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Hallux valgus (or onion) Definition, Risks, Causes and mechanisms, Symptoms


Definition of hallux valgus

Hallux valgus, often called "onion" by association is actually a deviation of the big toe of the foot outward. Frequently, the head of the first metatarsal is prominent and produces what is called the onion.

The onion can become inflammatory and autoentretient deformation: the angle of deviation increases, with repercussions on all the other toes (second toe claw, formation of a cor ...).

Pain and infection can be aggravated hallux valgus and onion.

Risks and origins of hallux valgus

5-10% would be affected by hallux valgus.

Women between 40 and 50 years are more prone to it, with pain, difficulty wearing shoes and deformation of the forefoot.

Men and children are exceptionally achieved (ratio of 1 man 30 women).
Genetic factors shape of the foot (wide forefoot or foot with a toe first feature called Egyptian foot), wearing certain shoes (heels, pointed toes ...) and finally the age and menopause promote hallux valgus and onion.

Causes and mechanisms of hallux valgus

Several factors combine to result in a distortion:

Hereditary predisposition

A hereditary predisposition made the bed of hallux valgus, with an angle between the first and second metatarsal increased.

Ill-fitting footwear

Hallux valgus is compounded by ill-fitting footwear or poor running technique.

Friction and inflammation

Friction and inflammation generated create a vault at the joint; this inflammation increases angulation and deformity.

What are the symptoms hallux valgus?

The Hallux valgus is visible by looking at his feet, the big toe is deflected outward with a fingernail located in a different axis of the other nails. The arch or swelling is the seat of inflammation at the base joint of the big toe.
The overlying skin is thickened and hardened. The skin is red, glistening from the fulcrum with the shoes.
The hallux valgus leads to a big toe that causes neighboring toes forward with an overlap of two toes: corns, blisters and thus pain are common.
Complications can also occur with toe claws, a true osteoarthritis annoying walking and infections friction areas.

With what would it be confused onion or hallux valgus?

Do not confuse foot deformities related to other causes with hallux valgus.

Indeed, paralysis, trauma or arthritis can deform the foot. An apparatus and / or rehabilitation allow to improve walking and symptoms.

Will it possible to prevent hallux valgus?

Prevention involves wearing shoes fit the foot (size, wide end and round, alternating small heels and flat shoes). The use of protective pads can help to slow the progression of an onion.
Pedicure treatments relieve and prevent the symptoms, as well as stretching exercises and massages.

Hallux valgus: when to consult?

It is advisable to consult early, before the stage of disability or complication.

At an early stage of the onion, change shoes or correct walking technique can be enough to break the vicious circle.

At a more advanced stage, the treatments will be heavier and sometimes less effective.

What does the doctor deal with an onion?
The doctor confirmed the diagnosis clinically.

It will also eliminate neurological or traumatic causes of hallux valgus. With the X-ray of the foot, angulations were measured and the impact on the entire foot visualized: the stage of hallux valgus can be determined (stages 1-3) and treatment.
A simple orthotic may be proposed by a podiatrist / Medical pedicure; it is a protective shell for onions that reduces friction and pressure. Damping products or gel base are available and play the same role.
Anti-inflammatory drugs relieve during inflammatory and painful flare and sometimes surgery is proposed. The operation tends to realign the toe by acting on the muscles, tendons and joint capsules, or directly on the bone (osteotomy).

How to prepare for my next visit?

In case of painful symptoms and inflammation of the joint, the installation of ice can temporarily relieve, pending such an anti-inflammatory prescription and causal treatment.

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Cure for Halitosis Bad Breath

Definition of halitosis

Halitosis, scientific term for bad breath, is an unpleasant odor or smelly from the mouth. Halitosis, also common in men than in women (women, however, tend to see), increases with age.

Risks and consequences of halitosis

There is little statistical data to determine the actual frequency of halitosis, especially no objective and universal test sets bad breath. Halitosis is, however, a common reason for dental consultation: between 5 and 10% of the population are regularly affected by bad breath, but everyone can be at a time of his life.

Causes and origins of halitosis

The term is defined by the air emitted from the mouth and nose during breathing.
Abnormal breath (halitosis or bad breath) is an unpleasant odor (rotten fish, eggs, rotten apple ...) and can be linked to a local or general pathology. It may be transient (food after eating garlic, tobacco or coffee) or longer (disorders of the oral cavity, head and neck, digestive or lung).

Symptoms and signs of halitosis

Bad breath in the morning upon waking is normal, due to a reduction in the production of saliva in the night and stasis food debris. Only persistence must consult their dentist.
Bad breath is often associated with dry mouth. In addition, weight loss, or high-protein diets, foods (garlic, onion, spices) or lifestyle (smoking, alcohol, coffee) promote bad breath, which is often difficult to realize oneself.

With what would it be confused halitosis?
The pseudo-halitosis is the impression for patients to have bad breath. In fact, a review would show a breath quite normal. Psychological support to convince them is often necessary.

Will it possible prevention of halitosis?

Perfect oral hygiene is a prerequisite: brushing after every meal, flossing, brushes against plaque, cleaning the back of the tongue (tongue scraper), denture care ...
Diet also plays a big role. Better to avoid garlic, onions, spices, dairy products, cauliflower, asparagus, alcohol, coffee, and reduce the amount of protein (beware protein diets). The fight against dry mouth through regular hydration (drinking water), especially at bedtime. And this is one more opportunity to stop smoking if not already done.

When to consult?

It is very difficult to see his own breath. So it is a third party that reveal most often bad breath and will point to the person concerned. Detection devices such as "fresh kiss" are commercially and quantify the odorous gases.

What does the doctor during halitosis?

... Or rather the dentist. The practice dentist a complete physical examination of the mouth looking for a local cause (hygiene, condition of the gums, coated tongue ...).
The importance of halitosis can then be evaluated by a sensory examination says with a score of 1 to 5 and / or electronic halimétrique (measurement of odorous gases).

Following the consultation, the character and identity of the supposed origin of halitosis usually possible to offer an effective treatment. In the absence of local cause, buccal, the dentist can direct to the doctor contractor who may send the patient to an ENT doctor or other specialist.
In all cases, the treatment of halitosis is based on the treatment of the cause, buccal or extraoral. Lozenges, toothpastes or mouthwashes may also be prescribed to mask odors or participate in treatment.

How to prepare for my next visit?

Identify the circumstances or promoting foods bad breath allows to discuss with her ​​doctor, who will confirm or invalidate their role.

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A / H1N1 flu: what preventive hygiene?


Why and how to wash their hands?

Bacteria and viruses are spread by hands. To eliminate them, use an alcohol-based or liquid soap. Bar soaps retain surface germs because they do not kill bacteria, it is not their function. They dissolve the lipid film that protects but it must then rub to remove germs. Washing hands is the SCRUB!

Use hot water temperature "bearable" (never above 45 ° because of the risk of burning), and do not forget to rub the furrows: wrists, between fingers, under fingernails. Rinsing should be careful to avoid maceration by residual soap. Close the valve with a disposable tissue, and dry your hands with a disposable paper towel. This expense of paper at a time can interfere ecological economics.

We can book the practice at the entourage of the sick and those in contact and confined environments where sharing germs is inevitable: offices, schools, community houses ...

When to wash your hands?

These are good habits to take every day, all year round.

It is essential to wash hands after:
- The working day, on the way home,
- Borrowing public transport,
- Stay in a public place,
- Having crossed an infected person,
- Going to the toilet,
- Blowing your nose, coughing, sneezing or spitting
- Removing his protective mask.

And ALWAYS before:
- Cooking,
- Eating,
- To take care of children, especially infants.

What mask and for whom?

The anti-projections said masks do not protect healthy people against the virus, but the patient to avoid infecting others and the environment.

To remain effective, they must be changed every 4 hours when wet. Which occurs relatively quickly due to the condensation of the breath.
Removing the mask, taking him by the fasteners to discard it immediately and wash your hands afterwards.

They are issued free pharmacy on prescription.
There pediatric masks for children 1 to 12 years.

How to use paper handkerchiefs?

Disposable paper handkerchiefs are an effective anti-viral dissemination weapon becomes a temporary mask when sneezing, coughing or blowing nose. It is also essential to use them to manipulate surfaces or objects that might be contaminated.

They must ALWAYS be discarded immediately after use.

Where to throw handkerchiefs, towels and used masks?

Elimination is household waste, placing them in an airtight bag.
Use double packaging if the bags are threatening to tear easily.
The simplest, but also the most expensive, is to place the masks and handkerchiefs in small plastic bags before throwing them in your trash "general".

How to limit the contamination of others and his own?

- Cover your mouth and nose with a disposable tissue when sneezing or coughing. In the absence of tissue, sneeze and cough into your elbow or hands by washing them immediately.
- Limit the bare minimum physical contact: no kisses, no hugs, no curly braces. The new A / H1N1 virus is contagious VERY.
- Wash your hands after hand contact: with a hydro-alcoholic solution (in your purse or pocket) when no source of water and soap is available.
- Do not use cloth towels in public toilets, but disposable towels or failing a tissue (in your purse or pocket).
- Health authorities have not officially recommended the routine use of masks. The mask called "surgical" anti-projections not protect from contamination but decreases the amount of miasma sucked.

Only the mask FFP2 ensures effective filtration of the virus, PROVIDED be used properly: mandatory use that may fail more often, however, in generating a false protection.
- Before traveling: check with the travel company, the Embassy or Consulate.

What to do when there is a flu at home?

- Isolate the sick day and night, if possible in a single room, even change the organization of the house. This piece will be regularly aired. Avoiding physical contact: stay at least 1 m according to official recommendations, 2 meters according to US data protection CF patients.
- Make the patient wear a surgical mask spray suppression in the presence of another person: ideally continuously until he coughs to protect the environment.
- Do not share any personal effects with the patient: towels, cutlery, toys. However, their washing can be done in the usual way without putting them apart.
- Clean surfaces and shared items (remote controls, flushing, door handles ... etc.), Hot water, with usual household products. The virus remains infective on surfaces likely to 6-8 hours.
- If compel strict rules of hygiene, especially hand washing.

How long does it contagious?

Influenza infection begins 24 to 48 hours before the onset of signs and persists 4-5 days or a week in total.

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Define Flu Meaning, Symptoms, Signs, Treatment, Flu Causes, Mechanisms and Prevention

Flu definition

Influenza is a viral infectious disease. The influenza virus of the family Myxovirus, mainly attacks the upper respiratory tract (nose, throat, bronchi) and sometimes the lungs. Viruses mutate from one year to another and are extremely contagious: they spread around the world in the form of sometimes dramatic epidemics (Spanish flu in 1918 and 1919 with 40 million dead, Asian flu in 1957 and flu Hong Kong in 1968).

Risks and consequences of influenza

Flu, mild in healthy subjects, can be fatal in younger or older people and / or patients (diabetes, cancer, kidney or heart problems). Each year, 5-15% of the population are affected during routine epidemics, with significant economic impact (sick leave, lower productivity ...) and 5 million serious cases and 250 000 to 500 000 deaths. Deaths occur mainly in people over 65 years.

Flu Causes and mechanisms


The influenza virus circulating nowadays and cause human epidemics are of two types: A and B. These viruses are genetically programmed to be able to mutate very easily, with minor modifications but imposing reformulate the vaccine each year..
These flu viruses are spread easily from one person to another by air via the microdroplets and particles expelled during coughing or sneezing. The virus enters through the mouth and nose and infects the body.
High population concentrations, dry and cold weather are conditions favorable to the spread of the flu.

Symptoms and signs of flu

The first symptoms appear several days after infection (1-4 days), but the patient is already contagious before symptoms appear. The flu lasts about a week and is characterized by a strong sudden fever, signs of soreness and muscle pain, headache and malaise. Dry cough, sore throat, and rhinitis (runny nose) directed towards diagnosis, especially as the environment is also achieved.

Symptoms resolve spontaneously or with symptomatic treatment in 1 to 2 weeks.
In compromised patients, complications of influenza may occur in the form of bacterial infections, of extrapulmonary involvement (digestive disorders, meningitis ...) or even fatal malignant flu (acute respiratory failure).

With what should we be confused?

Seasonal flu is not to be confused with avian influenza or "bird flu" that affects the moment the birds. Avian influenza viruses are indeed unable to directly infect humans.
Also, do not confuse the flu, viral, with other bacterial infections. Antibiotics are in the case of the influenza viruses on completely ineffective.

Will it possible prevention?

Vaccination remains the main flu prevention means for limiting the spread of the epidemic and avoid complications.
All seniors and all those at high risk of complications should benefit as it reduces mortality from 70 to 80%. Influenza viruses are constantly changing, vaccines are adjusted each year by the global network of the World Health Organization.

The Insurance supports vaccination of people aged over 65 and patients, regardless of age, with the following chronic diseases:

- Type 1 diabetes and Type 2 diabetes;
- Disabling stroke;
- Severe chronic kidney disease and primitive nephrotic syndrome;
- Severe neurological and muscular disorders (including myopathy), severe epilepsy;
- Cystic fibrosis;
- Severe heart failure, serious arrhythmias, severe valvular heart disease, severe congenital heart disease;
- Severe chronic respiratory insufficiency;
- Severe primary immunodeficiency requiring prolonged treatment, infection with human immunodeficiency virus;
- Sickle cell anemia;
- Asthma or chronic obstructive pulmonary disease;
- Children and adolescents aged 6 months to 18 years, whose health condition requires prolonged treatment with acetylsalicylic acid (complicated Kawasaki syndrome and juvenile chronic arthritis).

When to consult?

In young adult and free of pathologies, evolution of influenza is usually favorable spontaneously or with symptomatic treatment with free access to the pharmacy. However, in case of influenza in a fragile person (young children, persons over 65, chronic illness ...), a quick reference is needed.

What does the doctor?

The doctor confirms the diagnosis on questioning and clinical examination. The epidemic context, as well as health bulletins progression of influenza help make the diagnosis of presumption.
In uncomplicated cases, no sampling or examination is required. Treatment is symptomatic, to reduce fever and relieve pain. Antibiotics are antibacterial agents no effect on viruses and are therefore not indicated in the treatment of influenza (except in cases of bacterial infection).
Antivirals can be useful in certain directions but do not replace the vaccine.
If severe, hospitalization may be necessary, sometimes resuscitation.

How to prepare for my next visit?

Any worsening or persistent signs beyond 7 days must consult a doctor. In all cases and to prevent contamination of those around, simple measures are to be adopted: cover your mouth when sneezing, blowing nose in disposable paper handkerchiefs, avoid shaking hands, kissing, frequently washing hands or disinfect their hands with hydroalcoholic solution and well wear a surgical-type mask.

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Bone Marrow Transplant Success Rate, Procedure, Risk


Who is the bone marrow transplant?

The treatment of certain cancers may go through a bone marrow transplant, or more accurately a stem cell transplant contained in the bone marrow. This approach is used in particular in patients with leukemias or lymphomas.

What is the principle of this treatment?

Blood cells (red cells, white cells and platelets) are made ​​in the bone marrow from stem cells. The treatment of some cancers of the blood through the destruction of all such cells, and the reconstruction of a healthy bone marrow which produce healthy blood cells. This is where the graft.

Bone marrow transplant in practice

In practice, this therapeutic approach is carried out in two separate steps: in the first, the patient's bone marrow destroyed by chemotherapy or radiation therapy to eliminate tumor cells. The patient then finds herself momentarily devoid of immune system. Personnel must be protected from infection, and it is why it is placed in a sterile room.


During the second stage of treatment, the patient receives a stem cell transplant that will quickly restore the destroyed marrow. The graft may be a marrow sample previously taken to the patient. There is talk of autograft. This option is only possible if the cancer does not touch the bone marrow cells. The patient may also receive the marrow from a donor (allograft) or umbilical cord blood is rich in stem cells from cord blood bank.

Become a bone marrow donor

According to the Agency of Biomedicine, "Bone marrow transplant is only possible between a patient and a donor whose biological characteristics are as close as possible. When the patient does not have a donor among his brothers and sisters, the doctor uses the records to find a compatible donor. This compatibility is rare: one in a million chance between 2 random people. But that opportunity exists and can save a sick ".

To become a marrow donor, you must register on the National Register marrow transplant. For this, it must be over 18 and under 51, be perfectly healthy and answer a medical interview about his medical history and lifestyle.

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Glaucoma medical terms Definition, Risks, Causes, Origins, Prevention, Signs and Symptoms

Definition of glaucoma
Glaucoma is an increase in intraocular pressure within the eye, by excess and / or excessive retention of the aqueous humor.
We distinguish acute glaucoma, occurring suddenly, chronic glaucoma (80% of cases) progresses insidiously.
Glaucoma is called "closed-angle" when the angle between the iris and the cornea is very narrow, and "open angle" when no angle closure was observed.

Risks and consequences of glaucoma

Glaucoma

Chronic open-angle glaucoma is seen in all ages but is most common after age 40.
It is desirable to make it a routine screening from 70 years because it is the second cause of blindness in developed countries after macular degeneration related to age. 10% of global visual impairment due to glaucoma according to WHO (Action Plan against blindness, 2006-2011).
According to the Society of Ophthalmology (SFO), chronic glaucoma affects about one million A press conference of its 2011 congress, the SFO evokes up to a million people, but unaware of their disease.

The danger of glaucoma is the alteration of sight until total blindness if left unchecked. The decrease in visual acuity indicates an advanced form of glaucoma which should no longer be with a proper care.

Acute glaucoma

The acute form is urgent: acute glaucoma can cause blindness in 48 hours by compression of the optic disc area of the retina where the optic nerve emerges and blood vessels.
When glaucoma, slow compression of the optic disc gradually narrows the visual field (first peripheral vision) and central visual acuity (ability to distinguish two points when looking straight ahead).

Causes and origins of glaucoma

Aqueous humor is secreted fluid in the eye with a special area called "ciliary body", located on the outskirts of the lens. It is normally flows through resorption in the trabecular meshwork located in the iridocorneal angle (between the iris and the cornea). Many circumstances may inhibit or block this resorption. Since the production of aqueous humor does not stop for all that, the pressure increases faster or slower depending on the nature of the obstacle.

Old age affects the trabecular meshwork, which absorbed more slowly the aqueous humor.
The shape of the eye affects the anatomy of the anterior chamber angle. The eye very shortsighted closes the anterior chamber angle, which can block the flow of aqueous humor while the trabecular meshwork is "normal". The addition of other factors contributing to angle-closure glaucoma can cause an acute angle-closure.

Among these factors is the dilalation of the pupil (iris opening) by drugs and narcotics, by autonomic imbalance. Such parasympathetic hypertonia in the dark, cold, pain, stress or excitement. Trauma or ocular inflammation may also close the iridocorneal angle.

Finally, the presence of chronic diseases altering the arteries of the retina (mainly diabetes and / or hypertension) makes the papilla very sensitive to lower intraocular pressure. So we made a lot easier when you already acute glaucoma is a chronic glaucoma, especially if it is ignored, and when you suffer from diabetes or high blood pressure.

10% of glaucoma are called "closed angle"; it is most often an inherited anatomical anomaly. All other glaucoma are said to "open angle": the resorption of aqueous humor is the only cause, without angle anomalies.

Symptoms and signs of glaucoma

When chronic glaucoma moved silently and can not be manifested as blurred vision and reduced visual field. This is the regular monitoring of vision and eyestrain that can detect it.

In acute glaucoma, the eye suddenly becomes painful (but not always), very red (vessels dilate), and hard. The vision is blurred and not corrected with glasses or a magnifying glass. Mydriasis (constant enlargement of the pupil) is often present. Other symptoms should alert as headaches, nausea, or general malaise.

Will it possible prevention of glaucoma?

Yes, by the early detection of glaucoma factors, particularly advancing age. Consult an ophthalmologist regularly from the age of 40 years, even more so when a parent is already suffering from glaucoma.
Of course, avoid as much as possible situations that place the parasympathetic hypertonia: dark, cold, emotions, coffee, pain, stress, smoking, certain medications such as antihistamines, antispasmodics and antipsychotics.

It is recommended to avoid coffee increases the intraocular pressure and tobacco. However, the abuse of television, wearing lenses, reading or computer work are not sufficient in themselves risk.

When to see the doctor?

Systematically by regular eye balances to avoid an emergency situation, very dangerous for the view.

Emergency when acute glaucoma are signs: red eye, hard to palpation closed eyelid, vomiting, headache, blurred vision uncorrectable.

How to prepare for my consultation?

We must stand with the summary of all prescription treatments because some favor glaucoma.

What does the doctor?

The GP suggests the diagnosis for consideration and guidance urgently to a city in ophthalmologist or hospital if it is an acute glaucoma. He does the same for glaucoma but consultation may not take place within two hours.

He may prescribe eye drops immediately adapted to reduce the first pressure by draining the aqueous humor and then closing the pupil, which releases the iridocorneal angle. These are beta blockers, miotics, adrénaliniques, inhibitors of carbonic anhydrase, derivatives of clonidine and prostaglandins.

The emergency measure eye pressure (tonometry) and examination of the fundus, performed by an ophthalmologist in town or in the hospital, confirmed the diagnosis of glaucoma. Added to gonioscopy and exploration of the visual field that evaluate its causes and consequences eye.

Depending on the size of glaucoma or in case of ineffective treatments eyedrops, surgery with or without laser may be necessary.

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Gingivitis Definition Medical, Risks, Causes and Prevention


Definition of Gingivitis

Gingivitis is an inflammation of the gums caused by bacteria present in aggression in dental plaque, now called "bacterial biofilm." This disease occurs at all ages, to greater or lesser degrees. It can lead to a destruction of the surface portion of the gum; which causes severe pain to prohibit the supply.

Risks and health issues of gingivitis


If it is not treated in time, gingivitis may develop into periodontitis with loss of bone around the tooth, mobility and possible loss of it. Periodontally all tissue fixation and supporting the teeth, that is to say, the gum, the ligament and bone. Various studies show that gingivitis affects between 50 and 80% of people, and periodontitis 20 to 50%.

Gingivitis has a general impact on health: the bacteria in the mouth can spread in the body. Gingivitis is thus a risk factor of infarction, diabetes, and even premature births ...

Causes of Gingivitis

About 500 bacteria can cause gingivitis and their presence in the mouth varies by geographic areas and populations. The inequality of individuals with that infection is due to the familial susceptibility and oral hygiene. Those who have never had any decay are more likely to develop gingivitis: because the bacteria causing tooth decay compete with those responsible for gingivitis and reduce the "silence".
Power does not come into play in this disease although a vitamin C deficiency is a contributing factor. Bone loss is not related to age: gingivitis can begin in childhood and grow in the absence of proper oral hygiene.

Note: Some heavy treatments, such as immunosuppressive drugs given to transplant people favor gingivitis.

How manifests gingivitis?


The gums are red, sore and bleeding in simple non aggressive tooth brushing. That in the absence of anti-coagulant treatment in the absence of net deficiency of vitamin K and without liver disease that impairs blood clotting.
These signs are localized or generalized to the gum.

With what would it be confused gingivitis?

With dermatological diseases (leukoplakia or lichen type for doctors) that may develop in the mouth of otherwise unhealthy or defective oral hygiene, such as alcohol and tobacco abuse. Not periodontal disease.
Bleeding gums is the major sign of gingivitis that avoids confused with other diseases.

Will it possible prevention?

Good oral hygiene is both the prevention and treatment of gingivitis. The hygiene must be rigorous, effective and non traumatic: it is necessary to properly use his toothbrush, which must be adapted to the size and shape of the teeth.

A brush or a dental floss eliminate uninvolved interdental plaque by brushing.
Although the mechanical action is most useful when brushing, fluoride toothpaste helps protect the teeth more effectively. However, an antiseptic toothpaste, which can be useful against bacteria, should not be used all the time.

When to consult?

Consulting his dentist every year for at least scaling, is part of the prevention of gingivitis. If the gums bleed when you brush, she is ill: do not take this lightly but signs quickly consult your dentist for advice.

What does the dentist?

The dentist begins by analyzing the appearance of the gums (shape and color). He may need an x-ray to assess the quantity and quality of the bone under the gums if it suspects periodontitis. It can make a bacterial sample (simply rub the gums with a swab).

It establishes its diagnosis and treatment plan.
For simple gingivitis, an effective oral hygiene will be stimulated, after scaling and removal of dental plaque.
If periodontitis is installed, a mechanical treatment called surfacing (root cleaning and disinfection of the pockets, surgical or otherwise) is necessary.

How to prepare for my next visit to the dentist?

Summarizing medical history: our prescription medicines, surgery (especially transplant) and caries.

Explain the reason for the consultation (discomfort, pain, aesthetics), indicate whether it is a recurrence of gingivitis, if it has already been processed, and for how long is the inflammation.
Finally, family history (if parents are prone to gingivitis) give an indication.

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Frostbite Information, Risks, Health issues, Prevention and Consult


Information about frostbite

Frostbite of the extremities occur mainly in the mountains where the weather conditions are changing rapidly with falling temperatures of 6.5 ° C every 1000 meters. They are one of the consequences of prolonged exposure to cold. These are injuries to the movement disorders caused by cold, which mainly affect the extremities (hands and feet) and the face. Cold, humidity, but also skin contact with metal objects favor.

Risks and health issues frostbite

Cooling the body can cause many cold injury. Frostbite and hypothermia are the most serious. Frostbite concern mainly the fingers, toes, ears and nose, as these organs are devoid of major muscles to produce heat.

Mechanisms frostbite

The cold-induced vasoconstriction which decreases blood perfusion and thus oxygenation of the extremities. In case of exposure to cold, the body indeed preserves heat in internal organs, reducing peripheral blood circulation (the ends). Hands and feet thus tend to cool more quickly, leading up to frostbite.

How is he clear?

The first symptoms are tingling in the extremities. The skin then becomes white and cold, with a loss of sensitivity and blistering. When heated, pains are felt swelling.

A few days later, the affected area becomes black by tissue necrosis (tissue death) and in some cases the gangrene may require amputation of the limb.

With what should we be confused?

It should not be confused frostbite and chilblains. Frostbite is benign lesions caused by exposure to cold without freezing of tissues (temperature of the upper air freezing, 0 ° C).

The affected area is red, swollen with a tingling sensation or pain.

Will it possible prevention?

Prevention requires certain precautions: wear shoes and warm clothes and insulating wind and humidity, no excursion mountain without adequate equipment, always report their departure with an approximate schedule return for delivery of communication in case of problems.

Whatever the weather, we must fully cover, wear gloves and a hat that protects the ears, and use a lip balm that will prevent chapping and protect from the sun.

When to consult?


If symptoms such as tingling or pain, it is imperative to warm hands and extremities. Attention must slowly warm the tissue and avoid rubbing the affected parts.

Never use hot objects such as water bottles, and seek emergency at the stage of frostbite.

What does the doctor?

Frostbite evolve in three phases: numbness, movement disorders and tissue necrosis.

In the first stage, impairment is reversible with warming, including extremes: hot and sweet drinks, warming blanket.

Blood flow will be facilitated by loosening clothing and shoes and stirring the hands and feet.

From the second stage, the care is specialized treatment in hospital or ICU: not undertake any warming but wrap the victim in a blanket.

Warm baths of end abuses in warm water at 38 ° C can be provided.

At the stage of necrosis, sometimes amputation is the only treatment option.

How to prepare for my next visit?

The loss of sensitivity is one of the first signs of frostbite. The fingers are white as devoid of blood; at this stage, it is advisable to return the blood and sensitivity by moving, massaging or by warming under the armpits.

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Rotavirus gastroenteritis Definition, Health risks, Causes, Mechanisms, Signs and Symptoms


Definition of rotavirus gastroenteritis

Rotavirus gastroenteritis is a digestive infection caused by the invasion of a virus called "rotavirus" extremely contagious. Rotavirus gastroenteritis by changing seasonal epidemics, with a peak in winter, and mainly affects young children. It is also a nosocomial disease, by definition, hospital-acquired, as many children are infected while in hospital for another reason: bronchiolitis example.

Health risks and challenges of rotavirus gastroenteritis

Any diarrhea and / or vomiting is a risk of acute dehydration; it is especially important that the person is more fragile (very young or very old) and malnourished (importance of malnutrition in developing countries). Acute dehydration of a fragile person puts his life at risk. *

In a study published in 2005, Melliez and colleagues assessed morbidity and cost of digestive rotavirus infections in children under 5 years: they attribute to it every year 300,000 180,000 acute diarrhea and city consultations, 18,000 hospitalizations and death of ten.

The study Shrik * published in 2009 shows that nearly half (49.1%) of children admitted to the emergency for acute gastroenteritis suffer from rotavirus. They are very young: nearly 90% have less than 2 years and almost 20% less than 6 months.

For InVS, 43% to 51% of viral gastroenteritis in hospitalized under 5 are due to rotavirus. Complications, first dehydration occur in 20% of cases and cause thirty deaths annually. They are more common with rotavirus, particularly among infants less than 6 months.

In the city, only 20% of gastroenteritis due to rotavirus would, because of many "competitors" viral, including calicivirus (including the principal, Norovirus, may be more common than rotavirus), adenoviruses ... But gastro Rotavirus -entérites are most severe.

In people over 75 years, the mortality of viral gastroenteritis (all virus) is around 350 deaths annually. But the deaths are probably more because dehydration causes very poorly tolerated blood disorders in these individuals often malnourished, with several diseases and treatments delicate to handle: antihypertensive and cardiovascular drugs first.

Causes and mechanisms of gastroenteritis

The virus penetrates the intestinal cells and blocks its operation. The cells do not absorb water and food, the movement is reversed: they reject the intestine water and minerals essential to good blood balance. This digestive cell leakage is called "entero-toxigenic" it causes diarrhea and vomiting.
This viral invasion can permanently change the bacterial flora; and install a milk intolerance (sugar and protein) unwelcome in children.

Contagiousness is extreme: the stool of a baby can issue up to one billion viral particles of the 3rd day of the 5th day illness. Sometimes shedding continues for 15 days!

Symptoms and signs of gastroenteritis due to rotavirus

Rotavirus, like other gastrointestinal viruses, multiplies for two to three days after infection. The first symptom (usually but not always) has a high fever (up to 40 ° C) at the same time as diarrhea (from 3 stools / day more or less liquid) and sometimes vomiting. Vomiting is an unfavorable factor because they prevent food so rehydration. Any diarrhea carries a risk of dehydration, which made its danger.

Mild diarrhea

Mild diarrhea does not give signs of dehydration, there is no vomiting or weight loss.

Serious diarrhea

Serious diarrhea dehydrates. The symptoms are high fever, thirst (careful, toddlers do not know how to express it), a fold of skin (skin does not come back up immediately when pinched in the arm for example), the weight loss (5%), vomiting, loss of appetite ...

Severe diarrhea

Severe diarrhea sees signs of marked dehydration: persistent skin fold, sunken eyes,
dry mouth, crying without tears, gray complexion, significant weight loss +++ (10%), loss of consciousness leading to coma and death if no resuscitation is taken urgently.

With what should we be confused?

Any viral diarrhea is not: food poisoning bacteria (staphylococcus, E. coli, Salmonella) are not uncommon. The notion of a suspect food and similar cases in the entourage after the same meal referrals diagnosis. The presence of blood or mucus in the stool is a strong indication of bacterial infection.
Any diarrhea is not infectious: then there is no fever (except in special cases). The intolerance to cow's milk, gluten intolerance are causes to evoke systematically, especially when diarrhea persists.
Some diarrhea is associated with other infections or disorders: otitis, appendicitis, intussusception (occlusion) or deep UTI ...

Will it possible prevention?

The integral partial breastfeeding protects children against rotavirus gastroenteritis.
Hand hygiene and food (kitchen) is essential to limit epidemics and the number of people in a community (family, nursery).

Vaccination against rotavirus is 100% effective against the serious forms and hospitalizations. But it is not recommended in the general population by the Board of Public Hygiene since it protects against that half (at best) officials gastroenteritis virus. The oral vaccine is administered at the 6th week of life, especially to infants exposed to harsh conditions and / or random surveys. Two vaccines are licensed. One requires two doses to be taken by mouth and the other three doses.

When to consult?

Any liquid sudden diarrhea with vomiting requires rapid consultation of a doctor. Hospital emergency if the stools are continuous.

How to prepare for the consultation of doctor?

Immediately begin oral rehydration with "oral rehydration salts (ORS)" counter in pharmacies. In small regular amounts or even the syringe to the beginning if the child refuses solute bottle (1 sachet in 200ml of water).

Note the number of stools per day and their liquid or soft nature, presence or absence of blood and mucus.

Recall the context: current epidemic in the family, school, nursery, home nanny ...
But also other ongoing illnesses that make it very fragile person, heart and kidney disease in particular.

What does the doctor?

It checks the intensity of dehydration (weight, etc.), it evaluates the difficulty of re-hydrate and nourish the patient.

It identifies the exact cause as much as possible to develop the relevant treatment.

According to the condition, he decides to no supervision or hospitalization for intensive care.

It prescribes rehydration with oral rehydration solution (ORS) that restores blood and intestinal balance and recharge during illness. This resolves spontaneously within a week in mild cases. He explains the isolation of infants (out of the crib, or in the nanny) and hygiene rules to limit the spread of gastrointestinal virus. It adapts the current drugs, diarrhea and dehydration.

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Open or closed fractures what is it, Risks, Mechanisms and Prevention of fracture?


Open fractures, closed fractures: what is it?

A fracture is defined by the discontinuity or breakage of bones of the human body. We distinguish closed fractures (without wound and therefore no risk of infection) open fractures (with wound and risk of infection).

All the bones may be involved at all stages of life.

The causal mechanism of injury determines the type of fracture: compaction, avulsion if ligament injury, fracture of the femoral neck geared for example ...

What are the risks and health issues fractures?

All bones can be achieved but some fractures are most common in function of the age and location.

Compaction is characteristic of the vertebrae and occurs mainly in case of osteoporosis. Similarly, the femoral neck fracture occurs in a special way in the elderly.

Fracture risk factors are now identified: personal history of fracture fragility, age> 60 years, corticosteroids, history of fracture of the proximal femur in a first-degree relative, body mass index (BMI: weight / height squared) <19, early menopause (before age 40), smoking, alcohol abuse, decreased visual acuity, neuromuscular and orthopedic disorders.

What are the mechanisms of fractures?


A fracture occurs most often after trauma. Depending on the bone density (measured by BMD), a more or less violent trauma is necessary to break the bone.

For example: in a young patient, high energy is required to cause a fracture of the femur (accident of the public highway, high-rise fall ...) in an elderly patient, a simple fall from standing height enough.
In case of an open fracture, there is a communication between the outside and the fracture; the risk of infection is important because this communication represents an ideal gateway for infection.

How manifests a fracture?

Whatever the type of fracture, trauma is necessary for the cause. The main symptoms are a cracking, pain and swelling of the fractured region. Pain causes functional impairment, with inability example to set foot on the ground or to use the affected limb.

In an open fracture, skin lesions are visible with a break in the skin leaving collect a piece of bone. Nerves, muscles and vessels can also be affected.
In case of compaction, often vertebral pain is located in the back. No deformation is visible but palpation of the vertebra is painful. Signs of sciatica (leg pain) are also possible.
The bony avulsions follow a movement of a joint beyond the physiological possibilities; ligaments stretch and tear a piece of bone; exquisitely painful point is felt on palpation.

With what would it be confused fractures?

It should not be confused sprain or strain that affect joints and ligaments and fractures involving bones. A sprain can, however, be accompanied by avulsion fracture.
In the elderly, a broken hip meshed, that is to say, the femoral head and neck are nested, may go unnoticed because despite the pain, heel and leg can still move. Only radiography wide in these indications, will make the diagnosis.

Will it possible prevention of fracture?

The best prevention is still a good physical preparation, proper warm-up and a conservative sport.
Wearing appropriate clothing (knee, shin guards, helmet ...) avoids direct trauma.
The fight against risk factors is also recommended to prevent fractures. The diet should be balanced to avoid excess weight but also fight against deficiencies (lack of calcium and / or vitamin D). Tobacco and alcohol are two enemies of the bones and weaning is recommended.

If demineralization proven to bone densitometry (osteoporosis), hormone replacement therapy is offered in postmenopausal women (in the absence of cons-indication) and drugs fighting against bone destruction are available to all.

In case of suspected fracture, call for help, sit or lie the victim of severe pain to avoid discomfort and hold the two parts of the broken bone with a hand placed on each side to avoid they are mobile (intense pain factor). At best, place the fracture on a plane and straight support.

Tetanus immunization is checked for open fractures.

Fractures: when to consult?

Any persistent pain, swelling or deformity after trauma requires a medical consultation and possibly a radiograph.
Similarly, back pain, especially in patients with risk factors such as osteoporosis or treatment with corticosteroids should motivate a consultation not to neglect vertebral collapse.

What does the doctor faces a divide?

History of fracture risk factors (see above), mechanism of trauma and violence helps the practitioner to suspect a fracture. Palpation of bony prominences can highlight deformation or evocative painful point of a fracture or avulsion.

Elective pain on palpation of the spine fears vertebral collapse, but only the radiographic support or refute the diagnosis. Compaction can affect every facet of the vertebra or represent a compression fracture; MRI may specify any neurological compression.

In case of fracture of the femoral neck, several x-rays may be needed to clarify the type of fracture.

The common treatment of these fractures is the quiescence of the joint and the fight against pain.

Some are operable as femur fractures, open fractures or fractures settlement of unstable spine. For others, an asset or pulling suffice.

For open fractures, early antibiotic treatment prevents the risk of infection.

How to prepare for my next visit?
We must not neglect pain following injury and should be consulted.

In case of cast immobilization, any pain should be reported to the doctor to check the cast is not too tight and does not interfere with traffic.

If anticoagulant therapy is prescribed (spots) must be followed carefully to prevent phlebitis.
Wounds and sutures should be monitored; if they turn red, inflammatory with fever, a consultation is needed quickly.

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