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Most folks remember puberty – and not always in a good way. It can be an awkward stage of budding breasts, unwanted hair, acne and unexpected body odor. Puberty, when a child undergoes physical changes and becomes sexually mature, typically begins around age 8 in girls and age 9 in boys. But imagine, say, a 6- or 7-year-old undergoing such changes? Studies are showing that the onset of puberty for both boys and girls is occurring earlier and earlier, a phenomenon defined as precocious puberty. A study published in Pediatrics in 2010 found that among a population of 1,200 American girls, about 23 percent of African-Americans,15 percent of Latinas and 10 percent of Caucasian girls had begun puberty (marked by breast development) at age 7. In 2012, another study published in Pediatrics found that puberty in American boys – measured by testicular enlargement and pubic hair growth – was beginning six months to two years earlier than what research in previous decades had documented, particularly among African-American children.
There are several things to consider when trying to decide between gastric bypass surgery and gastric sleeve surgery. Unlike the laparoscopic adjustable gastric band (Lap Band), these two operations are both permanent, reduce hunger, and lead to the highest percentage of weight loss. To properly compare gastric sleeve surgery to gastric bypass surgery we will examine the following data : Expected weight loss. Speed of weight loss. Time of surgery. Gastric bypass benefits over sleeve. Gastric sleeve benefits over bypass. Risk of complications. Surgeon skill and preference.
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.
Chronic myeloid leukaemia is a common malignancy worldwide. We have come a long way from the limited treatment options and survival in this condition. Today, CML is a treatable malignancy with more than 80% patients surviving beyond 10 years after diagnosis, in absence of complications. This presentation deals with the definition, diagnostic criteria of chronic phase, accelerated and blastic phase (MD Anderson cancer centre, International bone marrow transplant registry and the WHO for the latter two) and management (first and second generation tyrosine kinase inhibitors) of this condition. Finally, a stepwise approach to chronic myeloid leukaemia is also presented including the definitive modality of treatment, allogeneic stem cell transplantation.
Gastrostomy tube is placed when a patient is not able to eat on his/her own as a result of neurological or other dysfunction. There are many different types of gastrostomy tubes but in general there are two bigger categories. The classic one and the low profile one. The gastroplexy technique is used preferably to avoid accidental pulling of the gastrostomy tube from an agitated or confused patient.
Initially, lead poisoning can be hard to detect — even people who seem healthy can have high blood levels of lead. Signs and symptoms usually don't appear until dangerous amounts have accumulated. Lead poisoning symptoms in children Signs and symptoms of lead poisoning in children include: Developmental delay Learning difficulties Irritability Loss of appetite Weight loss Sluggishness and fatigue Abdominal pain Vomiting Constipation Hearing loss Seizures Eating things, such as paint chips, that aren't food (pica) Lead poisoning symptoms in newborns Babies exposed to lead before birth might: Be born prematurely Have lower birth weight Have slowed growth Lead poisoning symptoms in adults Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults might include: High blood pressure Joint and muscle pain Difficulties with memory or concentration Headache Abdominal pain Mood disorders Reduced sperm count and abnormal sperm Miscarriage, stillbirth or premature birth in pregnant women Causes Lead is a metal that occurs naturally in the earth's crust, but human activity — mining, burning fossil fuels and manufacturing — has caused it to become more widespread. Lead was also once used in paint and gasoline and is still used in batteries, solder, pipes, pottery, roofing materials and some cosmetics. Lead in paint Lead-based paints for homes, children's toys and household furniture have been banned in the United States since 1978. But lead-based paint is still on walls and woodwork in many older homes and apartments. Most lead poisoning in children results from eating chips of deteriorating lead-based paint. Water pipes and imported canned goods Lead pipes, brass plumbing fixtures and copper pipes soldered with lead can release lead particles into tap water. Lead solder in food cans, banned in the United States, is still used in some countries. Other sources of lead exposure Lead sometimes can also be found in: Soil. Lead particles from leaded gasoline or paint settle on soil and can last years. Lead-contaminated soil is still a major problem around highways and in some urban settings. Some soil close to walls of older houses contains lead. Household dust. Household dust can contain lead from lead paint chips or from contaminated soil brought in from outside. Pottery. Glazes found on some ceramics, china and porcelain can contain lead that can leach into food served or stored in the pottery. Toys. Lead is sometimes found in toys and other products produced abroad. Cosmetics. Tiro, an eye cosmetic from Nigeria, has been linked to lead poisoning. Herbal or folk remedies. Lead poisoning has been linked to greta and azarcon, traditional Hispanic medicines, as well as some from India, China and other countries. Mexican candy. Tamarind, an ingredient used in some candies made in Mexico, might contain lead. Lead bullets. Time spent at firing ranges can lead to exposure. Occupations. People are exposed to lead and can bring it home on their clothes when they work in auto repair, mining, pipe fitting, battery manufacturing, painting, construction and certain other fields
If you look at someone’s back, you’ll see that the spine runs straight down the middle. When a person has scoliosis, their backbone curves to the side. The angle of the curve may be small, large or somewhere in between. But anything that measures more than 10 degrees is considered scoliosis. Doctors may use the letters “C” and “S” to describe the curve of the backbone. You probably don’t look directly at too many spines, but what you might notice about someone with scoliosis is the way they stand. They may lean a little or have shoulders or hips that look uneven. What Causes Scoliosis? In as many as 80% of cases, doctors don’t find the exact reason for a curved spine. Scoliosis without a known cause is what doctors call “idiopathic.” Some kinds of scoliosis do have clear causes. Doctors divide those curves into two types -- structural and nonstructural. In nonstructural scoliosis, the spine works normally, but looks curved. Why does this happen? There are a number of reasons, such as one leg’s being longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, this type of scoliosis often goes away. In structural scoliosis, the curve of the spine is rigid and can’t be reversed
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The average time from symptom onset to diagnosis has been reported to be approximately 2 years. Despite recent attempts at increasing the awareness of pulmonary arterial hypertension (PAH), especially associated PAH (APAH), this delay in diagnosis has not changed appreciably in recent years. Early symptoms are nonspecific. Often, neither the patient nor the physician recognizes the presence of the disease, which leads to delays in diagnosis. Complicating matters, idiopathic PAH (IPAH) requires an extensive workup in an attempt to elucidate an identifiable cause of the elevated pulmonary artery pressure. The most common symptoms and their frequency, reported in a national prospective study, are as follows: Dyspnea (60% of patients) Weakness (19%) Recurrent syncope (13%) Additional symptoms include fatigue, lethargy, anorexia, chest pain, and right upper quadrant pain. Cough, hemoptysis, and hoarseness are less common symptoms. Women are more likely to be symptomatic than men.