Type 1 Diabetes

 

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease.

In type 1 diabetes, the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives.

Diabetes - gestational

Credit: diabetic.org

Gestational diabetes is diabetes that occurs during pregnancy. Diabetes is a common condition where there is too much glucose in the blood. Women usually recover from gestational diabetes after their baby is born, when their blood glucose levels return to normal.

Our body makes insulin to help keep our blood glucose at the right level. Blood glucose becomes higher when we can’t make enough insulin or when it does not work as well as it should

Development of gestational diabetes

During pregnancy, hormones are made by the placenta to help the baby develop and grow. These hormones, however, stop the mother’s insulin from working properly. This is called insulin resistance. As the pregnancy develops and the baby grows bigger, the mother’s body has to make more insulin to keep her blood glucose at normal levels.  Later in pregnancy the amount of insulin needed to keep blood glucose levels normal is two to three times higher than usual. If the body is unable to produce enough insulin to keep blood glucose levels in the normal range, gestational diabetes develops.

Women at risk of gestational diabetes

Between three and eight per cent of pregnant women develop gestational diabetes. It is usually detected around weeks 24 to 28 of pregnancy, although it can develop earlier. Being diagnosed with gestational diabetes can be both unexpected and upsetting.

Certain women are at increased risk of developing gestational diabetes. This includes women who:

·        are over 30 years of age

·        have a family history of type 2 diabetes

·        are overweight or obese

·        are of Aboriginal and Torres Strait Islander descent

·        are of particular cultural groups, such as Indian, Chinese, Vietnamese, Middle Eastern, Polynesian and Melanesian

·        have previously had gestational diabetes

·        take some antipsychotic or steroid medications

·        have previously had a baby whose birth weight was greater than 4,500 grams (4.5 kg)

·        have had a previous complicated pregnancy.

·        have had polycystic ovarian syndrome.

Some women who develop gestational diabetes have no known risk factors.

Symptoms of gestational diabetes

Gestational diabetes usually has no obvious symptoms. If symptoms do occur, they can include:

·        unusual thirst

·        excessive urination

·        tiredness

·        thrush (yeast infections). 

Diagnosis of gestational diabetes

Most women are diagnosed using a pathology test, which requires a blood sample to be taken before and after a glucose drink. These tests are usually performed between 24 and 28 weeks into the pregnancy, or earlier if you are at high risk.
To diagnose gestational diabetes a pregnancy oral glucose tolerance test (POGTT) is recommended.

This involves taking a blood test after fasting overnight. Next you have a drink containing 75 grams of glucose and blood is taken to be tested one and two hours afterwards.

Diagnosis of gestational diabetes is made if the fasting blood glucose is raised or the two-hour blood glucose is raised (or both).The new diagnostic guidelines for gestational diabetes state a raised blood glucose level at one hour after the glucose drink also indicates gestational diabetes.

Some health centres may be still using the Glucose Challenge Test (GCT). A sweet glucose drink is given and the blood glucose measured one hour after the drink. If this is above normal, an oral glucose tolerance test is required. This test is no longer considered part of diagnostic testing as it is not specific or sensitive enough for diagnosing GDM.

Treatment for gestational diabetes

If you are diagnosed with gestational diabetes it is important that you are supported and know what to do to manage it. Health professionals such as your doctor, a dietitian, a diabetes nurse educator or sometimes a diabetes specialist will help you understand what to do and will support you. Family also can be a great support and it is important that they also understand about gestational diabetes and how it is managed.

It is important that blood glucose is kept as close to normal as possible, especially during pregnancy. High blood glucose levels can affect the baby before birth, later as a child and even as an adult.

During pregnancy, glucose crosses the placenta from mother to baby to provide energy for the growing baby. If your blood glucose levels are higher than normal, extra glucose will cross the placenta to the baby. To deal with this extra glucose, the baby then makes more insulin which makes the baby grow larger more quickly. If your blood glucose levels remain high, the baby may become larger than normal. This can lead to problems during and after birth.

Keeping blood glucose in the recommended range can prevent problems during birth and also helps reduce the baby’s risk of being overweight in childhood and developing type 2 diabetes later in life.

Management of gestational diabetes

Advice to help manage gestational diabetes (which will help to keep blood glucose levels close to normal) may include:

·        healthy diet – make sure you are eating a nutritious diet that helps you maintain a healthy weight. Choose varied and enjoyable food, including foods rich in calcium (milk and cheese), iron (red meat, chicken and fish) and folic acid (dark green leafy vegetables). Include some carbohydrates at each meal such as grains, cereals, fruits, pasta and rice. Reduce your saturated fat intake by limiting the amount of processed and takeaway foods that you eat. Avoid foods and drinks containing a lot of added sugar. Discuss with a dietitian how much carbohydrate you should eat and the best way to spread it out throughout the day to help control your blood glucose levels. A dietitian can also help you with any other questions about how to make sure you are eating the best diet for you and your baby

·        physical activity – such as walking, helps to keep you fit, prepares you for the birth of your baby and will help to control your blood glucose levels. Check with your doctor before starting a new or particularly strenuous exercise regimen

·        monitoring your blood glucose levels – is essential. It gives a guide as to whether the changes you have made to your lifestyle are effective or whether further treatment is required. A diabetes nurse educator can teach you how and when to measure your blood glucose levels. They will discuss the recommended blood glucose levels to aim for. Your doctor or diabetes educator can help you link in with the National Diabetes Services Scheme (NDSS) for cheaper blood glucose strips. Regular contact with your diabetes educator or doctor is recommended

·        insulin injections – may be needed to help keep your blood glucose level in the normal range. Many diabetes tablets are not safe to take during pregnancy so insulin injections may be necessary. Insulin is safe to take during pregnancy and does not cross the placenta from the mother to the baby

·        education – it is very important that you get information and support from your diabetes educator or doctor on how insulin works, how to give insulin and how to store it. Insulin sometimes causes blood glucose levels to go too low (hypoglycaemia), therefore it is very important that you learn the signs and symptoms of this and how to prevent and treat it (as well as safe blood glucose levels for driving).

After your baby is born

If you have been having insulin injections to help manage gestational diabetes, you can usually stop these injections once your baby is born. This is because your blood glucose levels usually return to normal quite quickly after the baby’s birth.

Your blood glucose levels will be measured for a few days after your baby is born to make sure that they are within the normal range. Testing times are usually before breakfast and two hours after meals. An Oral Glucose Tolerance test (OGTT) is done six to eight weeks after the baby is born to make sure that diabetes has gone away.

Following the birth of your baby, it is important that your baby’s blood glucose levels are measured to make sure that their blood glucose is not too low. If it is, this can be treated by feeding your baby breast milk or formula. Breastfeeding is encouraged as this is best for you and your baby.

A baby whose mother had gestational diabetes will not be born with diabetes, but, they may be at risk of developing type 2 diabetes later in life.

Future pregnancies and gestational diabetes

If you have had gestational diabetes you are more likely to have it again in future pregnancies. For that reason an OGTT will be performed early in any future pregnancy to look for gestational diabetes. If this test is normal, then another OGTT will be done again later in the pregnancy (between 22 and 28 weeks) to make sure blood glucose levels are still normal.

Reducing your risk of type 2 diabetes

Women who have gestational diabetes have a high chance (almost one in two) of developing type 2 diabetes within 10 to 20 years. Type 2 diabetes can be prevented, so it is important to take steps to reduce your risk.

You should:

·        maintain a healthy eating plan

·        maintain a healthy weight for your height

·        do regular physical activity

·        have a follow-up blood test (OGTT) every year to check your blood glucose levels.

Where to get help

·        Your doctor

·        Obstetrician

·        Diabetes specialist or endocrinologist

·        Diabetes educator – ask at the hospital where you are booked to have your baby, or alternatively, you may see a diabetes educator privately

·        Diabetes Info Line Tel. 1300 136 588

·        Dietitians Association of Australia Tel. (02) 6163 5200

Things to remember

·        Gestational diabetes is diabetes that occurs during pregnancy.

·        When the pregnancy is over, the diabetes usually disappears.

·        Women who develop gestational diabetes have an increased risk of developing type 2 diabetes. 

·        A healthy lifestyle is important for both mother and baby to reduce their risk of diabetes in the future.

·        If you have had gestational diabetes before, in future pregnancies, a test will be performed early in the pregnancy to make check that your blood glucose levels are in the normal range .

Source: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-gestational

Diabetes mellitus

Credit: wikipedia.org

Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, nonketotic hyperosmolar coma, or death. Serious long-term complications include heart disease, stroke, chronic kidney failure, foot ulcers, and damage to the eyes.

Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced. There are three main types of diabetes mellitus:

Type 1 DM results from the pancreas's failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is unknown.

Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The primary cause is excessive body weight and not enough exercise.

Gestational diabetes is the third main form and occurs when pregnant women without a previous history of diabetes develop high blood-sugar levels.

Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco. Control of blood pressure and maintaining proper foot care are important for people with the disease. Type 1 DM must be managed with insulin injections. Type 2 DM may be treated with medications with or without insulin. Insulin and some oral medications can cause low blood sugar. Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 DM. Gestational diabetes usually resolves after the birth of the baby.

As of 2015, an estimated 415 million people had diabetes worldwide, with type 2 DM making up about 90% of the cases. This represents 8.3% of the adult population, with equal rates in both women and men. As of 2014, trends suggested the rate would continue to rise. Diabetes at least doubles a person's risk of early death. From 2012 to 2015, approximately 1.5 to 5.0 million deaths each year resulted from diabetes. The global economic cost of diabetes in 2014 was estimated to be US$612 billion. In the United States, diabetes cost $245 billion in 2012.  Read more >>

Source: https://en.wikipedia.org/wiki/Diabetes_mellitus

Depression (mood)

Facial features of a person who is depressed (wikipedia.org)

Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being.

People with a depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, angry, ashamed or restless. They may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details or making decisions, experience relationship difficulties and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present.

Depressed mood is a feature of some psychiatric syndromes such as major depressive disorder, but it may also be a normal reaction, as long as it does not persist long term, to life events such as bereavement, a symptom of some bodily ailments or a side effect of some drugs and medical treatments. A DSM diagnosis distinguishes an episode (or 'state') of depression from the habitual (or 'trait') depressive symptoms someone can experience as part of their personality.

Dehydration in Adults

Dehydration in Adults

Pinched skin goes down slowly (Credit: alfa-img.com)

Dehydration in Adults Overview

Dehydration is a condition that occurs when the loss of body fluids, mostly water, exceeds the amount that is taken in. With dehydration, more water is moving out of our cells and bodies than what we take in through drinking.

We lose water every day in the form of water vapor in the breath we exhale and in our excreted sweat, urine, and stool. Along with the water, small amounts of salts are also lost.

When we lose too much water, our bodies may become out of balance or dehydrated. Severe dehydration can lead to death.

Cretinism

Congenital iodine deficiency syndrome (Credit: wikipedia.org)

Cretinism is a condition of severely stunted physical and mental growth due to untreated congenital deficiency of thyroid hormone (congenital hypothyroidism) usually due to maternal hypothyroidism.

Pathophysiology

Congenital hypothyroidism can be endemic, genetic, or sporadic. If untreated, it results in mild to severe impairment of both physical and mental growth and development.

Poor length growth is apparent as early as the first year of life. Adult stature without treatment ranges from 100 to 160 cm (3 ft 3 in to 5 ft 3 in), depending on severity, sex, and other genetic factors. In adults, Cretinism results in mental deterioration, swelling of the skin, loss of water and hair. Bone maturation and puberty are severely delayed. Ovulation is impeded, and infertility is common.

Neurological impairment may be mild, with reduced muscle tone and coordination, or so severe that the person cannot stand or walk. Cognitive impairment may also range from mild to so severe that the person is nonverbal and dependent on others for basic care. Thought and reflexes are slower.

Other signs may include thickened skin, enlarged tongue, or a protruding abdomen.

Dwarfism may also be caused by malnutrition or other hormonal deficiencies, such as insufficient growth hormone secretion, hypopituitarism, decreased secretion of growth hormone-releasing hormone, deficient growth hormone receptor activity and downstream causes, such as insulin-like growth factor 1 (IGF-1) deficiency.

Treatment

Sporadic and genetic cretinism results from abnormal development or function of the foetal thyroid gland. This type of cretinism has been almost completely eliminated in developed countries by early diagnosis by newborn screening schemes followed by lifelong treatment with thyroxine (T4).

Thyroxine must be dosed as tablets only, even to newborns, as the liquid oral suspensions and compounded forms cannot be depended on for reliable dosing. In the case of dosing infants, the T4 tablets are generally crushed and mixed with breast milk, formula milk or water. If the medication is mixed with formulas containing iron or soya products, larger doses may be required, as these substances may alter the absorption of thyroid hormone from the gut. Frequent monitoring (every 2–3 weeks during the first months of life) is recommended to ensure that infants with congenital hypothyroidism remain within the high end of normal range, or euthyroid.

Cause

Around the world, the most common cause of congenital hypothyroidism is iodine deficiency. Cretinism is therefore most probably due to a diet deficient in iodine. It has affected many people worldwide and continues to be a major public health problem in many countries. Iodine is an essential trace element, necessary primarily for the synthesis of thyroid hormones. Iodine deficiency is the most common preventable cause of brain damage worldwide. Although iodine is found in many foods, it is not universally present in all soils in adequate amounts. Most iodine, in iodide form, is in the oceans where the iodide ions oxidize to elemental iodine, which then enters the atmosphere and falls to earth as rain, introducing iodine to soils. Earth deficient in iodine is most common inland and in mountainous areas and areas of frequent flooding, but can also occur in coastal regions owing to past glaciation, and leaching by snow, water and heavy rainfall, which removes iodine from the soil. Plants and animals grown in iodine deficient soils are correspondingly deficient. Populations living in those areas without outside food sources are most at risk of iodine deficiency diseases.

Iodine deficiency results in the impairments in varying degrees of physical and mental development. It also causes gradual enlargement of the thyroid gland, referred to as a goitre. It is being combated in many countries by public health campaigns of iodine administration.

History

Goiter is the most specific clinical marker of either the direct or indirect insufficient intake of iodine in the human body. There is evidence of goiter, and its medical treatment with iodine-rich algae and burnt sponges, in Chinese, Egyptian, and Roman ancient medical texts. In 1848, the Italian King Carlo Alberto of Sardinia commissioned the first epidemiological study of goiter and cretinism in his Haute-Savoy territories, where hideous cases of goiters and cretinism frequently occurred in the population. In past centuries, the well reported social diseases prevalent among the poorer social classes and farmers, caused by dietary and agricultural monocultures, were: pellagra, rickets, beriberi, scurvy in long-term sailors, and the endemic goiter caused by I-deficiency. However, this disease was less mentioned in medical books because it was erroneously considered to be an aesthetic rather than a clinical disorder. Endemic cretinism was especially common in areas of southern Europe around the Alps and was described by ancient Roman writers, and often depicted by medieval artists. The earliest Alpine mountain climbers sometimes came upon whole villages of cretins. Alpine cretinism was described from a medical perspective by several travellers and physicians in the late 18th and early 19th centuries. At that time the cause was not known and it was often attributed to "stagnant air" in mountain valleys or "bad water". The proportion of people affected varied markedly throughout southern Europe and even within very small areas it might be common in one valley and not another. The number of severely affected persons was always a minority, and most persons were only affected to the extent of having a goitre and some degree of reduced cognition and growth. The majority of such cases were still socially functional in their pastoral villages.

More mildly affected areas of Europe and North America in the 19th century were referred to as "goitre belts". The degree of iodine deficiency was milder and manifested primarily as thyroid enlargement rather than severe mental and physical impairment. In Switzerland, for example, where soil does not contain a large amount of iodine, cases of cretinism were very abundant and even considered genetically caused. As the variety of food sources dramatically increased in Europe and North America and the populations became less completely dependent on locally grown food, the prevalence of endemic goitre diminished.

The early 20th century saw the discovery of the relationships of sporadic cretinism with congenital hypothyroidism, and of endemic cretinism with hypothyroidism due to iodine deficiency. Both have been largely eliminated in the developed world.

Etymology

The term cretin was once used to describe a person affected by cretinism, but, as with words such as spastic, and lunatic, it is now considered derogatory and inappropriate. Cretin became a medical term in the 18th century, from an Occitan and an Alpine French expression, prevalent in a region where persons with such a condition were especially common (see below); it saw wide medical use in the 19th and early 20th centuries, and was actually a "tick box" category on Victorian-era census forms in the UK. The term spread more widely in popular English as a markedly derogatory term for a person who behaves stupidly. Because of its pejorative connotations in popular speech, health-care workers have mostly abandoned cretin.

The etymology of cretin is uncertain. Several hypotheses exist. The most common derivation provided in English dictionaries is from the Alpine French dialect pronunciation of the word Chrétien ("(a)Christian"), which was a greeting there. According to the Oxford English Dictionary, the translation of the French term into "human creature" implies that the label "Christian" is a reminder of the humanity of the afflicted, in contrast to brute beasts. Other sources suggest that Christian describes the person's "Christ-like" inability to sin, stemming, in such cases, from an incapacity to distinguish right from wrong.

Other speculative etymologies have been offered:

• From creta, Latin for chalk, because of the pallor of those affected.
• From cretira, Grison-Romanche creature, from Latin creatus.
• From cretine, French for alluvium (soil deposited by flowing water), an allusion to the affliction's suspected origin in inadequate soil.

Source: https://en.wikipedia.org/wiki/Cretinism

Cowpox

Cowpox is an infectious disease caused by the cowpox virus. The virus, part of the orthopoxvirus family, is closely related to the vaccinia virus. The virus is zoonotic, meaning that it is transferable between species, such as from animal to human. The transferral of the disease was first observed in dairymaids who touched the udders of infected cows and consequently developed the signature pustules on their hands. Cowpox is more commonly found in animals other than bovines, such as rodents. Cowpox is similar to, but much milder than, the highly contagious and often deadly smallpox disease. Its close resemblance to the mild form of smallpox and the observation that dairymaids were immune from smallpox inspired the first smallpox vaccine, created and administered by English physician Edward Jenner.

Coronary artery disease

Coronary artery disease

Coronary artery disease (CAD), also known asischemic heart disease (IHD), is a group of diseases that includes: stable angina, unstable angina, myocardial infarction, and sudden cardiac death. It is within the group of cardiovascular diseases of which it is the most common type. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and get better with rest. Shortness of breath may also occur and sometimes no symptoms are present. The first sign is occasionally a heart attack. Other complications include heart failure or an irregular heartbeat.

Heart Disease and Congestive Heart Failure

Credit: www.newhealthadvisor.com

Heart failure affects nearly 6 million Americans. Roughly 670,000 people are diagnosed with heart failure each year. It is the leading cause of hospitalization in people older than 65.

What Is Heart Failure?

Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. As a result, the kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

What Causes Heart Failure?

Heart failure is caused by many conditions that damage the heart muscle, including:

• Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.
• Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly.
• Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.
• Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can occur when several diseases or conditions are present at once.  Read more >> 

Source: http://www.webmd.com/heart-disease/guide-heart-failure

Congenital insensitivity to pain with anhidrosis

Credit: pediatricneurosciences.com

Congenital insensitivity to pain with anhidrosis (CIPA), also called hereditary sensory and autonomic neuropathy type IV—is an extremely rare inherited disorder of the nervous system which prevents the sensation of pain, heat, cold, or any real nerve-related sensations (including feeling the need to urinate); however, patients can still feel pressure. CIPA is the fourth type of hereditary sensory and autonomic neuropathy (HSAN), known as HSAN IV. (It is also referred to as HSAN Type IV). A person with CIPA cannot feel pain or differentiate even extreme temperatures. "Anhidrosis" means the body does not sweat, and "congenital" indicates that the condition is present from birth.

Condyloma

Severe case of genital warts around the anus (Credit: wikipedia.org)

Condyloma (plural: "Condylomata", from Greek "knuckle") refers to an infection of the genitals. The two subtypes are:

• Condyloma acuminata, or genital warts, caused by human papilloma virus subtypes 6, 11, and others
• Condylomata lata, white lesions associated with secondary syphilis

Condylomata lata

Not to be confused with condyloma acuminata.

Condylomata lata or condyloma latum, is a cutaneous condition characterized by wart-like lesions on the genitals. They are generally symptoms of the secondary phase of syphilis, caused by the spirochete, Treponema pallidum.

Condylomata lata occurs in about one-third of syphilis patients and is characterized by painless, mucosal, and warty erosions. They tend to develop in warm, moist sites of the genitals and perineum. These lesions hold a high accumulation of spirochetes and are highly infectious. Complete resolution of the lesions is spontaneous and occurs after a few days to many weeks, where it is either resolved completely or enters the tertiary phase, defined by a latent state. (Source)

Common Cold

Understanding the Common Cold -- the Basics

Credit: lillingtonmedicalservices.org

A runny nose, scratchy throat, and nonstop sneezing -- you can't miss the signs of a cold. But mystery shrouds a lot of other things about it. Why do you seem to get them so often while your best friend stays well? And more importantly, how can you stay healthy this year? Get the lowdown on the all too common cold.

What Is It?

It's an illness caused by a tiny, living thing called a virus. More than 200 types lead to your misery, but the most common one is the rhinovirus, which brings on 10% to 40% of colds. The coronavirus is responsible for about 20% of cases, while the respiratory syncytial virus (RSV) and parainfluenza virus cause 10% of colds.

Colitis

A micrograph demonstrating cryptitis, a microscopic correlate of colitis. H&E stain

Colitis (pl. colitides) refers to an inflammation of the colon.

Colitis may be acute and self-limited or chronic, i.e. persistent, and broadly fits into the category of digestive diseases.

In a medical context, the label colitis (without qualification) is used if:

• The cause of the inflammation in the colon is undetermined; for example, colitis may be applied to Crohn's disease at a time when the diagnosis is unknown, or
• The context is clear; for example, an individual with ulcerative colitis is talking about their disease with a physician who knows the diagnosis.

Coccidioidomycosis

Credit: www.life-worldwide.org

Coccidioidomycosis is a pulmonary or hematogenously spread disseminated disease caused by the fungi Coccidioides immitisand C. posadasii; it usually occurs as an acute benign asymptomatic or self-limited respiratory infection. The organism occasionally disseminates to cause focal lesions in other tissues. Symptoms, if present, are those of lower respiratory infection or low-grade nonspecific disseminated disease. Diagnosis is suspected based on clinical and epidemiologic characteristics and confirmed by chest x-ray, culture, and serologic testing. Treatment, if needed, is usually withfluconazole, itraconazole, newer triazoles, or amphotericin B.

(See also the Infectious Diseases Society of America’s Coccidioidomycosis .)

In North America, the endemic area for coccidioidomycosis includes

• The southwestern US
• Northern Mexico

The affected areas of the southwestern US include Arizona, the central valley of California, parts of New Mexico, and Texas west of El Paso. The area extends into northern Mexico, and foci occur in parts of Central America and Argentina. About 30 to 60% of people who live in an endemic region are exposed to the fungus at some point during their life. In the US, about 150,000 infections develop annually; over half of them are subclinical.

Pathophysiology

Infections are acquired by inhaling spore-laden dust. Thus, certain occupations (eg, farming, construction) and outdoor recreational activities increase risk. Epidemics can occur when heavy rains, which promote the growth of mycelia, are followed by drought and winds. Because of travel and delayed onset of clinical manifestations, infections can become evident outside endemic areas.

Once inhaled, C. immitis spores convert to large tissue-invasive spherules. As spherules enlarge and then rupture, each releases thousands of small endospores, which may form new spherules. Pulmonary disease is characterized by an acute, subacute, or chronic granulomatous reaction with varying degrees of fibrosis. Lesions may cavitate or form nodular-like coin lesions.

Sometimes disease progresses, with widespread lung involvement, systemic dissemination, or both; focal lesions may form in almost any tissue, most commonly in skin, subcutaneous tissues, bones (osteomyelitis), and meninges (meningitis).

Progressive coccidioidomycosis is uncommon in otherwise healthy people and more likely to occur in the following contexts:

• HIV infection
• Use of immunosuppressants
• Advanced age
• 2nd half of pregnancy or postpartum
• Certain ethnic backgrounds (Filipino, African American, Native American, Hispanic, and Asian, in decreasing order of relative risk)

Symptoms and Signs

Primary coccidioidomycosis

Most patients are asymptomatic, but nonspecific respiratory symptoms resembling those of influenza, acute bronchitis, or, less often, acute pneumonia or pleural effusion sometimes occur. Symptoms, in decreasing order of frequency, include fever, cough, chest pain, chills, sputum production, sore throat, and hemoptysis.

Physical signs may be absent or limited to scattered rales with or without areas of dullness to percussion over lung fields. Some patients develop hypersensitivity to the localized respiratory infection, manifested by arthritis, conjunctivitis, erythema nodosum, or erythema multiforme. Read more >>

Source: https://www.merckmanuals.com/professional/infectious-diseases/fungi/coccidioidomycosis

Circadian rhythm sleep disorder

Credit: wikipedia.org

Circadian rhythm sleep disorders (CRSD), a family of sleep disorders, affect (among other bodily processes) the timing of sleep. People with circadian rhythm sleep disorders are unable to go to sleep and awaken at the times commonly required for work and school as well as social needs. They are generally able to get enough sleep if allowed to sleep and wake at the times dictated by their "body clocks". The quality of their sleep is usually normal unless they also have another sleep disorder.

Chorea

Credite: dokteranakku.net

Chorea (or choreia, occasionally) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term chorea is derived from the Greek word χορεία (=dance; see choreia), as the quick movements of the feet or hands are comparable to dancing.

The term hemichorea refers to chorea of one side of the body, such as chorea of one arm but not both (analogous to hemiballismus).

Chronic fatigue syndrome

Credit: hubpages.com

Chronic fatigue syndrome (CFS) is a complex medical condition, characterized by long-term fatigue and other symptoms. These symptoms are to such a degree that they limit a person's ability to carry out ordinary daily activities. Quality of life of persons with CFS can be compromised.

Chordoma

MRI of extensive clival chordoma in 17-year-old male patient, axial view. Tumor in the nasopharynx extending from nasal cavity to brainstem posteriorly is clearly visible. (Credit: wikipedia.org)

Chordoma is a rare slow-growing neoplasm thought to arise from cellular remnants of the notochord. The evidence for this is the location of the tumors (along the neuraxis), the similar immunohistochemical staining patterns, and the demonstration that notochordal cells are preferentially left behind in the clivus and sacrococcygeal regions when the remainder of the notochord regresses during fetal life.

Cholera

Credit: wikipedia

Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.

Cholera was prevalent in the U.S. in the 1800s, before modern water and sewage treatment systems eliminated its spread by contaminated water. Only about 10 cases of cholera are reported each year in the U.S. and half of these are acquired abroad. Rarely, contaminated seafood has caused cholera outbreaks in the U.S. However, cholera outbreaks are still a serious problem in other parts of the world. At least 150,000 cases are reported to the World Health Organization each year.

Chlamydia trachomatis

Credit: wikipedia.org

Chlamydia trachomatis (/kləˌmɪdiə/ /trəˈkoʊmətᵻs/), an organism responsible for the most prevalent STD in the United States, is one of four bacterial species in the genus Chlamydia. Chlamydia is a genus of pathogenic bacteria that are obligate intracellular parasites.C. trachomatis is a gram-negative bacterium. It is ovoid in shape and non-motile. The bacteria are non-spore-forming, but the elementary bodies act like spores when released into the host. The inclusion bodies of Chlamydia trachomatis were first described in 1942; theChlamydia trachomatis agent was first cultured in the yolk sacs of eggs by Professor Tang Fei-fan et al in 1957.