Medical Info: Diabetes Insipidus

Diabetes insipidus is a disorder in which the kidney is insensitive to a hormone, called anti-diuretic hormone (ADH) or in which there is not sufficient quantity of this hormone available. The result is excessive drinking and urination, or polydipsia and polyuria. This is one cause of changes in urinary habits that leads to problems with urination inside the house in dogs in which "housebreaking" seemed to be satisfactory prior to the disease onset.

ADH is secreted by the body when it has a need to conserve water. It makes the kidneys work harder to conserve water, which makes the urine more concentrated. When the dog can not respond to this hormone or doesn't make enough of it, the dog can not concentrate its urine. This can lead to serious problems, including death, if the dog does not have access to large quantities of water. On the other hand, it may not cause any significant problem if there is always plenty of water available. This problem can occur for a number of reasons and for no reason at all. Examples of predisposing causes are kidney failure, hyperadrenocorticism, liver disease, pyometra and others. These things affect the kidney's ability to respond. Head trauma or brain cancer can affect the body's ability to produce ADH.

This condition is treated using desmopressin acetate (DDAVP), which is a replacement for the anti-diuretic hormone. It can be administered intra-nasally or on the conjunctiva (the inside lining of the eyes). It is pretty effective. Unfortunately, it is also somewhat expensive. Some dogs benefit from therapy with other medications, including chlorpropamide and chlorothiazide diuretics.


Medical info:
The prognosis for this condition varies with the underlying cause. Dogs that have diabetes insipidus due to trauma often recover in a short time and the same is true after successful treatment of pyometra. The prognosis is good for spontaneous occurrences of diabetes insipidus as well. When it occurs for other reasons the prognosis is usually less favorable.

Medical Info: Priapism

Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and unable to drain. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction.

It can occur in all age groups, including newborns. However, it usually affects men between the ages of 5 to 10 years and 20 to 50 years.

There are two categories of priapism: low-flow and high-flow.

Low flow: This type of priapism is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but also affects men with sickle-cell disease, leukemia (cancer of the blood) or malaria.
High flow: High flow priapism is more rare than low-flow and usually less painful. It is the result of a ruptured artery from an injury to the penis or the perineum (area between the scrotum and anus), which prevents blood in the penis from circulating normally.
What causes priapism?

Sickle cell anemia: Some adult cases of priapism are the result of sickle-cell disease and approximately 42% of all adults with sickle-cell will eventually develop priapism.
Medications: A common cause of priapism is the use and/or misuse of medications. Drug-related priapism includes drugs such as Desyrel used to treat depression or Thorazine, used to treat certain mental illnesses. For people who have erectile dysfunction, injection therapy medications to treat the condition may also cause priapism.
Other causes of priapism include:

Trauma to the spinal cord or to the genital area
Black widow spider bites
Carbon monoxide poisoning
Illicit drug use, such as marijuana and cocaine
In rare cases, priapism may be related to cancers that can affect the penis and prevent the outflow of blood.

Medical info:

How is priapism diagnosed?
If you experience priapism, it is important that you seek medical care immediately. Tell your doctor:

The length of time you have had the erection
How long your erection usually lasts
Any medication or drugs, legal or illegal, which you have used. Be honest with your doctor, illegal drug use is particularly relevant since both marijuana and cocaine have been linked to priapism.
Whether or not priapism followed trauma to that area of the body.
Your doctor will review your medical history and perform a thorough physical examination to determine the cause of priapism. This will include checking the rectum and the abdomen for evidence of unusual growths or abnormalities that may indicate the presence of cancer.

After the physical exam is complete, the doctor will take a blood-gas measurement of the blood from the penis. During this test, a small needle is placed in the penis, some of the blood is drawn and then it is sent to a lab for analysis. This provides a clue as to how long the condition has been present and how much damage has occurred.

How is priapism treated?
The goal of all treatment is to make the erection go away and preserve future erectile function. If a person receives treatment within four to six hours, the erection can almost always be reduced with medication. If the erection has lasted less than four hours, decongestant medications, which may act to decease blood flow to the penis, may be very helpful. Other treatment options include:

Ice packs: Ice applied to the penis and perineum may reduce swelling.
Surgical ligation: Used in cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow.
Intracavernous injection: Used for low-flow priapism, during this treatment drugs known as alpha-agonists are injected into the penis that cause the veins to narrow reducing blood flow to the penis causing the swelling to subside.
Surgical shunt: Also used for low-flow priapism, a shunt is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal.
Aspiration: After numbing the penis, doctors will insert a needle and drain blood from the penis to reduce pressure and swelling.
If you suspect that you are experiencing priapism, you should not attempt to treat it yourself. Instead seek emergency as soon as possible.

What is the outlook for people with priapism?
As long as treatment is prompt, the outlook for most people is very good. However, the longer medical attention is delayed, the greater the risk of permanent erectile dysfunction.

Medical Info: Furunculosis

Furunculosis is a condition causing deep sores of the skin, also known as boils. Furuncles are painful, deep bacterial infections of hair follicles. The usual cause is infection, usually from Staphy-lococcus bacteria, that begins in the hair follicle and penetrates into deeper skin layers. Furunculosis is very uncommon in young children, but it occurs more frequency after puberty. Transmission from individual to individual can occur if contact is made with drainage of pus from a furuncle. The furuncle begins as a deep, tender, firm, red papule which enlarges rapidly into a tender, deep-seated nodule that remains painful. With appropriate treatment, the infection can be eradicated.

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Living With Your Diagnosis
Pain becomes more intense as the furuncle enlarges. Furuncles can appear suddenly and are usually 1/2 to 1 inch in diameter; some are larger. The furuncle either remains deep and reabsorbs or it will rupture through to the surface of the skin. The point of rupture heals with scarring. Without treatment, the infection may enter the bloodstream and spread to other body parts.

Treatment
Warm moist compresses provide comfort and encourage localization and pointing of the abscess; apply three or four times daily for 20 minutes each time. Your physician may incise and drain the furuncle when the skin over the furuncle becomes thin and the mass underneath is soft. Without treatment, the furuncle will heal in 10-20 days. With treatment, furuncles will heal in less time and symptoms will be less severe. A potential complication of treatment is that the pus that drains when the furuncle opens spontaneously may contaminate nearby skin, causing new furuncles.

The DOs
1) Do take prescribed antibiotics.
2) Do decrease activity until the infection heals. Avoid sweating and contact sports while furuncles are present.
3) Do keep the skin clean.

The DON'Ts
1) Dont use nonprescription antibiotic creams or ointments on the furuncles surface because they are ineffective.
2) Dont share towels, washcloths, or clothing with other household members.

When to Call Your Doctor
1) If fever occurs or symptoms do not improve in 3 or 4 days, despite treatment.
2) If new furuncles appear or furuncles develop in other family members.

Medical Info: Urticaria

Urticaria is a raised itchy and painful skin rash sometimes called a “nettle rash” or hives. There are two distinct types of urticaria:

Acute urticaria is often caused by an allergy to food or medication and can last between several hours and six weeks.

Chronic urticaria is diagnosed if the rash persists for six weeks or longer, the underlying cause is then usually not due to food allergies.

Medical info:

Causes

Acute Urticaria

The most likely cause of Acute Urticaria is an allergy due to exposure to pets, horses, latex rubber, food such as shellfish, nuts, egg and dairy products or bee and wasp stings. Allergies to medication such as antibiotics (penicillin, tetracycline, sulphonamides and cephalosporins), blood pressure pills (ACE inhibitors and diuretics), codeine and aspirin containing pain killers can cause acute urticaria. Sometimes viral infections such as glandular fever and hepatitis B, or bacteria (helicobacter, streptococci), fungal and parasitic infections can trigger urticaria. Allergic reactions to blood products, transfusions, xray contrast and vaccines have also been implicated. Papular urticaria is the medical term for “itchy bumps” or grouped urticarial lesions seen mainly in children and which follow insect bites from midges, fleas and mosquitoes.

Chronic Urticaria

The cause of Chronic Urticaria is much more difficult to identify. The role of true food allergy is hardly ever a significant trigger but food additives such as salicylate, sodium benzoate, colourings and nitrites may play a role. We often end up diagnosing Chronic Idiopathic Urticaria. This condition (which can persist for many years) is due to the production of “auto-antibodies” which in turn attack specific Mast Cells in our skin and tissues causing an enormous release of histamine. Why we suddenly switch-on production of these aggressive antibodies to our own skin cells is a complete enigma. Our bodies may continue producing these auto-antibodies for a number of years leading to a great deal of distress and discomfort for the urticaria sufferer. Unfortunately over 50% of Chronic Urticaria cases are due to production of these “auto-antibodies” to the IgE and its receptor on Mast Cells found in the skin.



Chronic parasitic infections and ACE inhibitor blood pressure pills may play a role in both acute and chronic urticaria. Stress is known to aggravate urticaria and stress reduction measures are very important in treating chronic urticaria.



Chronic urticaria can also be triggered by physical factors such as exposure to environmental heat (prickly heat), intense cold, sunlight, vibration or pressure on the skin (from tight clothing). Very rarely some people react to bath water, this is called “Aquagenic” Urticaria. Exercising after eating certain foods such as wheat, celery and shellfish might provoke delayed urticaria. Many people have very sensitive skin and any friction or rubbing will cause raised red lines to develop. This is called Dermatographism and indicates just how easily they can release histamine in their own skin. A good test for cold urticaria is to hold a block of ice against the skin for 5 minutes and see if an urticaria weal develops after the ice is removed.



Underlying thyroid diseases and autoimmune diseases such as Systemic Lupus and Rheumatoid Arthritis can provoke Chronic Urticaria or even Urticarial Vasculitis (a variant in which the lesions tend not to fluctuate but lead to skin discolouration). Urticarial Vasculitis may be associated with a fever, bone pains and joint swelling (Schnitzler’s Syndrome).



Occasionally an inherited deficiency of the C1 Esterase Inhibitor Enzyme leads to a non-itchy form of urticaria called Hereditary or Familial Angioedema. This condition affects mainly females in a family, is associated with sudden swelling of the face and neck which is not itchy but tends to be painful. These lesions usually last for 2 to 3 days and do not respond to antihistamine medication. Sufferers characteristically have low levels of the Complement C4 in their bloodstream and respond to medication called Danazol or Tranexamic acid which prevents attacks.

Medical Info: Gangrene

Gangrene is necrosis and subsequent decay of body tissues caused by infection or thrombosis or lack of blood flow. It is usually the result of critically insufficient blood supply sometimes caused by injury and subsequent contamination with bacteria. This condition is most common in the extremities. The best of all possible treatments is revascularization (restoration) of the affected organ, which can reverse some of the effects of necrosis and allow healing. Depending on the extent of tissue loss and location, treatment other than revascularization runs the gamut from allowing digits to auto-amputate (fall off), debridement and local care, to amputation, the removal of infected necrotic tissues.

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Gangrene caused by a serious bacterial infection is called wet gangrene.
Gangrene caused by lack of circulation in an injured or diseased area is called dry gangrene.

One specific example of gangrene is so called diabetic foot that can be seen in long-standing complicated diabetes. It is caused by a combination of arterial ischemia, injury and poor healing that is rather common in diabetics. It often combines poor healing with a superimposed infection. The picture here is of a foot with a recent amputation of a great toe and yet increasing loss of circulation (the bluish area) with subsequent tissue loss to come.

The most common surgical treatment for irreversible gangrene is immediate amputation, as the infection grows 2 to 3 cm per hour.


Wet gangrene
Wet gangrene is perhaps the more familiar of the two types, at least in media portrayals. An injury, such as a gunshot or laceration, leads to a bacterial infection, which produces pus. If the pus does not drain well, the blood supply to the area is blocked, and with it, the oxygen. With its oxygen supply cut off, the tissue dies.

Treatment of the underlying infection is necessary, as is removal of the dead tissue. Without treatment, the infection can spread further and destroy increasing amounts of tissue. Eventually, sepsis and death can result.


Dry gangrene
If the blood flow is interrupted for a reason other than severe bacterial infection, the result is a dry gangrene. Persons with impaired peripheral blood flow, such as diabetics, are at greater risk for dry gangrene.

The early signs of dry gangrene are a dull ache and sensation of coldness in the area, along with pallor of the flesh. If caught early, the process can sometimes be reversed by vascular surgery. However, if necrosis sets in, the affected tissue must be removed just as with wet gangrene.

Medical Info: Rhinitis

Rhinitis is one of the most common allergic conditions in the United States, affecting about 40 million people. It often coexists with other allergic disorders, such as asthma. It is important to treat rhinitis because it can contribute to other conditions such as sleep disorders, fatigue and learning problems.

There are two general types of rhinitis:

Allergic rhinitis
Allergic rhinitis is caused by substances called allergens. Allergens are often common, usually harmless substances that can cause an allergic reaction in some people.

Medical info:

Causes

When allergic rhinitis is caused by common outdoor allergens, such as airborne tree, grass and weed pollens or mold, it is called seasonal allergic rhinitis, or "hay fever."
Allergic rhinitis is also triggered by common indoor allergens, such as animal dander (dried skin flakes and saliva), indoor mold or droppings from cockroaches or dust mites. This is called perennial allergic rhinitis.

Symptoms

Sneezing
Congestion
Runny nose
Itchiness in the nose, roof of the mouth, throat, eyes and ears
Diagnosis
If you have symptoms of allergic rhinitis, an allergist/immunologist can help determine which specific allergens are triggering your reaction. He or she will take a thorough health history, and then test you to determine if you have allergies. Skin tests or Blood (RAST) tests are the most common methods for determining your allergic triggers.

Treatment
Once your allergic triggers are determined, your physician or nurse will work with you to develop a plan to avoid the allergens that trigger your symptoms. For example, if you are allergic to dust mites or indoor mold, you will want to take steps to reduce these allergens in your house as much as possible. The Tips brochures on Indoor Allergens and Outdoor Allergens provide helpful advice in this area.

Medical Info: Granuloma

Granuloma comes with the suffix, which means "a swelling" and "granule" meaning a small particle. In this case the "small particle" is tissue composed largely of capillaries and fibroblasts. A "fibroblast" is the name given to the original cells which then become differentiated into more specialized cells -- in this case the connective tissues of the body -- muscles, tendons generally tissue-building material.

Granuloma is a condition on the surface of the body on the skin. Typically it is an unhealing inflammation that can develop a scab, or crust, but never really heals. It will typically bleed at a time when the skin below the scab moves, breaking the seal between the scab and the skin, allowing blood to ooze out. If the area were to "heal" then the scab could break off leaving normal skin below it. If the area below the scab is NOT healing, then as the scab is broken off, or moved, the area beneath it is still the unhealed inflammation.

Medical info:

A doctor who examined Karl's "bump" believed that there was an 80% chance that it was a granuloma.

In the case of Karl Loren it is possible that the fly bite in Africa, some 40 years ago, caused some "foreign material" to be left in the site. (This tends to be true of spider bites, for instance.) This could have been some of the protein components of the larva that burrowed into his body from the fly. This protein material could well have been encased, years ago, and remained in a completely inactive state. Karl's efforts at self-treatment may well have broken into this casing and exposed the foreign material to the body's defense system the immune system.

While the immune system can handle many different types of antigens (bacteria) it may not be equipped to deal with this type of toxic residue. We have, then, a continuing number of immune system cells which die in the attempt to get rid of the toxic residue from that ancient fly episode.

Generally granuloma is never a malignant cancer however, the action of granuloma can be to "spread" which can cause destruction of tissue as the inflammation spreads.

Medical Info: Conjunctivitis

Conjunctivitis is one of the most common and treatable eye infections in children and adults. Often called "pink eye," it is an inflammation of the conjunctiva, the tissue that lines the inside of the eyelid. This tissue helps keep the eyelid and eyeball moist.

Conjunctivitis can be caused by a virus, bacteria, irritating substances (shampoos, dirt, smoke, and especially pool chlorine), allergens (substances that cause allergies) or sexually transmitted diseases (STDs). Pink eye caused by bacteria, viruses, and STDs can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

Medical info:

Symptoms:
Redness in the white of the eye or inner eyelid
Greater amount of tears
Thick yellow discharge that crusts over the eyelashes, especially after sleep (in conjunctivitis caused by bacteria)
Other discharge from your eye (green or white)
Itchy eyes (especially in conjunctivitis caused by allergies)
Burning eyes (especially in conjunctivitis caused by chemicals and irritants)
Blurred vision
Increased sensitivity to light
See your ophthalmologist (a doctor trained to treat eye conditions) or family doctor if you have any of these persistent symptoms. Ear infections also commonly occur in children who have bacterial conjunctivitis. The ophthalmologist will examine your eyes and possibly take a sample of fluid from the eyelid with a cotton swab. Bacteria or viruses that may have caused conjunctivitis can then be seen through a microscope.

Treatment:
Bacteria
Conjunctivitis caused by bacteria is treated with antibiotics, a type of medicine prescribed by your doctor. The antibiotic can be given as eye drops, ointments, or pills. Eye drops or ointments may need to be applied to the inside of the eyelid three to four times a day for five to seven days. It may be difficult to apply ointments inside of a child’s eye. If the ointment gets as far as the eyelashes, it will most likely melt and enter the eye. Pills may need to be taken for several days. The infection should improve within a week. Take the medicine as instructed by your doctor, even if the symptoms go away.
Virus
Medicine cannot treat conjunctivitis caused by a virus. This type of conjunctivitis often results from a common cold. Just as a cold must run its course, so must this form of conjunctivitis, which will last from 4 to 7 days. You may, however, help relieve symptoms by applying a cold compress.
Irritating substance
To treat this type of conjunctivitis, use warm water for five minutes to wash the irritating substance from the eye. You should also avoid further exposure to the irritating substances. Your eyes should begin to improve within four hours after washing away the substance. If they do not, call your doctor.
Allergies
Allergy-associated conjunctivitis should be evaluated by your ophthalmologist and an allergist. It may disappear completely when the allergy is treated with antihistamines or the when the allergen is removed. Relieve symptoms temporarily by applying a cold compress on closed eyes.
Ophthalmia neonatorum and STDs
The same bacteria that causes the sexually transmitted diseases chlamydia and gonorrhea can also infect the conjunctiva. This is called ophthalmia neonatorum and is most commonly spread during birth as the infant passes through the birth canal of an infected mother. Newborns are usually given eye drops immediately after birth to treat any possible infection.
Conjunctivitis can also be spread through hand contact when rubbing the eyes or touching contact lenses after touching infected genitals. Oral antibiotics in the form of pill, eye drops, or ointment are usually prescribed for treatment. Washing hands thoroughly can help prevent the spread of this type of conjunctivitis.

Being around a person who has conjunctivitis and wearing contact lenses may increase your risk of getting conjunctivitis, but the outcome is usually very good with treatment. The eyes can become re-infected. Call your doctor if symptoms last for more than three days after treatment.

What can I do to help relieve symptoms?

Protect your eyes from dirt and other irritating substances.
Remove contact lenses, if you wear them.
Place cold compresses on your eyes.
Wash your face and eyelids with mild soap or baby shampoo and rinse with water to remove irritating substances.
Non-prescription "artificial tears," a type of eye drops, may help relieve itching and burning from irritating substances. (Note: Other types of eye drops may irritate the eyes and should not be used.) Do not use the same bottle of drops in the other eye if it is not infected.

How can I prevent spreading the infection?

Don’t touch or rub the infected eye(s).
Wash your hands often with soap and warm water.
Wash any discharge from your eyes twice a day using a fresh cotton ball or paper towel. Afterwards, discard the cotton ball and wash your hands with soap and warm water.
Wash your bed linens, pillowcases, and towels in hot water and detergent.
Avoid wearing eye makeup.
Don’t share eye makeup with anyone else.
Never wear another person’s contact lens.
Wear glasses instead of contact lenses. Throw away disposable lenses or be sure to clean extended wear lenses and all eyewear cases.
Avoid sharing common articles such as unwashed towels, cups, and glasses.
Wash your hands after applying the eye drops or ointment to your eye or your child’s eye.
Do not use eye drops in a non-infected eye that were used for an infected one

Medical Info: Encopresis

Encopresis is defined in DSM IV as a pattern of passing faeces into inappropriate places, whether the passage is voluntary or involuntary. The pattern must be present for at least three months and the child’s age must be greater than 4 years. (Or the child must have the developmental level of a four year old.

The normal sequence of developing control over bowel and bladder function is as follows:

1. The development of nocturnal faecal continence.

2. Diurnal faecal continence.

3. Diurnal bladder control.

4. Nocturnal bladder control.

Medical info:


ENCOPRESIS-EPIDEMIOLOGY

In the western culture bowel control is established by the 4th birthday in more than 95% of children and 99% by the 5th birthday. Frequency decreases to virtual absence by the age of 16.

After age four encopresis is 3-4 times more common in boys than in girls.

AETIOLOGY

Lack of appropriate toilet training or inadequate toilet training.

Some encopretic children suffer from lifelong inefficient and ineffective sphincter control.

The above two factors offer an opportunity for a power struggle between the child and parent over issues of autonomy and control. When behavioural problems do occur they are often the consequence of the soiling.

Encopretic children who are clearly able to control their bowel function adequately and who deposit faeces of relatively normal consistency in abnormal places usually have a psychiatric difficulty.

Encopresis is also associated with other neurodevelopmental difficulties including easy distractibility, short attention span, low frustration tolerance, hyperactivity and poor coordination. Encopresis may be precipitated by life events such as the birth of a sibling or move to a new home.

Encopresis sometimes appears as a regression after certain stresses.

Many encopretic children also retain faeces and become constipated either voluntarily or as a result of painful defecation. The resulting chronic rectal distention from large hard faecal masses may cause loss of tone in the rectal wall and desensitization to pressure. Thus many children become unaware of the need to defecate, and overflow encopresis occurs, usually with small amounts of soft or liquid stool. Olfactory accommodation may limit sensory cues.

DIAGNOSIS AND CLINICAL FEATURES

Children may intentionally deposit faeces in their clothes or other places for a variety of reasons.

Some children may be angry at parental figures or may present oppositional defiant behaviour.

Some children develop repetitive behaviours that seem to seek negative attention. Some children have sporadic episodes at times of stress. Encopresis may also be present on an involuntary basis in the absence of physiological abnormalities- the child may not exercise adequate control over his sphincter muscles because he is absorbed in another activity or is not aware of the process. The faeces may be normal, near normal or liquid in consistency. In rare cases involuntary overflow of stool results from psychological causes of diarrhoea and anxiety disorders.

Studies have indicated that children who do not have GI disorder have high rates of abnormal sphincter contractions. This is particularly prevalent in children with constipation and overflow. Children with constipation who have difficulties with sphincter relaxation are not likely to be good responders to laxatives.

Medical Info: Mesothelioma

Mesothelioma is an uncommon form of cancer, usually associated with previous exposure to asbestos. In this disease, malignant (cancerous) cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products.

Medical info:

Signs and symptoms
Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.

Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

These symptoms may be caused by mesothelioma or by other, less serious conditions.


Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of occupational exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).

If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a histopathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.

If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

Medical Info: Pancreatitis

Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy.

Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food. But if these enzymes become active inside the pancreas, they start "digesting" the pancreas itself.


Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Pseudocysts, accumulations of fluid and tissue debris, may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.

Acute Pancreatitis
Some people have more than one attack and recover completely after each, but acute pancreatitis can be a severe, life-threatening illness with many complications. About 80,000 cases occur in the United States each year; some 20 percent of them are severe. Acute pancreatitis occurs more often in men than women.

Acute pancreatitis is usually caused by gallstones or by drinking too much alcohol, but these aren't the only causes. If alcohol use and gallstones are ruled out, other possible causes of pancreatitis should be carefully examined so that appropriate treatment—if available—can begin.

Medical info:

Symptoms
Acute pancreatitis usually begins with pain in the upper abdomen that may last for a few days. The pain may be severe and may become constant—just in the abdomen—or it may reach to the back and other areas. It may be sudden and intense or begin as a mild pain that gets worse when food is eaten. Someone with acute pancreatitis often looks and feels very sick. Other symptoms may include

swollen and tender abdomen
nausea
vomiting
fever
rapid pulse
Severe cases may cause dehydration and low blood pressure. The heart, lungs, or kidneys may fail. If bleeding occurs in the pancreas, shock and sometimes even death follow.

Medical Info: Phimosis

Phimosis, or preputial stenosis, is a term that usually means any condition where the foreskin of the penis cannot be retracted.

Most infants are born with a foreskin that cannot be retracted and the prepuce may be tight until after puberty.

A fully retractable foreskin occurs in 50% of ten year olds, 90% of 16 year olds and 98 to 99% of 18 year olds.
Causes of Phimosis Phimosis can be caused by failure of foreskin to loosen during growth, infections such as balinitis, deformities caused by trauma and diseases of the genitals.

Symptoms Phimosis is usually painless condition. Infection may result from an inability to carry out effective cleaning of the area in which case swelling, redness and discharge may all be present making the area tender and painful. A very tight foreskin can cause problems during intercourse, urination.

Paraphimosis An inability to pull back the foreskin into position over the head of the penis can cause pain, swelling of the head of the penis and the foreskin. It may cause restricted blood flow, causing the head of the penis to become dark purple in color. If this should occur emergency treatment is required.

Medical info:
Deciding on treatment Medical opinion differs on the condition and on treatment. It has been suggested that any radical or surgical treatments for phimosis should not be done until after puberty. This has partly come about because of the reaction to the over use of circumcision as a mainstream treatment for phimosis. It has also been reported by bodies such as CIRP that significant numbers of doctors are unable to recognise normal developmental tight prepuce and pathological phimosis. It is believed that many unnecessary circumcisions are performed because of current medical practice and misdiagnosis of phimosis. Balanitis xeroticia obliterans has been sited as one of the only causes of phimosis that should lead to a surgical circumcision.

Medical Info: Retinoschisis

Retinoschisis is a disease of the nerve tissue in the eye. It affects the retinal cells in the macula (the central fixation point of vision at the back of the eye). Retinoschisis is technically a form of macular degeneration. However there are different types of macular degeneration and many people diagnosed with macular degeneration do not have retinoschisis.

Retinoschisis is a genetic eye disease that affects the vision of men who inherit the disease from their mothers. This condition frequently starts during childhood and is officially called Juvenile X-linked Retinoschisis. Affected men inherit this trait from their mothers who carry the condition but retain normal vision.

Juvenile X-linked Retinoschisis is a genetic disease of the retina and affects primarily boys and young men. It is estimated that retinoschisis affects one in 5,000 to 25,000 individuals, primarily young males. Affected males are usually identified in grade school, but occasionally are identified as young infants. Affected boys and men should have periodic eye examinations.

Senile retinoschisis is the splitting of the retina as a result of aging. It can affect men and women. This is not a genetic condition.

Very few affected individuals go blind from retinoschisis. However, some men with retinoschisis have very limited reading vision and are "legally blind" because their visual acuity is less than 20/200 in both eyes. (Acuity of 20/60 or better is usually required for a drivers license.)

Medical info:
Retinoschisis (RS) affects two primary aspects of vision. First, central vision can be impaired. Visual acuity can range from 20/30 to less than 20/200. The acuity loss in RS is caused by the formation of tiny cysts in the retina. These cysts often form a "spoke-wheel" pattern which is frequently very subtle and is usually detected only by a trained clinician. Since the nerve tissue is damaged by these cysts, the visual acuity cannot be improved with glasses. Second, peripheral vision can be lost due to the splitting of the inner layer of nerve cells from the outer layer of cells. "Schisis" is derived from a Latin word meaning "splitting" and gives the name to this disease.

Retinal detachments can occur if the anchoring of the outer layer of the retina to the eye wall is impaired. Since RS patients are more susceptible to retinal detachments, regular examinations with an ophthalmologist are important. When detected early, retinal detachments can be treated surgically (see information about retinal detachment). However, splitting or schisis of the retina cannot be corrected by medication or surgery.

Retinoschisis can be confused with other eye diseases, such as a "lazy eye". If someone in your family has retinoschisis and you are diagnosed with a lazy eye you should have an thorough exam by an ophthalmologist.

Medical Info: Pericarditis

Pericarditis is a swelling and irritation of the pericardium, the thin sac-like membrane that surrounds your heart. This condition often causes chest pain and other signs and symptoms.

Pericarditis may be acute or chronic. The sharp chest pain associated with acute pericarditis occurs when the pericardium rubs against the heart's outer layer.

Mild cases may improve on their own. Treatment for more severe cases may include medications and surgery. Early diagnosis and treatment is important to reduce the risk of long-term complications.

Medical info:

Signs and Symptoms

The most common symptom of pericarditis is chest pain. The pain is predominantly felt below the breastbone (sternum) and/or below the ribs on the left side of the chest and, occasionally, in the upper back or neck. Breathing causes the lungs and heart to move in the chest and rub against the irritated pericardium, worsening the pain. Pain may worsen when patients lie down and may improve when they sit up and lean forward. Changes in position can increase or decrease pressure on and irritation of the inflamed pericardium.

Several things that cause pericarditis also cause fluid to accumulate between the pericardium and the heart (pericardial effusion). If enough fluid builds up quickly in this space, it can "compress" the heart's chambers. Through some fairly complex mechanisms, this sometimes leads to shortness of breath (dyspnea). The development of dyspnea is a matter of concern because it may indicate that the amount of fluid is reaching a critical point and requires urgent medical treatment.

While pericarditis usually is not a life-threatening condition, other life-threatening conditions may cause chest pain, including heart attack (myocardial infarction), dissection of the aorta ("tearing" of the body's main artery that runs through the chest and abdomen), blood clot lodged in the lung (pulmonary embolus), a collapsed lung, and perforation or rupture of parts of the digestive tract (e.g., esophagus, stomach). It is critical for anyone who experiences chest pain to seek immediate medical attention to determine the cause and receive prompt, appropriate treatment.

Medical Info: Hypertension

The heart is a pump designed to force blood through our body. Blood is pumped from the heart through the arteries out to our muscles and organs.

Pumps work by generating pressure. Put simply, too much pressure puts a strain on the arteries and on the heart itself. This can cause an artery to rupture or the heart to fail under the strain - in the worst case stopping altogether.

Blood pressure depends on a combination of two factors:

- how forcefully the heart pumps blood around the body
- how narrowed or relaxed your arteries are.

Hypertension occurs when blood is forced through the arteries at an increased pressure.

Medical info:
There is a natural tendency for blood pressure to rise with age due to the reduced elasticity of the arterial system. Age is therefore one of the factors that needs to be taken into account in deciding whether a person's blood pressure is too high.

In general terms, people with a systolic blood pressure consistently above 160mmHg and/or a diastolic pressure over 100mmHg need treatment to lower their blood pressure.

People with slightly lower blood pressures (140-159mmHg systolic or 90-99mmHg diastolic) may also need treatment if they have a high risk of developing cardiovascular disease, eg stroke or angina (chest pains).

Medical Info: Cholesterol Embolism

Cholesterol embolism syndrome should be suspected in a patient who develops worsening renal function, hypertension, distal ischemia, or acute multisystem dysfunction after an invasive arterial procedure. Atheroemboli may also occur spontaneously. The protean manifestations of this syndrome make the diagnosis challenging. As the population ages, the incidence of cholesterol embolism syndrome will increase.

Any organ system, with the exception of the lungs, may be directly affected. Cholesterol embolism syndrome has 2 mechanisms of action.

Medical info:
In the first, cholesterol crystals spontaneously break off from severely atherosclerotic plaques and shower into downstream organs, occluding arterioles 100-200 micrometers in diameter. The crystals induce an inflammatory body reaction and adventitial fibrosis, which eventually obliterate the vessel lumen. Local vasospastic mediators compound tissue ischemia and produce progressive, irreversible organ damage.

With the second mechanism, larger cholesterol plaques break off and occlude larger arteries, causing tissue infarction with acute organ dysfunction. This can occur after local trauma to the atherosclerotic plaque, such as that caused by angiography or aortic trauma, or it can occur after destabilization of the protective clot overlying the plaque, which can occur as a result of anticoagulation.

Cholesterol crystal embolization occurs from the arterial system, and crystals are trapped in the arterioles where they either immediately occlude the vessels or induce an intense inflammatory response that leads to tissue ischemia. Crystals do not travel to the lungs; however, inflammatory mediators released by ischemic tissue may result in acute lung injury.

Medical Info: Leukemia

Leukemia (leukaemia in Commonwealth English) is a cancer of the blood or bone marrow characterized by an abnormal proliferation of white blood cells (leukocytes).

The word leukemia refers to a group of cancers which affect the white blood cells. In the 19th century, it was seen as one single, homogenous deadly disease, characterized by a white (leuko-) appearance of blood samples. Leukemia was first recognized by the German pathologist Rudolf Virchow in 1847 and the first case was described by British pathologist John Hughes Bennett in 1845.

Leukemia arises in the bone marrow. The bone marrow produces three major types of blood cells.

Red blood cells contain hemoglobin and are responsible for carrying oxygen to the body.
White blood cells are responsible for fighting infection.
Platelets assist with blood clotting.
Leukemia is characterised by an excessive production of abnormal white blood cells, overcrowding the bone marrow and often spilling out into the peripheral blood. The infiltration of the bone marrow results in decreased production and function of normal blood cells. Leukemia, dependent on the type, can spread to the lymph nodes, spleen, liver, central nervous system and other organs or tissues, causing the affected area to swell.

Medical info:
Damage to the bone marrow results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).

White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional, putting the patient at risk of infection.

Finally, the red blood cell deficiency leads to anemia, which may cause shortness of breath and fatigue. Bone or joint pain may occur because of cancer spreading to these areas. Headaches and vomiting are indicative of the cancer having disseminated to the central nervous system.

Enlarged lymph nodes or splenomegaly (an enlarged spleen) may occur in some types. All symptoms may also be attributable to other diseases; for diagnosis, blood tests and a bone marrow biopsy are required.

Medical Info: Phlebitis

Phlebitis means a clot in the vein. As the venous system is divided in deep veins and superficial veins one can have clot in each of the systems. Only very rarely clotting can occur in both of the systems in the same time.

Superficial vein thrombosis or SVT is also called superficial thrombophlebitis/phlebitis. The "itis" denotes that the vein is engulfed in an inflamatory process: the skin around the vein is read and painful. Swelling can be present as well. Unfortunately, many physicians treat this condition with antibiotics. This is completely unnecessary as in most of cases there is no bacterial infection. The main cause for the condition are varicose veins. Blood stagnates in those venous pools and will clot easily especially during inactivity. Injecting varicose veins can lead to superficial phlebitis as well. In the absence of varicose veins one should look for other reasons such as malignancy elsewhere in the body, gout, Buerger's disease. or an inherited tendency to clot.

Medical info:
The treatment of the condition is simple: evacuation of clot if the patient comes early to the physician, local compression with ace bandages or surgical stockings, and ambulation. The only medication to be given is ibuprofen (Motrin/Advil) 5-7 days that will ease the pain and calm the inflamatory reaction. Occasionally SVT can be associated with DVT. Only in these cases is anticoagulation treatment necessary. If the underling condition for the superficial phlebitis was varicose veins after the inflamatory process has cooled off, surgery for the varicose veins is indicated.

Deep vein thrombosis (abbreviated as DVT) is ussually localized in the deep veins of the calf but it can extend into the deep veins of the thigh and even beyond. The more extensive the clot the more dangerous the condition is. Among the clinical signs are calf pain and swelling (edema) of the ankle and possibly calf. It is potentially a dangerous conditions as a piece of the clot can "fly" through the venous circulation and lodge in the lungs occluding the pulmonary circulation. This is called pulmonary emboli or PE. It can be fatal if it is massive.

Once DVT is suspected clinically it should be verified with a duplex imager. If not found with this non invasive ultrasonic device, though highly suspected on clinical grounds, an X-ray should be done (called ascending phlebogram). A newer method is the magnetic resonance phlebogram (MR phlebogram). Once diagnosed, the patient has to be anticoagulated i.e. the blood has to be thinned out. In the begining this is obtained with Heparin injections followed by Coumadin tablets for aproximately 6 months. To adjust the proper dose hospitalization for a few days up to a week is recommended. Compression treatment of the calf is a must. If embolization does occur in spite of thinned blood, filters have to be introduced in the main vein of the abdomen (vena cava) to prevent PE. Damage to the deep vein valves by the retracting clot in the ensuing months could leed in a few years to venous circulatory problems in the leg that if not treated with compression can evolve even into skin ulceration. This is chronic venous insufficiency and venous ulceration repectivly.

Medical Info: Lymphadenitis

Lymphadenitis is the inflammation of a lymph node. It is often a complication of a bacterial infection of a wound, although it can also be caused by viruses or other disease agents. Lymphadenitis may be either generalized, involving a number of lymph nodes; or limited to a few nodes in the area of a localized infection. Lymphadenitis is sometimes accompanied by lymphangitis, which is the inflammation of the lymphatic vessels that connect the lymph nodes.


Medical info:

Lymphadenitis is marked by swollen lymph nodes that are painful, in most cases, when the doctor touches them. If the lymphadenitis is related to an infected wound, the skin over the nodes may be red and warm to the touch. If the lymphatic vessels are also infected, there will be red streaks extending from the wound in the direction of the lymph nodes. In most cases, the infectious organisms are hemolytic Streptococci or Staphylococci. Hemolytic means that the bacteria produce a toxin that destroys red blood cells.

The extensive network of lymphatic vessels throughout the body and their relation to the lymph nodes helps to explain why bacterial infection of the nodes can spread rapidly to or from other parts of the body. Lymphadenitis in children often occurs in the neck area because these lymph nodes are close to the ears and throat, which are frequent locations of bacterial infections in children.

Causes and symptoms
Streptococcal and staphylococcal bacteria are the most common causes of lymphadenitis, although viruses, protozoa, rickettsiae, fungi, and the tuberculosis bacillus can also infect the lymph nodes. Diseases or disorders that involve lymph nodes in specific areas of the body include rabbit fever (tularemia), cat-scratch disease, lymphogranuloma venereum, chancroid, genital herpes, infected acne, dental abscesses, and bubonic plague. In children, tonsillitis or bacterial sore throats are the most common causes of lymphadenitis in the neck area. Diseases that involve lymph nodes throughout the body include mononucleosis, cytomegalovirus infection, toxoplasmosis, and brucellosis.

The early symptoms of lymphadenitis are swelling of the nodes caused by a buildup of tissue fluid and an increased number of white blood cells resulting from the body's response to the infection. Further developments include fever, often as high as 101-102°F (38-39°C) together with chills, loss of appetite, heavy perspiration, a rapid pulse, and general weakness.

Diagnosis
The diagnosis of lymphadenitis is usually based on a combination of the patient's history, the external symptoms, and laboratory cultures. The doctor will press (palpate) the affected lymph nodes to see if they are sore or tender. Swollen nodes without soreness are often caused by cat-scratch disease. In children, the doctor will need to rule out mumps, tumors in the neck region, and congenital cysts that resemble swollen lymph nodes.

Although lymphadenitis is usually diagnosed in lymph nodes in the neck, arms, or legs, it can also occur in lymph nodes in the chest or abdomen. If the patient has acutely swollen lymph nodes in the groin, the doctor will need to rule out a hernia in the groin that has failed to reduce (incarcerated inguinal hernia). Hernias occur in 1% of the general population; 85% of patients with hernias are male.

Rebecca J. Frey PhD.

Medical Info: Esophagitis

Esophagitis is inflammation, irritation, and swelling of the esophagus, the tube that leads from the back of the mouth to the stomach.

Medical Info:

Causes, incidence, and risk factors:
Esophagitis is frequently caused by backflow of acid-containing fluid from the stomach to the esophagus (gastroesophageal reflux). It can also be caused by vomiting, surgery, medications or hernias.


In patients with weakened immune systems caused by HIV and certain medications (such as corticosteroids), esophagitis may be caused by an infection of the esophagus. Esophageal infection can be caused by viruses (such as herpes or cytomegalovirus) and fungi or yeast (especially Candida infections).

The infection or irritation can cause the tissues to become inflamed and can occasionally cause ulcers. There may also be difficulty when swallowing, and a burning sensation in esophagus.

Medical Info: Acromegaly

Acromegaly is a hormonal disorder that results when the pituitary gland produces excess growth hormone (GH). It most commonly affects middle-aged adults and can result in serious illness and premature death. Once recognized, acromegaly is treatable in most patients, but because of its slow and often insidious onset, it frequently is not diagnosed correctly.

The name acromegaly comes from the Greek words for "extremities" and "enlargement" and reflects one of its most common symptoms, the abnormal growth of the hands and feet. Soft tissue swelling of the hands and feet is often an early feature, with patients noticing a change in ring or shoe size. Gradually, bony changes alter the patient's facial features: the brow and lower jaw protrude, the nasal bone enlarges, and spacing of the teeth increases.

Medical info:
Overgrowth of bone and cartilage often leads to arthritis. When tissue thickens, it may trap nerves, causing carpal tunnel syndrome, characterized by numbness and weakness of the hands. Other symptoms of acromegaly include thick, coarse, oily skin; skin tags; enlarged lips, nose and tongue; deepening of the voice due to enlarged sinuses and vocal cords; snoring due to upper airway obstruction; excessive sweating and skin odor; fatigue and weakness; headaches; impaired vision; abnormalities of the menstrual cycle and sometimes breast discharge in women; and impotence in men. There may be enlargement of body organs, including the liver, spleen, kidneys and heart.

The most serious health consequences of acromegaly are diabetes mellitus, hypertension, and increased risk of cardiovascular disease. Patients with acromegaly are also at increased risk for polyps of the colon that can develop into cancer.

When GH-producing tumors occur in childhood, the disease that results is called gigantism rather than acromegaly. Fusion of the growth plates of the long bones occurs after puberty so that development of excessive GH production in adults does not result in increased height. Prolonged exposure to excess GH before fusion of the growth plates causes increased growth of the long bones and increased height.

Medical Info: Edema

Edema (BE: oedema, formerly known as dropsy) is swelling of any organ or tissue due to accumulation of excess fluid. Edema has many root causes, but its common mechanism is accumulation of fluid into the tissues.

Medical info:
Edema can occur in whole body, then it is called generalized (anasarca), or can be limited to only some parts or organs, then it is localized. Edema without a modifier usually refers to peripheral edema, which is edematous swelling from the legs upwards. Types of edema are pitting edema and non-pitting edema. The former is present if pressing of the affected body part creates a small pit that disappears within a few seconds, while non-pitting edema is not compressible.

Causes of peripheral edema are:

high hydrostatic pressure of the veins, leading to poor reabsorption of fluid
venous obstruction, e.g. deep vein thrombosis (typically one-sided)
congestive heart failure
varicose veins
low oncotic pressure
cirrhosis
malnutrition
nephrotic syndrome (renal protein loss)
epidemic dropsy
inflammation (active secretion of fluid into the interstitial space):
allergic conditions (e.g. Angioedema)
any other form of inflammation (tumor - or swelling - is one of the main characteristics of inflammation)
Edema of specific organs (cerebral edema, pulmonary edema) may impair function. It has different causes from peripheral edema, although pulmonary edema is seen together with peripheral edema in severe fluid overload.
Source: http://en.wikipedia.org/wiki/Edema

Medical Info: Mycoses

Mycoses refers to the infections produced by the ubiquitous encapsulated yeast Cryptococcus neoformans. The infection commonly starts following inhalation of the organism. The primary infection may remain localized into the lungs or disseminate througout the body. Some authors have made the distinction between localized and disseminated cryptococcosis, based on the number of organs involved. However, cryptococcocal meningitis can only occur once the fungus has reach CNS tissue from the primary point of entry. Based on this, most authors consider any form of extra-pulmonary cryptococcosis to be a form of disseminated disease. Primary pulmonary infections have no diagnostic symptoms and usually are asymptomatic. However, a chronic form may develop producing a variety of lesions. The prostate may be a reservoir for relapse. A positive serum cryptooccal antigen titer is highly suggestive of dissemination. Cryptococcosis is considered an opportunistic infections as it affects mainly immunosupressed individuals.


Medical info:
There are 37 species within the genus Cryptococcus, however the major human pathogen is Cryptococcus neoformans. A few cases of cryptococcosis cause by other species (C. albidus and C.laurentii) have been reported in the literature. Cryptococcus neoformans is an encapsulated round to oval yeastlike fungus measuring 4 to 6 microns. A characteristic polysaccharide capsule of variable thickness (1 to 30 microns) surrounds these yeasts. In its natural enviroment the capsule is thinner and the yeast smaller, while thicker capsules tend to be found from infected tissues. The polysaccharide capsule, the phenoloxidase enzyme of Cryptococcus neoformans, and the organism's ability to grow at 37°C, are its major virulence factors. Recent data suggest that phospholipase enzymes may also be virulence factors.

Within the species Cryptococcus neoformans, there are major varieties with differing biological, ecological, and epidemiological characteristics. For many years, only , C. neoformans var. neoformans and C. neoformans var. gattii were described. However, based on molecular studies and genetic variation a new variety C. neoformans var. grubii has been incorporated to this list

Medical Info: Cardiomegaly

There are three basic types of cardiomyopathy: 1. Dilated cardiomyopathy. The heart muscle becomes weak and the heart chambers subsequently enlarge (dilate). 2. Hypertrophic cardiomyopathy. The heart muscle itself is much thicker than normal. 3. Restrictive cardiomyopathy. The heart becomes stiff and cannot fill efficiently during distal, the period of the heartbeat when the chambers fill with blood. Dilated Cardiomyopathy Dilated cardiomyopathy refers to overall enlargement (dilatation) of the heart chambers, especially the ventricles. Although this enlargement is a key part of dilated cardiomyopathy, it is not the initial problem, but rather the heart's own response to a weakness of heart muscle and poor pumping ability. The weakness of the heart muscle in this condition is generalized, "global" - all parts of the myocardium are affected about equally. Enlargement of the heart is the heart's way of trying to compensate for the weakness of its muscle. This is called a compensatory mechanism. If the heart muscle is weak, it is unable to pump out the same portion of blood that it could at normal strength. Rather than simply "accepting" the limitations of decreased pumping ability, the heart and other organs of the body undergo compensatory changes to try to maximize their efforts. Dilated cardiomyopathy causes heart failure - an inability of the heart to provide an adequate supply of blood to the body's organs and tissues - which if left untreated is always associated with excess fluid retention, congestion in the lungs and liver, and swelling of the legs. Hypertrophic Cardiomyopathy Hypertrophic cardiomyopathy is an overgrowth of heart muscle that can impair blood flow both into and out of the heart. The disease is characterized by a disorderly growth of heart muscle fibers, causing the heart chambers to become thick-walled and bulky. All the chambers are affected, but the thickening is generally most striking in the walls of the left ventricle. Most commonly, one of the walls, the septum, which separates the right and left ventricles, is asymmetrically enlarged. The distorted left ventricle contracts, but the supply of blood to the brain and other vital organs may be inadequate because blood is trapped within the heart during contractions. Hypertrophic cardiomyopathy is sometimes called idiopathic hypertrophic subaortic (beneath the aorta) stenosis, abbreviated IHSS. This overgrowth creates a bulge that protrudes into the ventricular chamber and impedes the flow of blood from the heart to the aorta and the rest of the body. When this obstruction is present, the cardiomyopathy is also called hypertrophic obstructive cardiomyopathy (HOCUM, often pronounced "hokum"). In this condition, the problem is not that the heart muscle is weak but that the overgrown heart muscle impedes the flow of blood through and out of the heart. Restrictive Cardiomyopathy Restrictive cardiomyopathy is less common than the other two forms. It can stem from infiltration of the heart muscle with abnormal material (for example in amyloidosis) or with any other type of chronic fibrosing process. The result is a heart that cannot expand sufficiently to fill with blood, and cannot contract efficiently such that adequate amounts of blood perfuse either the lungs for oxygenation, or the tissues for normal blood supply.

Medical info:
Possible causes of dilated congestive cardiomyopathy include: inflammation of the heart muscle (myocarditis) either infectious or non-infectious, excessive alcohol consumption, nutritional deficiencies, complications arising shortly before or after childbirth (postpartum), and genetic disorders. Causes of the hypertrophic and restrictive forms are usually unknown.

Medical Info: Mastoiditis

Mastoiditis is a bacterial infection of the air cells in the bony skull in the area behind the ear. The air chambers serve to lighten the skull; they communicate with the outside air via small passages that lead to the inner ear behind the eardrum. Mastoiditis almost always occurs as a complication of untreated otitis media with chronic ear drainage. Once very common (mastoidectomy was once the most common operation in the United States as late as the 1940's), the infection has all but disappeared. I have seen two cases in my career.

Medical info:
Parents will from time to time encounter articles in which it is stated that in certain European countries, antibiotics are not given for ear infections routinely. These articles usually fail to add that the incidence of mastoiditis, with its attendant complications of painful illness, surgery and hearing loss, are much higher in those countries. Now that the push is on to cut back antibiotic treatment of otitis media, I suppose we will have to learn about this disease again.

Medical Info: Pyogenic Granuloma

Pyogenic granuloma is a relatively common skin growth. It is usually a small red, oozing and bleeding bump that looks like raw hamburger meat. It often seems to follows a minor injury and grows rapidly over a period of a few weeks to an average size of a half an inch. The head, neck, upper trunk and hands and feet are the most commonly sites.

Pyogenic granuloma can occur at any age, but is least common in the very young and the very old. It is seen most often in children, pregnant women ("pregnancy tumor") and those taking the drugs Indinavir, Soriatane, Accutane and oral contraceptives.

Medical Info:
Pyogenic granulomas are always benign growths. Still there is always a concern that they could be cancerous, and rarely a cancer can mimic pyogenic granuloma. A sample is usually obtained for biopsy analysis. This is particularly important since as many as half of treated cases will recur (grow back) and need a second treatment.

Those that appear on the upper back in young adults are more prone to recur. At times multiple smaller pyogenic granulomas form following a treatment (these are known as "satellites"). It appears that pieces of pyogenic granuloma may spread though local blood vessels. Pyogenic granulomas in pregnant women may go away after delivery on their own, and sometimes waiting is the best strategy in those cases.

Most pyogenic granulomas are scraped off with an instrument called a curette and lightly cauterized to decrease the chance they will re-grow. An injection of local anesthesia is required (lidocaine is used-similar to Novocaine). Some doctors prefer to treat with chemicals (TCA, podophyllin, phenol, silver nitrate). Laser surgery can also be done but has not been proven to be superior. The highest cure rates are obtained when the growth is removed by full thickness surgical excision, and closed with stitches.

Medical Info.

Medical Info: Medulloblastoma

Medulloblastoma is the most common primary central nervous system tumor which arises in childhood. Its management represents both the progress and limitations involved in patient care over the last 20 years.

Medulloblastomas arise in the fourth ventricle, between the brain stem and the cerebellum. Common symptoms are unsteadiness, headaches, and vomiting due to hydrocephalus (from blockage of cerebrospinal fluid flow). Diagnosis is usually within one to three months of the onset of symptoms, as this is a fast-growing tumor. Occasionally due to bleeding within the tumor, a patient will be in a coma or severe distress at diagnosis. While there has been significant improvement in survival for children with this disease, much progress needs to be made.

Histologically similar tumors may also be seen in the pineal region or the cerebral cortex (the thinking part of the brain). It is uncertain whether tumors which arise in these different areas of the brain are identical to medulloblastoma in their biologic behavior, as the actual cell of origin of the medulloblastoma remains unknown. Despite many investigations, the "medulloblast" has never been identified. Factors which account for the development of the medulloblastoma, its tendency to spread outside of its primary site of origin, or its ability to withstand chemotherapy and radiation are unknown.

Treatment has evolved over the past 30 years with the majority of patients requiring surgery, radiation, and chemotherapy. Over the past 20 years, surgery for children with medulloblastoma has become safer, yet two of every ten children will develop severe, sometimes irreversible, neurologic problems afterwards, including loss of speech and severe balance difficulties. These problems may not be apparent for 24 hours after surgery and such complications have been called the "pseudobulbar syndrome" or "postcerebellar surgery mutism syndrome." There is strong evidence that medulloblastomas which are only biopsied at the time of surgery are very difficult to control, despite the use of radiation and chemotherapy. Children whose tumors are resected (totally when possible) have a better overall rate of survival.

Medical info:
Medulloblastoma has the tendency to spread to other sites in the nervous system and, infrequently, to other body organs. Staging studies are needed and they include cerebrospinal fluid analysis (spinal taps) for evaluation of tumor cells within the spinal fluid, and MRI scans (head and spine), performed with and without contrast agents. Newer molecular genetic tests are under study and may add to the ability to predict the behavior of medulloblastomas. Factors, such as the expression of TrkC, erb-B, and n-myc, may be extremely important; but these tests are not yet commercially available and must still be considered research tools.

Radiation to the entire brain and spine at the time of diagnosis, with additional radiation (boost) to the tumor site, has been a major treatment advance. With it, the overall five-year survival rate has risen from 20% to well over 50% in the last 20 years.

Over the past ten years, there has been increasing evidence that chemotherapy improves survival for children whose tumors cannot be fully resected, or have spread beyond the primary site (disseminated) at diagnosis. In a study originating at Children's Hospital of Philadelphia and completed at Children's National Medical Center in Washington, D.C., eight out of ten children with high-risk medulloblastoma were alive and disease-free five years from diagnosis, many likely cured of their disease. Studies are underway to determine what type of chemotherapy is most effective and safest for children with medulloblastoma. Some patients may need more aggressive chemotherapy which would delay radiation for a few weeks or months.



Aggressive treatment approaches, especially craniospinal irradiation, can harm the developing brain. It is hard to predict what dose of radiotherapy will be harmful in each individual child. It is well known that very young children will have significant learning problems from full-dose radiotherapy and older children may have difficulties in school. A decrease in dosage may also decrease its efficacy on the tumor. Approaches using reduced-dose craniospinal irradiation and chemotherapy, to decrease cognitive, endocrinologic, and psychological deficits, are being evaluated. They may decrease late effects, but carry with them the risk of having more disease failures.

Studies attempting to delay and possibly even obviate radiotherapy in children less than three years of age, are also underway using high-dose, multiple agent chemotherapy, given immediately after surgery, in an attempt to stop the tumor from growing. Other studies are also employing chemotherapy put directly into the cerebrospinal fluid. Autologous bone marrow transplant or peripheral stem cell rescue, with growth factors that stimulate white blood cell production, are being utilized now and must be closely evaluated for overall safety.

Medical Info.

Medical Info List

Most of the following diseases will be explained at Medical Info.

A
A-alphalipoprotein Neuropathy (see Tangier Disease)
Abdominal Cramps (see Colic)
Abdominal Delivery (see Cesarean Section)
Abdominal Injuries
Abnormalities
Abortion, Induced
Abortion, Spontaneous
Abscess
Abscess, Amebic (see Amebiasis)
Abscess, Retropharyngeal (see Retropharyngeal Abscess)
Acantholysis Bullosa (see Epidermolysis Bullosa)
Acariasis (see Mite Infestations)
Achalasia, Esophageal (see Esophageal Achalasia)
Achondroplasia
Achromatopsia (see Color Vision Defects)
Acid-Base Imbalance
Acidosis
Acidosis, Diabetic (see Diabetic Ketoacidosis)
Acne (see Acne Vulgaris)
Acne Vulgaris
Acoustic Neuroma (see Neuroma, Acoustic)
Acquired Childhoood Aphasia with Convulsive Disorder (see Landau-Kleffner Syndrome)
Acquired Facial Neuropathy (see Facial Nerve Diseases)
Acquired Hyperostosis Syndrome
Acquired Immunodeficiency Syndrome
Acrocephalosyndactylia
Acrocephaly (see Craniosynostoses)
Acrodysplasia V (see Langer-Giedion Syndrome)
Acromegaly
Actinic Reticuloid Syndrome (see Photosensitivity Disorders)
Actinomyces Infections (see Actinomycosis)
Actinomycosis
Action Tremor (see Tremor)
Acupuncture Therapy
Acute Autoimmune Neuropathy (see Guillain-Barre Syndrome)
Acute Confusional Migraine (see Migraine Disorders)
Acute Confusional Senile Dementia (see Alzheimer Disease)
Acute Inflammatory Demyelinating Polyradiculoneuropathy (see Guillain-Barre Syndrome)
Acute Inflammatory Polyneuropathy (see Guillain-Barre Syndrome)
Acute Zonal Occult Outer Retinopathy (not on MeSH)
Adam-Stokes Disease (see Arrhythmia)
Addison Disease
Addison's Anemia (see Anemia, Pernicious)
Adenitis (see Lymphadenitis)
Adenohypophyseal Diseases (see Pituitary Diseases)
Adenohypophyseal Hyposecretion (see Hypopituitarism)
Adenoma
Adenoma, Basal Cell (see Adenoma)
Adenoma, beta-Cell (see Insulinoma)
Adenoma, Follicular (see Adenoma)
Adenoma, Microcystic (see Adenoma)
Adenoma, Monomorphic (see Adenoma)
Adenoma, Papillary (see Adenoma)
Adenoma, Trabecular (see Adenoma)
Adenomatous Polyposis Coli
Adenomyosis (see Endometriosis (Adenomyosis))
Adenoviridae Infections
Adenovirus Infections (see Adenoviridae Infections)
Adhesions, Pelvic (not on MeSH)
Adhesive Capsulitis (see Bursitis)
Adiadochokinesis (see Cerebellar Ataxia)
Adie Syndrome
Adiposis Dolorosa
Adnexitis (see Pelvic Inflammatory Disease)
Adrenal Gland Diseases
Adrenal Hyperplasia, Congenital
Adrenoleukodystrophy
Adrenoleukodystrophy, Neonatal (see Peroxisomal Disorders)
Adrenomyeloneuropathy (see Adrenoleukodystrophy)
Affective Psychosis, Bipolar (see Bipolar Disorder)
Afferent Pupillary Defect (see PUPIL DISORDERS)
Afibrinogenemia
African Lymphoma (see Burkitt Lymphoma)
African Sleeping Sickness (see Trypanosomiasis, African)
Agammaglobulinemia
Aganglionosis, Colonic (see Hirschsprung Disease)
Age-Related Osteoporosis (see Osteoporosis)
Aggression
Agnogenic Myeloid Metaplasia (see Myeloid Metaplasia)
Agnosia
Agnosia for Faces (see Prosopagnosia)
Aicardi Syndrome (not on MeSH)
AIDP (see Guillain-Barre Syndrome)
AIDS (see Acquired Immunodeficiency Syndrome)
Airflow Obstruction, Chronic (see Pulmonary Disease, Chronic Obstructive)
Airsickness (see Motion Sickness)
Airway Obstruction
Alagille Syndrome
Alastrim (see Smallpox)
Albers-Schoenberg Disease (see Osteopetrosis)
Albinism
Albinism, Ocular
Albright's Syndrome (see Fibrous Dysplasia, Polyostotic)
Aldosteronism (see Hyperaldosteronism)
Aldrich Syndrome (see Wiskott-Aldrich Syndrome)
Alexander Disease
Alexia (see Dyslexia)
Algodystrophy (see Reflex Sympathetic Dystrophy (Type I Complex Regional Pain Syndrome))
Alkalosis
Alkaptonuria
Allergic Angiitis (see Churg-Strauss Syndrome (Allergic Granulomatosis))
Allergic Granulomatous Angiitis (see Churg-Strauss Syndrome (Allergic Granulomatosis))
Allergic Purpura (see Purpura, Schoenlein-Henoch)
Allergy (see HYPERSENSITIVITY)
Allergy, Latex (see Latex Hypersensitivity)
Alobar Holoprosencephaly (see Holoprosencephaly)
Alopecia
Alopecia, Androgenetic (see Alopecia)
Alpers Syndrome (see Diffuse Cerebral Sclerosis of Schilder)
alpha 1-Antitrypsin Deficiency
alpha-Lipoprotein Deficiency Disease, Familial (see Tangier Disease)
alpha-Mannosidosis
Alphavirus Infections
Alport's Syndrome (see Nephritis, Hereditary (Alport's Syndrome))
ALS (see Amyotrophic Lateral Sclerosis)
Alstrom Syndrome (see Nystagmus, Pathologic)
Alternative Medicine (see Complementary Therapies)
Altitude Sickness
Alveolitis, Fibrosing (see Pulmonary Fibrosis)
Alzheimer Disease
Amaurosis (see Blindness)
Amaurosis Fugax
Amblyopia
Ambulation Disorders, Neurologic (see Gait Disorders, Neurologic)
Amebiasis
Ameboma (see Amebiasis)
Ametropia (see REFRACTIVE ERRORS)
Amino Acid Metabolism, Inborn Errors
Amino Acid Transport Disorder, Neutral (see Hartnup Disease)
Amino Acidopathies, Congenital (see Amino Acid Metabolism, Inborn Errors)
Amnesia
Amniotic Band Syndrome
Amniotic Bands (see Amniotic Band Syndrome)
Amoebiasis (see Amebiasis)
Amphibian Diseases (not on MeSH)
Amputation, Intrauterine (see Amniotic Band Syndrome)
Amyloidosis
Amyoplasia Congenita (see Arthrogryposis)
Amyotonia Congenita (see Neuromuscular Diseases)
Amyotrophic Lateral Sclerosis
Amyotrophy, Neuralgic (see Brachial Plexus Neuritis (Parsonage-Turner Syndrome))
Anal Sex (see Sexual Behavior)
Analgesia
Analphalipoproteinemia (see Tangier Disease)
Anaphylactic Reaction (see Anaphylaxis)
Anaphylactoid Purpura (see Purpura, Schoenlein-Henoch)
Anaphylaxis
Anatomy and Orthopedics
Anderson-Fabry Disease (see Fabry Disease)
Androgen-Insensitivity Syndrome
Anemia
Anemia, Addison's (see Anemia, Pernicious)
Anemia, Aplastic
Anemia, Fanconi (see Fanconi Anemia)
Anemia, Hemolytic
Anemia, Hemolytic, Acquired (see Anemia, Hemolytic)
Anemia, Hemolytic, Congenital Nonspherocytic
Anemia, Hypoplastic (see Anemia, Aplastic)
Anemia, Iron-Deficiency
Anemia, Megaloblastic
Anemia, Microangiopathic (see Anemia, Hemolytic)
Anemia, Pernicious
Anemia, Sickle Cell
Anencephaly
Anesthesia
Anesthesia and Analgesia
Aneurysm
Aneurysm, Cerebral (see Intracranial Aneurysm)
Angelman Syndrome
Angiitis (see Vasculitis)
Angiitis, Allergic Granulomatous (see Churg-Strauss Syndrome (Allergic Granulomatosis))
Angina Pectoris
Angina Pectoris with Normal Coronary Arteriogram (see Microvascular Angina)
Angina, Microvascular (see Microvascular Angina)
Angioedema (see Angioneurotic Edema)
Angiofibroma
Angiofollicular Lymphoid Hyperplasia (see Giant Lymph Node Hyperplasia)
Angiohemophilia (see von Willebrand Disease)
Angiokeratoma Corporis Diffusum (see Fabry Disease)
Angiolymphoid Hyperplasia with Eosinophilia
Angioma (see Hemangioma)
Angiomyxoma (see Myxoma)
Angioneurotic Edema
Angor Pectoris (see Angina Pectoris)
Anguilluliasis (see Strongyloidiasis)
Anhidrosis (see Hypohidrosis)
Anhidrotic Ectodermal Dysplasia (see Ectodermal Dysplasia)
Animal Diseases
Animal Diseases
Aniridia
Anisakiasis
Anisocoria
Anisocoria, Physiologic (see Anisocoria)
Anisometropic Amblyopia (see Amblyopia)
Ankyloglossia (not on MeSH)
Annular Grooves (see Amniotic Band Syndrome)
Anomia
Anophthalmos
Anosmia (see Olfaction Disorders)
Anoxia
Anoxia, Brain (see Hypoxia, Brain)
Anoxic Encephalopathy (see Hypoxia, Brain)
Anterior Horn Cell Disease (see Motor Neuron Disease)
Anterior Ischemic Optic Neuropathy (see Optic Neuropathy, Ischemic)
Anterior Pituitary Hyposecretion Syndrome (see Hypopituitarism)
Anthrax
Anthropology, Forensic (see Forensic Anthropology)
Antibiotic-Associated Colitis (see Enterocolitis, Pseudomembranous)
Antibody Deficiency Syndrome (see IMMUNOLOGIC DEFICIENCY SYNDROMES)
Anti-GBM Disease (see Anti-Glomerular Basement Membrane Disease)
Anti-Glomerular Basement Membrane Disease
Antiphospholipid Syndrome
Antithrombin III Deficiency
Anus Diseases
Anus Prolapse (see Rectal Prolapse)
Anxiety Disorders
Anxiety Neuroses (see ANXIETY DISORDERS)
Anxiety States, Neurotic (see ANXIETY DISORDERS)
Aortic Arteritis, Giant Cell (see Temporal Arteritis)
Aortic Stenosis (see Aortic Valve Stenosis)
Aortic Valve Stenosis
Aortitis, Giant Cell (see Temporal Arteritis)
Apert Syndrome (see Acrocephalosyndactylia)
Aphakia
Aphasia
Aphasia, Acquired (see Aphasia)
Aphasia, Acquired Epileptic (see Landau-Kleffner Syndrome)
Aphasia, Amnesic (see Anomia)
Aphasia, Anomic (see Anomia)
Aphasia, Nominal (see Anomia)
Aphthae (see Stomatitis, Aphthous)
Aplasia Cutis Congenita (see Ectodermal Dysplasia)
Apnea
Apnea, Sleep, Central (see Sleep Apnea, Central)
Appendicitis
Appetite Disorders (see EATING DISORDERS)
Apraxias
Aprosencephaly (see Anencephaly)
Aprosodia (see Speech Disorders)
Arachnodactyly (see Marfan Syndrome)
Arachnoid Cysts
Arachnoid Diverticula (see Arachnoid Cysts)
Arachnoidal Cerebellar Sarcoma, Circumscribed (see Medulloblastoma)
Arachnoiditis
Arbovirus Infections
Argentaffinoma (see Carcinoid Tumor)
Arhinencephaly (see Holoprosencephaly)
Arm Injuries
Arnold-Chiari Malformation
Arrhythmia
Arrhythmogenic Right Ventricular Cardiomyopathy (see Arrhythmogenic Right Ventricular Dysplasia)
Arrhythmogenic Right Ventricular Dysplasia
Arsenic Poisoning
Arson (see Firesetting Behavior)
Arteriohepatic Dysplasia (see Alagille Syndrome)
Arteriosclerosis
Arteriosclerotic Dementia (see Dementia, Vascular)
Arteriovenous Malformations
Arteritis, Takayasu's (see Takayasu's Arteritis)
Arteritis, Temporal (see Temporal Arteritis)
Arthritis
Arthritis, Degenerative (see Osteoarthritis)
Arthritis, Juvenile Chronic (see Arthritis, Juvenile Rheumatoid)
Arthritis, Juvenile Idiopathic (see Arthritis, Juvenile Rheumatoid)
Arthritis, Juvenile Rheumatoid
Arthritis, Rheumatic, Acute (see Rheumatic Fever)
Arthritis, Rheumatoid
Arthrogryposis
Arthromyodysplasia, Congenital (see Arthrogryposis)
Arthropathy, Neurogenic
Arthropod Diseases (not on MeSH)
Arthropod-Borne Encephalitis (see Encephalitis, Arbovirus)
Arylsulfatase A Deficiency Disease (see Leukodystrophy, Metachromatic)
Asbestosis
Ascariasis
Ascites
Ascites, Gelatinous (see Pseudomyxoma Peritonei)
Ascorbic Acid Deficiency
Aseptic Necrosis of Bone (see Osteonecrosis)
Asialia (see Xerostomia)
Asperger Syndrome
Aspergillosis
Asphyxia
Assaultive Behavior (see Violence)
Asthma
Asthma, Bronchial (see Asthma)
Astigmatism
Astrocytoma
Astrocytoma, Grade IV (see Glioblastoma)
Astrocytoma, Subependymal Giant Cell (see Astrocytoma)
Asymmetric Septal Hypertrophy (see Cardiomyopathy, Hypertrophic)
Ataxia Telangiectasia
Ataxia, Cerebellar (see Cerebellar Ataxia)
Atelectasis
Atheroembolism (see Embolism, Cholesterol)
Athlet's Foot (see Dermatomycoses)
Atopic Hypersensitivity (see Hypersensitivity, Immediate)
Atresia, Biliary (see Biliary Atresia)
Atresia, Esophageal (see Esophageal Atresia)
Atresia, Pulmonary (see Pulmonary Atresia)
Atresia, Tricuspid (see Tricuspid Atresia)
Atrial Fibrillation
Atrioventricular Block (see Heart Block)
Atrocities (see Violence)
Atrophy, Muscular, Peroneal (see Charcot-Marie-Tooth Disease (HMSN I, II))
Attention Deficit Disorder (see Attention Deficit Disorder with Hyperactivity)
Attention Deficit Disorder with Hyperactivity
Attention Deficit Hyperactivity Disorder (see Attention Deficit Disorder with Hyperactivity)
Attitude to Death
Auditory Agnosia (see Agnosia)
Auditory Hyperesthesia (see Hyperacusis)
Aura (see Epilepsy)
Auricular Cancer (see Ear Neoplasms)
Auricular Fibrillation (see Atrial Fibrillation)
Auricular Neoplasms (see Ear Neoplasms)
Auriculo-Ventricular Dissociation (see Heart Block)
Autism, Infantile (see Autistic Disorder)
Autism-Dementia-Ataxia-Loss of Purposeful Hand Use Syndrome (see Rett Syndrome)
Autistic Disorder
Autoimmune Diseases
Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal-Dystrophy (see Polyendocrinopathies, Autoimmune)
Autoimmune Syndrome Type I, Polyglandular (see Polyendocrinopathies, Autoimmune)
Autoimmune Syndrome Type II, Polyglandular (see Polyendocrinopathies, Autoimmune)
Autoimmune Thyroiditis (see Thyroiditis, Autoimmune)
Autonomic Failure, Progressive (see Shy-Drager Syndrome)
Autonomic Nervous System Diseases
Autosomal Chromosome Disorders (see Chromosome Disorders)
Awakening Epilepsy (see Epilepsy)
Avascular Necrosis of Bone (see Osteonecrosis)
Avian Flu (see Influenza, Avian)
Avian Influenza (see Influenza, Avian)
Avitaminosis
Ayerza's Syndrome (see Hypertension, Pulmonary)
Azorean Disease (see Machado-Joseph Disease)


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