Friday, October 16, 2009

Leukoencephalopathy (brain white matter changes)

Leukoencephalopathy (brain white matter changes) is caused by the reactivation of a common virus in the central nervous system of individuals with lowered immune defenses, such as individuals with acquired immune deficiency syndrome (AIDS); people undergoing chronic corticosteroid or immunosuppressive therapy; and individuals with cancer. This disorder may be associated with neurofibromatosis type 1 that can also develop cancer. Other clinical studies eported that leucoencephalopathy can also be due to gene mutation.
The symptoms of leucoenecephalopathy are the result of loss of white matter (which is made up of myelin, a substance the surrounds and protects nerve fibers) in multiple areas of the brain. Without the protection of myelin, nerve signals can’t travel successfully from the brain to the rest of the body. The most prominent symptoms are clumsiness; progressive weakness; and visual, speech, and sometimes, personality changes. In general, the progression of deficits leads to life-threatening disability and death over weeks to months, although some survive till adult age left with severe neurological disabilities. People with this disorder are particularly vulnerable to stresses such as infection, mild head trauma or other injury, or even extreme fright. These stresses may trigger the first symptoms of the condition or worsen existing symptoms, and can cause affected individuals to become lethargic or comatose.

Tuesday, October 13, 2009

Neurofibromatosis Type 1

Neurofibromatosis type 1 (NF1) is a progressive disorder, which means most symptoms will worsen over time. In general, most people with NF1 will develop mild to moderate symptoms, and have a normal life expectancy.

The condition is caused by mutation of gene that could result in overactive cell growth, learning impairments, and skeletal defects. Clinical manifestations of neurofibromatosis type 1 may vary greatly in range and severity from case to case, Some findings are as follows:
· flat patches on the skin that are darker than the surrounding area. These spots increase in size and number as the individual grows older.
· noncancerous (benign) tumors, named neurofibromas that are usually located on or just under the skin. These tumors may also occur in nerves near the spinal cord or along nerves elsewhere in the body. Some (3-5%) develop cancerous tumors that grow along nerves, and/or develop other cancers, including brain tumors and cancer of blood-forming tissue (leukemia).
· episodes of seizures, learning disabilities (50% of children with the condition), speech difficulties, attention deficit hyperactive disorders, and skeletal malformations, including progressive curvature of the spine (scoliosis), and bowing of the lower legs.
· high blood pressure

Treatments for the condition are aimed at controlling or relieving symptoms. Headache and seizures are treated with medications. Benign tumours may be removed surgically. Cancerous tumours may be treated with surgery, chemotherapy, and/or radiotherapy.

Thursday, October 8, 2009

Small Bowel Obstructions

Small bowel obstruction, a mechanical bowel blockage arising from a structural abnormality, presents a physical barrier to the progression of gut contents. Patient of such a condition may then experience abdominal pain, bloating, and vomiting. Small-bowel obstructions can result from a variety of causes. Peritoneal adhesions are the most common cause of Small Bowel Obstruction (SBO) accounting for approximately 65% to 75% of cases. It is estimated that the risk of SBO is 1% to 10% after appendectomy, 6.4% after open cholecystectomy, and 10% to 25% after intestinal surgery. It is also estimated that 93% to 100% of patients who undergo transperitoneal surgery will develop postoperative adhesions. Most patients with adhesions do not experience any overt clinical symptoms. However, clinical symptoms may manifest when complication resulting from the adhesions are eventually developed.

Bowel obstruction may take many years to develop after abdominal/transperitoneal surgery. A clinical study reported that 21% of bowel obstructions caused by adhesions occur within the first month after surgery, 18% of bowel obstructions caused by postoperative adhesions occur between 1 month and 1 year after surgery, 21% occur between 1 and 5 years and 28% occur after 5 years.

About peritoneal adhesions, they are scar tissues forming abnormal attachments between organs or tissues or both in the abdominal cavity that are normally separated. Most are acquired as a result of peritoneal injury, the most common cause of which is abdomino-pelvic surgery.4 Less commonly, adhesions may form as the result of inflammatory conditions, intraperitoneal infection or abdominal trauma. The extent of adhesion formation varies but is most dependent on the type and magnitude of surgery performed, as well as whether any postoperative complications develop.

Friday, October 2, 2009

Myoma or Uterine Fibroid

Myoma or Uterine Fibroids are noncancerous tumours that grow slowly within the muscular wall of the womb (also known as uterus in medical term). It is estimated that 25% of women over the age of 35 have fibroids at some time during their life. One clinical study using pelvic ultrasound in women in the U.S. ,with no symptom aged 35-49, found that over 50% of women did have fibroids on pelvic ultrasound exam. Small fibroids may not cause problems, but larger ones may cause prolonged/heavy menstrual bleeding, abdominal pain during menstruations, infertility or recurrent miscarriages. Fibroids may also press on the bladder, causing a need to pass urine often, or on the rectum, causing low back pain. Generally fibroids do not need treatment when they are not symptomatic. However, they should be checked regularly by your doctor to make sure that they have not grown. If treatment is necessary, fibroids may be removed surgically. Some fibroids are treated using an injection of a substance that blocks the blood vessels supplying them, causing the fibroids to shrink.
 

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