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For the first few days after giving birth, a new mother’s breasts remain soft. They will produce colostrum. Colostrum, the first milk, is available in just the right amount, and is rich in immune factors that protect newborns. Sometime during the next few days, the breasts will become full, firm, warm, and perhaps tender. When this occurs, people say: “the milk is coming in!” The scientific term for this event is: engorgement. Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to two weeks.

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how do you know if I have a clogged duct or mastitis? You'll always have a clogged duct before you have mastitis and sometimes mastitis can be prevented if you jump on it fast enough. A clogged duct may be red, it can be a tender lump on one side or the other, just feel a little bit painful in one area when you nurse, and the best thing to do is apply warm compresses especially before nursing, massage the area from your armpit down towards the nipple, and then nurse your baby. The goal is to unclog that duct, get your baby to fully empty the breast, and hopefully it will prevent an infection. An infection or mastitis develops if the clogged duct isn't unclogged and bacteria start to harbor and grow and then you have an infection. Symptoms can be the same as a clogged duct as far as how the breasts feel. You might notice a red tender area or a lump. In addition to that you usually do have a fever or flu-like symptoms or just have generalized malaise, and fatigue, and aches. If you feel this way, call your doctor as soon as possible because it requires treatment. An antibiotic is the treatment as well as drinking lots of fluids and nursing your baby as frequently as possible. The milk that comes from the clogged duct is not harmful for your baby but sometimes it tastes a little extra salty and babies refuse it. If that's the case be sure to pump so that you're emptying your breast frequently. The more frequently you empty your breast the quicker you'll get over the infection. Also, of course, taking the antibiotics your doctor has prescribed and be sure to finish the entire course. If you have any other questions for me in the future feel free to ask them on our Facebook page at Facebook.com/IntermountainMoms and recommend us to your friends and family too.

Pharyngitis is caused by swelling in the back of the throat (pharynx) between the tonsils and the voice box (larynx). Most sore throats are caused by colds, the flu, coxsackie virus or mono (mononucleosis). Bacteria that can cause pharyngitis in some cases: Strep throat is caused by group A streptococcus.

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The hepatitis E virus, responsible for major epidemics of viral hepatitis in subtropical and tropical countries, was cloned only 7 years ago.1 Hepatitis E was found to belong to the family of Caliciviridae, which includes the Norwalk virus—a common cause of gastroenteritis in humans—and consists of a single, plus-strand RNA genome of approximately 7.2 kb without an envelope (Fig. 1). The virus contains at least three open reading frames encoding viral proteins against which antibodies are made on exposure. These antibodies, especially those against the capsid protein derived from the second open reading frame2 and a protein of unknown function derived from the third open reading frame, are detected by currently available serologic assays. Retrospective studies on stored sera of past epidemics of viral hepatitis in Mexico, Africa, Afghanistan, Pakistan, India, Bangladesh, Burma, Nepal, and Borneo have revealed that all were caused by strains of hepatitis E. In addition, hepatitis E was found to be responsible for the hepatitis epidemic in the southern part of Xinjiang, China, in which 120,000 persons became infected between September 1986 and April 1988.3 Hepatitis E predominantly affects young adults (15 to 40 years old). The symptoms of hepatitis E are similar to those of hepatitis A. Frequently, a prodrome consisting of anorexia, nausea, low-grade fever, and right upper abdominal pain is present 3 to 7 days before jaundice develops. Aminotransferase levels peak (usually between 1,000 and 2,000 U/L) near the onset of symptoms; bilirubin levels (10 to 20 mg/dL) peak later. Jaundice usually resolves after 1 to 2 weeks. In about 10% of cases, the disease is fulminant—especially in pregnant women, among whom mortality rates as high as 20% due to hemorrhagic and thrombotic complications have been reported. No evidence has suggested that hepatitis E can cause chronic infection. Transmission is by the fecal-oral route, predominantly through fecally contaminated drinking water supplies. In addition, however, preliminary reports have suggested transmission of the hepatitis E virus through blood transfusions. Volunteer studies confirmed the presence of the virus in serum and feces before and during clinical disease.4 The virus is shed into feces approximately 1 week before symptoms develop. The incubation period varies from 2 to 9 weeks (mean duration, approximately 45 days). Until now, a few reports had described symptomatic hepatitis E acquired in Europe;5, 6 all patients with symptomatic hepatitis E in the United States were travelers returning from Mexico, Africa, or the Far East, in whom hepatitis E developed after their return home.7 In this issue of the Mayo Clinic Proceedings (pages 1133 to 1136), Kwo and associates describe a case of hepatitis E in a man who had not left the United States during the previous 10 years. Specific serologic tests for hepatitis E virus IgG (enzyme immunoassays and a fluorescent antibody blocking assay) and IgM8 (US strain-specific enzyme-linked immunosorbent assay with use of synthetic polypeptides deduced from the viral genome, as shown in Figure 1), developed at Abbott Laboratories (IgG and IgM) as well as at the Centers for Disease Control and Prevention (IgG), were used to prove that the patient indeed had acute hepatitis E. Researchers at Abbott Laboratories have prepared a report that describes most of the viral genome in this patient (Fig. I).8 Their results are interesting because this strain from the United States differs considerably from hepatitis E strains isolated in Mexico, Burma, Pakistan, or China. Furthermore, the sequence of the US strain is highly homologous (98% and 94% homology at the amino acid level to the second and third open reading frames, respectively) to a recently isolated hepatitis E strain from American swine.9 This finding suggests that, in the United States, hepatitis E is a zoonosis with the swine population as one of its hosts. This relationship would confirm earlier studies in Asia, where swine were also found to carry variants of the hepatitis E virus.10 Why are these two recent discoveries important for medicine in the United States? First, other sporadic, locally acquired cases of acute hepatitis may be caused by hepatitis E. Second, these back-to-back discoveries strongly suggest that a common natural host for hepatitis E is present in countries with more moderate climates. Because swine do not seem to experience any symptoms associated with infection and because symptoms in humans can be minor or absent, we now may also have an explanation for the 1 to 2% of positive hepatitis E serologic results in blood donors in the United States,11 Netherlands,12 and Italy,6 countries with large swine staples. Clearly, more research needs to be done to confirm this hypothesis. Third, in countries with more moderate climates, hepatitis E may often result in a subclinical infection. Is this variation in manifestation due to less virulent strains, and do sequence variations determine virulence? Fourth, swine may be used as an animal model for study of the disease as well as vaccine development.

Juvenile polyposis syndrome (JPS) is a hereditary condition that is characterized by the presence of hamartomatous polyps in the digestive tract. Hamartomas are noncancerous (benign) masses of normal tissue that build up in the intestines or other places. These masses are called polyps if they develop inside a body structure, such as the intestines. The term “juvenile polyposis” refers to the type of polyp (juvenile polyp) that is found after examination of the polyp under a microscope, not the age at which people are diagnosed with JPS.

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The Hypertensive urgency must be distinguished from hypertensive emergency. Urgency is defined as severely elevated blood pressure (ie, systolic >220 mm Hg or diastolic >120 mm Hg) with no evidence of target organ damage.

The baby suffered from ectopia cordis, a rare condition where a baby's heart is located either partially or totally outside the chest. Only 8 out of 1 million babies are born with the condition, and 90 percent of those babies are either stillborn or die within the first three days of life.

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1. La Hidratación.

Como primera medida, asegúrese de estar bien hidratada. Si usted bebe la cantidad de líquido necesaria, logrará eliminar las toxinas y desechos que se encuentran acumulados en su organismo, los cuales en muchas ocasiones colaboran con la aparición de los fibromas

Por otro lado, el estreñimiento también puede ser una consecuencia de la falta de hidratación y esto también colabora con la acumulación de toxinas y desechos que vuelven a ser absorbidos por el cuerpo.

Prefiera alimentos como el salmón, las aceitunas, el aceite de oliva, la palta, etc.
Evite alimentos ricos en grasas saturadas como los quesos duros, la mantequilla, carnes grasas, embutidos y comida chatarra.

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There’s a strange, mysterious world inside us, an alien-looking environment that turns the food we eat into nutrients that keep us alive. Michael Mosley swallows a camera to take a closer look.

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