ray to drain the fluid. This technique can successfully cure the condition. In many cases, however, it gives rise to various complications including constant leakage from the surgically created drainage spot and infection of the Pancreatic Pseudocyst. Due to such risks, this surgery is generally not used for treatment of the condition.

Pancreatic Pseudocyst Prognosis

Generally, the outcome of this pancreatic disorder is good after a successful surgery. However, the condition can become much more serious if left untreated.

Pancreatic Pseudocyst Complications

The condition may lead to various complications, such as:

• Rupture
• Infection
• Hemorrhage
• Obstruction

The obstruction or blockage can cause GI tract compression from stomach to colon as well as compressions in the biliary system, urinary system and arteriovenous system. Leaving the condition untreated for a long time may also lead to severe health problems.

Pancreatic Pseudocyst Recurrence

The chances of recurrence of these abnormal vesicles are very low. It is believed that surgical treatment reduces the risks of recurrence more than percutaneous treatment options.

Pancreatic Pseudocyst is a highly painful abdominal condition. Without proper treatment, it may also lead to various acute health disorders. However, there are numerous surgical procedures that can cure the problem, allowing an affected individual to live a long and normal life. If you have a family member having symptoms of this disorder, get in touch with a healthcare professional as fast as you can. Timely treatment will help cure the condition faster and allow preventing unnecessary complications.

References:

http://health.nytimes.com/health/guides/disease/pancreatic-pseudocyst/overview.html

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001317/

http://www.mdainternet.com/MDA4/topics/p/pancreatic_pseudocyst.asp

http://www.nlm.nih.gov/medlineplus/ency/article/000272.htm

http://health.yahoo.net/adamcontent/pancreatic-pseudocyst

Hypoplastic Left Heart Syndrome (HLHS) is a condition in which only the right section of the heart functions properly. Read on to know more about this heart disease, including its causes, symptoms and treatment options.

What is Hypoplastic Left Heart Syndrome?

It is a very rare congenital heart condition which causes the left ventricle of the heart to remain critically underdeveloped. Abnormal underdevelopment of fetal heart sections during the first 2 months of pregnancy causes these heart defects. The problem is also known as single ventricle condition.

Hypoplastic Left Heart Syndrome Incidence

This condition generally occurs in four cases out of 10,000 live births and accounts for 8% of all congenital heart diseases. Boys are slightly more prone to this condition than girls.

Hypoplastic Left Heart Syndrome Causes

In HLHS, the left area of the heart is unable to properly pump blood into the body. As a result, the right ventricle has to pump blood into the lungs as well as the entire body. The right part of the body can properly carry out this additional work for a while. Soon, however, the right ventricle starts to fail due to the extra workload.

Picture 1 – Hypoplastic Left Heart Syndrome

Like many other congenital heart conditions, the exact causes for HLHS are not known. The defects in the heart develop before there is proper growth of other cardiac structures, such as:

• Left ventricle
• The entrance and exit to the ventricle
• Aortic valves
• Mitral valves
• Blood vessels of the aorta

The left ventricle and the aorta are very poorly developed in this heart disease.

The occurrence of this disorder is often associated with Gap junction alpha-1 protein. According to a study conducted by the Cincinnati Children’s Hospital, Ohio, season and environment are important factors behind the origin of this condition. The study comprised of findings from around 1500 newborn children from approximately 38 hospitals in the US. The study commenced during the 1990s and ended in 2006. This research showed that babies born in the months of April-July were more susceptible to this heart defect.

Hypoplastic Left Heart Syndrome Presentation

In a healthy heart, the deoxygenated blood from the entire body travels to the right atrium and reaches the right ventricle. The blood is then pumped into the lungs via the pulmonary artery to receive oxygen. The oxygenated blood then leaves the lungs and travels to the left ventricle through the left atrium. The left ventricle pumps the blood to different parts of the body.

In an HLHS patient, almost all the structures in the left part of the heart are underdeveloped and defective. The stage of underdevelopment varies from one patient to another. The structures that are generally affected by this heart defect include:

Mitral valve

It controls the flow of blood from the left atrium to the left ventricle.

Left ventricle

It is the chamber situated at the lower left-hand side of the heart. It is responsible for pumping oxygen-rich blood to the aorta.

Aortic valve

This valve controls the flow of blood to the aorta from the left ventricle.

Aorta

It is responsible for taking the oxygenated blood to various parts of the body.

An underdeveloped left ventricle is probably the most serious defect in HLHS patients. This chamber is responsible for pumping blood to all parts of the body. Due to this reason, it needs to be strong and muscular. When weak and undersized, it cannot function properly.

Hypoplastic Left Heart Syndrome Symptoms

Children born with HLHS do not look any different from a normal baby at the time of birth. However, they get seriously ill within a few days after birth. If left untreated, this condition can turn fatal within the first few days or months of an affected baby’s life. Its common symptoms include:

• Cyanosis or bluish-grey skin color
• Cold feet and hands (extremities)
• Sweaty skin
• Lethargy or lack of energy
• Poor pulse
• Pounding of the heart
• Shortness of breath
• Rapid breathing
• Poor feeding

Without proper treatment, Hypoplastic Left Heart Syndrome can close the natural connection between the right and left sections of the heart. In these cases, a suffering baby is likely to go into a shock and may even die. Some of the main signs and symptoms of a shock are:

• Pale or gray, cool skin
• A weak yet rapid pulse
• Abnormal breathing (Either extremely rapid or very slow)
• Dilated pupils
• Lackluster, staring eyes
• Unconsciousness

Hypoplastic Left Heart Syndrome Prevention

Presently, there is no way to prevent this congenital cardiac defect. Couples with a family history of congenital heart diseases should consult a genetic counselor to evaluate the chances of having a baby with HLHS. Couples who already have a baby suffering from this condition should consult an experienced cardiologist before planning another child.

Various tests, such as the Echocardiogram, may possibly determine whether an unborn child is affected by this congenital defect. Doctors often suggest terminating an infant if it is diagnosed with HLHS. Many parents are opting for termination after learning of confirmed HLHS in their babies.

Hypoplastic Left Heart Syndrome Diagnosis

The symptoms of this condition help in its correct diagnosis. Doctors may perform some physical examinations that may help identify the various signs of heart failure, such as:

• Faster heart rate
• Abnormal heart sounds
• Lethargy
• Rapid breathing
• Liver enlargement

Some other diagnostic tests used for determining this procedure include:

Echocardiogram

One of the common tests used for diagnosing HLHS, it produces a detailed image of the patient’s heart using an ultrasound or echocardiogram sound waves. The process can also be used to diagnose the disorder in an unborn child.

Cardiac catheterization

This test involves insertion of a thin, long tube into one of the arteries of the arm or groin area of an affected baby. An x-ray imaging is then used to guide a catheter into the heart of the patient. Sometimes, doctors perform catheterization to check the functioning of a heart affected by HLHS.

Chest x-ray

The shape and size of the heart and lungs can be determined by a chest x-ray. It also reveals heart enlargement.

Electrocardiogram (ECG)

The sensory patches, attached to the electrodes or wires, help in measuring the electrical impulses emitted by the heart of a suffering child. Any enlargement in the lower-right chamber of the heart can be detected by this medical examination.

Hypoplastic Left Heart Syndrome Treatment

There are two options for curing a child with HLHS. One is a three-step surgical process and another is heart transplant. If an unborn infant is diagnosed with this condition, doctors recommend hospitals with cardiac surgery centers for delivery.

Hypoplastic Left Heart Syndrome Management

Doctors generally recommend various medications and other options for the management of this syndrome prior to a transplant or surgery.

Medications

Alprostadil medication allows expansion of blood vessels and also helps the ductus arteriosus to remain open.

Breathing assistance

Breathing machines or ventilators ensure enough supply of oxygen to the lungs of HLHS patients.

Intravenous fluids

Certain fluids are entered into the body of an affected baby through a tube inserted into his/her vein. These fluids contain essential medications that help the body combat the symptoms of HLHS.

Atrial septostomy

This process creates an opening between the upper chambers of the heart. This is done in case the foramen ovale is found to be closed due to Hypoplastic syndrome. If a baby patient has an atrial septal defect, he or she may not require an atrial septostomy.

Hypoplastic Left Heart Syndrome Surgery

Surgical treatment for this disorder involves a three stage operative procedure. It is not possible to repair the heart defects in an HLHS patient. Surgery makes it possible for deoxygenated blood to flow into the heart normally, to receive oxygen and the oxygenated blood to reach every part of the body. At present, surgeons examine radiologic images of an affected heart to understand the condition properly before performing the operation.

Step 1- The Norwood operation

This surgery is generally carried out within the first 14 days after the baby’s birth. In this process, the aorta is reconstructed and directly connected to the lower right chamber of the heart (right ventricle). This method makes it possible for the right ventricle to pump blood into the lungs as well as the body. However, the skin of a patient continues to be slightly bluish as the deoxygenated and oxygenated blood mingles within the heart (even after the surgery).

Step 2- Hemi-Fontan or bi-directional Glenn Operation

It is carried out when an HLHS patient is aged between 4 and 12 months. The hemi-Fontan procedure decreases the workload of the right ventricle by letting it pump blood primarily to the aorta. It also allows movement of most of the deoxygenated blood straight into the lungs. After this surgery, all the deoxygenated blood from the upper parts of the body directly reaches the lungs, allowing the right ventricle to pump more oxygenated blood to all the organs and tissues in the body.

Step 3- The Fontan procedure

This procedure is performed when an affected baby is 18 to 36 months old. It allows the deoxygenated blood coming from the rest of the body to flow straight into the lungs. The deoxygenated and oxygenated bloods no longer mix with within the heart. Naturally, the skin of patients operated upon no longer appears blue.

Hypoplastic Left Heart Syndrome Heart Transplant

Heart transplant is another surgical option for treatment of this syndrome. The procedure is performed if the heart defects are very complex. The use of certain medications might be necessary before the transplant can be performed.

Hypoplastic Left Heart Syndrome Follow-up Care

Lifelong follow-up care is necessary after a surgery or transplant for HLHS treatment. Patients have to keep regular contact with a cardiologist, specializing in congenital heart diseases. The cardiologist will monitor the health of the patient’s heart. The HLHS affected individual may also require some medications to ensure proper functioning of the heart. Anti-rejection medication will be necessary for a baby who has received a heart transplant.

Hypoplastic Left Heart Syndrome Complications

The following complications are associated with the HLHS surgery:

• Artificial shunt blockage
• Chronic diarrhea
• Fluid accumulation in the in the lungs and the abdomen
• Heart failure
• Cardiac arrhythmia or irregular heart rhythms
• Nervous system complications and strokes
• Sudden death

This condition may result in premature death of a suffering child if not treated properly from the very early stages. With the discovery of proper treatments, the mortality rate for HLHS is now reducing at a rapid rate.

Hypoplastic Left Heart Syndrome Prognosis

Picture 2 – Hypoplastic Left Heart Syndrome Image

This heart defect can be fatal if left untreated. But, the affected child can have a long and normal life with proper treatment and surgery. The survival rates become higher once the Hypoplastic Left Heart Syndrome patient successfully passes through the first stage of surgery.

Hypoplastic Left Heart Syndrome Recurrence Risk

Current researches show Hypoplastic Left Heart Syndrome to be a hereditary condition. According to these studies, this condition occurs due to various genetic causes. The recurrence risk of HLHS in the siblings of an affected child is 0.5 %. There is a 13.4% chance that the siblings of a HLHS patient will have other forms of congenitally defective hearts.

Hypoplastic Left Heart Syndrome Life Expectancy

The life expectancy varies from patient to patient depending on the success of the surgeries. But generally, the surgeries or heart transplant allows a baby with HLHS to reach adulthood. They can also lead a fairly normal life with some restrictions.

Hypoplastic Left Heart Syndrome is an incurable congenital heart condition. However, with proper treatment, the defective heart can be made workable to so that a suffering individual can have a reasonably long and happy life. There are many support groups who provide guidance and awareness to the families of children affected by this disorder.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002096/

http://www.mayoclinic.com/health/hypoplastic-left-heart-syndrome/DS00744/DSECTION=treatments-and-drugs

http://www.cincinnatichildrens.org/health/h/hlhs/

http://www.chw.org/display/PPF/DocID/23065/router.asp

http://emedicine.medscape.com/article/890196-treatment#showall

Ever seen anyone who occasionally behaves and dresses in a very strange fashion, but is completely normal otherwise? It may be a case of Brief Psychotic Disorder (BPD), a short term mental condition, which the person is possibly suffering from. Read and find out more about the causes, symptoms, treatment options and prognosis of this condition.

Brief Psychotic Disorder Definition

It is a temporary psychological condition that gives rise to one or more common symptoms of Psychosis, such as delusions, strange bodily movements, hallucinations and peculiar speech pattern. At least 1 of the principal psychosis symptoms must be present in a BDP patient for less than a month.

Brief Psychotic Disorder Causes

The exact causes of this disorder are still not clear. According to some theories, this is a genetic condition that is believed to arise due to a combination of mental and external factors. Some of the commonly suspected factors for this disorder are believed to be:

Picture 1 – Brief Psychotic Disorder

Mental Stress

BPD is often supposed to arise due to severe stress, which may involve bereavement. However, a suffering individual tends to return to normalcy once the source of the mental stress subsides.

Postpartum Depression

Postpartum hormonal change may also result into a BPD attack shortly after childbirth.

Personality Disorder

As per researches, individuals with some personality disorders are more prone to this disorder when under stress. This is due to the fact that the adult mechanisms of sufferers of personality disorders often do not develop properly.

Brief Psychotic Disorder Symptoms

Patients of BPD are always found to exhibit one or more psychosis symptoms. However, these symptoms are not evident in the daily life of a patient. These are only experienced by him/her during brief periods of attack. The most common symptoms of this brief psychological disorder are:

Hallucination

Hallucination refers to a sensory perception of imaginary objects. Patients of this disorder experience various types of hallucinations including seeing things, hearing voices and feeling sensations on the skin despite absence of such objects.

Delusion

This is a condition that makes patients hold on to some false assumptions that they refuse to give up under any circumstances, even while facing contradictory facts.

Some other symptoms commonly observed in BPD patients include:

• Disorganized thinking
• Unusual behavior and attire
• Problems with memory
• Language and speech that do not make sense
• Disorientation
• Mental confusion
• Changes in eating and sleeping habits
• Weight change
• Increased or decreased energy level

Brief Psychotic Disorder Tests and Diagnosis

Special DSM-IV-TR diagnostic criteria are generally used for identifying the symptoms of Brief Psychotic Disorder. The duration, over which psychosis symptoms are experienced, is considered to be a very important diagnosis criterion as it forms the main differential factor between three different major psychotic disorders.

• If an individual has suffered from the symptoms for a period of a few days to one month, he or she is said to be suffering from BPD.
• If the signs have been present for over a month but less than six months, the individual is considered to be a patient of Schizophreniform Disorder.
• If an individual has suffered from the symptoms for over six months, he or she is regarded as a sufferer of Schizophrenia.

The symptoms of Brief Psychotic Disorder can be similar to those of mania or Delusional Disorder present in Bipolar Disorder.

There are no accurate laboratory tests for the diagnosis of BPD. However, a doctor may use various tests, including x-rays and blood tests, to rule out any possibility of a physical disorder causing the symptoms.

Brief Psychotic Disorder Prevention

Extreme mental stress, due to any natural disaster or some personal loss, is one of the major suspected causes of this disorder. Post-crisis counseling and proper social support can assist susceptible individuals to combat stress and prevent this disorder.

Brief Psychotic Disorder and Schizophrenia

Clinicians often believe BPD as an early stage of Schizophrenia, which is a more permanent mental condition. This is due to the many similarities in the symptoms of these two disorders. In most cases, the symptoms of a BPD patient deteriorate with time. The condition can lead to Schizophrenia unless diagnosed at an earlier stage.

Brief Psychotic Disorder and Postpartum Psychosis

Some women may suffer from BPD shortly after childbirth. In such cases, the condition is often referred to as “postpartum psychosis”. However, the disorder is often misdiagnosed which may lead the patient to commit suicide or kill her own newborn child.

Brief Psychotic Disorder Treatment and Medication

The treatment for BPD varies according to the symptoms present in patients and the duration for which are suffering from the condition. Various medications and therapies are useful for the management of this disease. Early diagnosis allows more time to cure the disorder completely. If the disorder reaches an advanced stage, patients would require hospitalization. This is because there is always a chance that they may harm themselves or people around them. Two of the main treatment options for this disorder are:

Picture 2 – Brief Psychotic Disorder Image

Medications

Doctors often prescribe different antipsychotic drugs to cure the brief attack by eliminating or reducing the symptoms. The antipsychotics generally used for this purpose include

• Navane
• Prolixin
• Thorazine
• Mellaril
• Trilafon
• Stelazine
• Haldol

Many new drugs are also used for treating BPD, such as:

• Clozaril
• Seroquel
• Zyprexa
• Risperdal
• Geodon

In case a patient is suffering from extreme anxiety, doctors may use tranquilizers like Ativan and Valium.

Psychotherapy

It helps BPD patients identify and properly handle the situation that triggered the psychological disorder.

Brief Psychotic Disorder Care Plan and Guidelines

There are many support groups that help the families of BPD patients to cope with the situation. These groups guide and teach relatives of affected individuals about the importance of family support in the treatment of the disorder.

Brief Psychotic Disorder Prognosis

The prognosis or outcome of this disorder is quite positive as it does not last for long duration. In most cases, individuals having BPD can return to normal day-to-day activities after receiving proper treatment. People having some type of personality disorder along with BPD have a relatively negative prognosis compared to those who suffer from the condition due to some mental trauma.

Brief Psychotic Disorder Recurrence

The possibility of recurrence of BPD is generally very low if the disorder is triggered by some traumatic event or mental stress. However, the condition is likelier to recur if it is initiated by a personality syndrome instead of any specific event or experience. In these cases, BPD may be an initial symptom of Schizophrenia.

Brief Psychotic Disorder Prevalence

The incidence of BPD is considered to be ten times higher in developing countries than in developed nations such as the United States. However, many women suffer from BPD in the US. Women are, in fact, twice more susceptible to the condition as compared to men. The disorder generally affects individuals between their late-thirties and early-forties in age.

Brief Psychotic Disorder in Famous People

Some well-known people and celebrities, believed to have this disorder, are

• Donald Trump
• Ian Puleston-Davies
• Cameron Diaz
• Dr. Samuel Johnson
• Jim Eisenreich

BPD is a temporary condition which cannot be halted or prevented at the outset by some drugs. However, early diagnosis makes it possible to cure the condition completely and allows patients to lead a long and normal life.

References:

http://www.minddisorders.com/Br-Del/Brief-psychotic-disorder.html

http://emedicine.medscape.com/article/294416-treatment

http://www.webmd.com/schizophrenia/guide/mental-health-brief-psychotic-disorder

http://www.allaboutcounseling.com/library/brief-psychotic-disorder/

Proctalgia Fugax (PF) is a digestive disorder marked by intermittent but severe pain in the rectum. If you are experiencing such symptoms, read on to know whether you are actually having this condition as well as about its various causes, symptoms and treatment options.

What is Proctalgia Fugax?

It is a disease characterized by occasional but severe pain, uneasiness and pressure in the sacrum, rectum and coccyx regions. The symptoms tend to worsen when a patient is in a sitting position.

Proctalgia Fugax Other Names

The condition is known by various other names, such as:

• Levator Ani Syndrome
• Coccygodynia
• Levator Ani Spasm Syndrome
• Proctodynia

It is also referred to as “Anal Cold”.

Proctalgia Fugax Causes

The exact cause of this condition is unknown. However, one or more of the following conditions is suspected to result in this syndrome:

Picture 1 – Proctalgia Fugax

• Pelvic floor (LAS) muscle spasm
• Anal sphincter (PF) muscle spasm
• Levator ani muscle spasm
• Pubococcygeus muscle cramp
• Low-fiber diet
• Pudendal nerve neuralgia

PF, much like constipation, is supposed to occur due to genetic factors. The condition is sometimes associated with IBS (Irritable Bowel Syndrome). This is due to the fact that the two muscles impacted in these disorders are anatomically close which makes them possible to co-exist. Both disorders are supposed to arise due to the same underlying malfunctions.

Proctalgia Fugax Symptoms

The symptoms of this condition may vary with its severity. Some of the common signs of the syndrome are:

• Pain, which may be initiated by urination and defecation
• Sharp pain, which often makes patients wake up from deep and sound sleep
• A short episode of pain, which does not usually last more than a few minutes
• Sweating, palpitation and even fainting, caused by severe pain
• Bowel movements, not resulting from defecation

PF pain mainly occurs during mid-night and lasts for short periods of time. This pain is similar to that of another condition known as Levator Ani Syndrome, which causes severe aching that lasts for over 20 minutes. According to a 2007 study, 33 percent of 1809 patients with PF suffered the attacks during daytime while another 33% suffered during night time. Generally, people get affected by this syndrome when around 45 years old.

Patients do not experience any pain except for certain periods. Pain caused by PF may occur frequently before subsiding for a long time. In most cases, however, the pain is likely to reoccur after some time. A patient may suffer from multiple attacks as frequently as several times in one week. The pain lessens automatically within a short time after an attack. Sometime, the attacks may also be as rare as once in a year.

Sometimes, the blood pressure of a patient may drop suddenly during a painful episode, leading to loss of consciousness. Due to this reason, patients are suggested to lie down during an attack.

Proctalgia Fugax Diagnosis

The diagnosis of PF depends on the symptoms present in an individual. The condition is often misdiagnosed owing to the similarity of many of its symptoms with those of various other diseases. The tests done for diagnosing PF include:

• Examination of bony pelvis and axial spine
• Digital Rectal Examination (DRE)
• Complete Blood Count (CBC)
• Radiological test including CT Scan, MRI, Plain film X-ray and Ultrasound
• Transrectal Ultrasound
• Barium Enema X-Ray
• Sigmoidoscopy
• Nerve conduction
• Electromyelography (EMG)
• Anorectal Manography
• Cinedefography

Tenderness in the levator muscle can be revealed by a rectal examination. Pain tends to increase when the muscle is digitally pressed. Doctors should check for any signs of anemia in case there is a chance of gastrointestinal bleeding.

Proctalgia Fugax Differential Diagnosis

The differential diagnosis of this disorder involves distinguishing it from other conditions that are likely to be present along with PF, such as:

• Irritable Bowel Syndrome
• Ulcerative Colitis or Crohn’s Disease
• Solitary chronic rectal ulcer
• Hemorrhoids ± Thrombosis
• Rectal Carcinoma
• Rectal foreign body
• Perirectal abscess
• Proctitis
• Diverticular Disease
• Pruritus ani
• Rectal Prolapse
• Retrorectal cysts
• Prostatitis
• Hereditary Anal Sphincter Myopathy
• Condylomata Acuminate
• Bilateral Internal Iliac Artery Occlusion
• Coccygodynia
• Testicular Carcinoma
• Cystitis

Proctalgia Fugax Management and Relief

Once the presence of PF has been confirmed in a person, various treatment options can be used for its management. In many cases, reassurance helps a patient fight the pain better. In most cases, the attacks are very transient and require no specific medications. Patients should perform relaxation exercises regularly to reduce anxiety and stress which may act as trigger factors for the pain.

Proctalgia Fugax Treatment and Medications

Warm baths, enemas, fiber supplements, analgesics, anti-inflammatories and various other medications are useful for treating PF. Relaxation techniques, including biofeedbacks, are also considered to be effective for its treatment. The traditional treatment options for PF comprise of warm baths and hot enemas. While sleeping, pressing an electric heating pad to the anal region can prevent the attacks.

Individuals suffering from frequent, severe and prolonged attacks may inhale salbutamol medications for fighting PF and reducing the duration of the pain. Botulinum toxin can also be used as a low dose diazepam and analgesic at bedtime to prevent occurrence of these attacks. The treatment of a PF patient should depend on the symptoms and the amount of pain experienced by him or her. Relaxation techniques are very useful in reassuring patients that the pain is not severe in nature.

Massaging the spastic muscle with some muscle relaxants may also help reduce stiffness and pain. If massaging the area is found to be ineffective, Electrogalvanic stimulation can be applied.

Proctalgia Fugax Prognosis

The prognosis depends on how long the individual has been suffering from the condition and how frequent the attacks are. But, proper treatment generally has a favorable outcome.

Proctalgia Fugax and Pregnancy

Picture 2 – Proctalgia Fugax Image

PF may also arise from an Ectopic pregnancy, a very rare condition characterized by gestation in some other part of the body other than the uterus. Ectopic pregnancy happens in only one out of hundred cases of maternity and is a general cause of bleeding during the first trimester.

Proctalgia Fugax Risk Factors

Old age and being female have been found to be the main risk factors for this digestive disease. Most PF patients have been found to be aged between 30 years and 60 years. Many researches show women to be more prone to the condition as compared to men. The symptoms of this disorder are likely to decline after the age of 45. However, PF can be prevalent in children and young people.

Proctalgia Fugax Prevention

There is no definite way to prevent PF as its exact causes are still unknown. Eating fiber-rich foods and drinking plenty of water can be effective for avoiding the onset of this disorder. Patients are also recommended to take fiber supplements along with their normal diet. An individual should undergo regular medical check-ups to make physicians identify any serious health problems.

Proctalgia Fugax is a highly painful condition. Fortunately, proper diagnosis, medications and other management options can help reduce its painful symptoms in patients. However, the disorder can lead to more serious diseases if left untreated. Due to this reason, it should be treated on an immediate basis as soon as detected.

References:

http://www.healthscout.com/ency/1/373/main.html

http://www.patient.co.uk/doctor/Proctalgia-Fugax-and-Anal-Pain.htm

http://www.ygoy.com/2011/05/08/what-is-proctalgia-fugax-symptoms/

http://surgerysearch.blogspot.in/2008/10/proctalgia-fugax.html

What is Follicular Cyst?

It is an odontogenic cyst that arises from the epithelium of the dental lamina and the tooth bud. It is actually another name for Follicular ovarian cyst and is by far the most frequent type of cyst associated with the ovary.

Its width may range from a few millimeters to 15 centimeters or even 6 inches.

Follicular Cyst Meaning

The ovary is part of the reproductive organ of the female body. It comes in pairs and contains eggs. A very sensitive part of the body, it is prone to several illnesses and complications. This includes ovarian cysts. Fortunately most of the cysts developing in various parts of the ovary, including the follicle, are diagnosed as malign. This means that the cyst can be removed without endangering the life of the woman.

Types of Follicular Cyst

Follicular cyst is not limited to the ovaries and may develop in various parts of the body. According to the region of their development, these cysts are classified into various types like:

Picture 1 – Follicular Cyst

Ovarian Follicular Cyst

It is by far the most known type of follicular cyst in the world. It may develop even when ovulation does not occur. Generally, these cysts do not produce any symptoms and resolve in a few months.

Follicular Infundibular Cyst

This type of cyst occurs in the skin – the overlying portions of the epidermis. It manifests as a single lesion but may soon erupt in multiple forms. Due to its development on various areas, such as face, neck, scalp or trunk it is referred to by various other names, such as:

• Epidermoid cyst
• Epidermal inclusion cysts
• Epidermal cysts

The size of these vesicles may vary from two millimeters to even five centimeters. These growths often appear with a gray, yellowish, or brown cheesy material within it that eventually erupts on its own.

Follicular Cyst Causes

This vesicle normally develops during the time of ovulation. Studies reveal that in some cases the sac of the ovary holding the egg fails to break for some reason. Due to this, it does not open and release the egg. This creates an unhealthy environment within the ovarian area making it an ideal place for cyst growth. Due to the pH level of the ovary, some of the cysts simply dissolve on their own after three months. Some cysts may, however, need to be physically removed to help prevent further complications.

Ovarian Follicular Cyst Causes

Some of the factors that may cause the development of ovarian follicular cysts are:

Hormonal Imbalance

Estrogen and progesterone are the two main hormones produced in the follicles that guarantee a timely release of the egg. If an imbalance of these hormones occurs within the ovary, the follicle would fail to receive the signal that it needs to release the egg. It would grow abnormally in size and continue to become larger until it becomes a fully developed ovarian follicular cyst. It is best to seek medical assistance to maintain normal hormonal balance in your body to avoid getting these cysts.

Unhealthy Diet

Food plays an important role in the development of these growths. As a popular saying goes, “you are what you eat.” Studies reveal that individuals who consume very acidic foods, refined carbohydrates, and processed foods (containing too many toxins) are most likely to suffer from this disorder. The toxins need to be flushed out of the system by supplying the body with enough raw and fresh foods. A failure to do this would result in disorders, such as cysts.

Failed Ovulation Process

As aforementioned, the follicles would most likely develop into cysts if ovulation does not occur. The vesicles are likely to disappear on their own. However, if you feel any pain and discomfort near your ovarian section it is best to see your gynecologist for diagnosis.

Women having a family history of this cyst are most likely to suffer from it. Those having an irregular menstrual cycle and having their period before the age of 11 may also be at a higher risk.

Follicular Infundibular Cyst Causes

The exact cause of development of these vesicles is not known. Exposure to sun is believed to have a role in the occurrence of this type. These cysts are also found to develop more in females and those over 60 years of age. Hence, gender and age are supposed to be possible factors for the growth of these abnormal structures.

Follicular Cyst Symptoms

Some of the common symptoms experienced in this condition are:

Pain

The pain is normally felt near the pelvic region. Pain may be triggered due to the fast growth of the cyst that causes the twisting and eventual disruption of the blood supply. It may soon result in bleeding or rupture of cyst. When this occurs, patients are likely to complain of sharp shooting pain in only one side of the body (where the cyst is most likely to be located). At times, this pain may be experienced in the middle of the menstrual cycle quite close to the time of ovulation.

Abdominal Bloating and Cramps

A feeling of fullness is another common symptom of this condition. It may be experienced due to pressing of the cyst on the pelvic organs. Some women may even suffer from nausea due to the abdominal pressure and intense pain that they may experience.

Irregular Bleeding

Although this is a rare symptom of follicular ovarian cyst, women often complain of extremely heavy menstrual flow with spotting in between their periods. Some would experience a delayed cycle followed by a very painful menstrual flow.

Follicular Cyst Complications

Although most follicular cysts are diagnosed as benign, women suffering from them should not be too comfortable with their condition. It is necessary for them to consult their physician because of the various risks it may bring to their health.

Ovarian Cyst Rupture

This is the most common cause of internal bleeding or hemorrhage in women. Immediate medical care is needed due to the possible complications that may arise from it. The pain experienced by affected woman is unbearable and is not to be ignored.

Increased Growth Size

If the cyst grows in size, it would hamper the function of other organs near the ovary. It may cause severe damage to the ovary and cut off its blood supply. This is a very dangerous situation. If doctors recommend an immediate surgery for the removal of follicular ovarian cyst, patients should go ahead and follow the advice without any hesitation.

Infertility

Not being able to be a mother is the most depressing thing for most women. Doctors and researchers are continuously trying their best to find treatment options that would save the reproductive organ of the woman and remove difficulties in child-bearing. Even in case of small cysts, effective methods would cure the problem and reduce the possibility of infertility.

Cancer

Although rare, there is a possibility of cancerous developments from this condition. Eliminate the risks of infecting other cells of the body and seek medical assistance at the soonest.

Follicular Cyst Treatment

The treatment of these cysts may vary depending on the type that one is suffering from and the health condition of the patient. Know about the common treatment methods for both types of this condition:

Picture 2 – Follicular Cyst Image

Ovarian Follicular Cyst Treatment

This type of vesicles can be cured by:

Surgery

Large cysts, which are in danger of getting ruptured and twisting the ovary, would require surgical removal. If the size of the cyst is less than two and half inches, a Laparascopy may be carried out.

Hormonal Therapy

This is recommended by physicians to make the cysts dissolve naturally. The body has to gain hormonal balance to get rid of the abnormal chunk of cells inside your ovary. Hormonal therapy is likely to restore this balance and regulate hormone levels in the body. Women are generally advised by physicians not to take birth control pills during the hormonal therapy as it would complicate the balance that the treatment is aimed to accomplish.

Healthy Lifestyle

Apart from medical treatment, healthy diet, proper sleep, exercise and stress-management measures should be implemented. Diets rich in fruits and vegetables will also help get rid of the toxins within the body.

Follicular Cyst Infundibular Treatment

The treatment for this type of vesicles includes:

Alkaline Treatment

Those suffering from infundibular follicular cysts may apply alkalize pH water along with sea salt on the affected area to help get rid of it. Lowering the acidity of the skin will help eliminate possibilities of further development of this unwanted cyst. It can help increase capillary action and thus remove problems of obstruction.

Drinking Plenty of Water

Drink enough water to get rid of toxins within the body. You may add sea salt to the water you drink for increased potency.

Hot compression

If you feel pain then a mild hot compress applied on it for 15 to 20 minutes will help relieve you from the discomfort. In any case, it is always best to see a doctor for the appropriate diagnosis.

If you suspect yourself to be experiencing symptoms of this disorder, get in touch with a doctor as early as possible. Timely treatment will help you keep all complications at bay and get cured of this condition faster than you can imagine.

References:

http://en.wikipedia.org/wiki/Follicular_cyst_of_ovary

http://www.emedicinehealth.com/ovarian_cysts/article_em.htm

http://www.nlm.nih.gov/medlineplus/ency/article/001504.htm

http://www.ovarian-cyst-symptoms.info/Follicular-Cyst.html