The Health Blog
Welcome to our look into the world health.
Archive for March 12th, 2009
What is a carrier?
The body’s immune system doesn’t always completely eliminate HBV: 5 per cent of infected adults still carry the virus in their blood six months after they first became ill, even though all symptoms have cleared up. These people are called hepatitis В carriers, and can pass on the infection to others. Half of them will get rid of the virus and become non-infectious over the next two years. The rest remain infected (and infectious) and are at risk of developing complications such as chronic liver disease, cirrhosis and cancer of the liver later in life. A person may become a carrier without having developed symptoms after becoming infected.
How common is hepatitis B?
It is estimated that, worldwide, there are around 300 million carriers of HBV. It is mainly the carriers, especially those who don’t know they’ve ever been infected, who keep spreading hepatitis B. The number of people infected by HBV varies in different parts of the world. The prevalence of hepatitis В also varies between different population groups within a country. In Australia, chronic carriers of the infection are most commonly found among homosexual men, intravenous drug users, Aborigines and migrants from Southeast Asia.
How is hepatitis В diagnosed?
Present and past infection and the carrier state can be diagnosed by a simple blood test that may be performed on request by any doctor, public hospital or sexual health clinic for anyone who thinks they may have ever been at risk.
If you develop jaundice and the other typical symptoms of hepatitis, you will be offered a test for hepatitis В along with other blood tests to try to find the cause of the symptoms and to see how much your liver function has been disturbed. You’ll be advised to have further blood tests after the jaundice has faded and until liver function is normal again, and, if your hepatitis is caused by HBV, to see whether you’ve become immune or a carrier.
The blood tests are very reliable. The diagnosis is only likely to be missed if hepatitis В causes mild symptoms or none.
How can hepatitis В be prevented? Spread can be prevented by avoiding contact with body fluids of infected persons or carriers, particularly blood and sexual secretions. Good hygiene and staying with one sexual partner make wise precautions.
Sexual and other close contacts of people with hepatitis В should ask their doctor whether they need a vaccination for post-exposure or for permanent immunity.
If babies are exposed to HBV at birth, treatment can be given to help prevent them from becoming carriers.
Hepatitis В vaccination
Vaccination to give permanent immunity against hepatitis В is now available: three injections, two a month apart and the third six months later. It is advisable for all sexual and close contacts of carriers and for sex workers, health workers and others at risk of contact with other people’s body fluids.
*313/31/5*
read comments (0)
To understand incontinence we must know something of the normal control of urination. The bladder is a muscular t that drains to the outside through the urethra. Urine produced by the kidneys flows through the ureters into the bladder, where it is stored. Urine only escapes when pressure inside the bladder is greater than the pressure that keeps the urethra closed. Most of the time the urethra is compressed and kept closed by its sphincter and the pelvic-floor muscles that support it. A sphincter is a muscular cuff that acts like a rubber band or valve when it’s contracted to close off the tubular organ it surrounds.
When the amount of urine in the bladder reaches about 400 ml (though the amount varies from person to person and in certain circumstances), its muscle wall begins to stretch. Nerve endings in the muscle tell you that your bladder’s full and you feel the urge to pass urine. In childhood you slowly learn to consciously control this urge until it’s convenient to urinate. When you feel you want to go but must wait a while, your sphincter muscle and the pelvic-floor muscles tighten their hold around the urethra to help you hold on.
When you decide that it’s the right time to empty your bladder (which is usually when you’re seated on the toilet), you consciously release control and a series of muscle activities begins:
• the muscles that keep the urethra closed relax
• the muscles in the bladder wall contract so that urine is pushed out through the urethra
The most common causes of incontinence in women are things that upset the balance or strength of the muscles that keep the bladder outlet closed, and the muscles that cause the bladder to empty. The two types that commonly affect women are stress incontinence and urge incontinence, or a combination of both.
Incontinence can also result from anything that affects the nerves controlling urination such as spinal injury and some other nerve disorders such as strokes, multiple sclerosis and Parkinson’s disease.
Myra’s story
Myra is 55 years of age. During a recent routine checkup, she mentioned that she had put on more weight than she liked since her menopause at the age of 51 years. ‘I suppose it’s because I’ve had to give up my tennis,’ she said. Knowing that she was a good player who really enjoyed a game with her friends, I asked ‘Why?’. ‘Oh, bladder problems,’ replied Myra, blushing. ‘I’ve had a bit of a weakness for ages, but until I was about 50 I could control it pretty well. In the last few years it’s really got the better of me. Now, every time I serve or run for a return, I wet my pants. It’s so embarrassing. I’ve heard about the operations but I’d prefer not to have surgery, so I guess I’ll just have to put up with it.’
Myra’s story is like that of many women who suffer some pelvic-floor damage during childbirth but don’t develop troublesome symptoms until after the menopause. If she had been doing pelvic-floor exercises since her first baby was born, it’s unlikely that she’d have had these problems. She commenced pelvic-floor exercises the next day and decided to start hormone replacement therapy. Three months later she was playing tennis twice each week without fear of accidents, and had lost 4 kg.
*284/31/5*
WOMEN’S BODIES: HIRSUTISM: TYPES AND CAUSE
Author: admin
There are two types: ’simple’ hirsutism and hirsutism with virilisation (obvious evidence of masculinisation).
‘Simple’ hirsutism
This is growth of varying amounts of terminal hair on ‘male’ sites in women who] have no other signs of masculinisation. One or many sites may be affected, beginning around puberty.
Why does simple hirsutism occur in some women and not in others if all women produce some male hormones after puberty? Many factors may be responsible, including how much male hormone is produced, how it is circulated and used in the body, and increased sensitivity to androgens of the hair follicles id the sites affected. All of these factors ten to be controlled by our genes, which explains why the tendency to simple hirsutism runs in some families and races. It is
common in southern Mediterranean and Middle Eastern women, variable in Caucasians and rare in Asian women.
Hirsutism with virilisation
This is always associated with an excess of male hormones. The onset may be before (rarely), during or after puberty. Male-pattern hair growth is usually much more pronounced than in simple hirsutism (but a diamond-shaped or ‘male’ pattern of pubic hair growth is normal for many women and is not regarded as a sign of virilisation). Other symptoms and signs of virilisation include missed or scanty periods, subfertility, acne, deepening of the voice, altered body shape and increased masculinity, shrinkage of the breasts, male-type baldness and an enlarged clitoris. The excess hormone may come from overactivity or hormone-producing tumours of the ovaries, adrenal glands or pituitary gland, or from drugs (mainly anabolic steroids and the anticonvulsant phenytoin; less commonly synthetic progestogens with masculinising properties; rarely corticosteroids).
After the menopause some women gradually develop hirsutism with features of virilisation. This happens because the body continues to make androgens but these are no longer counteracted by oestrogens from the ovary. The unopposed Meet of even small amounts of androgens may have a masculinising effect.
Finding the cause
It’s important for any woman worried by hirsutism to see a doctor, first, to rule out the possibility of excess androgen production or drug-induced hirsutism and, second, because medical treatment can also help simple hirsutism.
Your doctor will want to know when the condition was first noticed, how rapidly it developed, your family history, if you are on medication, your menstrual history, and of any other health disorders. The physical examination will include looking for signs of virilisation, a general examination, and a pelvic examination to look for abnormalities of the ovaries. A blood sample for measuring hormone levels is usually taken. A common cause of hirsutism with or without virilisation is polycystic ovaries; therefore pelvic ultrasound examination may be suggested at this stage. If there is any evidence of increased androgens, you’ll probably be referred to an endocrinologist (specialist in hormone disorders) or gynaecologist for further investigations and treatment.
*255/31/5*
WOMEN’S BODIES: PREMENSTRUAL SYNDROME (PMS)
Author: admin
The premenstrual syndrome describes a wide range of symptoms that trouble some women from one to ten days before menstruation. The symptoms vary from woman to woman and also in the same woman from one cycle to the next.
The most common symptoms are abdominal bloating, breast enlargement and tenderness, and mood changes. Other physical symptoms include fluid retention leading to weight gain and swelling of the feet, ankles and hands; skin disorders; hot flushes; headache; pelvic discomfort; backache; changes in bowel habit (often constipation); bladder irritability.
Nervous symptoms are often called premenstrual tension (PMT) and include irritability, aggression, anxiety, depression tearfulness, lethargy, insomnia, change in appetite, food cravings, thirst, change in libido, loss of concentration, and co-ordination leading to clumsiness and increased risk of accidents.
Even a single symptom can be distressing. Sore breasts can disturb walking running and can affect your game at sp they can hurt when you play the piano o| violin and when you brush your hair; can make you flinch when your toddler jumps onto your lap and when your partner embraces you. Mood changes make you respond to people and situations in a way that’s just not ‘you’ and that you’ll feel regretful or ashamed about, and it’s no comfort to blame PMS when you’ve offended someone. What is responsible for these unwanted changes in your body and mind?
Many questions about PMS remain unanswered. What causes it? Why do some women suffer regularly while others notice symptoms only sometimes or never? How can it be treated? Since PMS first described in 1931, researchers have been trying to answer these questions.
After 60 years we’re not much wiser. The results of research have been mixed and conflicting.
Is PMS a real disease?
All women who have ever experienced any premenstrual changes (and is there anyone among us who has never noticed a few facial spots, some different breast sensations, or a tendency to drop plates?) know that their symptoms are real. But because there is no precise definition of PMS, and because it is rarely associated with changes that can be seen or measured, doctors have often been baffled and disconcerted when women consult them about premenstrual symptoms. The disorder has often been put in the ‘too hard’ basket: doctors are inclined to dismiss and ignore things they can’t understand. Women have often felt that their very real symptoms have been discounted or belittled.
*226/31/5*
Long-term lack of oestrogen leads to changes in many systems of the body that make them more liable to degeneration and disease. After the age of about 60, most women who don’t have hormone replacement will have some signs of health deterioration due to a lack of oestrogen, though the degree of disability varies greatly.
Muscular aches, weakness and stiffness may be due to reduced muscle tone and joint ageing, which are accelerated without oestrogen. Osteoporosis can lead to crush fractures of spinal vertebrae resulting in dowager’s hump and increased risk of other fractures, especially of the hip and wrist. Deterioration in the cardiovascular system can lead to angina and heart attack.
Some symptoms that start around the menopause become worse with the years. Dryness and thinning of the vaginal lining and genital skin are progressive and sex may become painful or impossible.
There may be loss of scalp hair, excessive hair growth on the upper lip and chin, and sometimes deepening of the voice. These changes (and acne-like skin eruptions) are caused by male hormones that are produced by the ovaries in small amounts throughout adult life; before the menopause their effects are cancelled out by oestrogen. After the menopause male hormone production declines very slowly, so that for some years there is a relative excess of androgens.
Much of the past 30 years of research into the menopause and its consequences has been aimed at preventing or reducing menopausal problems and finding means to help older women enjoy better health -about time, too. This branch of health care was previously entirely neglected.
*197/31/5*