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Elongation - Definition torn hamstring, Prevention, Consultation


Definition of hamstrings

The hamstring muscles are located in the back of the thigh (upper leg) and consist of three muscles: biceps femoris, semitendinosus and semimembranosus. This muscle group is involved in flexing the leg at the knee, and the extension of the leg at the hip.


Definition of pulled muscle

Muscular elongation hamstring muscle is torn regards only few fibers; tearing (or breakdown) as it relates to a larger number of fibers. There are three levels of torn hamstrings, until complete rupture.

Risks and origins tears or pulled hamstring muscle

The elongation, or even torn hamstring muscle, usually occur during knee extension with a sudden contraction of the muscle. This injury is common in the context of a sports exercise and inadequate heating can promote it, 90% of muscle accidents involve the lower limbs, especially the elongation or tearing of the hamstring muscle.

Causes tears or pulled thigh

The hamstring muscles allow to walk, run or jump. That these actions are carried out correctly, there must be coordination and regional regulation of all the muscles, tendons and joint leading the movement.
Muscle injuries can occur in the event of default in this regulation. The elongation of the hamstrings occurs for example when the knee extends and the muscle is suddenly contracted. Powerful muscular contraction, with simultaneous stretching and high speed generates two opposing forces responsible for elongation or a tear. The elongation corresponds to muscle micro tears overflow elasticity fibers.
A direct impact on the muscle can also cause damage to the muscle.

Elongation - Prevention

How it does it manifest?

Elongation takes place during the year and is characterized by moderate pain behind the thigh. It is a feeling of stretching the muscle but the pain does not preclude further effort.
Tear Level 1 causes a severe pain in the muscle located in the back of the thigh muscle is sore to the touch, but not bruised.


Tear Level 2 also causes pain to exercise, with a contusion (bruise visible after several hours) where the muscle fibers are torn.

Finally, a tear Level 3 corresponds to a breakdown of muscle fibers. The pain is associated with a snap in the thigh causing them to stop the effort.

With what should we be confused?

Do not stretch the hamstrings to be confused with a simple curvature. Pain related to an elongation occurs during exercise, unlike the stiffness that occurs after exercise. Pain elongation disappears after exercise and reappears in subsequent years.

Will it possible prevention?

Prevention of muscle injury based on a healthy lifestyle with a balanced diet and fight against overweight, to avoid stress on the muscles.

Sports training should be progressive and depending on your physical condition. The equipment must be adapted to correct eg support possible defects with good shoes. Especially, the gradual heating of the muscles and tendons (10 minutes) is essential before and after physical activity: a stretching session, alternating tension and relaxation maintained, allow a better recovery.


Ideally, the advice of a professional trainer help perfect the technique, and to hunt movements or dangerous behavior.

Elongation - Consultation


When you consult?

At the onset of pain during physical exercise, it is imperative to stop the current activity not aggravate injuries. Must be cooled and compressed muscle.
The rest should be continued sporting several days, a medical consultation is needed to determine the extent of damage and consider physiotherapy.
In cases of severe elongation and complete tear of the muscle, immediate care, emergency, is required.

What is the doctor?

The doctor confirms the diagnosis stretching or tearing of the hamstring clinically (palpation, visual inspection). Clinical examination also eliminates another cause (tendon rupture, or avulsion fracture).
Ultrasound is complementary examination to specify the exact location and nature of the muscle injury.
Treatment depends on the severity of the infringement. The acute phase has a glaze (to relieve pain and reduce inflammation), rest, and compression of the muscle. Some analgesic or anti-inflammatory drugs are sometimes prescribed in this phase.
The rehabilitation period (a few days) includes physiotherapy / physical therapy.
Surgery as it relates to the complete muscle ruptures.

How to prepare my next visit?

Sporting activity and muscle load must be taken only when all pain has disappeared, and the strength and mobility have returned to normal. Premature resumption causes a significant risk of relapse. Similarly, do not rub or apply heat to the affected muscle. This can aggravate the pain, injuries and cause bleeding.


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Infant eczema - Definition, Caus, Risks, Prevention, Consultation

Definition of infant eczema

Eczema Infant eczema is called constitutional or atopic. It is a chronic skin disease that begins between the ages of 2-3 months and 2 years and usually resolves spontaneously after a few years.
Eczema keeper however the first years baby (and their parents) manifesting itself by inflammation and the appearance of small bubbles (or vesicles) with severe itching. In children, eczema flares are often triggered by infections, digestive disorders, or the output of a tooth.

Risks and origin of eczema

Eczema is a common skin disease, rising steadily for 30 years in connection with a polluted environment allergens of all kinds. Infants or children predisposed to promote awareness of and develop eczema or later other forms of allergies.

Cause of infant eczema

The main cause of eczema is primarily an allergic phenomenon. Children affected by eczema have a genetic predisposition, family, and awareness to allergens in their environment. Other allergic eczema often accompany such as allergic rhinitis, conjunctivitis or asthma or urticaria.

Infant eczema Prevention

How to manifest infant eczema?

In infants, eczema develops in the first two years. Its evolution is marked by recurrent attacks and improvements red, oozing and crusting plaques, especially on the face. Cheeks and forehead are the first affected infants, the nose being generally respected. Plates itchy, causing scratching, crying and nervousness which only maintain the phenomenon.

After 2 years, the plates often reach the folds of the elbows, wrists or knees.
Between outbreaks, the skin becomes dry (called xerosis) and may facilitate the entry of allergens.
Fortunately, outbreaks gradually decrease with age until it disappears completely in a few years (or puberty) to make room for some other allergies.

With what should we be confused?

Contact eczema is a disease independent of the constitutional or atopic eczema. Contact eczema is manifested on contact with an allergenic product remains highly localized and this contact area. Skin tests performed by a dermatologist or allergist can identify the trigger (nickel costume jewelry, for example). The removal of the product concerned cure.

Will it possible prevention?

The comfort of the skin is enhanced by simple hygiene measures:
- Warm daily bath (36 ° C) with a surgras soap;
- Do not wipe baby but dab the skin to dry, moisturize with an emollient cream;
- Prefer cotton underwear (rather than wool or synthetic) and white (undyed);
- Do not use fabric softener but phosphate-free detergents or soap.

General measures to eliminate mites or allergens from the home are beneficial. Similarly, spa treatments improve symptoms.
In case of herpes (cold sores) in a member of the entourage, proscribe kiss (risk of very serious complication).

Infant eczema Prepare consultation

When you consult?

Eczema is a chronic disease requiring medical treatment at the first signs. Avoid a vicious circle is established and that parents overprotect. Moreover, a serious complication requires medical care in emergency: it is a secondary infection (fever, pustules ...) by the herpes virus called Kaposi's sarcoma-Juliusberg.
What is the doctor?

The diagnosis is easy on the lesions presented and their location, scratching and chronic evolution and outbreaks of eczema. No examination is required, an allergy assessment may be proposed to the age of 5 years to determine the allergens in question if associated symptoms (asthma, rhinitis or conjunctivitis).
During outbreaks, medical treatment based ointments corticosteroids applied locally and in small quantities on the patches of eczema, prescribed and it should never be stopped abruptly but gradually decrease or between doses.
If intense itching, antihistamines improve symptoms. Some spas (Avene, La Roche-Posay) propose, on prescription, children and parents of courses dedicated to the care of the skin with an anti-inflammatory and soothing effect demonstrated.

How to prepare my next visit?

In children, the output of a tooth or digestive disorders are all triggers that should be noted and report to the doctor. Some allergens (animals, dust ...) cause more severe attacks: spot eliminates them more easily.

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Eczema in adults definition, risks factor, signs and symptoms, prevention


Definition of eczema

Otherwise known as atopic eczema or atopic dermatitis, eczema is a chronic skin disease manifested by inflammation and small bubbles (or vesicles) with severe itching.

Eczema appears between the ages of 2-3 months and 2 years in the form of red patches and small vesicles and usually regresses to 5 years to disappear in most cases to 12 years. Outbreaks are often triggered by infections in children and stress in adults.

Risks and consequences of eczema


Eczema is a common skin disease, rising steadily for 30 years. The increasing awareness of environmental allergens and familial predisposition are two major causes of eczema. More common in children, eczema is approximately 2% of adults.

Causes and origins of eczema


Eczema is first and foremost an allergic phenomenon. Children affected by eczema have a genetic predisposition, family, and awareness to allergens in their environment. Other allergic eczema often accompany such as allergic rhinitis, conjunctivitis or asthma or urticaria.

Signs and symptoms of eczema

The rash eczema develops four symptoms: itchy rash, blisters can come together and form a bubble, oozing blisters burst by forming a crust and finally scarring.
Itching is systematic, sometimes very large, creating a compelling envenomed scratching the lesions.

Adult and strength of itching and scratching, the skin becomes dry, rough and talk about xerosis. After several years, the thick skin turns gray and is called lichenification. Pruritus and lichenification are two elements in adults with severely affected areas like the face, neck, flexures and bust.
The development of symptoms is characteristic sawtooth (relapsing, remitting), outbreaks are reducing gradually with age.

Eczema in adults Prevention


With what should we not confuse eczema in adults?


Contact eczema is a disease independent of atopic eczema or atopic. Contact eczema manifested on contact with an allergenic product remains highly localized and this contact area. Skin tests performed by a dermatologist or allergist can identify the trigger (nickel costume jewelry, hair dyes or colorings among professionals ...). The removal of the product concerned cure.

Will it possible prevention of eczema?


The comfort of the skin is enhanced by simple hygiene measures:

- Toilet or bath daily with soap surgras;

- Dab the skin dry (do not wipe) and moisturise with an emollient cream;
- Prefer cotton wool and synthetic clothing;
- Do not use fabric softener but phosphate-free detergents or soap.
General measures to eliminate mites or allergens from the home are beneficial. Similarly, spa treatments improve symptoms.


To reduce the urge to scratch, it is best to stay cool (avoid differences in body temperature), use moisturizers when itching and refrigerate (placing the tubes in a refrigerator), and if the desire is too strong, better rub or pinch the skin rather than scratching.
Eczema in adults Prepare consultation

When you consult?


Eczema is a chronic disease requiring medical treatment at the first signs. Dry skin in adults should be supported and the vicious circle "scratch-itch-injury" broken.

What is the doctor?

The diagnosis is easy on the lesions presented and their location, scratching and chronic evolution and outbreaks of eczema. No examination is therefore required. Eczema adolescent or adult usually follows a form of the infant, but spontaneous late forms are possible.

The affected areas are reversed compared to infants with pleats (elbow, knee) with head and nipples. During outbreaks, medical treatment based ointments corticosteroids applied locally and in small quantities on the patches of eczema, prescribed and it should never be stopped abruptly but gradually. If intense itching, antihistamines improve symptoms. The fight against dry skin is a priority.

How to prepare my next visit?


Stress, anger, but also outside temperature are all triggers that should be noted and report to the doctor. Some allergens (animals, dust ...) cause more severe attacks: spot eliminates them more easily.

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Uterine cervical dysplasia definition, prevention, treatment



Definition of cervical dysplasia


Cervical dysplasia are precancerous lesions of the cervix that can lead to cancer after a few years. This is why it is imperative to detect and monitor.

Origin of cervical dysplasia

Cervical dysplasia can occur in all age groups from 25-30 years. It is not related to hereditary factors, but to infection by a virus of the family papillomavirus (HPV). HPV is an extremely common sexually transmitted virus. A number of subtypes (but not all) can cause dysplasia.

Screening for cervical dysplasia


All women should receive at least one gynecological exam per year, at the beginning of their sexual lives. This review is an opportunity to make a Pap smear: Using a small brush or spatula, the doctor takes a sample of cells in the cervix and the vagina. The levy is very quick and painless. It is spread on a glass slide and sent to a laboratory for analysis. The blade is then observed under a microscope by experts who examine cells collected, type and quantity. Normally receive a Pap smear is the best way to identify precancerous lesions such as dysplasia and early cancer lesions, easily treated. It is recommended to perform a Pap smear every two to three years (after the first two regular examinations a year apart), this early in his sexual life and up to 65 years.

Prevent dysplasia and cervical cancer vaccine


Preventive vaccines "HPV" lead the body to synthesize neutralizing antibodies capable of protecting us when meeting with the majority of HPV responsible for cervical dysplasia and cancer of the cervix.
The High Council of Public Health recommends vaccination "all girls aged 14 years to protect them before they are at risk of infection." Similarly, "the vaccine is also offered to girls and young women aged 15 to 23 years who have not had sex or at the latest within one year after the beginning of their sexual lives." However, vaccination against HPV infections do not replace screening with Pap smear.

The treatment of dysplastic cervical


Some dysplasias regress spontaneously and do not degenerate into cancer. They just need to be monitored. But others must be processed.

- The injury surveillance is done through a painless test called "colposcopy". This examination can view lesions and monitor their progress. It is played using a colposcope, an instrument that magnifies the image of the vaginal and uterine lining.

- When dysplasia requires treatment, three main approaches can be used, depending on the type and extent of the lesion. The first method is to locally apply a laser vaporization that will burn injury. The second method, cryotherapy, aims to destroy the lesion by freezing. Sometimes it is necessary to perform a minor surgical procedure called cervical conization (see box).
After treatment of dysplasia, there will simply be an earlier gynecological monitoring to verify the absence of recurrence.

Conization of the cervix


Conization is to surgically remove a portion of the cervix. The procedure to confirm the exact type of cervical lesion and its extent. It also allows to completely remove the lesions and thus prevent their progression to cancer of the cervix.
Conization is done by natural means. It can be achieved using electrocautery (électroconisation), a laser, or a "conventional" knife. The procedure can be performed under local anesthesia, locoregional (epidural) or general, depending on the choice of the patient and the decisions of the surgeon and the anesthetist.
Conization does not cause virtually no post-operative pain. This procedure is compatible with subsequent pregnancies.

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Dyslipidemia definition, risks, symptoms, prevention, consultation


Dyslipidemia: definition

Dyslipidemia are abnormal lipids (fats) in the blood. By definition these are figures: assays of biological indicators.

These indicators are part of lipid cardiovascular risk factors. They relate to different forms of blood cholesterol and triglycerides. Cholesterol is not soluble, it is transported as LDL (Low Density Lipoprotein) or bad cholesterol, and HDL-cholesterol (High Density Lipoprotein) or good cholesterol. Their transporter proteins are Apolipoprotein B for LDL-cholesterol and apolipoprotein A1 in HDL-cholesterol.

Deficits in blood lipids are rare in industrialized West, there is little talk of hypolipidemia (or hypolipemia). However, excesses are legion. Hyperlipidemia (or hyperlipidemia) refers to the overall excess blood lipids. One distinguishes excess cholesterol, hypercholesterolemia, of excess triglycerides, hypertriglyceridemia. The different varieties of hyperlipidemia make the rather complex domain there is a medical specialty Lipidology.


Dyslipidemia: risks and challenges

Dyslipidemia is a cardiovascular risk factor, especially the bad cholesterol (LDL-cholesterol). Other risk factors are hypertension, smoking, diabetes, alcohol, obesity (especially abdominal), age, sedentary lifestyle, hormonal contraception and hormone therapy for menopause. The latest recommendations of the European Society of Cardiology (ESC, 2011) add to this already long list HDL-cholesterol in insufficient quantities.

The combination of these factors quickly increases the overall cardiovascular risk, determines the management of dyslipidemia. It can be calculated by using tables to several parameters, refined according to the national level of risk in Europe (SCORE tables).

Overall cardiovascular risk is often responsible for fatal diseases always disabling: atheroma (clogged arteries), aggravation of hypertension, coronary heart disease (angina, myocardial infarction), stroke ( AVC), arteritis of the lower limbs ...

Dyslipidemia are silent for the patient for many years, but present. The proportion of pure hypocholesterolemias (without elevated triglycerides) population would be 30% from Ferrieres et al. (Archives of Diseases of the heart and vessels, 2005).


Dyslipidemia: running

Triglycerides are the reflection of the feed, but not cholesterol depends to 25%. Three quarters of blood cholesterol is produced by the body (liver) mainly under the influence of genetic inheritance. Drugs, endocrine diseases such as hypothyroidism or diabetes also have an impact on blood lipids.

LDL cholesterol is a soluble lipoprotein that transports cholesterol from the liver, where it is produced continuously, bodies in need. These requirements are important because the cell membranes of many hormones are manufactured based cholesterol. Cholesterol is an essential molecule.

LDL cholesterol is called "bad cholesterol" because it is not consumed rapidly by the tissue is deposited in the arteries. There form atherosclerotic plaques, rigid, inflammatory, capable of causing local blood coagulation. The clot can block the artery at the site of its formation, or migrate to the butcher elsewhere (frequent phenomenon in stroke).

HDL transports cholesterol in excess cholesterol to the liver organ which degrades the bile salts and the evacuated in the stool. It is essential to clean the excess cholesterol and therefore called "good cholesterol."

Atherosclerosis combines atheroma (plaques LDL) cholesterol and arterial damage of smoking, diabetes, for example. It is a disease due to cardiovascular risk factors and family history.


Dyslipidemia: symptoms

Dyslipidemia have the distinction of being long silent, that is to say not manifest any symptoms. When symptoms occur cardiovascular (myocardial infarction, angina pectoris, arteritis ...), arterial atherosclerosis and cardiac lesions are already significant.


However, a large excess cholesterol is expressed by fatty deposits around the eyes (xanthelasma) or around the iris of the eye (corneal gerontoxon or arc). This applies especially familial hypercholesterolemia due to a particular genetic profile. Family history of cardiovascular disease, particularly those occurring before age 50, justify the consultation for a full assessment.

The silence of dyslipidemia justifies a regular Blood tests of the population. But how often? In the USA, considerable prevalence of obesity in children (almost 30%) did pediatricians recommend a routine blood screening between ages 9 and 11. The blood test is recommended based on specific clinical situations.

Dyslipidemia Prevention

With what should we be confused dyslipidemia?

The diagnosis of dyslipidemia is a biological definition encrypted, which can not be confused with another disease.


However, it is not a disease in itself until you have verified that dyslipidemia is not part of another disease, or that it is a particular genetic profile.


Will it possible prevention of dyslipidemia?

Yes, before any incident prevention (primary prevention) is possible and desirable for a healthy lifestyle, effective but demanding. A Finnish study showed that anti-cholesterol and adequate exercise regime fell cardiovascular mortality by 65% ​​in men. (Progress in Cardiovascular diseases, November 2006).

Weight loss in overweight people lowers blood fats, the sugar and the blood pressure. After a stroke, the lifestyle changes and medication are significantly lower risk of recurrence (secondary prevention).

National campaign to promote good health habits established by the Ministry of Health (National Health NFHP or nutrition program) aimed at reducing cardiovascular risk according to the public health laws passed since 2004.

Dyslipidemia Prepare consultation

When did you consult?

As dyslipidemia are long silent must carry out regular assessments. Screening every five years from age 40 for men (50 years or menopause for women) is usually recommended when there is no other known cardiovascular risk factors that will require the practice earlier. Family history of dyslipidemia warrant early detection, sometimes from childhood.


How to prepare the consultation with the doctor?

Gather family history of cholesterol, triglycerides and cardiovascular disease.
Bring his blood tests with the determination of cholesterol and triglycerides.


Finally, a summary of its power gives valuable insights.


What is the doctor?

He practices a blood test as recommended best practices, in addition to the comprehensive review of the patient, particularly when advancing age. He is looking for an organ by atherosclerosis reached.


The lipid laboratory tests used to assess cardiovascular risk. The controversy over the levy fasting or not was decided by the European Society of Cardiology (Recommendations on dyslipidemia, 2011). Triglycerides should be measured fasting. But total cholesterol, apolipoproteins A1 and B, and HDL-cholesterol can be assayed at any time.

Then the doctor makes the counting of cardiovascular risk factors and place the patient in a European risk tables: SCORE. The European Society of Cardiology has updated in 2011. Cardiovascular risk is expressed in percent, this risk is at least a cardiovascular event within 10 years. Between 1 and 5%, the person is said to moderate risk between 5-10% high risk (high risk), beyond 10% the risk is very high (very high risk).

This explains why we can not set standards for assembly without cardiovascular risk. For a healthy young adult without further risk, total cholesterol should be less than or equal to 2 g / l, greater than or equal to 0.4 g HDL cholesterol / l, less than or equal to 1.5 g triglyceride / l. These values ​​are more severe with the confirmation of the adverse impact of hyperlipidemia on health, and especially as life expectancy is high.


Support depends on the risk


In patients at very high risk, LDL-cholesterol (LDL-C) should ideally be less than 0.7 g / l. If this goal can not be achieved, it must be reduced by at least 50% of the initial value of LDL-C. In patients at high risk, it is an LDL-C less than 1 g / l. In patients at moderate risk, is an LDL-C less than 1.15 g / l.

Various measures are taken by successive additions, or immediately when the whole cardiovascular risk is high or very high. The first is the implementation of SUITABLE lifestyle and dietary measures, the second is the disappearance or reduction of other modifiable risk factors: smoking, obesity, hormonal contraception ...


The treatment of hyperlipidemia by lipid-lowering drugs may be necessary. He never taught the proper treatment of associated diseases: hypertension, metabolic syndrome, diabetes ...

Regular monitoring is essential because it determines the success of follow-up care.

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Sickle Cell Definition, Prevention, Consultation


Definition of SCD

Sickle cell disease is a genetic disorder, hereditary, characterized by abnormal hemoglobin in the red blood cells. The hemoglobin is to carry oxygen and abnormal sickle cell hemoglobin (hemoglobin S) prevents the cells to perform this function.

For a child to be reached by the disease, it is necessary that both parents have transmitted the S gene: it is then homozygous SS. In case of transmission of a single S gene (heterozygous patients AS), the child will not develop the disease but it may transmit to their offspring.

Screening and risk of SCD

In France, 300 SS homozygous sickle cell children were born in 2003. The geographical distribution is concentrated in Ile-de-France and the Caribbean.
The people carrying the sickle cell gene are mostly from sub-Saharan Africa, the Caribbean and North Africa.



Screening for sickle cell disease at birth has been generalized by the French Association for the detection and prevention of disability (AFDPH) and is targeted to infants whose parents are from "country risk".
Anti-infective treatments and education is now possible to handle the complications of sickle cell disease.

Causes and origins of sickle cell disease

To develop the disease and the symptoms of sickle cell disease, it is necessary to have both SS genes: this is called homozygous SS.
The patient homozygous hemoglobin SS is changed and when oxygen is scarce (cold, fever, dehydration, altitude), red blood cells change shape ("sickle"). They rigidify and become unable to circulate throughout the body, causing the occlusion of painful crises and premature destruction.

Signs and symptoms of sickle cell disease


Patients with only one abnormal gene S are asymptomatic.
If both genes are defective, the abnormal hemoglobin causes several symptoms. Anemia (low hemoglobin) is chronic because red blood cells are fragile: fatigue, yellow whites of the eyes are usually the only well tolerated signs.


However crises punctuate the evolution of the disease and are associated with red blood cells that form plugs in blood vessels: it is called "vasoocclusives crises." These crises affect the limbs (hands, feet), spleen (which can not fulfill its role antiinfection), but potentially all organs.

They are responsible for pain, redness members, increase the volume of the abdomen, fever ...
Bone and lung infections are the most frequent, especially in children under 3 years ssignes.
The frequency of attacks is very variable.

Sickle Cell Prevention

With what should we be confused?


Do not confuse "sickle cell trait" which means that the patient has sickle cell gene and sickle regards the holders of two genes. Only the latter are affected by sickle cell crises.

Will it possible prevention?


With relatives may be carriers of the sickle cell gene, genetic counseling can be offered for prenatal diagnosis during pregnancy.


With sickle cell disease proved (homozygous SS), preventive measures aimed at reducing the frequency of seizures. Cold exposure should be minimized (remain in the classroom at recess, after drying the pool ...). Sports and violent efforts are to be avoided, as all situations at risk of dehydration, altitude above 1500 m is prohibited (skiing holidays cons-indicated).


No special diet is recommended but drinks must be abundant.
Vaccinations (including pneumococcal) are to be followed scrupulously.
The school child will receive an individualized home Project (PAI) related to parents, teachers and doctors.

Sickle Cell Prepare consultation

When you consult?


Any fever above 38 ° C requires special vigilance and a medical consultation in case of pain, it is advisable to stay hydrated and take a pain medication until the medical consultation.
If you have chest pain, high fever, pallor important or unusual pain, immediate hospitalization is recommended (UAS Centre 15).

What does the doctor in case of sickle cell anemia?

Theoretically, the diagnosis is made ​​during the screening at birth. Consultation between the parents and the doctor (hematologist, pediatrician) can explain the disease, which manifests itself yet. An assessment is recommended during this first consultation with essentially a blood (red cells, blood group, G6PD assay, determination of iron, hemoglobin S research ...).
There is no treatment for the genetic cause of this disease. Treatment is symptomatic crisis (oxygen, analgesic against the pain ...). Blood transfusion is a resort of emergency deep anemia.

How to prepare my next visit?


Therapeutic education of parents is fundamental. Between visits, you must monitor the occurrence of fever or behavior changes (irritability, crying ...), first witnessed a vasoocclusive crisis.

Drugs against pain are given by the environment, but in case of high fever or abnormal reaction, a quick reference is needed. Identify triggering circumstances will better avoided.

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Degenerative Disc Disease - Definition, Origin, Causes, Symptoms, Prevention, Consultation


Definition of degenerative disc disease


Degenerative disc disease is a major cause of back pain. It corresponds to a loss of flexibility and elasticity of intervertebral discs, which lose their capacity to absorb shocks. The ligaments surrounding the discs are also affected, as the bones (vertebrae). The most common and lumbar degenerative disc disease is also called lumbar osteoarthritis.

Origin of degenerative disc disease


Degenerative disc disease is a process linked to natural aging. It is estimated that 80% of French people suffer from back pain, the causes are variable.


Some predisposing factors, such as genetic predisposition, but poor posture or incorrect movements can accelerate the process.

Causes of degenerative disc disease


Age is the main factor for degenerative disc disease. The intervertebral discs are the cushions shock absorbers between the vertebrae, and are used to absorb shock when walking, running or any other movement seeking the spine. By drying with aging, these discs lose their flexibility qualities, the ligaments that surround become brittle and ultimately degenerative disc disease causes pain, including nerve root compression. Some back injuries can also promote the alteration of records.

Symptoms of degenerative disc disease

Low back pain, or pain in the lower back are the most common symptoms. They are linked to the development of degenerative disc disease that can even lead to nerve root compression, with pain in the legs and a feeling of weakness. The stiffness of the spine, especially the lumbar stiffness, is also common, especially in the late afternoon.

Degenerative Disc Disease - Prevention

With what should we be confused?

It should not be confused degenerative disc disease and herniated discs. The herniated disc is a protrusion of the intervertebral disc, the latter out of its shell and compresses the nerve roots, producing the classic sciatic pain.
-
Another differential diagnosis of infectious spondylitis, that is to say, the infection of an intervertebral disc. This rare condition is characterized by constant pain, inflammatory pain is called because they occur during the day and night, and are not related to movement. Inflammatory pain is a major pain in the evening and early night and decreases after heating, it is a pain stiffness, unlike mechanical pain that is aggravated by ous support and rest.

Will it possible prevention?

As with any back pain, from simple lifestyle advice to prevent or reduce pain. Regular exercises, abdominal muscles and dorsal satisfactory (support of the spine) and the fight against overweight are essential.


Gestures and postures are the basic steps of prevention: back straight, look right, squat by bending the knees to lift a load, to provide rest periods to stretch or expand when station sitting, use straight-backed chairs and possibly swivel to avoid twisting.


Wearing backpacks is preferred to handbags and high heels more than 5 cm are recommended.

Degenerative disc disease - Consultation

When consulted?

Some advanced discopathies can cause a significant narrowing and neurological cuts. In case of very severe pain, signs of muscle weakness in the lower or even paralysis members should be consulted in an emergency.

What is the doctor?

The doctor suspects the diagnosis of degenerative disc disease on examination data (age, type of pain, rate of pain ...) and full consultation with a complete physical examination. Neurological examination eliminates one complication, and test muscle strength and reflexes. The rheumatological examination checks the mobility and flexibility of the spine.

X-rays or even a CT scan or MRI are often used to visualize lesions. The radiography and for example in case of degenerative disc disease, narrowing of the spaces between the vertebral body is visible, as well as bone defects from osteoarthritis, or "caps parrot".


Regarding remedies, most people are relieved by non-surgical treatments (exercises, physiotherapy). Medicines and injections are sometimes necessary to relieve pain.

Surgical treatment is reserved for advanced forms. A disc prosthesis with an artificial disc may come to replace the damaged disc. Another technique, spinal fusion is to weld two vertebrae together to stabilize the spine and relieve pain.

How to prepare for my next visit?

It is desirable to identify the circumstances or movements that trigger pain. In fact, your doctor or physical therapist can offer you accommodation of position or posture.


At work, the occupational physician can also help you in terms of ergonomics.

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Acute diarrhea Prevention, Prepare consultation

Acute diarrhea Prevention

With what should we not confuse acute diarrhea?

With diarrhea called "chronic" (persisting for more than six weeks with at least one liquid stool per day), which may manifest as episodes that the patient does not connect them.


Chronic diarrhea resulting in weight loss and fatigue is always suspect.

These signs may indicate serious chronic parasitosis, colorectal, Crohn's, celiac disease, overactive thyroid disease or cancer ... sustainable food intolerance (lactose in cow's milk, sorbitol, gluten, fruits, alcohol, spicy foods or too, etc.).


Is there a possible prevention of infectious diarrhea?

It is very effective but little practiced! To prevent infectious diarrhea, strict hand hygiene and health is necessary and largely sufficient.


Wash your hands frequently with soap and water or with an alcohol-based gel.


Use disposable paper to wipe your hands and not cloth napkins.

To avoid food poisoning, watch what you eat: expiration date and proper storage of food. Keep perishable food in the refrigerator and check there.

To prevent traveler's diarrhea (Montezuma), do not drink tap water or ice. Do not eat raw food. Prefer baked or fried foods prepared before your eyes and immediately consumed: germs do not have time to grow it.

To prevent gastroenteritis in infants and young children, all of the above advice is good. Under certain circumstances (family instability) vaccines are available (against rotavirus for example).

Acute diarrhea Prepare consultation

When did you consult?

Quickly when the diarrhea is accompanied by so-called gravity signs: blood in the stool or pus, mucus (substances like egg white). But as fever, vomiting preventing feed and rehydrate, general malaise imposing bed, confusion and delirium, coma.

In general, any acute adult diarrhea that lasts more than 48 hours without any improvement should be seen by a doctor.

For infants, do not wait, because their dehydration is very fast (a few hours). The alarm is in the child's general health and weight loss. A weight loss of 4% requires the urgent hospitalization must act before! A child who does not respond is in great danger.

The elderly are also at the first signs of dehydration to avoid sequelae sensitive organs: kidneys, brain, heart. And prevent death.

Diarrhea that lasts for several weeks is never normal, consult your doctor immediately weight loss.

How to prepare the consultation with the doctor?

List your eating habits and your recent meal, epidemics occurring in the environment, as well as medications taken, including those taken without a prescription.

Children and the frail elderly should be immediately rehydrated with oral rehydration solutions (ORS) sold in pharmacies.


What is the doctor?

After general examination and weighing of the patient, the doctor distinguishes transient mild diarrhea that resolves spontaneously, a worrying diarrhea requiring special treatment or hospitalization explorations.
He may prescribe a blood, urine, and stool analysis.


Persistent diarrhea without clear explanation, or requiring an assessment justifies a colonoscopy (endoscopic examination of the intestine) and specific research (testing a gluten intolerance or celiac disease).

Faced with a bacterial or parasitic infectious diarrhea, targeted antibiotic treatment is usually necessary, sometimes pitting initially. Adequate rehydration treatment with complete rest at home. Hospitalization is required when an infection toxigenic (toxin-producing E. coli) because the toxins severely affect organs.

Faced with an epidemic viral diarrhea, says symptomatic treatment (relieving the signs) can wait for spontaneous recovery in 3-4 days: Regular rehydration, antispasmodic, digestive buffers, anti-diarrheal, and rest at home. This second objective is to prevent the spread of epidemic virus in school or professional circle.

Strict hand hygiene and sanitation is essential in all cases.


The persistence of acute diarrhea 48 hours despite appropriate treatment is suspected, should be consulted again.


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Acute Diarrhea definition, risk, operation, symptoms


Acute diarrhea: definition

Acute diarrhea is a sudden functional gastrointestinal disorder, which may be only a symptom of a broader disease, alone or summarize the disease.

It is characterized by numerous stools, pasty or liquid in a fecal volume often increased.

Diarrhea is called "acute" when it lasts less than ten days with more than three loose or watery stools per day (according to WHO).

Its impact on the overall condition can be very fast (a few hours).

This justifies an active monitoring of its evolution by weighing the patient, especially at the extreme ages of life: infant, child, old man.



Acute diarrhea: risk

According to the National Institute of Health Surveillance (VS): "Data from sentinel network can estimate that every winter, acute gastroenteritis (AGE) is the cause of 1 million to 2.5 million consultations in general practice. During the epidemic peak, the incidence of consultations for GEA is estimated between 300 and 600 consultations per 100,000 people per week but can be up to 900 consultations per 100,000 people per week as in January 2001. "

Besides fatigue and illness hampering social and professional activity, diarrhea is a major factor of dehydration, such as vomiting which is frequently associated during digestive infectious epidemics.

Caused by sudden water and electrolyte loss, it has serious consequences in the elderly and children. One percent weight loss has an impact on body balance. From 4% weight loss, dehydration is called severe and requires hospital care generally taken. Coma sets in, sometimes to death (eg cholera).

Diarrhea makes ineffective, partially or totally, because the drugs are less well absorbed (transit too fast). On the other hand, the dehydrated body is more sensitive to their action. For example, blood levels of anti-hypertensive drugs rises, which greatly lowers blood pressure, since overdose is added to the current dehydration.

Acute diarrhea: operation

In the colon (last part of the intestine), the stools are normally drained by reabsorption of water and nutrients. In case of diarrhea, intestinal reabsorption is impaired or completely reversed, with body water leak and useful ions. This flight is of course increased by possible concomitant vomiting.

The most common causes are infectious, often epidemic (virus) and usually transient in people whose immunity is correct.

- Gastroenteritis epidemic, the culprit is the rotavirus in 70-80% of cases.

- Food Poisoning, individual or collective, with bacteria such as Salmonella or E. coli (Escherichia coli). Some coliform bacteria produce toxins that can kill (called E. coli STEC).

- Parasitic infections are often transient, and are characterized by "digestive crisis" more or less close together, a tapeworm infestation or lamblias. Always thinking of returning from a trip to the tropics or a known endemic countries.

The antibiotics disrupt the intestinal flora for at least three weeks, particularly if they are broad spectrum. According to the personal profile of digestive flora and repeat treatments (especially in children) modification of commensal bacteria (which digest food for the person hosting) causes chronic poor absorption of nutrients, to break the curve infant growth or cause weight loss.

Anxiety, intense emotions (competitions, exams) also trigger acute diarrhea, called motor, as well as certain medications or treatments (veinotonic, radiotherapy).

Finally general diseases or infections of adjacent organs also have a strong digestive repercussions: appendicitis, peritonitis, endometriosis, gluten intolerance ...

Acute diarrhea: symptoms

The most banal is the epidemic viral gastroenteritis: it does not last more than four days and heals spontaneously. It is in the first 24 hours the symptoms are more pronounced: the stools are liquid or soft with abdominal cramps (colic). There may be a transient fever (sometimes up to 41 ° C with chills).

In general, any accompanying fever diarrhea (or vomiting) is a sign of severity, as well as blood in the stool.

Weakness, dizziness, dry mouth, thirst reflect the intensity of dehydration as well as less frequent urination, weight loss, and sunken eyes. These warning signs are signs of severity. Weighing the patient is very important to quantify the loss of water, and make a treatment decision.

All signs of severity require rapid medical attention.

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Type 2 diabetes (Definition, Causes, Symptoms and Signs, Prevention, Consultation)


Definition of type 2 diabetes


Diabetes is defined as an excess of sugar in the blood (or blood sugar) in excess of 1.26 g / l fasting or 2 g / l non-fasting. There are several types of diabetes are the two main type 1 and type 2.

Only type 2 diabetes (formerly called non-insulin-dependent diabetes) is discussed in this chapter type 2 diabetes usually occurs from 40-50 years. Its onset is earlier and earlier due to dietary habits and mode sedentary life. The type 2 diabetic patients often have several factors cardiovascular risk should detect and prevent: overweight, high blood pressure, excess lipids in the blood, physical inactivity.

Risks and consequences of type 2 diabetes


Diabetes is a chronic disease more common in industrialized countries. Prevalence (number of diabetics / population) treated diabetes is estimated at 3.8%. Diabetes affects about 3 million subjects (types 1 and 2 combined), but experts agree that this figure is grossly underestimated because a third of diabetics are unaware of their condition.


In fact, diabetes can initially remain completely silent. Complications are, however, a major public health, both medically and economically. Cardiovascular complications are the leading cause of death in patients with type 2 diabetes.

Causes and origins of type 2 diabetes


The type 2 diabetes is due to an abnormality of glucose utilization by the cells of the body. Unlike type 1 diabetes, insulin produced by the pancreas do not lack (the rate is normal), but it can not be used by the cells of the diabetic patient in order to bring the sugar as fuel. We talk about insulin resistance and the consequence is an increase in the rate of blood sugar (hyperglycemia).

Symptoms and signs of type 2 diabetes


The onset of symptoms is usually insidious and completely silent. The diabetic patient is unaware lives quite normally until complications reveal his illness. Screening by measuring blood glucose is essential.
The complications of diabetes are the severity of the disease. The chronic excess sugar in the blood causes symptoms of irreversible damage to the eyes, kidneys and nerves Diabetic microangiopathy is responsible for blindness, kidney failure or progressive loss of sensitivity feet. Vessels larger sizes are also affected and responsible for macrovascular disease (risk of myocardial infarction, stroke or amputation).

Type 2 diabetes Prevention

With what should we be confused?


The type 2 diabetes should not be confused with other types of diabetes, type 1. This (formerly called insulin-dependent diabetes) occurs mostly in children and young adults and for 170,000 people. There is often a sudden weight loss, thirst and increased urination.
Diabetes insipidus is it about a leak due to a hormonal abnormality: the volume of urine up to 10 l / day.

Will it possible prevention?


Adopt a balanced diet adapted to their lifestyle should be a priority for any diabetic. Similarly, it is essential to conduct regular physical activity (eg, 30-minute walk three times a week), reduce other factors of cardiovascular risk by controlling weight.

The goal is to get a body mass index (ie your weight / your height, squared) less than 25, reducing his cholesterol and stopping smoking. Vaccination against influenza is also part of the recommendations, diabetic subjects are more sensitive and vulnerable to infection.

Finally, diabetic feet should be examined regularly (skin deformations) and pampered (port shoe care pedicures ...). An annual visit to the eye doctor and dentist complete prevention.

Type 2 diabetes Prepare consultation

When consulted?

The type 2 diabetes is often asymptomatic for years.
Only testing can therefore highlight hyperglycemia. This screening, in the form of a blood test in the laboratory fasting is useful from 45 years in subjects with other risk factors (overweight, hypertension, high cholesterol, family history ...) . Screenings are also regularly offered in pharmacies during campaigns.

What is the doctor in case of type 2 diabetes?

The doctor, in coordination with the specialist (diabetologist, endocrinologist) will confirm the diagnosis by blood tests and possibly other tests to detect an origin, risk factors or complications of diabetes. Factors of cardiovascular risk may be associated with diabetes are smoking, overweight or obesity, hypertension and disorders of fat. The initial assessment is therefore used to determine the treatment and monitoring of disease.
The main goal of diabetes treatment is to control blood glucose (blood sugar). Other treatments used to control weight, blood pressure and reduce fat levels in the blood, or to quit smoking. The treatment first call to the diet and the resumption of regular physical activity. If necessary, oral antidiabetic drugs or insulin, transitional or permanent, may be indicated.

How to prepare for my next visit?

Measured by the patient's blood glucose in a drop of blood (self) is important in some cases between consultations. The glycemic target is set by the doctor and the rhythm monitoring. A blood test (glycated hemoglobin or HbA1c) every 3 months to check blood sugar control.

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