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Through the hormones it produces, the thyroid gland influences almost all of the metabolic processes in your body. Thyroid disorders can range from a small, harmless goiter (enlarged gland) that needs no treatment to life-threatening cancer. The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Although the effects can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.

There are currently 2 types of pneumococcal vaccines: pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) and pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax®). PCV13 is recommended for all children younger than 5 years old, all adults 65 years or older, and people 6 years or older with certain risk factors.

Goiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. Your doctor may recommend: Observation. If your goiter is small and doesn't cause problems, and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach. Medications. If you have hypothyroidism, thyroid hormone replacement with levothyroxine (Levoxyl, Synthroid, Tirosint) will resolve the symptoms of hypothyroidism as well as slow the release of thyroid-stimulating hormone from your pituitary gland, often decreasing the size of the goiter. For inflammation of your thyroid gland, your doctor may suggest aspirin or a corticosteroid medication to treat the inflammation. For goiters associated with hyperthyroidism, you may need medications to normalize hormone levels. Surgery. Removing all or part of your thyroid gland (total or partial thyroidectomy) is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing, or in some cases, if you have a nodular goiter causing hyperthyroidism.

The brain is that part of the CNS contained within the cranial cavity (figure 13.1). It is the control center for many of the body's functions. The brain is much like a complex central computer but with additional functions that no computer can as yet match. Indeed, one goal in computer technology is to make computers that can function more like the human brain. The brain consists of the brainstem, the cerebellum, the diencephalon, and the cerebrum (table 13.1). The brainstem includes the medulla oblongata, pons, midbrain, and reticular formation. The structure of the brain is described in this chapter. Its functions are primarily discussed in chapter 14. Twelve pairs of cranial nerves, which are part of the PNS, arise directly from the brain. Two pairs arise from the cerebrum, nine pairs arise from the brainstem, and one pair arises from the spinal cord.

Scleroderma (skleer-oh-DUR-muh) is a group of rare diseases that involve the hardening and tightening of the skin and connective tissues — the fibers that provide the framework and support for your body. In some people, scleroderma affects only the skin. But in many people, scleroderma also harms structures beyond the skin — such as blood vessels, internal organs and the digestive tract. Signs and symptoms vary, depending on which structures are affected. Scleroderma affects women more often than men and most commonly occurs between the ages of 30 and 50. While there is no cure for scleroderma, a variety of treatments can ease symptoms and improve quality of life.

There's only one group of people who really know what happens when you die: the dead. And since the dead won't be revealing their secrets anytime soon, it's up to scientists to explain what happens when a person dies. Death, just like life, is a process, scientists say. The first stage of this process is known as clinical death. It lasts from four to six minutes, beginning when a person stops breathing and the heart stops pumping blood. During this time, there may be enough oxygen in the brain that no permanent brain damage occurs. Other organs, such as the kidneys and eyes, also remain alive throughout clinical death.

Pelvic ureter. The ureter enters the pelvis, where it crosses anteriorly to the iliac vessels, which usually occurs at the bifurcation of the common iliac artery into the internal and external iliac arteries. Here, the ureters are within 5 cm of one another before they diverge laterally.

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If it is not removed, tooth decay will begin. The acids in plaque damage the enamel covering your teeth. It also creates holes in the tooth called cavities. Cavities usually do not hurt, unless they grow very large and affect nerves or cause a tooth fracture.

How to examine a patient's wrist if you suspect a scaphoid fracture: by Cape Town Emergency Medicine

Knee replacement, also called arthroplasty, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery may be considered for someone who has severe arthritis or a severe knee injury.

Treatment for kidney stones varies, depending on the type of stone and the cause. Small stones with minimal symptoms Most kidney stones won't require invasive treatment. You may be able to pass a small stone by: Drinking water. Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system. Unless your doctor tells you otherwise, drink enough fluid — mostly water — to produce clear or nearly clear urine. Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve). Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain. Large stones and those that cause symptoms Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more extensive treatment. Procedures may include: Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL). ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable. ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract. Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back. You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL was unsuccessful. Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter. Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure. Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result. Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that's causing your parathyroid gland to overproduce the hormone.

A pneumothorax is usually caused by an injury to the chest, such as a broken rib or puncture wound. It may also occur suddenly without an injury. A pneumothorax can result from damage to the lungs caused by conditions such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, and pneumonia.

Rheumatic heart disease (RHD) is the most common acquired heart disease in children in many countries of the world, especially in developing countries. The global burden of disease caused by rheumatic fever currently falls disproportionately on children living in the developing world, especially where poverty is widespread. RHD is a chronic heart condition caused by rheumatic fever that can be prevented and controlled. Rheumatic fever is caused by a preceding group A streptococcal (strep) infection. Treating strep throat with antibiotics can prevent rheumatic fever. Moreover, regular antibiotics (usually monthly injections) can prevent patients with rheumatic fever from contracting further strep infections and causing progression of valve damage. Consequences of rheumatic heart disease Acute rheumatic fever primarily affects the heart, joints and central nervous system. The major importance of acute rheumatic fever is its ability to cause fibrosis of heart valves, leading to crippling valvular heart disease, heart failure and death. The decline of rheumatic fever in developed countries is believed to be the result of improved living conditions and availability of antibiotics for treatment of group A streptococcal infection. Overcrowding, poor housing conditions, undernutrition and lack of access to healthcare play a role in the persistence of this disease in developing countries.

Trisomy 18, also called Edwards syndrome, is a chromosomal condition associated with abnormalities in many parts of the body. Individuals with trisomy 18 often have slow growth before birth (intrauterine growth retardation) and a low birth weight. Affected individuals may have heart defects and abnormalities of other organs that develop before birth. Other features of trisomy 18 include a small, abnormally shaped head; a small jaw and mouth; and clenched fists with overlapping fingers. Due to the presence of several life-threatening medical problems, many individuals with trisomy 18 die before birth or within their first month. Five to 10 percent of children with this condition live past their first year, and these children often have severe intellectual disability.

Diarrhea in Children: Common Causes and Treatments Diarrhea is the body's way of ridding itself of germs, and most episodes last a few days to a week. Diarrhea often occurs with fever, nausea, vomiting, cramps, and dehydration. Some of the most common reasons kids get diarrhea include: Infection from viruses like rotavirus, bacteria like salmonella and, rarely, parasites like giardia. Viruses are the most common cause of a child's diarrhea. Along with loose or watery stools, symptoms of a viral gastroenteritis infection often include vomiting, stomachache, headache, and fever. When treating viral gastroenteritis -- which can last 5-14 days -- it's important to prevent fluid loss. Offer additional breast milk or an oral rehydration solution (ORS) to infants and young children. Water alone doesn't have enough sodium, potassium, and other nutrients to safely rehydrate very young children. Be sure to talk to your doctor about the amount of fluids your child needs, how to make sure he or she gets them, when to give them, and how to watch for dehydration. Older children with diarrhea can drink anything they like to stay hydrated, including ORS and brand-name products (their names usually end in "lyte"). Popsicles can also be a good way to get fluids into a child who's been vomiting and needs to rehydrate slowly.

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Marfan syndrome is a genetic disorder that affects the body’s connective tissue. Connective tissue holds all the body’s cells, organs and tissue together. It also plays an important role in helping the body grow and develop properly. marfan_general_2.jpg What is Marfan Syndrome?Connective tissue is made up of proteins. The protein that plays a role in Marfan syndrome is called fibrillin-1. Marfan syndrome is caused by a defect (or mutation) in the gene that tells the body how to make fibrillin-1. This mutation results in an increase in a protein called transforming growth factor beta, or TGF-β. The increase in TGF-β causes problems in connective tissues throughout the body, which in turn creates the features and medical problems associated with Marfan syndrome and some related disorders. Because connective tissue is found throughout the body, Marfan syndrome can affect many different parts of the body, as well. Features of the disorder are most often found in the heart, blood vessels, bones, joints, and eyes. Some Marfan features – for example, aortic enlargement (expansion of the main blood vessel that carries blood away from the heart to the rest of the body) – can be life-threatening. The lungs, skin and nervous system may also be affected. Marfan syndrome does not affect intelligence.

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