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Herniated Disc Definition, Causes and mechanisms, Symptoms and signs


Definition of herniated disc

The herniated disc is an anatomical mechanism. Herniated disk in fact corresponds to the output of the disc located between the vertebrae of the spine.

Protruding outside its casing, the disc can compress the nerve roots and trigger eg vector sciatica. Thus, the herniated disc is often less known than its main symptom of sciatica.

All regions of the back can be involved, but the lumbar region (lower back) is widely the most affected.

Origins of herniated disks

Disc herniation is common in young subjects between 30 and 40 years.

Some postures like sitting position (drivers ...) or carrying heavy loads (snap-action, wrong move ...) favor herniated discs.

The age or trauma also accelerate aging of the disc and hernia.
Some risk factors are also identified to promote herniated disc: This is overweight and pregnancy. Genetic predisposition may also exist in some families; herniated discs while generally occur earlier than in the general population.

Causes and mechanisms of a herniated disc

The spine or vertebral spine is formed of a stack of vertebrae separated by intervertebral discs.

In case of overweight, improper movement or simply degeneration, this gelatinous disc can deform and break its protective bag. It then projects and forms the herniated disc.

A herniated disc can be asymptomatic if it compresses any nerve.
On the contrary, it can cause inflammation and pain if it compresses certain nerve roots (sciatica or femoral).

Symptoms and signs of a herniated disc
A herniated disc can long remain asymptomatic and cause no discomfort. In favor of a motion or time, it may be in pain, simple backache to the paralyzing sciatica.

These symptoms can appear suddenly and disappear or persist chronically.
Some triggers are often found, such as coughing, laughing or sneezing by increased abdominal pressure or forward leaning position.

The most common disc herniations are located in the lower back, with back pain and leg. The simple "back pain" is called low back pain, while pain that goes down the leg below the knee and is called sciatica or femoral neuralgia according to the compressed nerve root.

The sciatica associates for its pain with lumbar spine pain (irradiation) in a leg.

Herniated discs are possible in the cervical spine (neck area) and then cause arm pain spreading to the fingers.

With what should we be confused herniated discs?
It initially not confuse the word "hiatal hernia" and "herniated disc".

Hiatal hernia is a digestive disease which corresponds to the passage of a portion of the stomach above the diaphragm.

Furthermore, the pains of sciatica or back pain should not be confused with pain caused by another disease such as renal colic. Renal colic (kidney stones) also causes pain starting from the lower back and radiating to the front (towards the external genitalia).

Conducting a dipstick (or urinalysis) will usually very quickly diagnosis.

Will it possible to prevent slipped discs?
Simple lifestyle tips to prevent or limit the consequences of a protrusion or herniated disc.

This is to exercise regularly, to warm up before starting an effort to maintain and ensure a satisfactory abdominal and dorsal (support the spine).

Overweight should be avoided as much as possible by a balanced diet.
Gestures and postures are fundamental steps of prevention:

straight back, straight look, squat by bending the knees to lift a load, rest periods to stretch and stretch when sitting, straight-backed chairs and if possible swivel to avoid torsion.

The backpacks port is preferred to handbags and high heels (above 5 cm) are not recommended.


In addition to these tips and if proven herniated disc, you should not look too far forward or to make efforts (charging port ...).

Some simple exercises improve symptoms (on the back, bring knees to chest ...): consult your doctor.

Weight loss will also be beneficial.

When to consult?
In case of pain in the back or sciatic pain, signs must be warning signs and motivate emergency consultation.

This is the loss of strength (motor deficit) in one leg or paralysis (inability to take off the foot), difficulty urinating or bowel movement or otherwise of incontinence.
This is called medical emergencies which can sometimes require surgery to decompress the nerve roots crushed by the herniated disk.
Similarly, the unbearable pain despite treatment constitutes an emergency.

What is the doctor?
The doctor looks for certain signs suggestive of the original disc pain: increased cough, pain in the leg elevation (Lasegue), pain in the leg pressure between two vertebrae ...

The examination will specify the triggering circumstances (effort, wrong moves ...) and a complete neurological examination eliminate paralysis or complication.


Additional tests such as radiography of the spine or lumbar spine CT (or a magnetic resonance imaging or MRI) may be prescribed and confirm the presence of disc herniation (conflict between the disc and the nerve root). They are not systematic in front of a classic sciatica.

Treatment aims to relieve pain by non-steroidal anti-inflammatory drugs, drugs against pain and muscle relaxants. The local injection of anti-inflammatory corticosteroid is also possible in case of failure of the first treatment.

Strict bed rest is usually offered for one or two days maximum, as it promotes muscle weakening back.

The prescription of physical therapy is also beneficial, especially to prevent recurrences.
Lumbar restraint belts are useful and help to keep activity during treatment.
Radical treatment is offered in second-line in case of failure of medical treatment. Two techniques are possible: surgically remove the disc or dissolve.

How to prepare my next appointment?
It is desirable to distinguish circumstances or movements that trigger pain. In fact, your doctor or physical therapist can offer the amenities of position or posture.

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

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Viral Hepatitis Definition, Causes and symptoms, treatment, diagnosis

Definition of viral hepatitis

Viral hepatitis is an infection that mainly affects the liver and causing inflammatory lesions.

Six viruses cause hepatitis: viruses A, B, C, D, E and G. There is talk of hepatitis "acute" during the invasion phase of the organism by the virus; we speak of "chronic" hepatitis as the disease persists beyond six months after infection. Hepatitis B, C and D can become chronic hepatitis, which makes dangerousness.

Risks and health challenges of viral hepatitis

The three most common viral hepatitis are Hepatitis A, B and C. Hepatitis A is usually mild and heal in 10 to 15 days. However, hepatitis B and C are more serious as they can become chronic and develop into cirrhosis and liver cancer.
280,000 people (0.65% of the adult population) are chronic carriers of hepatitis B. For hepatitis C, 180 million people are infected with the virus worldwide, of which 500 000 a 650 000.

Causes and Symptoms of viral hepatitis

Hepatitis is transmitted by viruses. The hepatitis A virus (HAV) is transmitted through the digestive tract (fecal-oral) and primarily affects young adult or child. It is eliminated by the stool and do not persist chronically in the body.
Viral hepatitis B is consecutive in turn to infection by the hepatitis B virus (HBV); its transmission is through contact with bodily fluids of infected persons (unprotected sex, prick or cut with blood transmission during pregnancy ...).

The infection heals spontaneously in most cases but can sometimes remain in the body: People are then carry the virus without showing symptoms, while others have a progressive chronic hepatitis.

The Hepatitis C virus (HCV) is transmitted by blood, primarily by use of intravenous drugs. Spontaneous cure of hepatitis C is rare (20% of cases) and the infection becomes chronic in most patients.

How manifest viral hepatitis?

Acute hepatitis manifested by symptoms that are common to all hepatitis. They may first be asymptomatic; their diagnosis will be made after the event on serology. Otherwise fatigue, nausea, abdominal pain (under the right ribs in the liver) dominate. The appearance of dark urine and jaundice are characteristic of hepatitis. Very severe cases may even lead to liver transplant exist: it is fulminant hepatitis with rapid destruction of the liver.
In hepatitis A, the illness resolves spontaneously without the risk of chronicity. In hepatitis B and C, the change can be made ​​to chronicity that will be diagnosed by blood tests. Cirrhosis and liver cancer are then two formidable complications.

With what should we be confused?

It initially be confused hepatitis viruses among themselves. Hepatitis A is a mild disease which does not have the risk of becoming chronic.
All hepatitis are not infectious and viral; certain liver injury has a drug issue, alcoholic or immune.
Finally, it should not be confused jaundice and hepatitis. Jaundice reflects the poor liver function. Other diseases are responsible as gallstones, Gilbert's disease (hereditary anomaly) or anemia.

Will it possible prevention?

Prevention is essential and differs between the relevant virus.
For hepatitis A, it is based primarily on hygiene: hand washing, food washing, not sharing cutlery and utensils ... A vaccination is recommended for the traveler who had no history of hepatitis A (unimmunized) and traveling in heavily contaminated areas.

For hepatitis B, the preventive measures are many. The condom use is essential during sex with a partner or unknown HIV status; gloves for health professionals is essential. Screening for hepatitis B is also mandatory in case of pregnancy or when giving blood.
Vaccination is widely proposed, for professional or non-professional. Only a history of neurological disease like multiple sclerosis indicate that vaccination-against.

Hepatitis C finally the sharing of injection equipment among drug users is prohibited. The posttransfusionnelles contamination have now become exceptional because all blood donations are screened and treated.

When to consult?


Any fatigue, jaundice or unexplained persistent symptoms should motivate a medical consultation to make a diagnosis. Some forms of hepatitis may represent genuine emergencies: the liver is destroyed and can not perform its functions. Coagulation disorders and impaired consciousness (encephalopathy) lead to death within hours if no treatment is established.
Screening for hepatitis B and C, even in the absence of symptoms, is in any way significant.

What is the doctor?

The doctor can only suspect hepatitis. It will look for arguments in favor of a mode of transmission (drug use, sex ...) The clinical examination is not specific for hepatitis. In case of abdominal pain, palpation find a pain in the right upper quadrant abdomen; haemorrhagic signs are detected and are a sign of seriousness.

The diagnosis is often made ​​after a blood test reveals elevated liver enzymes, transaminases (up to 20 to 40 times normal). Coagulation is also tested and can be collapsed in severe hepatitis. The key consideration is the serology of hepatitis. Antibodies against viruses A, B and C are most often requested. These antibodies require a delay before they appear; several blood tests are sometimes necessary.

In cases of hepatitis A, no further action is usually required. However, in the case of hepatitis B or C, regular blood tests or examinations as the liver biopsy will be proposed to ensure that hepatitis does not become chronic and active. In this case, the treatments involved in interferon as antiviral for example.

How to prepare my next appointment?

Even in the absence of symptoms after acute hepatitis B or C, it is essential to respect the prescribed blood tests. Only early detection and treatment will prevent the dreaded complications.

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Toxic Hepatitis definition, treatment, diagnosis, diet, recovery, symptoms, causes


Definition of toxic hepatitis

Toxic hepatitis, like all hepatitis, means any inflammatory disease of the liver. Toxic hepatitis is related to drugs, alcohol consumption or toxic products or food (plants, mushrooms ...). Some exposure to solvents or other substances may occur in the workplace and also cause acute or chronic hepatitis of toxic origin.
Hepatitis toxic, such as viral hepatitis can progress to fulminant form and death.

Risks and challenges of toxic hepatitis

Alcohol is the # 1 cause of toxic hepatitis. One of the most common causes also toxic hepatitis is drug-induced hepatitis with about 1,000 drugs known to be potentially hepatotoxic. The toxicity depends on several factors such as genetics, diet, age ... Certain medications are only revealed toxic to the liver after they are placed on the market; some have been withdrawn due to the frequency and severity of this side effect.

Toxic hepatitis occurring in the workplace are part of the framework of occupational diseases; the most dangerous products have been replaced by less toxic products. However, vigilance is needed to reintroduce new substances.

Causes and Symptoms of toxic hepatitis

Whatever the mechanism involved, severe hepatitis can lead to liver destruction and unless liver transplantation, death.
The product absorbed, inhaled or ingested, can be toxic by itself or its metabolites in the body after conversion. Moreover, some products can cause hepatitis in an individual and not in another, we speak of interindividual variability.
Among the implicated drugs include acetaminophen, which can cause injury from 6-8 g that can become irreversible or death beyond 12 g.
Alongside these drug-induced hepatitis, toxic hepatitis related to fungi like Amanita phalloides. This releases a poisonous mushroom liver damage toxin responsible; its mortality is 15%.

How manifest toxic hepatitis?
Acute hepatitis, toxic or not, manifested by nonspecific symptoms of the cause, but may first be asymptomatic. Otherwise, fatigue, nausea, abdominal pain (under the right ribs in the liver) dominate. The appearance of dark urine and jaundice is characteristic of hepatitis. Very severe cases may even lead to liver transplant exist: it is fulminant hepatitis with rapid destruction of the liver.

Unlike viral hepatitis there are no signs of infection, and toxic cause is strongly suspected in the concomitant symptoms with the consumption of a drug or a fungus. The time to onset of symptoms is also variable: a few hours for fungi up to several days for toxic drugs or other.

Phalloïdien The syndrome is characteristic of poisoning by mushrooms (Amanita phalloides, Amanita Verna, Amanita virosa ...). Symptoms include diarrhea and dehydration in benign forms and an array of sometimes severe acute hepatitis with confusion, bleeding ...

With what should we be confused?

Toxic hepatitis should not be confused with viral hepatitis, which are viral infections. In addition, any symptoms occur after taking the drug or fungus is not synonymous with hepatitis. Allergies, gastroenteritis or simple mundane intoxications are fortunately more common than liver disease. The doctor will make a difference in particular based on blood tests.

Will it possible prevention?

Toxic hepatitis is associated with exposure to a toxic, the best prevention is the non-exposure to this toxic. The alcoholic abstinence is therefore essential; at least, consumption should be moderate.

Strict adherence to drug regimens can prevent drug-induced hepatitis dose-dependent.

For mushrooms, it is better not to consume those collected without being sure of their safety. Your pharmacist can help you in this regard, provided picking mushrooms in their entirety (foot base). Avoid storing them in plastic bags (rotting), separate the poisonous mushroom species that does not come contaminate edible, eat in moderation and any uncertainty, do not consume.

When to consult?


If symptoms following ingestion of mushrooms, it is imperative to consult quickly. Life support measures are sometimes necessary. Similarly, in case of accidental or intentional overdose drug, call the SAMU Centre 15, itself interconnected with the Poison Control Center, is imperative.

What is the doctor?

Besides the usual clinical examination and screening for signs of gravity requiring immediate hospitalization, the doctor will try to reconstruct the history of the disease symptoms to relate to taking medication or exposure to toxic (taking of alcohol for example). For this, the questioning is fundamental, the temporal relationship between the onset of signs and also taken.

Blood samples are generally prescribed to confirm hepatitis (transaminase elevation), judge its severity (impact on coagulation in particular) and rule out other causes, particularly for viral serology.

The first therapeutic measure is of course to stop taking the medication or exposure to toxic. Then symptomatic measures up to resuscitation will be taken. The monitoring is based on control of liver function and coagulation; sometimes the liver damage is such that only a liver transplant patient saves it.

How to prepare my next appointment?

The examination is an important step in diagnosis. Try to remember the absorbed drugs, plants or consumed mushrooms and potential contact with toxic in the last six months before the symptoms. This will help your doctor; well, tell her if others around you, family or professional, have the same problems.

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Hemorrhoids Definition, Risks, Symptoms, Signs and Prevention?


Definition of hemorrhoids

Hemorrhoids (or hemorrhoidal disease) are anal conditions related to dilated veins in (called internal hemorrhoids) or around the anus (called external hemorrhoids).

The expression "having hemorrhoids" is a misnomer since everyone has anatomically hemorrhoids; in case of symptoms, we should speak of "hemorrhoidal crisis." Internal hemorrhoids (deep part of the anus) are purple and are not visible; you need a device (anoscope) to see.

Risks and health issues hemorrhoids

Hemorrhoidal disease is a common condition in adults (one in two people in life), responsible for a large number of medical consultations. The frequency is the same for both sexes, but men seem to complain earlier. This frequency increases with age with a maximum after 70 years. Some risk factors have been identified but remain controversial: alcohol, coffee, obesity ...

Causes and mechanisms of hémarroïdes

Hemorrhoids are vessels normally present at the anus. Anatomically, there are external hemorrhoids and the internal hemorrhoids, deeper.

The cause of the haemorrhoidal expansion is still unclear. Hemorrhoids often appear to support an increase in abdominal pressure (constipation ...) which interferes with venous return and lead to venous dilatation. In fact, several factors are probably involved as a relaxation of the supporting tissues related to age and / or encouraging terrain.

Symptoms and signs of hemorrhoids

The output of hemorrhoids outside the anus causes symptoms of discomfort, itching, pain and bleeding rectal called. Such bleeding are related to the erosion hemorrhoidal packets; blood is red, occurring at the end of defecation (he tries toilet paper, splashes bowl ...).

A possible complication is the local formation of a clot causing an external hemorrhoidal thrombosis most often. One then notes a bluish swelling with a more or less intense pain until elimination of the blood clot.
The other complication is related to the loss of blood and iron, which can in extreme cases lead to an iron deficiency anemia (iron deficiency).

With what should we be confused?

Rectal bleeding should not always be attributed to hemorrhoids. Other diseases such as tumors must be removed first before bleeding.

Moreover, anal fissure, ulceration thermometer, inflammatory bowel disease (colitis, proctitis ...) can also give bleeding and pain. Their treatments are specific.

Will it possible prevention?

There are no preventive measures to avoid completely the hemorrhoidal attacks. Local hygiene, without excess, and physical activity to fight against physical inactivity are recommended.

The fight against constipation is an axis of treatment with use of mucilage and / or increasing the daily intake of dietary fiber. Foods to eat are whole wheat bread, fresh fruits and vegetables, legumes (lentils, split peas), grains (oats, bran, wheat).

Alcohol and spices are good contributing factors as well as prolonged sitting: When is prone to hemorrhoids, it is best to avoid them.

The ointment application can also relieve symptoms.

When to consult?

The occurrence of bleeding from the anus should lead to a medical consultation urgently to eliminate gastrointestinal bleeding and / or tumor. If necessary, an exploration through a colonoscopy will list possible causes and to take samples.

What is the doctor?

The doctor makes the diagnosis by questioning and clinical examination. The latter includes an examination of the anus and, if possible, a digital rectal examination.

The doctor may refer you to a specialist colleague (proctologist, gastroenterologist) for additional tests: Anoscopy explores the anus, proctosigmoidoscopy back in the digestive tract (rectum, sigmoid) and colonoscopy shows almost full. A blood test may help verify the absence of anemia.

The proposed treatments for hemorrhoids are of three types: medical, surgical and instrumental. The effectiveness of drugs is controversial veinotonic; correction of bowel dysfunction (fight against constipation or diarrhea), however, is unanimously recognized.

The drugs against pain (analgesics) are effective on pain of internal and external hemorrhoidal thrombosis, as well as nonsteroidal anti-inflammatory.

Instrumental techniques (coagulation) are reserved for surgical or medical treatment failures.
If thrombosis, incision under local anesthesia relieves symptoms.

How to prepare my next appointment?

Identify triggers or relieve seizures allows to establish appropriate therapeutic strategies. Furthermore, hemorrhoids can manifest as prolapse (externalization) Intermittent: note the frequency of prolapse.

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Hemochromatosis type 1 Definition, Signs & Symptoms, health issues, Prevention, Causes and mechanisms


Definition of hemochromatosis

The type 1 hemochromatosis is an iron overload in the body by increasing the intestinal absorption of dietary iron. It is an autosomal recessive genetic disease, by mutation of the HFE gene that regulates the digestive transfer of dietary iron.

It is often misunderstood and is revealed mostly belatedly after 40 years first in men. In women, menstruation (menses) limit the expression of the disease until menopause.

It is not present in the black African populations nor the populations of Southeast Asia; but that can change with the global mixing.

Symptoms and health issues of hemochromatosis

The frequency of the disease is estimated in Western and Northern Europe to a patient for 200 or 300 people; it's a lot and uncertain because most patients are unaware that they are achieved. The figures are hypothetical, because of late diagnosis, or not at all when the expression of the disease is low.


However the length and quality of life of untreated patients is reduced because of:


Involvement of the liver first

- Cirrhosis, which can lead to cancer, especially if there are risk co-factors (chronic hepatitis B or C, chronic alcoholism ...)


The achievement of the pancreas in addition to the liver

- Diabetes increased by the usual risk factors (dietary imbalance, physical inactivity)


Involvement of the heart

- Heart failure and arrhythmias


The achievement of the sex glands

- Subfertility and sexual dysfunction (impotence)


The achievement of the skin

- The skin complexion is a metal "bronze" grayish.


Joint involvement

- These disorders are early and often related to its true cause, the source of pain and disability in everyday life.

Causes and mechanisms of hemochromatosis

This autosomal recessive hereditary disease is almost always caused by a mutation of the HFE gene, which produces hepcidin, a hormone regulating the digestive absorption of iron.


A so-called C282Y mutation affects almost 100% of cases and 70 to 95% of European patients. Obvious patients are usually carrying a double mutation C282Y: 6 came on the chromosome of their father and on chromosome 6 came from their mother. They are called homozygous for the mutation.
Holders of a single mutation in one of their two chromosomes 6 are called heterozygous; they have little or no suffering, so even less often diagnosed.

Penetrance of the mutation (expression) is very variable, so its gravity; severe cases are rare in practice.
But as the mutation is common in the general population (5 to 10% of heterozygous mutations), the risk that a man and a woman have children together with is great.

Normally, only 5 to 10% of dietary iron is absorbed from the gastrointestinal tract, or 1 mg / day roughly corresponding to the daily losses (one liter of blood contains 500 mg of iron). Hepcidin limits this iron entrance.

In his absence, the absorption increases freely. Among adolescent women, the menstrual blood flow more or less correct this increase in gastrointestinal absorption. This correction disappears at menopause.

What are the signs of the disease?

The accumulation of iron in the body first saturates the liver which is the natural reserve of iron, then the pancreas.

Iron deposits in joints cause chronic pain.

The muscles are in turn achieved, including the heart muscle. This explains heart failure and chronic fatigue hemochromatosis.

Unfortunately for them, in the absence of correct diagnosis on their prescribed iron and vitamins, including vitamin C, to "get back"; or vitamin C increases the absorption of iron, which is itself in excess. Therefore aggravates poisoning wanting to do well.


One cause paradoxical and known as hemochromatosis is iron supplementation in anemic or blood transfusions from undiagnosed patients.

The disease is labeled in four stages of increasing severity: I, II, III and IV, as the importance of achieving organs: liver, pancreas, heart, sex glands, muscles, joints ...

    In Stage 1, shows no sign of disease, even blood tests are normal. This is the stage of young patients before 15-20 years. Women do not express the disease or rarely before menopause.
    In stage II, the disease is still not visible but the blood abnormalities are present from 20 years. One of the first signs is the painful joint handshake.
    In stage III, blood abnormalities are revealed during a balance sheet to the signs of the disease appear around age 30 in men later in women:
    asthenia (fatigue) chronic joint pain and inflammation, liver cirrhosis, heart disease or sexual dysfunction (impotence).
    Stage IV is the stage where the achievement of various organs is clear and irreversible, usually after 40 years later in women.

With what should we be confused?


    Rheumatic fever as gout or chondrocalcinosis; especially as the joint symptoms of hemochromatosis occur more around 40 years and think rather to the "joint aging" as a former chronic disease.
    The liver damage from alcohol or viral hepatitis may unduly disrupt explorations when the doctor is satisfied with this explanation. Or there may be excessive alcohol and hemochromatosis, given its frequency in the population.
    Take diabetes for hemochromatosis for general overhead while diabetes is an iron overload.

Will it possible prevention of type 1 hemochromatosis?


Because of the frequency of this genetic disease in the population, routine screening is feasible in the population, at birth or later after 40 years when the disease clearly revealed. However, this option was not chosen until now.

It is therefore the opportunity during a family survey around a diagnosed cases.
In heterozygous people, almost not affected, dietary advice may be sufficient to scarce bloodletting.

When to see the doctor?

In case of permanent fatigue and joint pain, and whenever we know or doubt of a close family member that would be achieved.
It is important to make the diagnosis early because the treatment is not effective when the organs are damaged, that is to say, in stage III and IV.

What does the doctor?

It conducts a complete physical examination, seeking joint damage characteristic of hands and liver and heart damage, which are the most urgent to know.

A battery of tests done things in perspective. But only two tests are needed to diagnose the disease in a non-inflammatory context:

    the transferrin saturation, if hemochromatosis is the early stage (I)
    and ferritin levels in the blood (serum ferritin) if the disease is already later stage (II, III or IV).

The definitive diagnosis is made ​​by genotyping the patient and the review of the HFE gene mutation involved. If he confirms the genetic disease, we proceed to a family survey (first degree relatives) with the patient's consent, to know the mutation carriers and provide support after full assessment.

For parents waiting for a child, genotyping of the parents figure the risk of transmission to the child.

Treatment is by regular bloodletting: every three months at least, every week if needed in the beginning. Possibly one resorts to iron chelators to quickly reduce intoxication.

This treatment is only effective before achieving proven organs, particularly the liver cirrhosis. Hence the importance of family to detect treatable patients inquiry quickly and avoid complications.

How to prepare the medical consultation?

By collecting family data to rule out or talk hemochromatosis, on one hand, and blood tests over time if we kept them.

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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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