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All About Epilepsy Definition, Prevention, Risks, Causes, Sign and Symptoms


Definition of epilepsy

Epilepsy (also called lobe epilepsy by doctors) is a neurological brain disease characterized by repeated attacks of very varied. We distinguish two types according to their visible progress (signs), but also their electrical sequence described by the electroencephalogram (EEG) with generalized epilepsy total unconsciousness and partial epilepsy (or focal) where consciousness is only altered, suspended.
A first seizure may mean an entry of epilepsy (repeated attacks), or otherwise never be followed by no other. A crisis that remains isolated (50% of cases) is not epilepsy.

Epilepsy affects all ages, its genetic share is estimated at 40%. Half of the cases begins in childhood. It is not always definitive: an epileptic child often more crisis after adolescence, when the brain completes its maturation.

A seizure lasts a few minutes. The longer it takes the more it is serious. Beyond 30 minutes, we speak of a "status epilepticus". This is a medical emergency.

Risks and origins of epilepsy

In 2010, various forms of epilepsy is the most common neurological disability in Europe, affecting 6 million patients of all ages and all conditions. With a total cost estimated at 0.2% of GDP in industrialized countries.

Second neurological disease after migraine: it affects about 1% of the population is 500,000 to 600,000 people, half under 20 years. ; at an estimated annual cost of 3.5 billion euros. Better management of epilepsy represents a major economic issue. A 10% misdiagnosis would allow savings of around 15 million euros per year (National Committee report for Epilepsy, March 2011).

This health problem is even heavier than epilepsy is still considered a shameful disease by the general public and patients themselves. The refusal of the disease leads to poor adherence to long-term treatment, which limits its effectiveness.

Any seizure exposed to fatal accidents since the unconscious person loses all protective reflex drowning, road accidents, fractures ...

Epilepsy also exposed to a high risk of sudden death during attacks by neurons disturbances to control heart rhythm (autonomic nervous system). Genes and environment (neuronal growth) are very involved in this entanglement epilepsy / sudden death.

The repetition of seizures decreased brain performance. For each crisis frees aggressive substances for neurons, which cause their "suicide" (apoptosis). Which in turn results in a greater tendency to crisis by aberrant reorganization of neuronal connections. Hence the aphorism doctors "that crisis crisera" ... unless effective treatment.

The deterioration in intellectual performance promotes socio-professional failure patients who already suffer discrimination for safety reasons: temporary license and under conditions prohibiting workstations requiring sustained attention.

Causes and mechanisms of seizure

It is a disorder of brain function that promotes the unexpected appearance of electrochemical discharges of neurons, intense and synchronous discharges. These bursts can travel throughout the brain or remained localized. They stop themselves through brain brakes (inhibitor system), except during a status epilepticus.

Brain activity is regulated in particular by gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system. In patients with epilepsy, the inhibitory action of GABA is reduced. In addition, the control of neuronal receptors to GABA is deficient in patients with epilepsy.

In one third of cases, cerebral scar serves as a trigger, we speak of epileptic focus. It is frequently due to a head injury, brain damage at birth, meningitis, cerebral vascular accident (stroke), a brain tumor, a fever ... Two-thirds of epilepsies have no identifiable initial focus in imaging.

A large Danish study (Christensen et al. Lancet Neurology, March 28, 2009) showed that the risk of epilepsy in a child or young adult is doubled after moderate head injury, and increased more than 7 when the brain injury is severe. This risk persists after 10 years and is even higher than the young is older (over 15 years) at the time of trauma and it belongs to a family of epilepsy.

An epileptic focus can trigger a crisis if the state allows neurons: high level of excitability, inefficient stabilizer systems. It is the seizure threshold which, if exceeded, enables the deployment of the crisis. It varies from one individual to another and for the same individual, depending on the genes, the circumstances of his traumatic story ... Some situations lower the seizure threshold. They expose anyone to a crisis, even non-epilepsy fatigue, lack of sleep, overwork, alcohol, repetitive visual stimulation (tree-lined road, video screen), consumption of stimulants, drugs and toxic.

Symptoms of an epileptic seizure

The symptoms depend on the brain area concerned: generalized or partial seizure. The epileptic focus (area where born the anarchic activation of neurons) is also used to describe them.

They can be dramatic or very discreet, ranging from a simple muscle twitching cheek, from the corner of the mouth, and the rhythm generalized spasm of four members.

The widespread crisis ("grand mal") is the most spectacular manifestation but not the most common. Unconsciousness is complete and is accompanied by a fall, sometimes a tongue biting and loss of urine. A temporary amnesia is still present even at least: amnesia of the crisis, the current date, events before the crisis.

In children, the generalized crisis occurs most often as an absence ("petit mal") that is to say, a break contact of a few seconds, with a stare, automatic gestures and mouthing. It is very often overlooked. And frequent.

Will it possible prevention of epilepsy?

Avoid or aggressively treat any infringement or acquired brain injury: environmental toxins, alcohol, drugs, infectious meningitis and encephalitis ...

Every human being has an epileptic personal threshold. If it's low (by genetic constitution, disease, brain trauma), it is necessary to avoid anything which further lowers and enables the emergence of a crisis. First, the lack of sleep. Then stimulants (tea, coffee), drugs, alcohol, overwork and repetitive visual stimulation (video screens, TV, etc.).

When to see the doctor?

Once a person has a loss of consciousness accompanied by contractions or spasms, even discrete, members or face. Especially if there is amnesia of the episode and loss of urine. Sphincter relaxation is an evocative sign of seizure.

How to prepare for the consultation?

Keep a calendar of bizarre events, crises and circumstances in which they appear: current medications taken of toxic, lack of sleep, pee in bed suddenly ...

Maintain his medical book containing all treatment history and personal and family medical history.

What does the doctor?

The doctor examines and questions the patient and then prescribe an electroencephalogram (EEG - recording brain electrical activity), and a CT scan or MRI to take stock of a possible outbreak brain behind the crisis.

It sends the patient to a neurologist epileptologist to confirm the diagnosis, initiation of treatment and follow-up are specialist.

Support 100% is under Affection Long Term (ALD) 9 for severe epilepsy.

A long-term treatment is not systematic in a single isolated attack. But when it is required, it is introduced for several years.

In case of inefficiency (persistence of crises under treatment) or intolerance, we can change and / or combine several different drugs.

Taken properly, effective treatment can lead a normal life during drug-sensitive epilepsy (two-thirds of cases).

When the disease is resistant to treatment (drug-resistant epilepsy, 30% of cases), surgery is possible if there is an epileptogenic focus that can be removed without too much damage to brain function. The total cure is possible in about 70% of cases (National Committee report for Epilepsy, March 2011).

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Exudative pleural effusion (pleural effusion) Definition, Causes , mechanisms, Signs and Symptoms


Definition of pleural effusion

Pleural effusion is the presence of liquid between the layers of the pleura, protective membrane around the lungs.

The pleura is normally composed of two layers (one on the inner side of the rib cage, the other on the lung) which slide on one another during the breathing movements in a virtual space between the two. A pleural effusion (pleurisy), the space is filled with liquid.

Puncture distinguishes exudative pleural effusion associated with inflammation with many proteins (infection, cancer), pleural effusion transsudatif linked to heart failure. Puncture therefore highlights the effusion of forming mechanism.

Origins of pleural effusion

The number and the evolution of pleural effusion depends on the cause.

If pleural effusion transsudatif related to heart failure (1-3% of the general population and more than 5% after 75 years), the treatment is effective and regressed effusion.
If exudative effusion linked for example to cancer, the prognosis is one of the causal disease. Meanwhile mesothelioma is a cancer of the pleura associated with exposure to asbestos, and is constantly growing.

Causes and mechanisms of pleural effusion
The pleural space normally contains very little fluid and proteins. The liquid from the bloodstream and it is locally absorbed by the lymphatics.

In heart failure, the heart struggles to pump blood stagnating upstream in the lungs (pulmonary edema) and tends to accumulate in the pleura as to form a transsudatif pleural effusion by increasing the pressure.

In case of inflammatory process (cancer, infection), vascular permeability is increased and favors the passage of liquid in the pleura: one speaks of exudative effusion.

Pleural puncture allows the analysis of pleural fluid and directs the cause. In case of clear liquid protein content information on the origin: a lot of protein = exudative, little protein = transsudatif.
When the pleural effusion is large, the liquid prevents the lungs to move, causing respiratory difficulty.

Symptoms and signs of pleural effusion

Symptoms depend on the abundance of pleural effusion and its cause.
Sometimes the discovery is fortuitous on a chest x-ray as pleural effusion is asymptomatic. Otherwise, the pain is the main point of call. It is of gradual onset type gravity or next point and raised on deep inspiration or coughing. Difficulty breathing signs occur when the effusion is important.

There are no clinical difference between exudative effusions and transsudatifs. However, the underlying disease causes symptoms that are specific as edema, shortness of breath (heart failure) or fever, weight loss (infection, cancer).

With what he does not confuse pleural effusion?
Any chest pain should receive a medical examination because it can be a heart attack, pulmonary embolism, ulcers or pneumonia or pneumothorax (air in the pleural cavity). Only the doctor can make a diagnosis, especially after the completion of exams.

Pneumothorax is also a filling of the pleural space, not by a liquid, but by air. The risk of asphyxia by compression of the lungs.

Will it possible to prevent pleural effusion?

There is no specific prevention.
Prevention of mesothelioma is through non-asbestos exposure. Smoking cessation is also recommended to reduce the risk of cancer.

In heart failure, relapse prevention through compliance with prescribed treatments and lifestyle changes (diet without salt or low-salt in particular).

In case of pain, lying on the side of the effusion usually relieves, in addition to prescribed pain medication.

Pleural effusion: when to consult?

Any severe pain and prolonged chest or difficulty breathing requires medical attention or call the SAMU Centre 15.

If the pleural effusion is known and previously diagnosed, a consultation is necessary if symptoms worsen, modification of pain and / or shortness of breath more intense.

What does the doctor deal with pleural effusion?

The examination by the doctor clarifies history (occupational exposure to asbestos, smoking, infections ...), the characteristics of pain (spontaneous, when breathing, night ...) and impact.

A history of heart failure or pulmonary edema moving towards a transsudatif effusion. Clinical examination confirmed the pleural effusion by percussion of the chest with fingers: the sound reflects a perceived dullness and auscultation shows a lack of breathing the area.

A chest x-ray and / or CT scan (or scan) are generally prescribed to highlight the effusion.

Pleural puncture under local anesthesia is the key consideration; introducing a needle in full area effusion, pleural fluid was removed and analyzed. His exudative or transsudatif character is then determined and guide treatment.

In case of repetition or by diagnosis, surgical bonding by talc pleurodesis is sometimes indicated to pick the pleura. Specific treatments depend on the cause: antibiotics for infections, heart condition treatment in case of transsudatif effusion in cases of mesothelioma chemotherapy or surgery ...

How to prepare for my next visit?


If pain or breathing difficulties majorem, it is necessary to re-consult. Chest radiography control allow you to see the evolution of pleurisy (liquid volume).

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Sprained knee injury of the anterior cruciate ligament definition, causes, symptoms and signs

Definition of the lesion of the anterior cruciate ligament

The achievement of the anterior cruciate ligament occurs during knee trauma and especially during a knee sprain. The twist of the joint causes stretching, tearing or rupture of the anterior cruciate ligament, and undermines the stability of the knee.

The disease may be mild because of the simple stretching, or severe by rupture of anterior cruciate ligament.

Other lesions may be associated (cartilage, menisci, fracture ...).

Origins and consequences of a knee sprain

The anterior cruciate ligament is often achieved in sporting accidents, highway or rough handling during false (blocked foot and knee twists). Skiing is alone provider of knee sprains 50,000 per year.

The achievement of the cruciate ligaments sign in general a serious breach, with important consequences for knee instability, chronic pain, meniscal lesions and risk of osteoarthritis.

Causes of a sprained knee injury of the anterior cruciate ligament

The knee joint comprises a plurality of ligaments (two collateral ligaments and two cruciate ligaments) which connect the femur to the tibia or fibula.

The cruciate ligaments are inside the joint with the anterior cruciate ligament or ACL and the posterior cruciate ligament, or PCL.
The knee sprain is a movement that causes a stretch or tear more or less complete ligaments.

In sports accidents, the anterior cruciate ligament is most frequently achieved.

Symptoms and signs of a knee sprain

In case of isolated injury of the anterior cruciate ligament pain is small and there is not necessarily signs of swelling or joint swelling.

Otherwise, the symptoms are acute knee pain and swelling associated with joint effusion (hemarthrosis).


Walking is often still possible and impossible to lay the ground by foot is rare.

With what must we not confuse a knee sprain?

It should not be confused with sprains fractures.

A fracture is a bone injury by tearing or bone breakage, while the concerns sprain ligaments. Conversely, a sprain can be complicated fracture because the stretching of the ligament sometimes hard bone on which it is inserted. An x-ray is often necessary in case of breach to eliminate this complication.

Will it possible prevention in knee sprain?

The best prevention is still a good physical preparation, proper warm-up and a conservative sport.

The ACL is the ligament most often broken knee.
Football, basketball, volleyball, judo and especially skiing (30% of sprains) require good physical condition.

The drive includes a cardiovascular general component (cycle, jogging, swimming, step for endurance) and a more specific aspect of building muscle, especially around the knee (stretching, weight training with weight ...).

Knee sprain: when to consult?

If knee pain after trauma, consider that it is a sprain and seek prompt medical attention if one knee specialist (sports doctor, orthopedic ...).

In the meantime, do not walk, apply ice to the joint and extend the leg.

What does the doctor deal with a knee injury?

The doctor will clarify the mechanism of injury (torsion, blocked up, crunch ...) and will practice a specific examination for abnormal movements of the joint.

Radiography is often proposed to remove a bone injury, but it does not allow to visualize the ligaments. Only MRI may show a lesion cruciate ligament or meniscus.
Treatment includes rest, painkillers or anti-inflammatory medications and immobilization with a splint. Icing reduces pain and edema.

The judgment of the sport is desirable, but physical therapy helps maintain activity to avoid the stiffness of the joint.

Surgical treatment is seldom urgent and involves repairing ligament (ligament arthroscopic). It is proposed in case of knee instability in a young patient with a sport.

How to prepare for my next visit?

We must not neglect a knee pain and risk not diagnose an isolated involvement of the cruciate ligament. The risk of functional disability and pain exist, as the risk of osteoarthritis. Discuss this with your doctor who will direct you.

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Endometriosis Definition, Causes and risk, Sign and Symptoms, Prevention


Definition of endometriosis


Endometriosis is a common condition of women. The uterus is covered by a mucosa; however, in endometriosis, uterine lining islands that are implanted outside the uterus. These foci of endometriosis may be in the belly (the ovaries, bowel or bladder) or elsewhere as to the skin or lungs.

As the uterus, endometriosis these maps undergo hormonal changes in the menstrual cycle and cause pain and bleeding on each cycle.

Causes and risk of endometriosis


Endometriosis is a common gynecological disorder affecting about 10-15% of women of childbearing age. For women affected by infertility, half would have endometriosis. Physical pain but also psychological peppering the lives of women victims of endometriosis. The exact causes of endometriosis are little known; genetic and environmental factors (dioxin) probably play a role.

Symptoms of endometriosis


The lining of the uterus is called the endometrium. The endometrium responds to hormonal processes of the menstrual cycle: cycle start growing and after ovulation, stopping growth and finally menarche hormonal fall.

If the endometrium is found outside the uterus, it defines endometriosis and is subject to the same rules.


Endometriosis then changes to worsen because the menstrual blood accumulates in the affected areas, including the abdomen, creating local inflammatory reactions. Distance, particles of uterine lining can be transported by the lymphatic channels or through the bloodstream to other organs (lungs).

What are the symptoms of endometriosis?


Endometriosis can be very discreet or asymptomatic. Otherwise, the pain is in the foreground. Their cyclical nature should suggest endometriosis. It can include dysmenorrhea, that is to say, a pain occurring during and at the end of rules, dyspareunia (pain occurring during sexual intercourse), chronic pain (stomach, pelvis ...) and finally painful defecation or painful urination.


Sterility is also a revelation endometriosis mode; sometimes infertile patients have no symptoms other than their infertility, and this is exploration by laparoscopy which reveals endometriosis.
Chronic pain and often diffuse weigh on the morale of patients, which then have chronic fatigue and mood swings.

With what should we be confused?


Lumps of the ovaries as functional cysts may falsely suggest the diagnosis of endometriosis. Imaging or surgical exploration will make the difference.

Do not confuse PMS with its accompanying pain and discomfort, which disappears in a few days. This syndrome regresses under treatment and do not worsen over time, in contrast to endometriosis.

Will it possible prevention?


There is no preventive treatment of endometriosis.
Pain, like the pain of the rules, will eventually be relieved by applying a hot water bottle on the painful area.


The particular hormonal treatments (progestin) with side effects, it should be prevented. Weight gain will be limited through healthy food hygiene: three meals a day, no snacking, limiting sugars. Similarly, lipid metabolism disorders (fats) will be notified by reducing dietary fat (meats, cheese, cream ...).

When to consult?


Since endometriosis is manifested by various symptoms, the diagnosis is often delayed, at the stage of infertility or of disturbances of other organs. For recurrent pain, punctuated by the rules, it is essential to quickly consult your doctor or gynecologist.

What does the doctor?


The clinical examination by the doctor is often disappointing; it can evoke endometriosis on the cyclical nature of the symptoms. Bluish and reddish cysts can be seen on the cervix during a pelvic examination (speculum examination, vaginal).


Additional tests are used to make the diagnosis Ultrasound is often proposed and can find an ovarian cyst;. MRI can also provide valuable information. However, the key consideration is laparoscopy performed in the operating room under general anesthesia; biopsies made during surgery confirmed the diagnosis, and surgical removal of endometriosis lesions or targeted hormonal treatment can be achieved.


In all cases, the treatments are individual and tailored to each patient.
Analgesics or nonsteroidal antiinflammatory fight against pain; birth control pills may also improve symptoms.

How to prepare for my next visit?


Proposed treatments are individual and tailored to each case. So, sometimes it is necessary to "test" some treatments before finding the most suitable; discuss its effectiveness with your doctor.

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Pulmonary embolism Definition, Risks, Prevention, Causes, Signs and symptoms

Pulmonary embolism: definition

Pulmonary embolism is obstruction of one or both of the pulmonary arteries by a blood clot (thrombosis). It has mostly migrated from a vein in the lower limbs reached by phlebitis also called venous thrombosis (70% of cases *). These two events - embolism and thrombosis - are part of the same disease, venous thromboembolism (VTE).

Depending on the level of obstruction, and the diameter of the clot, or any part of the lung is deprived of blood. This obstruction results in a subsequent heart block with acute respiratory failure and heart failure that can be fatal: that massive pulmonary embolism with cardiac arrest immediately.

Pulmonary embolism: risks and consequences


The venous thromboembolic disease affects about 150,000 people per year. Following him, pulmonary embolism (PE) causes 20,000 deaths; this is the third leading cause of cardiovascular death after myocardial infarction and stroke (source: interviews Bichat, 2010).

The risk depends on the importance of the private territory of pulmonary blood, so the percentage of obstruction by clots or migrants. Advanced age is a risk factor for death.

Only 10% of EP are fatal in one hour. But in half of the cases they cause insufficient heart more or less well tolerated in time and absolutely require good care. A distance embolism treated, the risk of pulmonary hypertension is 5% *.


Pulmonary embolism: origins and causes

One or more blood clots in the pulmonary arteries block during passage of the blood to be oxygenated. Lacking the blood blocked upstream, the heart fails to work properly, then it should just provide an extra effort to correct this lack of blood throughout the body.

About 70% of cases of pulmonary embolism are caused by the migration of a clot from phlebitis of the lower limbs (DVT). To meet and consider embolism, it is still necessary that the phlebitis of the legs occurs, it is the case for less than one out of four *. More often we are dealing with phlebitis of the pelvis or the inferior vena cava (large vein in the abdomen) totally invisible. But in this case the risk of embolism is massive high.

Venous clots of thromboembolic disease appear particularly susceptible individuals by genetic background (personal or family history) or suffering from cancer. Genetic disorders of coagulation causes are increasingly recognized in this disease.

But the great cause of phlebitis venous stasis. First by bed rest, he must follow an illness or surgery; then by poor circulation or varicose field. Phlebitis is also feared as a cast of the lower limbs or in a long-haul air travel in a dry atmosphere (dehydration makes the blood less fluid), even if it is followed by a trek at altitude dehydration persistence (total effort and the dry atmosphere). All situations causing hyperviscosity are at risk of thrombosis (caillotage), so pulmonary embolism: smoking, obesity, pregnancy, childbirth and after, heart failure, oral contraception days.

Venous clot breaks off more easily since it was formed less than 5 days and it moves at sunrise after prolonged bed rest (home or hospital) for example.

Signs and symptoms of pulmonary embolism

Pulmonary embolism is often understated: there must be at least 30 to 40% of the pulmonary arteries to be clogged that the signs are visible. Therefore, pulmonary embolisms are rarely diagnosed. Only "big" are noticed. The diagnosis is made during a pulmonary imaging (CT, MRI) for another reason.

The classic table combines a sudden difficulty breathing (dyspnea) with a sharp chest pain, like a stitch or a dagger that increases on inspiration. Shortness of breath sudden unexplained is the only sign still present (pain may be missing). It may be added tachycardia (rapid heartbeat), unexplained anxiety, cough, fever 38%, cyanosis of the extremities (bluish fingers), one or coughing up blood (hemoptysis).

Chest pain stabbing and difficulty breathing enough to evoke a pulmonary embolism even if one is not aware of phlebitis. The urgent consultation of doctor or emergency services if necessary.

Pulmonary embolism are more frequent in winter, due to an increase in clotting related to winter infections, reduced physical activity and venous constriction caused by the cold.

Not to be confused with what?

Acute bronchitis, pericarditis (inflammation of the lining around the heart), asthma, myocardial infarction, pulmonary disease or infection of the gallbladder (cholecystitis) can simulate a pulmonary embolism.

Will it prevent a pulmonary embolism?


Yes. This is identical to that of the lower limb vein thrombosis.

Early up after surgery or childbirth, the active mobilization of the lower limbs, wearing stockings or compression socks; and prescription of heparin called "low molecular weight" (LMWH) in high-risk situations: bed rest, plaster, surgery.

In pul monaires recurrent embolism, it can be a filter in the inferior vena cava to prevent the rise of any clots from leg veins.

When to call the doctor?


Emergency after the occurrence of sudden unexplained like a stitch or stabbing chest pain; especially if it is accompanied by difficulty breathing, coughing and discomfort. But also occurs when an unexplained respiratory difficulty.

How to prepare the consultation?

Summarize his treatment, the events of recent weeks (phlebitis or circumstances conducive to phlebitis), provide medical and possibly his last book electrocardiogram.

What does the doctor facing a suspicion of pulmonary embolism?

It confirms the signs suggestive of pulmonary embolism and evaluates its general tolerance. He can do an electrocardiogram to add arguments to the diagnosis.

Hospitalization is required to confirm and treat pulmonary embolism. The electrocardiogram (ECG), chest radiograph, a study of blood gases, blood levels of certain markers ("D-dimer") and a Doppler ultrasound of the lower limbs are always facts.

Examinations have certainty as appropriate and availability: a lung scan, angio-CT, angiography (opacification of vessels) or transcardially ultrasound. Support resuscitation depends on the severity of the embolism.

Once the diagnosis is confirmed, it is possible to surgically remove a large clot or destroy thrombolysis. In all cases, the treated venous thromboembolic disease, causing embolism, by anti-coagulants (heparin) to effective dose. That pose a risk of bleeding, imposing strict controls and good patient compliance.

Due to the high risk of recurrence, anticoagulation was continued several months with venous contention, changing heparin by anti-vitamin K or a new class of anti-coagulant: the "anti-Xa" type or "anti-IIa." Prescription and monitoring is specialist business.

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Urinary calculi (kidney and bladder), Definition, Risks, Causes, Symptoms and signs, infection, prevention

Urinary calculi: Definition

Urinary calculi (or urolithiasis) are salt crystals that form in the urinary tract. Kidney, ureter (connecting the kidney to the bladder), the bladder or urethra (connecting the bladder urinary meatus) are involved in the formation of urinary stones.

The small stones are eliminated naturally but the biggest are responsible for pain when they can not be removed: we speak of renal colic.

Risks and health issues of urinary calculi

2-3% of the general population suffer from urolithiasis. Men are slightly more affected than women and the left kidney is more often affected than the right kidney.

In case of recurrence of the crisis, the risk is a breach of the kidney itself with decreased functioning (renal failure).

Causes of urinary calculi

Various types of computations are involved according to their composition. One distinguishes calculations related to the crystallization of calcium, uric acid or cystine.

A high protein diet promotes calculations; a low intake of drinks is causing concentrated urine conducive to the formation of stones. Similarly, certain blood disorders with excess calcium or uric acid promote urinary calculi.

Symptoms and signs of urinary calculi

Urinary calculi may be asymptomatic, form and eliminate naturally it comes to small stones. Otherwise, the symptoms are three in number.

Pain

The pain is the first symptom; this is called colic. The pain from the lower back (lumbar) and radiates to the external genitalia. The crisis is brutal and very violent.

Hematuria

The second symptom is the presence of blood in the urine or hematuria. In most cases, hematuria is not visible to the eye but detected by a urine dipstick or analysis. In case of large amount of blood, it can be noticed by the patient.

Urinary infection

Finally, a urinary tract infection can complicate the urinary calculi with burning on urination, more frequent urination and cloudy urine. Fever may occur and aggravate the table (prostatitis in men, acute pyelonephritis in both sexes).

With what should we be confused?

Lumbar pain should not be confused with a "back strain" or lumbago. It is therefore desirable to provide a urine dipstick test for the presence of blood, while signing the diagnosis of renal colic.
Similarly, a strong feeling and renal colic pain may be due to aneurysms of the abdominal aorta.

Will it possible prevention?

The lifestyle measures are fundamental and always recommended.
Beverage intake should be between 1.5 and 2 l l per day (increase in hot weather or sweating the normal color of urine should be colorless or pale yellow).
A balanced diet includes a sufficient intake of calcium (800 mg to 1 g) of animal protein in moderation and not too much salt.

Depending on the nature of the calculation, some guidance will be given specifically, such as limiting the use of chocolate in the case of oxalate or calcium limit if excessive inputs.

When you consult?

The pain is so in case of renal colic that consultation is needed urgently.
In case of fever or anuria (more urine), consultation is also needed urgently to avoid complications (kidney destruction, widespread infection ...).

What is the doctor?

The examination on the type of pain, its location and evolution (crisis ...) is suggestive of the diagnosis of urinary stones. Reactive dipstick dipped in urine, the firm, confirm the presence of blood and / or infection.

Then tests can directly visualize the calculations. This is urinary ultrasonography (hyperechoic images), radiography of the abdomen without preparation or ASP, of intravenous urography (IVU) and finally the scanner or abdominal CT scan. The scanner has the advantage of highlighting other causes of pain (differential diagnosis). Of urinalysis as Urine culture or urinalysis complete the balance sheet, and a blood test to check the concentration of calcium, uric acid and phosphorus as well as renal function.

Different therapeutic options are available, from simple monitoring to surgery through the extracorporeal lithotripsy to dissolve stones. Treatment by natural means also allow extraction or stone fragmentation through the urinary tract.

How to prepare my next visit?
When a single monitoring is recommended, the position calculation is controlled by ultrasound or radiography regularly (a few days to a month or more). Meanwhile, sufficient hydration is necessary.

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Hair Dandruff treatment, remedies, causes, tips solution

Origin of Hair Dandruff

As the skin, scalp renews itself continuously eliminating "dead" cell surface, or dander. This phenomenon is called flaking normally pass unnoticed.

When the elimination of these cells becomes more important, the scales are larger and thicker, clump together and become very visible, they remain attached to the hairline or fall on their shoulders.

Different types of films

Dry dandruff
Dry dandruff, sometimes called "tinea capitis simplex" (but unrelated to the fungus causing tinea versicolor), are small, white and falling "snow" on clothing. They are usually associated with a dry scalp.

Oily dandruff
Oily dandruff (or tinea steatoid) are larger, thicker, often yellowish. They occur on oily scalps with overproduction of sebum. Films agglomerate with excess sebum, to form a thick layer that sticks to the scalp and hairline.

Risks and consequences of hair dandruff

The presence of dandruff on the scalp, the accumulation of sebaceous secretions, lesions due to scratching, causing a "vicious" circle with inflammation that promotes superinfection with bacteria or fungi, and this increases superinfection dandruff .

Why were films in our hair?

When external aggression or internal disturbances irritate or dry out the scalp, it reacts by producing and eliminating more cells.

Local causes
Anything that irritates the scalp can cause dandruff: sweating, heat (sun exposure, use a hairdryer or repeated too high temperature), air conditioning or heating excessive exposure to dust laden atmospheres, coloring, poor hygiene of scalp, aggressive shampoos, often wearing caps, hats or "charlotte" gripping the hair in certain professions (medical or paramedical, food industry ... etc.).

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The poor condition

The scalp is very sensitive to hormonal changes during puberty, pregnancy, menopause or birth control pills, as well as poor diet, lack of sleep, active or passive smoking. Situations of anxiety or stress can cause dandruff.

Can you prevent dandruff?

The term hairy "leather" should not forget that it is almost as fragile as the skin and as such should not be attacked. Shampoos must rid the hair and scalp of impurities and accumulated sebum, but not excessive: products that dry the scalp, even if greasy hair, cause a reaction by increased sebum secretion.
We must not listen to the myth that recommends "not to wash your hair too not to attack the scalp" gentle shampoo more often, every 2 days for example, often used to control an easy dandruff.
Especially, shampoo should be rinsed and the hair dryer used at low temperatures.

With what should we not confuse dandruff?

It is easy to recognize films that should not however be confused with:
1- seborrheic dermatitis is an inflammatory disease of the skin and scalp; it is caused by hypersecretion of the sebaceous glands which encourages the development of a fungus that perpetuates and aggravates seborrheic dermatitis. Thick films are accompanied by red and oozing lesions of the scalp and often severe itching.
2- psoriasis is a skin disease causing dander in various parts of the body, including the scalp. The scales are thick and very limited. The existence of scaly lesions in other parts of the body (elbows, knees especially) helps make the diagnosis.

When to call your doctor?


When the films are very heavy or do not go away with dandruff shampoo. Or when the itching is hard to calm down, and very red scalp.

The doctor confirmed that it is dandruff and not psoriasis or seborrheic dermatitis. He is looking for the cause of dandruff and offers treatment tailored to the type of scalp.

Rebel films can motivate a dermatological consultation because it is sometimes difficult to distinguish between simple and seborrheic dermatitis dandruff: in this case, medicated shampoo containing ketoconazole or ciclopirox olamine issued only on prescription are helpful.

What is the action taken against dandruff?

Must refrain from seeking to eliminate dandruff by scraping or brushing the scalp vigorously.

The supply of dandruff shampoos is particularly rich: you choose a gentle dandruff shampoo, preferably with frequent use. If dry scalp shampoos course have "special dry hair", it seems preferable to use on oily scalp shampoo hair greasy or normal but not too dry. Do not completely eliminate the sebum that normally has a protective vis-à-vis the hair and scalp role.

Parallel is taken to a sleep pattern and a balanced diet.

Prescription shampoo or products to treat secondary infection by bacteria or fungus, or to reduce sebaceous hypersecretion is the responsibility of the physician.

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3 Health Tips to prevent Diabetes with your diet


KITCHEN - The type 2 diabetes is a chronic disease that affects 4%. To protect you, you can pay attention to your diet. Follow our advice.

Diabetes is a chronic disease that, affects 3 million people, or 4.6% of the population. Type 2 diabetes is the most common. It affects 2.5 million. These figures are also rising steadily between 1999 and 2016, the number of people treated for diabetes increase by 44%. This would increase to 38% due to the increase in obesity.

Obviously, "all overweight people are not diabetic," says dietician to MetroNews CHU Toulouse Jacqueline Delaunay. But environmental factors add to genetic factors. Result: "By practicing physical activity and paying attention to your diet, you limit the discovery of diabetes." Then follow the guide.

Avoid sugary foods, soda with chocolate bars

Rule number one: "Do not skip meals to avoid snacking." Because if you start to nibble, we know very well that you goinfrerez sugary snacks like chocolate bars or cakes, or swallow amount of soft drinks and syrups.

But there is nothing worse than the sugary liquids to high glycemic index "They tend to raise blood sugar, they require a response insulin largest fast and long sursollicitent the pancreas. " Not to mention that the consuming you will tend to gain weight.
preventing diabetes diet plan, best diet to prevent diabetes
Follow the 1/3 rule meat, 1/3 vegetable, 1/3 starch

For glucose rises slower, it calls less insulin and uses less strongly the mechanism of pancreatic prefer green vegetables, fiber, starch, in the form of whole grains and legumes, and pasta long as they are al dente. "A balanced plate, leading to a feeling of satiety, that is one third of meat, vegetables third, one third of starches."

For big eaters, here some tips: Play on the size of your plate, measure volumes with a spoon and cut your bread before the meal. If you eat more starchy foods, eat less bread - and vice versa. Another tip: Use your green vegetables in larger quantities to fill your plate.

Do not eat a fatty food per meal

It is also important to limit your intake of saturated fat. You have to choose between ham, cheese, sauce and fried. In the end, it is better not exceed a fatty food per meal. Avoid cream and butter and vary oils (sunflower, olive, rapeseed ...) to season your vegetables.

Attention oil and margarine, it's for flavor but in no case for cooking: "No need of additional fat Especially there are utensils that do not stick.". So Broil, bake or steam the en papillote. Please note, "it is not to be against traditional dishes." On the contrary, the dietician ordered to revisit stews , tagines , pot-au-feu and pho because they taste, with spices and herbs, and allow to eat vegetables. It remains to choose their pieces of meat and to involve the plain rice or steamed potatoes. Enjoy your meal!

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3 Health Advice to reduce the risk of Heart attack in women


INFARCTION
- Pain squeezed in the chest, jaw and arm, are the most common heart attack symptoms. But in women, coronary accidents occur with other signs. Follow the leader.

Infarction does not affect men between 50 and 60 years who smoke, do some exercise and are overweight. It is also a female disease: one in three women will die of cardiovascular disease. By comparison, a twenty-five succumb to breast cancer. And while cases of myocardial infarction have been declining in men, the reverse is true among women over 55 years. Follow our tips to recognize that cardiovascular accident.


Smoking and stress, know the risk factors

The risk factors are smoking, high blood pressure (and stress), cholesterol, obesity, physical inactivity and alcohol. As for the man. But they do not have the same effect on the arteries of the woman, told MetroNews Professor Claire Mounier-Vehier, first vice-president of the Federation of Cardiology (FC).

The reason is physiological. The arteries of women are thinner and tear more easily. In addition, five years after menopause, the protective effect of natural estrogen, allowing the arteries to be flexible, dilated and prevent clots, disappears. In parallel, the rate of triglycerides and bad cholesterol increase. Result: "The arteries thicken, stiffen and are dirty."

Stomach pain and shortness of breath, recognize the symptoms

Now that you know that myocardial also affects women, learn to recognize the symptoms . The most common is chest pain, the feeling of grip in the chest. But women also develop other symptoms such as stomach pain may suggest a gastric ulcer, vomiting, shortness of breath on exertion or palpitations. Well beware, they may also reflect cardiac risk.

Call 15 and follow a cardiac rehabilitation

What worries the vice-presidency of the (FC) is that women are "sitters." When one of them has symptoms of heart attack, it takes an hour longer than a man before calling the ambulance. But it is important to act quickly to unclog arteries and limit the extent of infarction. To do this, you'd better call the ambulance, which will take the patient directly to a cardiology department.

Another problem, "we must give them kicking butt so they follow a rehabilitation after stroke, whereas it reduces the risk of recurrence. " In fact, only one in ten women following rehabilitation. A glimmer of hope remains: "Women become informed vectors prevention among their friends and colleagues." Have a ball.

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Disease Ebola hemorrhagic fever or African

Up to date, the ebola virus was a half-dozen sources violent outbreaks especially in West Africa. - The Ebola virus was first identified in 1976 in Sudan as well as Nzara Yambuku northern Zaire. June November 1976, the Ebola virus infected 284 people in Sudan by 117 deaths. In Zaire, there were 318 cases with 280 deaths in October from September. An isolated case occurred Tandala in Zaire in 1977 and a second blaze broke out in Sudan in 1979.

- In 1989 and 1990, a filovirus named Ebola-Reston was isolated from macaque monkeys quarantined laboratories in Reston (Virginia), Alice (Texas) and Philadelphia (Pennsylvania) in the USA.
These monkeys all came quarantine export licenses dune near Manila in the Philippines where the virus was also isolated.

- A large epidemic occurred in Kikwit in Zaire in 1995, there were 315 infections including 244 deaths.

- An isolated case of Ebola hemorrhagic fever and epidemic among chimpanzees were also observed in Ivory Coast in 1994.

- In Gabon, the first outbreak of Ebola haemorrhagic fever virus was identified in 1994, other outbreaks were documented in February 1996 and July 1996.

- No infection with Ebola virus navait been reported until this epidemic quéclate Gulu in Uganda in the fall 2000.

In total, approximately 1,100 cases with 800 deaths have been identified since the discovery of the virus.
virology


The haemorrhagic fever viruses are divided into four families: The flaviridés the bunyaridés the Arenaviridae and Filoviridae which are the longest virus that we know.

Ebola belongs to the family of filoviridae, gender filoviruses which includes several different biotypes: the débola Zaire virus (called Mayinga), Ebola Sudan and Ebola Reston.

Ebola virus is an enveloped single-stranded RNA viruses (helical nucleocapsid) which is similar to the morphology of Marburg virus antigenic structure but differs.
It can measure up to 1500 nm long with a diameter of 80 nm.

Natural Reservoir

Primary human cases result from contamination from an animal reservoir and then the very high contagiousness of the disease is responsible for a large diffusion.
The natural reservoir of the Ebola virus seems to inhabit rainforests and dAfrique Dasie, but it has not yet been identified.

Related to Ebola filoviruses were isolated from cynomolgus monkeys (Macacca fascicularis) that had been imported from the Philippines to the United States of America in 1989. But the virus kills primates too quickly for them is a good tank .

Recent work by a team of CNRS Rennes in collaboration with the Institut Pasteur in Bangui, have uncovered sequences of the virus in different organs of 242 small mammals.

Transmission

After the accidental contamination of a first man, the virus is then transmitted from the body fluids of a patient in clinical phase through direct contact with blood, secretions, organs or semen infected (saliva, blood, urine, faeces of patients are rich in virus) or by contact with the aerosol, and vomit may be sweat. The ingestion of infectious materials is associated with a risk of infection and a high fatality rate. Potential transmission through sexual contact with a patient cured is not determined, but it was shown that the Ebola virus is found in the genital secretions of convalescents several weeks after illness. Contamination therefore has a strong family or nosocomial. - Family Transmission: In families, the two major risks patient care and funeral toilet. - Transmission caregivers: During epidemics, lack of hygiene, lack of sterilization of equipment and especially needles and syringes contaminated facilitated nosocomial transmission of the virus.

Airborne transmission has been particularly studied in the survey conducted in the families of 34 cases of Nzara in 1979. This survey showed no risk due to a simple cohabitation in the same room and a five times higher risk for people with physical contact due to patient care compared to those with only "family" contacts.

Clinical signs

Incubation time: 2 to 21 days - 5 to 12 days in most cases.
Duration of illness: from 6 to 10 days in fatal forms.

Ebola hemorrhagic fever occurs in most patients within a few days after infection by a sudden rise in temperature, with fatigue, muscle pain, headache, and diarrhea.
Some patients may show sore throat, hiccups, rash, vomiting blood and bloody diarrhea (called "red diarrhea" in Francophone Africa). Other symptoms may occur: conjunctivitis injected dysphagia.

The patient is extremely asthenic quickly and has a significant weight loss, due to both the lack of nutrition of this weakness in the absence of food and the disease itself.

Followed by vomiting, diarrhea, maculopapular rash, kidney and liver damage and bleeding diathesis; liver damage, pancreatic, kidney, and to a much lesser extent, of the CNS and of the heart; leukopenia, thrombocytopenia and elevated transaminases.

Fever, often undulating in the early days, may disappear in the terminal phase.

Death is preceded by the appearance of tachypnea, hypotension, tachycardia, and anuria. The limited data available do not show pulmonary explaining tachypnea, and blood loss due to hemorrhage is still too low to explain the hypotension.

Diagnosis

The diagnosis is difficult because précoses symptoms such as red eyes and itchy eyes are nonspecific. If someone shows symptoms mentioned above and the Ebola virus infection is suspected, several laboratory tests are to be made (ELISA, virus isolation).

"Lhospitalisation of isolation with appropriate measures, including during transport, SimPose to viral haemorrhagic fever clinical suspicion: recent fever quickly create an accompanying rash (4-5 th day) and hemorrhagic signs superficial and visceral (6-7 th day) an epidemic quickly taking shape step by step in the population. "(therapeutic protocol support for victims, record No. 6" Agents of viral haemorrhagic fevers ").

The fatality rate is between 50 and 90%. Most often, death is caused by a cerebral embolism (stroke).

Processing


There is no specific treatment or vaccine. There is no serotherapy.

Severe cases are placed in the intensive care unit: these patients are dehydrated and need to be placed on a drip for rehydration.

Maintain kidney function Treatment aims and electrolyte balance and combat hemorrhage and shock. Replacement of coagulation factors and platelets can be useful.

For patients who survive, recovery is accompanied by intense fatigue and arthralgia migrants often affecting large joints.

Prevention and safety

Suspected cases should be isolated from other patients and caregivers should operate under conditions of high security. Hospital staff should wear gowns, gloves and masks individual. Gloves and masks should not be reused unless they have been disinfected. Very important for certain actions such as the installation of an infusion risk, handling of blood and secretions, catheters and suction devices, which must be carried out in conditions of high security. The dead must be buried or cremated quickly.

Conclusion

Viruses such as Ebola existed for millions of years, long before the appearance of man. They can not live in free society and they rarely come out of their tank because they do not have the ability to easily colonize new host species.

Meet other species is an accident that does not result in the long term sustainability of the virus into a new species.

Low risk to the human population except where the possibility of coexisting primary contamination, poor hygiene and social structures disrupted.

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