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Fever.
Varicocele.
Metabolic Syndrome.

FEVER.


DEFINITION

A fever isn’t an illness itself, but it’s usually that something out of the ordinary is going on in your body. Fevers aren’t necessarily bad. In fact, fevers seem to play a key role in helping your fight off a number of infections.
If you’re an adult, a fever may be uncomfortable, but it usually isn’t dangerous unless it measures 103 F (39.3° C)  or higher. For very young children and infants, however, even slightly elevated temperatures may indicate a serious infection.
Because a fever can occur with many different conditions, other signs and symptoms can often help identify the cause.
Most fevers go away in a relatively short time – usually within a few days. Not all fevers need treatment with medications. And it’s possibile for fever medications to have side effects, especially for the very young.

SYMPTOMS

A fever occurs when your temperature rises above its normal range. What’s normal for you may be a little higher or lower than the average temperature of 98.6 F (37° C). But a rectal temperature higher than 100.4 F is always considered a fever. A rectal temperature reading is generally 1 degree Fahrenhait higher than an oral reading.
Depending on what’s causing your fever, additional fever symptoms may include:

  • Sweating
  • Shivering
  • Headache
  • Muscles aches
  • Lack of appetite
  • Dehydration
  • General Weakness

Very high fevers, between 103 and 106 F, may cause:

  • Hallucinations
  • Confusion
  • Irritability
  • Convulsions

Fever-induced seizures
About 4 percent of children younger than age 5 experience fever-induced seizures (febbrile seizures). The signs of febrile seizures, which occur when a child’s temperature rises or falls rapidly, include a brief loss of consciousness and convulsions.

Although these seizures be extremely alarming, most children don’t experience any lasting efects. Febrile seizures are ofetn triggered by a fever from a common childhood illness such as roseola, a viral infection that causes a high fever, swollen glands and a rash.

CAUSES

Even when you’re well, your body temperature varies throughout the day – it’s lower the morning and higher in the late afternoon and evening. In fact, your normal temperature can range from about 97 to 99 F. Althought most people consider 98.6 F a healthy body temperature, yours may vary by a degree or more.
Your body temperature is set by your hypothalamus, an area at the base of your brain that acts as a thermostat for your whole system. When something’s wrong, your normal temperature is simply set a few points higher. The new set-point, for example, may be 102 F instead of 97 or 98 F.

What happens with a fever

When a fever starts and your body tries to elevate its temperature, you feel chilly and may shiver to generate heat. at this point, you probably wrap yourself in your thickest blanket and turn up tthe heating pad. But eventually, as your body reaches its new set-point, you likely feel hot. And when your temperature finally begins to return to normal, you may sweat profusely, which is your body’s way of dissipating the excess heat.

A fever usullay means your body is responding to a viral or bacterial infection. Sometimes heat exhaustion, extreme sunburn or certain inflammatory conditions such as temporal arteritis – inflammation of an artery in your head – may trigger fever as well. In rare instances, a malignant tumor or some forms of kidney cancer may cause a fecer.

Fever can be a side effect of some medications such as antibiotics and drugs used to treat high blood pressure or seizures. Some infants and children develop fevers after receiving routine immunizations, such as the diphtheria, tetanus and acellular pertussis (DTaP) or pneumococcal vaccines.

Sometimes it’s not possibile to identify the cause of a fever. If you have a temperature hiogher than 100.9 F for more than three weeks and your doctor isn’t able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin. In most cases, though, the reason for your fever can be found and treated.

WHEN TO SEEK MEDICALE ADVICE

Fevers by themselves may not be a cause for alarm – or a reason to call a doctor.yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.

For infants
An unexplained fever is greater cause for concern in infants and in children than in adults. Call your baby’s doctor if your baby:

  • Is younger than 3 months of age and has a rectal temperature of 100.4 F or higher. Even if your baby doesn’t have other signs or symptoms, call doctor just to be safe.
  • Is older than 3 months of age and has a temperature of 102 F or higher.
  • Has a fever and unexplained irritability, such as marked crying when you change your baby’s diapers or when he or she is moved.
  • Has fever and seems lethargic and unresponsive. In infants and children younger than 2, these may be signs of meningitis – an infection and inflammation of the membranes and fluid surrounding the brain and spinal cord. If you’re worried that your baby might have meningitis, see your doctor right away. Don’t wait until morning to see your usual physician – meningitis is an emergency.
  • Is a newborn and has a lower than normal tempertaure – less than 97 F. Very youngs babies may not regulate their body temperature well they are ill and may become cold rather than hot.

For children
Children often tolerate fevers quite well, although high temperature may cause parents a great deal of concern. Still, it’s best to be guided more by how your child acts than particular temperature measurement. There’s probably no cause for alarm if your child has a fever but is reponsive – making eye contact with you and responding to your facial expressions and to your voice, is drinking plenty of fluids and wants to play.

Call your pediatrician if your child:

  • Is listless or irritable, vomits repeatedly, has a severe headache or stomachache, or has any other symptoms causing significant discomfort.
  • Has a fever after being left in a very hot car. Seek medical care immediately.
  • If fever persists longer than one day in a child younger than age 2 or longer than three days in a child age 2 or older.

Ask your doctor for guidance if you have special circumstances, such as a child with immune system problems or with a pre-existing illness. Your doctor also may recommend different precautions if your child has just started taking a new prescription medicine.

Don’t treat below 102 F with any medications unless advised by your doctor.

Sometimes, older children can have a lower-than-normal temperature. This can happen to older children with severe neurological impairments, children with a life-threatening bacterial infection in the blood (sepsis), and children with a suppressed immune system.

For adults
Call your doctor about a fever if:

  • Your temperature is more than 103 F
  • You’ve had a fever for more than three days

In addition, call your doctor immediately if any signs and symptoms accomapny a fever:

  • Severe headache
  • Severe swelling of your throat
  • Unusual skin rash, especially if the rash gets rapidly worse
  • Unusual eye sensitivity to bright light
  • Stiff neck and pain when you bend your head forward
  • Mental confusion
  • Persistent vomiting
  • difficulty breathing or chest pain
  • Extreme listlessness or irritability
  • Abdominal pain or pain when urinating
  • Any other unexplained signs or symptoms

Taking a temperature
To check your or your child’s temperature level, you can choose from several types of thermometers, including eletronic thermometers and ear (tympanic) thermometers. Thermometers with digital readouts and those that take the temperature quickly from the ear canal are especially useful for young children and older adults. Because glass mercury thermometers harm both humans and the environment, they have been phased out and are no longer recommended.

Although it’s not the most accurate way to take a temperature, you can also an oral thermometer for an armpit (axillary) reading. Place the thermometer in the armpit with arms crossed over the chest. Wait four to five minutes. The axillary temperature is about 1 degree F lower than an oral temperature. If you call your doctor, report the actual number on the thermometer and where on the body the temperature was taken rather than adding or subtracting numbers.

Use a rectal thermometer for infants. Place a dab of petroleum jelly on the bulb. Lay your baby on his or her tummy. Carefully insert the bulb one-half inch to one inch into your baby’s rectum. Hold the bulb and your baby still for three minutes. Don’t let go of the thermometer while it’s inside your baby. IT your baby squirms, the thermometer could go deeper and cause an injury.

LYON

LYON

TESTS AND DIAGNOSIS

Your doctor will likely diagnose the cause of your fever based on your other symptoms and a physical exam. Sometimes you may need additional tests to confirm a diagnosis.
If you have a low-grade fever that persists for three weeks or more, but have no other symptoms, your doctor may recommend a variety of tests to help find the cause. These may include blood tests and X-rays.

COMPLICATIONS

A rapid or fall in temperature may cause a fever-induced seizure (febrile seizure) in a small number of children younger than age 5. Although they’re alarming for patients, the vast majority of febrile seizures cause no lasting effects.
If a seizure occurs, lay your child on his or her side. Remove any sharp objects that are near child, loosen tight clothing and hold your child to prevent injury. Don’t place anything in your child’s mouth or try to stop the seizure. Although most seizures stop on their own, call for emergency medical assistance if a seizure lasts longer than 10 minutes.

If possibile, try to time the seizure using your watch or a lock. Because they’re so larming, seizures often semm to last longer than really do. Also try to note which part of your child’s body begins to shake first. This can help your doctor understand the cause of the seizure. Take your child to your pediatrician as soon as possibile.

TREATMENTS AND DRUGS

Medical treatment depends on the cause of your fever. Your doctor will likely prescribe antibiotics for bacterial infections, such as pneumonia or strep throat. For viral infections, including stomach infection (gastroenteritis) and mononucleosis, the best treatment is often rest and plenty of fluids.

Over-the count medications
Your doctor may also make a recommendation about using over-the counter medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to lower a high fever. Adults may also use aspirin. But don’t give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye’s syndrome.

The downside of lowering a fever
IF you have only a low-grade fever, it’s not advisable to try to lower your temperature. Doing so may only prolong the illness or mask your symptoms and make it harder to determine the cause.

Some experts believe that aggressively treating a fever actually interferes with your body’s immune response. That’s because the viruses that cause colds and other respiratory infections thrive at cool temperature. By producing a low-grade fever, your body may actually be helping eliminate a virus.

PREVENTION

The best way to prevent fevers is to reduce your exposure to infectious diseases. One of the most effective ways to do that is also one of the simplest – frequent hand washing.

Teach your children to wash their hands often, especially before they eat and after using the toilet, spending the toilet, spending time in a crowded place, or petting animals. Show them how to wash their hands vigorously, covering both the front and back of each hand with soap, and rinsing throughly under running water, Carry hand-washing towelettes with you for times when you don’t have access to soap and water. When possibile, teach your kids not to touch their noses, mouths or eyes – the main way viral infectious are transmitted.

LIFESTYLE AND HOME REMEDIES

Because your body loses more water with a fever, be sure to drink plenty of fluids to avoid dehydration. Water is a good choice for adults, but the best liquid for a sick child under age 1 is an oral rehydration solution such as Pedialyte. These solutions contain water and salts in specific proportions to repelnish both fluids and electrolytes in children. Frozen pedialyte ice pops are also available.

Make sure that you or your child enough rest. Don’t be concerned with treating a fever just because it’s a fever is actually helping fight off an infection. In addition, follow these guidelines for both older children and adults:

For temperatures below 102 F
Don’t use any medication for a fever in this range unless advised by your doctor. And don’t give children aspirin because of the risk of Reye’s syndrome. Instead, dress in comfortable, light clothing and try bathing in lukewarm water. At bedtime, cover yourself or your child with just a sheet or light blanket.

For temperature between 102 and 104 F
Take acetaminophen or ibuprofen according to the instructions or as recommended by your doctor. If you’re not sure about the proper dosage, be sure to check with your doctor or pharmacist. Adults may use aspirin instead.

Be careful to avoid too much medication. High doses or long-term use of acetaminophen may cause liver or kidney damage, and acute overdoses can be fatal. If you’re not able to get your child fever down, don’t give more medication. Call your doctor instead. Side effects of aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen include stomach pain, bleeding and ulcers.

For temperatures above 104 F
Give adults or chidren acetaminophen or ibuprofen according to the manufacture’s instructions or as recommended by your doctor. Adults may use aspirin instead. If you’re not sure about the dosage, check with your doctor or pharmacist. Be careful to avoid too much medication.

Acetaminophen is available in liquid, chewable and suppository forms for children, but it’s often easiest to give medications in liquid form. For a small child, use a syringe with measurements on the side and a bulb on the tip. Gently squirt the medicine in the back corners of your child’s mouth.

Sponge baths
Use a five to 10-minute sponge bath of lukewarm water to try to bring your own or your child’s high temperature down. A sponge bath is most likely to help if it’s used shortly afetr a dosage of acetaminophen or ibuprofen, so that the medication can work to keep the fever down after the bath takes effect.

If your child shivers in the bath, stop the bath, dry your child aand wait. Shivering actually raises the body’s internal temperature – shaking muscles generate heat. If the fever doesn’t modertae or your child has a febrile seizure that lasts longer than 10 minutes, seek immediate medical care.

By Mayo Clinic staff

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VARICOCELE


DEFINITION

A varicocele is an enlargement of the veins within the scotum, the loose bag of skin that holds your testicules. A varicocele is similar to a varicose vein that can occur in your leg.

About one in six men have a varicocele. For males who are infertile, the figure is higher – about 40 percent. Varicoceles are the most common cause of low sperm production and decreased sperm quality, although not all varicoceles affect sperm production.

Most varicoceles develop over time. Fortunately, can be repaired surgically.

SYMPTOMS

A varicocele often produces no symptoms. Rarely, it may cause pain that may worsen over the course of day because of physical exertion and typically is relleved by lying down on your back. With time, varicoceles may grow larger and become noticeable.

CAUSES

The spermatic cord, which supplies blood to and returns blood from the testicle, houses the vas deferens, which carries sperm from the testicles. The pampiniform plexus is a group of veins within the scrotum and above the testicules. The pampiniform plexus drains blood from the testicules. Enlargement of these veins often occurs during puberty.

It’s not certain what causes varicoceles, but many experts believe abnormal valves within the veins prevent normal blood flow. The resulting backup causes the veins to widen (dilate).

Varicoceles usually occur in the region of the left testicle, most likley because of the position of the left testicular vein. However, a variccocele in one testicle can affect sperm production in both testicles.

RISK FACTORS

You’re at greater risk of varicoceles between the ages of 15 and 25.

WHEN TO SEEK MEDICAL ADVICE

Because of the lack of symptoms, a varicocele often is discovered during an evalution of fertility or during a routine physical exam.

However, if you experience pain or swelling in your scrotum, contact your doctor. A number of conditions can cause testicular pain, and some of the conditions require immediate treatment. Your doctor can determine which condition is causing your pain.

TESTS AND DIAGNOSIS

Your doctor will conduct a physical exam, which may reveal a twisted, nontender mass above your testicle. Some people have described the mass as feeling like a bag of worms. If it’s large enough, your doctor will be able to feel it while you’re standing up. If you have a smaller varicocele, your doctor may ask you to take a deep breath and hold it while you bear down (Valsalva maneuver). This helps your doctor detect abnormal enlargement of the veins.

If the physical exame is inconclusive, your doctor may order a scrotal ultrasound. This test, which uses high-frequency sound to create precise images of structures inside your body, may be used to ensure there isn’t another reason for your symptoms. One such condition is a tumor that compresses the spermatic vein

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COMPLICATIONS

A varicocele may cause:

  • shrinkage of the affected testicle (atrophy). The bulk of the testicle is made up of sperm-producing tubules. When damaged, as what varicocele, the testicle shrinks and softens. It’s not valves allow blood to pool in the veins, which can rsult in increased pressure in the veins and exposure to toxins in the blood that may cause testicular damage.
  • Infertility. It’s not clear how varicoceles affect feritility. Some experts believe the testicular veins cool blood in the testicular artery, helping to maintain the proper temperature for optimal sperm production. By blocking blood flow, a varicocele may keep thetemperature too high, affecting sperm formation and movement (motility).

TREATMENTS AND DRUGS

Varicocele treatment may not be necessary. However, if you’re infertile or your varicocele cause pain or testicular atrophy, you may want to undergo varicocele repair. Treatment is aimed at sealing off the affected vein to redirect the blood flow into normal veins.

Although varicoceles typically develop in adolescence, it’s less clear whether you should have varicocele repair at that time. Indications for reparing a varicocele in adolescence include progressive testicular atrophy, pain or abnormal semen analysis results

Varicocele repair presents relatively few risks. Increased fluid around the testicles (hydrocele) occurs in a small percentage of cases, Recurrence of varicoceles is a risk, affecting perhaps one in 10 men who undergo repair. Repair methods include:

  • Open surgery. This most common form of treatment usually is done an outpatient basis, using general or local anesthetic. Your surgeon may approach the vein through your groin (transinguinal), abdomen (retroperitoneal) or below your groin (infrainguinal/infrapubic). Transinguinal surgery is most frequently used.Recovery after surgical repair usually proceeds rapidly. Your doctor may advise you to return to normal activities that aren’t strenuous normal activity, such as exercising, after two weeks. Pain resulting from this surgery is generally mild. Your doctor may prescribe pain mediction dfor the first two days after surgery. After that, your doctor may advise you to take over-the-conuter (OTC) painkillers, such as acetaminophen (Tylenol, others) or ibuprofen (Mortin, Advile, others) to relieve discomfort.

    Your doctor may advise you not to have sexual intercourse for one week. It takes about 72 days for sperm to generate, so you’ll have to wait three or four months after surgery to get a semen analysis to determine whether the varicocele repair was successufl in restoring your fertility.

  • Laparoscopic surgery. With this approach, your surgeon makes a small incision in your abdomen and passes a tiny instrument through the incision to see and to repair the varicocele. However, this procedure, which requires general anesthetic, isn’t used commonly because it poses more risk while offering little advanttage.
  • Percutaneous embolization. A radiologist inserts a tube into a vein in your groin or neck through which instruments can be passed. Viewing your enlarged veins on a monitor, the doctor releases coils or balloons to create a blockage in the testicular veins, which interrupts the blood flow and repairs the varicocele. This procedure uses sedation and may take several hours. Again, because of presenting greater risks than open surgery and offering little advantage, this procedure isn’t widely used.

LIFESTYLE AND HOME REMEDIES

If you have a varicocele that causes you minor discomfort but doesn’t affect your fertility, you mighl try following for pain relief:

  • Take over-the counter painkillers, such as acetaminophen or ibuprofen
  • Wear an athletic supporter to relieve pressure

By Mayo Clinic staff.

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METABOLIC SYNDROME


Opera di Catalina Florea

Opera di Catalina Florea

DEFINITION

Metabolic syndrome (MS) is a cluster of conditions that occur togther, increasing your risk of heart disease, stroke and diabetes.

Harving just one of these conditions – increased blood pressure, elevated insulin levels, excess body fat around the waist or abdominal cholesterol levels- isn’t diagnosed as metabolic syndrome, but it does contribute to your risk of serious disease. If more than one of these conditions occur in combination, your risk is event greater.

If you have MS or any of the components of MS, you have the opportunity to make aggressive changes. Making these changes can delay or derail the development of serious diseases that may result from metabolic syndrome.

SYMPTOMS

Having MS means you have several disorders related to your metabolism at the same time, including:

  • Obesity, particularly around your waist (having an “apple shape”)
  • Elevated blood pressure
  • An elevated level of the blood fat called triglycerides and a low level of high -density lipoprotein (HDL) – the “good” Cholesterol
  • Resistance to insulin, a hormone that helps to regulate the amount of sugar in your body

Having one component of MS means you’re more likely to have others. And the more components you have, the greater are the risks to your health.

CAUSES

Reasearch into the complex underlying process linking the group of conditions involved in MS is ongoing. As the name suggests, MS is tied your body’s metabolism, possibly to a condition called insulin resistance. Insulin is a hormone made by your pancreas that help control the amount of sugar in your bloodstream.

Normally, your digestive system breaks down some of the foods you eat into sugar (glucose). Your blood carries the glucose to your body’s tissues, where the cells use it as fuel. Glucose enters your cells with the help of insulin. In people with insulin resistance (IR), cells don’t respond normally to insulin, and glucose can’t enter the cells as easily. Your body reacts by churning out more and more insulin to help glucose get into your cells. The result is higher than normal levels of both insulin and glucose in your blood.

Although perhaps not high enough to qualify as diabetes, an elevated glucose level still interferes with your body processes. Increased insulin raises your triglyceride level and other blood fat levels. It also interferes with how your kidney’s work, leading to higher blood pressure. These combined effects of insulin resistance put you at risk of heart disease, diabetes and other conditions.

Combination of factors

Researchers are still learning what causes insulin resistance. It probably involves a variety of genetic and environmental factors. They think some peopole are genetically prone to insulin resistance, inherting the tendency from their parents. But being overwieght and inactive are major contributors.

RISK FACTORS

The following factors increase your chances of having metabolic syndrome:

  • Age: the prevalence of MS increases with age, affecting less than 10 percent of peopole in thier 20s and 40 percent of people in their 60s. However, some research shows that about one in eight schoolchildren has three or more components of MS. And, other research has identified an association between childrenhood MS and adult cardiovascular disease decades later.
  • Race: hispanics and asians seem to be at greater risk of MS than other races are.
  • Obesity: a body mass index (BMI) – a measure of your percentage of body fat based on height and weight – greater then 25 increases your risk of MS. So does abdominal obesity – having an apple shap rather a pear shap.
  • History of diabetes: you’r more likely to have MS if you have a family history of type 2 diabetes or a history of diabetes during pregnancy (gestational diabetes)
  • other diseases: a diagnosis of high blood pressure, cardiovascular disease or polycystic ovary syndrome – a similar type of metabolic problem that affects a woman’s homeones and reproductive system – also increases your risk of MS.

TESTS AND DIAGNOSIS

Although your doctor is not typically looking for “metabolic syndrome”, the label may apply if you have three or more of traits associated with this condition.

Several organizations criteria for diagnosing MS. These guidelines were created by the National Cholesterol Education Program (NCEP) with modifications by the american heart association. According to these guidelines, you have MS if you have 3 or more of these traits:

  • Elevated waist circumference: greater than 35 inches for women and 40 inches for men. Certain genetic risk factors, such as having a family history of diabetes or being of Asian descent – which increases your risk of insulin resistance – lower the waist circumerference limit. If you have one of these genetic risk factors, waist circumference limits are 31 to 35 inches for women and 37 to 39 inches for men.
  • Elevated level: of triglycerides of 150 mg/dl or higher, or you’re receiving treatment for high triglycerides.
  • Reduced HDL: (less than 40 mg/dl in men or less than 50 mg/dl in women) or you’re receiving treatment for low HDL.
  • Elevated blood pressure: of 130 mmHg systolic (the top number)or higher or 85 mmHg diastolic (the bottom number) or higher, or you’re receiving treatmenmt for high blood pressure.
  • Elevated fasting blood sugar: (blood glucose) of 100 mg/dl or higher, or you’re receiving treatment fort high sugar.

WHEN TO SEEK MEDICAL ADVICE

If you know you have at least one aspect of MS – such as high blood pressure, high cholesterol or an apple-shaped body – you may have the others and not know it. It’s worth checking with your doctor. Ask whether need testing for other components of the syndrome and what you can do to avoid serious diseases.

PREVENTION

Whether you have one, two or none of the components of MS , the following lifestyle changes will reduce your risk of heart disease, diabetes and stroke:

  • Commit to a healthy diet: eat plenty of fruits and vegetables. Choose lean cuts of white meat or fish over red meat. Avoid processed or deep-fried food. Eliminate table salt and experiment with other herbs and spices.
  • Get moving: get plenty of regular, moderately strenuous physical activity.
  • Schedule regular chekups: Chek your blood pressure, cholesterol and blood sugar levels on a regular basis. Make additional lifestyle modifications if the numbers are going the wrong way.

LIFESTYLE AND HOME REMEDIES

You can do something about tour risk of MS and its complications – diabetes, stroke and heart disease. You can begin to curb your insulin resistance by making these lifestyle changes:

  • Lose weight: losing as little as 5% to 10% of your body weight can reduce insulin levels and blood pressure, and decrease your risk of diabetes.
  • Exercise: doctors recommend getting 30 to 60 minutes of moderate – intensity exercise, such as brisk walking, every day.
  • Stop smoking: ssmoking cigarettes increases insulin resistance and worsens the health consequences of MS. Talk to your doctor if you need kicking the cigarette habit.
  • Eat fiber-rich foods: make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels.

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