Category: C

Cirrhosis:  This chronic disorder is marked by
diffuse destruction and fibrotic regeneration of hepatic cells.  As
necrotic tissue yields to fibrosis, cirrhosis alters liver structure and
normal vasculature, impairs blood and lymph flow, and ultimately causes
hepatic insufficiency.  It is twice as common in men as in women –
particularly among malnourished chronic alcoholic patients over age 50. 
Mortality is high; many patients die within 5 years of onset

Portal, nutritional or alcoholic cirrhosis also known as Laennec’s cirrhosis,
is the most common type, results from malnutrition, especially of dietary
protein, and chronic alcohol ingestion. 

Biliary cirrhosis results from bile duct diseases.

Postnecrotic (posthepatitic) cirrhosis stems from various types of hepatitis

Pigment cirrhosis may stem from disorders such as hemochromatosis

In 10% of patients, cirrhosis has no known cause.

Symptoms:

Gastrointestinal – usually early and vague – Anorexia, indigestion,
nausea and vomiting, constipation or diarrhea, dull abdominal ache

Respiratory:  Pleural effusion, limited thoracic expansion

Central nervous system:  progressive symptoms of hepatic encephalopathy,
including lethargy, mental changes, slurred speech, asterixis (flapping
tremor), peripheral neuritis, paranoia, hallucinations, extreme obtundation,
and coma

Hematologic:  bleeding tendencies (nosebleeds, easy bruising, bleeding
gums), anemia

Endocrine:  testicular atrophy, menstrual irregularities, gynecomastia,
loss of chest and axillary hair

Skin:  severe pruritus, extreme dryness, poor tissue turgor, abnormal
pigmentation, spider angiomas, palmar erythema, possibly jaundice

Hepatic:  jaundice, hepatomegaly, ascites, edema of the legs

Miscellaneous:  musty breath, enlarged superficial abdominal veins,
muscle atrophy, pain in the right upper abdominal quadrant that worsens
when the patient sits up or leans forward, palpable liver or spleen, temperature
of 101 degree to 103 degree F, bleeding from esophageal varices.

Treatment:

Treatment aims to remove or alleviate the underlying cause of cirrhosis,
to prevent further liver damage, and to prevent or treat complications.

High protein diet (but this may be restricted by developing hepatic
encephalopathy.)

Sodium is usually restricted to 200mg to 500mg per day and fluids to
1,000 to 1,500 ml/day

Hospitalization:  if the patients condition continues to deteriorate,
he may need tube feeding

Rest, moderate exercise, and avoiding exposure to infections and toxic
agents are essential.

Paracentesis and infusion of salt poor albumin may alleviate ascites. 
A LeVeen shunt may be used

Surgical procedures include ligation of varices, splenectomy, esophagogastric
resection, and surgical shunts to relieve portal hypertension

Programs for preventing cirrhosis usually emphasize avoiding alcohol

Chlamydial Infections:  The
most common sexually transmitted disease (STD) in the United States, the infecting
agent is Chlamydia trachomatis, a bacterium.  Chlamydial infection
include urethritis ( inflammation of the  urethra; – a passage through
which urine is discharged from the bladder to the exterior or the body)
in men, and cervicitis ( inflammation of the cervix )  in women, and
lymphogranuloma venereum or LGV ( mark by a primary transient ulcerative
lesion of the genitals, cause by chlamydial infec. ) for both male and
female Because many of theses infections may produce no symptoms until
late in their development, sexual transmission usually occurs unknowingly.

Cold Sore Freedom In 3 Days

Chickenpox:  Varicella, a common viral infectious disease.  More common in school age children but can affect any age. Adults run the risk of serious complications, such as bacterial pneumonia and adult patients usually have a severe case that last longer where as in children it is usually mild.  Chickenpox is very contagious, and keeping your child home until blisters are dry and have scab over.

Those who have had chickenpox usually develop a lifetime immunity, but the virus remains dormant in the body, and if you had chickenpox as a child, there may be a possibility of developing shingles as an adult.

Chickenpox can pass from a pregnant woman to her unborn child therefore, doctors often advise women of child bearing years to confirm their immunity with a blood test, chickenpox can cause birth defects.

Cause:  Chickenpox is caused by the herpes zoster virus or what is also called varicella zoster virus.  The incubation period is 7 to 21 days, and the patient is most contagious a day before the rash appears and up to 7 days after, or until the rash forms scabs.  It is spread by droplets:  coughing, sneezing, or by contact with the clothing or oozing vesicles of an infected person.

Symptoms:

Rash that is very itchy, red bumps that spreads from the face, neck, torso, and all limbs. 

The rash progresses from red spots to fluid filled blisters (vesicles- that may drain) and scab over.  The rash, can last up to 10 days.

Blisters may also appear in the mouth, on the genital,  and around the eyes that can be very painful

Treatment:

Chickenpox is highly contagious and keeping affected patients away from others helps to stop the spread of this viral infection.  Keep child or patient home until blister is dry and the scabs have fallen off.

Your doctor may prescribe an antihistamine, such as diphenhydramine, to relieve pain and swelling – for severe cases the doctor may prescribe acyclovir (which speeds up healing) and or antibiotic to prevent secondary infection.

Calamine lotion may be apply to itchy areas

Doctors advise that you do not give aspirin to children.

If you are pregnant and believe that you have been expose to chickenpox virus, call your doctor promptly.

Prevention:  Immunization of varicella zoster vaccine is helpful (pregnant women should consult with your doctor) 

Cervical Polyps:  The cause of cervical
polyps is not fully understood, but it usuallly resuts from infections. 
It can be associated with;  Chronic inflammation, increase estrogen
levels that the body does not respond well with, or local congestion of
cervical blood vessles.  Cervcal polyps is very common in the ages
of 20 and over who had children.  it is fairly common to find one
single polyp and in some cases 2 more are found.

Cervical polyps is a projectile growth originating from the mucosal
surface of the cervix, or even the endocervical cannall.  It is a
small growth that hang from a stalk and sticks out (protrude) through the
internal or exterior os (or cervical opening)

Infection and chronic inflammation needs to be treated always, and treated
immediatly to help with the prevention of this disorder.

 Symptoms:

abnormal vaginal bleeding after intercourse, and douching

abnormal bleeding between menstrual cycle

abnormal bleeding after menopause

white or yellow mucous discharge 

menorrhagia ( abnorml heavy bleeding during menstrual cycle)

Treatment:

Removal of the polyp. It is done as an outpatient procedure
electrocautery or laser vaporization

Antibiotic therapy is usually prescribed because many polyps are infected.

Most cervical polyps are benign, the excised tissue is usually
sent to a pathologist for microscopic examination  ( some cervical
cancers may have appeared as a polyp )

Regrowth of polyps is uncommon

a Pap smear is recommedned at regular intervals

Carpal tunnel syndrome:  Carpus- the joint
between the arm and hand, made up of eight bones; the wrist.  Also
the corresponding forelimb joint in quadrupeds) 

The most common nerve entrapment syndrome, carpal tunnel syndrome results
from compression of the median nerve at the wrist, within the carpal tunnel
(formed by the carpal bones and the transverse carpal ligament). 
The median nerve, along with blood vessels and flexor tendons, passes through
this tunnel to the fingers and thumb.  Compression neuropathy causes
sensory and motor changes in the median distribution of the hand.

Many conditions can cause the contents or structure of the carpal tunnel
to swell and press the median nerve against the transverse carpal ligament. 
Carpal tunnel syndrome usually occurs more in women between the ages of
30 – 60, it posses a serious occupational health problem.  Any strenuous
use of the hands aggravates this condition, those at risk are; assembly
line workers and those who uses poorly designed tools.

Symptoms:

• Weakness of one or both hands
• Pain
• Burning
• Numbness and or tingling

The above symptoms can affect one or both hands, and can affect
the thumb, forefinger, middle finger, and the forearm. In some severe cases,
pain can spread as far as the shoulder.  The patient may have a decease
sensation to light touch or pinpricks in the affected fingers.  He
may have difficulty with clenching his hands to make a fist.

Treatment:

Resting the affected hand

Hand splint may be used

Physical Therapy may be require

May have to change occupation if it has been link to the patient job
details

If above treatment fails, surgical decompression of the nerve by sectioning
the entire transverse carpal tunnel ligament.

Neurolysis (freeing the nerve fibers) may also be necessary

Calories Per Activity & HDL Cholesterol Levels

  This type of herpes primarily affects the skin and mucous membranes, commonly producing cold sores and fever blisters.

After the first herpes simplex infection, the patient becomes susceptible to recurrent infections, which may be provoked by fever, menses, stress, heat, and cold. 

Cause:  Caused by Herpes-virus hominis.  It is transmitted by oral and respiratory secretions and drainage from lesions.

Symptoms:

Primary infection:  patient may experience a brief period of prodromal tingling and itching, accompanied by fever and pharyngitis, followed by eruption of vesicles on any part of the oral mucosa, especially in the tongue, gums, and cheeks.

Vesicles (sac -like filled with fluid) form on an erythematous (red) base, then rupture and leave a painful ulcer, followed by a yellowish crust

Increased salivation

Halitosis

Possible anorexia

Conjunctivitis

Fever

Treatment:

Symptomatic and supportive therapy is essential

Primary infection usually requires an analgesic-antipyretic to reduce fever and relieve pain.

Anesthetic mouthwashes, such as viscous lidocaine, to help reduce the pain of gingivostomatitis, enabling the patient to eat and for preventing dehydration.

Drying agents, such as calamine lotion, make skin lesions less painful

Your doctor may prescribe Acyclovir, and antiviral agent, to decrease symptoms, the recurrence rate, and contagion.

Helpful hints and home remedies:

Replace your toothbrush – Toothbrush can harbor the herpes virus for days, reinfecting you after the present cold sore heals.  (throw toothbrush away after the blister develops, and when it heals replace again with a new one.)

Stay away from food that are arginine rich such as chocolate, cola, peas, peanuts, gelatin, beer, and grain cereals.

Stress enhance this disorder – so relax.