Osteoporosis

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Sleepiness, tiredness and fatigue are complaints which must be thoroughly analyzed to eliminate blur and ambiguity.
Physiological sleepiness (“sleep pressure”) increases while being awake and additionally underlies the circadian rhythm with a lower threshold to fall asleep during night time.
Excessive daytime sleepiness (EDS) is considered normal only after sleep deprivation. Clinically, EDS manifests by frequents daytime napping and/or reduced alertness with automatic behavior or - in its extreme form - in recurrent attacks of sudden, uncontrollable compulsion to sleep also in inappropriate situations (= “sleep attacks”).
EDS is “objectively” addressed by measuring the mean sleep latency to four to five nap opportunities throughout the day using the multiple sleep latency test (MSLT) or the maintenance of wakefulness test (MWT).
EDS denotes both, a ready entrance into sleep as well as difficulty in staying awake during daytime or accordingly in inappropriate situations. These two partially independent aspects of EDS are separately assessed by the “passive” MSLT and the “active” MWT respectively.
For that reason the MSLT and MWT only weakly correlate with each other when tested over a broad range of patients with EDS. It is important to keep in mind, that these tests are importantly influenced by a great variety of factors such as mood, anxiety, and motivation.
“Vigilance” comprises wakefulness, alertness and attention and therefore is more than just the reciprocal to sleepiness. Cognitive performance tasks such as Steer Clear Reaction Time Test (SCRTT) or driving simulators require the complete integrity of vigilance to achieve normal results. Hypersomnia is usually broadly defined as the combination of abnormally prolonged night-time sleep (regularly >10 h) with EDS during ≥1 months.
On the other hand, the term hypersomnia has also been used in a narrower scene for the isolated abnormality of a prolonged night-time sleep need (>10 h). “Tiredness”, also in colloquial language often used for sleepiness, in a broader sense also describes the feeling of lack of energy, motivation and initiative.

These patients seek rest rather than sleep. They often cannot fall asleep when given the opportunity in spite of feeling tired, and hence, in an MSLT, do not show an abnormally short sleep latency. Furthermore, tiredness (and fatigue) as opposed to sleepiness has a mental (“central”) and physiological (bodily or “peripheral”) component, which the patients can readily distinguish. Patients with insomnia, mild sleep apnea syndrome, or depression rather suffer from mental tiredness than sleepiness during the day.
The simple subjective self-assessment using the Epworth Sleepiness Scale (ESS) quite reliably differentiates between sleepiness and mental tiredness (without sleepiness), which makes it a widely used test. The term “fatigue” is also heterogeneously used.
In physiology the “fatigue” implied a “time on task performance decrement” to describe decreasing muscle force during a sustained physical effort. In clinical medicine one distinguishes physical (“peripheral”) from mental (“central”) fatigue and the term usually denotes a chronic and more abnormal situation than tiredness.
In a broad sense “fatigue” implies a deficiency in coping satisfactorily with mental and physical work load. The chronic fatigue syndrome entails both mental as well as a physical fatigue (so called “leaden paralysis” of limbs). Depressive states are often associated with insomnia and fatigue, but there are also cases with hypersomnia rather than insomnia ( non organic hypersomnia , “atypical depression” or “hypersomnolent depression”)
Sometimes these patients have a tendency to spend much of the day lying in the bed without actually sleeping (so called clinophilia). The basic and clinical aspects of fatigu

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What is a mole? Many people refer to a mole as any dark spot or irregularity in the skin. Doctors use different terms. But the following types of skin marks such as these are not treated the same way moles are and are not discussed here: Birthmarks Abnormal formations of blood vessels (hemangiomas) Keratoses (benign or precancerous spots, which appear after about age 30 years)

If you have a blocked artery, your doctor may need to open the blockage and restore blood flow using a small mesh tube called a stent. The stent is inserted in your artery during an angioplasty procedure. Until now, stents were permanent. Now there is a fully dissolving stent available to treat blockages.

Bell's palsy is a form of facial paralysis resulting from damage or trauma to the facial nerves. The facial nerve-also called the 7th cranial nerve-travels through a narrow, bony canal (called the Fallopian canal) in the skull, beneath the ear, to the muscles on each side of the face. For most of its journey, the nerve is encased in this bony shell. Each facial nerve directs the muscles on one side of the face, including those that control eye blinking and closing, and facial expressions such as smiling and frowning. Additionally, the facial nerve carries nerve impulses to the lacrimal or tear glands, the saliva glands, and the muscles of a small bone in the middle of the ear called the stapes. The facial nerve also transmits taste sensations from the tongue. When Bell's palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis. Bell's palsy is named for Sir Charles Bell, a 19th century Scottish surgeon who described the facial nerve and its connection to the condition. The disorder, which is not related to stroke, is the most common cause of facial paralysis. Generally, Bell's palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases, it can affect both sides.

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Asbestosis (as-bes-TOE-sis) is a chronic lung disease caused by inhaling asbestos fibers. Prolonged exposure to these fibers can cause lung tissue scarring and shortness of breath. Asbestosis symptoms can range from mild to severe, and usually don't appear until many years after continued exposure. Asbestos is a natural mineral product that's resistant to heat and corrosion. It was used extensively in the past in products such as insulation, cement and some floor tiles. Most people with asbestosis acquired it on the job before the federal government began regulating the use of asbestos and asbestos products in the 1970s. Today, its handling is strictly regulated. Acquiring asbestosis is extremely unlikely if you follow your employer's safety procedures. Treatment focuses on relieving your symptoms.

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What are the symptoms of spinal meningitis in adults? Causes. The most common cause of viral meningitis is. ... Symptoms. Viral meningitis usually begins with symptoms of a viral infection, such as fever, a general feeling of illness (malaise), cough, muscle aches, vomiting, loss of appetite, and headache. ... Diagnosis. ... Treatment. ... Prognosis.

The occurrence and extent of cerebral infarction is determined by three basic factors: i) site of arterial occlusion, ii) the rapidity of arterial occlusion, and iii) the presence or absence of collateral circulation. Grossly, infarcts are usually divided into pale (non-hemorrhagic) and hemorrhagic types. Infarcts evolve over time, thus their gross appearance gives a clue to when they occurred. The temporal evolution of an infarct occurs in three stages: i) acute (1 day – 1 week) – the involved area is soft and edematous and there is a blurring of anatomic detail; ii) subacute (1 week – 1 month) – there is obvious tissue destruction and liquefactive necrosis of the involved brain; iii) chronic (>1 month) – the damaged tissue has been phagocytized and there is cavition with surrounding gliosis. Microscopically there is also a temporal evolution of cerebral infarcts. During the earliest phase of infarction (0-48 hours) chromatolysis and swollen eosinophilic neurons are seen. Neuronal cell necrosis and an acute inflammatory response are usually seen from 24-72 hours. This response is typically followed by an influx of mononuclear cells which begin to phagocytize necrotic debris (3-5 days). From 1-2 weeks after the infarct there is vascular proliferation and reactive astrocytosis. Over time (>1 month) the necrotic tissue will be completely removed and a cystic cavity surrounded by a glial scar will be formed.

Fibroadenomas (fy-broe-ad-uh-NO-muhz) are solid, noncancerous breast tumors that occur most often in adolescent girls and women under the age of 30. You might describe a fibroadenoma as firm, smooth, rubbery or hard with a well-defined shape. Usually painless, a fibroadenoma might feel like a marble in your breast, moving easily under your skin when touched. Fibroadenomas vary in size, and they can get bigger or even shrink on their own. Fibroadenomas are among the most common breast lumps in young women. Treatment may include monitoring to detect changes in the size or feel of the fibroadenoma, a biopsy to evaluate the lump, or surgery to remove it.

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.

Elbow. In primates, including humans, the elbow joint is the synovial hinge joint between the humerus in the upper arm and the radius and ulna in the forearm which allows the hand to be moved towards and away from the body.

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A cricothyrotomy (also called crike, thyrocricotomy, cricothyroidotomy, inferior laryngotomy, intercricothyrotomy, coniotomy or emergency airway puncture) is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by ...