Thursday, August 17

African Trypanosomiasis, The Sleeping Sickness

Trypanosoma Brucei In Human Blood
Trypanosoma Brucei In Human Blood
African Trypanosomiasis, also known as "sleeping sickness", is caused by microscopic parasites of the species Trypanosoma brucei. It is transmitted by the tse-tse fly (Glossina species), which is found only in rural Africa. Although the infection is not found in the United Kingdom or the United States, historically, it has been a serious public health problem in some regions of sub-Saharan Africa.

Currently, about 10,000 new cases each year are reported to the World Health organization. However, it is believed that many cases go undiagnosed and unreported. Sleeping sickness is curable with medication, but is fatal if left untreated.

African Trypanosomiasis Disease

The clinical course of human African trypanosomiasis has two stages:
First Stage: In the first stage, the parasite is found in the peripheral circulation, but it has not yet invaded the central nervous system. 
Second Stage: Once the parasite crosses the blood-brain barrier and infects the central nervous system, the disease enters the second stage.
The subspecies that cause African trypanosomiasis have different rates of disease progression, and the clinical features depend on which form of the parasite (T. B. Rhodesiense or T. B. Gambiense) is causing the infection. However, infection with either form will eventually lead to coma and death if not treated.
The Tse-Tse Fly
The Tse-Tse Fly
T. B. Rhodesiense infection (East African sleeping sickness) progresses rapidly. In some patients, a large sore (a chancre) will develop at the site of the tse-tse fly bite. Most patients develop fever, headache, muscle and joint aches, and enlarged lymph nodes within 1-2 weeks of the infective bite. Some people develop a rash. After a few weeks of infection, the parasite invades the central nervous system and eventually causes mental deterioration and other neurologic problems. Death ensues usually within months.

T. B. Gambiense infection (West African sleeping sickness) progresses more slowly. At first, there may be only mild symptoms. Infected persons may have intermittent fevers, headaches, muscle and joint aches, and malaise. Itching of the skin, swollen lymph nodes, and weight loss can occur. Usually, after 1-2 years, there is evidence of central nervous system involvement, with personality changes, daytime sleepiness with night-time sleep disturbance, and progressive confusion. Other neurologic signs, such as partial paralysis or problems with balance or walking may occur, as well as hormonal imbalances. The course of untreated infection rarely lasts longer than 6-7 years and more often kills in about 3 years.

Diagnosis of African Trypanosomiasis

The diagnosis of African Trypanosomiasis is made through laboratory methods, because the clinical features of infection are not sufficiently specific. The diagnosis rests on finding the parasite in body fluid or tissue by microscopy. The parasite load in T. B. Rhodesiense infection is substantially higher than the level in T. B. Gambiense infection.

T. B. Rhodesiense parasites can easily be found in blood. They can also be found in lymph node fluid or in fluid or biopsy of a chancre. Serologic testing is not widely available and is not used in the diagnosis, since microscopic detection of the parasite is straightforward.

Life-cycle of Sleeping Sickness
Life-cycle of Sleeping Sickness
The classic method for diagnosing T. B. Gambiense infection is by microscopic examination of lymph node aspirate, usually from a posterior cervical node. It is often difficult to detect T. B. Gambiense in blood. Concentration techniques and serial examinations are frequently needed. Serologic testing is available outside the U.S. for T. B. Gambiense; however, it normally is used for screening purposes only and the definitive diagnosis rests on microscopic observation of the parasite.

All patients diagnosed with African trypanosomiasis must have their cerebrospinal fluid examined to determine whether there is involvement of the central nervous system, since the choice of treatment drug(s) will depend on the disease stage. The World Health Organization criteria for central nervous system involvement include increased protein in cerebrospinal fluid and a white cell count of more than 5. Trypanosomes can often be observed in cerebrospinal fluid in persons with second stage infection.

Treatment

All persons diagnosed with African Trypanosomiasis should receive treatment. The specific drug and treatment course will depend on the type of infection (T. B. Gambiense or T. B. Rhodesiense) and the disease stage (i.e. whether the central nervous system has been invaded by the parasite). Pentamidine, which is the recommended drug for first stage T. B. Gambiense infection, is widely available. The other drugs (suramin, melarsoprol, eflornithine, and nifurtimox) used to treat African trypanosomiasis are also available.

There is no test of cure for African trypanosomiasis. After treatment patients need to have serial examinations of their cerebrospinal fluid for 2 years, so that relapse can be detected if it occurs.
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Wednesday, August 16

Things You May Want To Know About Aging

Old People In Line

Lots of Know-How

They're called the golden years for a reason. Getting older has its perks. For one, you're good at using what you've learned. This is called crystalized intelligence, and it keeps getting better, even when you're 65 or 70.

Become The Nice Person

Turns out you might not be a grumpy old man (or woman), after all. You'll probably get more agreeable as you age, at least through your 60s. You're also likely to be happier and less inclined to get angry. Scientists haven't figured out exactly why this happens, but they do have some theories. Older people might control their emotions better and focus more on how to make the most of life.

Play Well With Others

You're more in tune with other people's emotions in your 40s and older than at any other time in your life. That insight into how others think and feel can make living with your loved ones easier and help you get along better with your coworkers, too.

A Taste for Life

As you age, medications, illness (colds, flu, gum diseases, etc.) and allergies all can change your sense of smell and taste. And that can affect your diet and health. If you find things need to be spiced up, try some olive oil, herbs like rosemary and thyme, garlic, onion, peppers, or mustard. Just stay away from the salt.

Better Sex
A Loving Older Couple

Older women may have sex less often than when they were younger, but apparently they make it count. In a study of women 40 and over, researchers found that sexual satisfaction improved with age. Women over 80 were more likely than those between 55 and 79 to say they were satisfied during sex.

Rise And Shine

There's a good chance you'll become the morning person you've always wanted to be - in your 60s. Our sleeping patterns can shift as we age, so we get sleepier earlier and wake up earlier. That seems to work out well. One study showed that even though folks over 65 tend to wake up during the night, most said they regularly get a good night's sleep.

Bye-Bye Migraines

Once you hit your 70s, those migraines you may have had much of your life may go away. Only 10% of women and 5% of men over 70 still report migraines. Even better news: Even if you have a migraine, it may not actually come with the headache. As we age they're more like to show up as visual or sensory disturbances instead.

Don't Quit Your Day Job

Early retirement might not be the best thing for your health - unless you have a fun second career. A study called the Longevity Project found that people who work hard at a job they enjoy live the longest. That, along with good friends and a good marriage, could be the key to sticking around a while.

Fear Is Not Your Friend

You may worry more about breaking bones as you age. But you're more likely to take a tumble if you're scared of falling. One study found that about a third of adults over 65 have that fear. And it's understandable, because falls are the leading cause of injuries for older people.

What's That Doing There?
Older Woman Plucking Hairs From Her Chin

Around the time the hair on your head starts to disappear, it can show up in the strangest places. This can mean large hairs in older guys' noses and ears. Older women may notice small hairs on their chins. This is all caused by changes in our hormones.

Self-Confidence

Self-esteem soars as you age, studies show, and increases with wealth, education, good health, and employment. But it takes a dip after 60. That may be because people begin to have health issues and start searching for a new sense of purpose following retirement. With increasing life spans, healthier lifestyles, and working to an older age, we may see that change.

Less Stress

Baby boomers and older adults report less stress than their younger counterparts. That doesn't mean, it goes away. Health and money problems still crop up. But studies show that 9 of 10 older adults say they're doing enough to manage it.

Weight of the World

The longer you're alive, the more gravity brings you down. The spaces between the bones in your spine - called vertebrae - get closer together. That can make you about an inch shorter as you get older.

Strength in Numbers
Older Woman Drinking Coffee

Those 60 and over tend to cast ballots more than any other age group. And they're the fastest-growing block of voters in general worldwide. That means more voting power on topics that matter as you age such as Social Security and health care.
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Blood Clots and Travel, Facts You Need to Know

Blood Clot
Blood Clot
More than 300 million people travel on long-distance flights (generally more than four hours) each year. Blood clots, also called deep vein thrombosis (DVT), can be a serious risk for some long-distance travelers. Most information about blood clots and long-distance travel comes from information that has been gathered about air travel. However, anyone traveling more than four hours, whether by air, car, bus, or train, can be at risk for blood clots.

Blood clots can form in the deep veins (veins below the surface that are not visible through the skin) of your legs during travel because you are sitting still in a confined space for long periods of time. The longer you are immobile, the greater is your risk of developing a blood clot. Many times the blood clot will dissolve on its own.

However, a serious health problem can occur when a part of the blood clot breaks off and travels to the lungs causing a blockage. This is called a pulmonary embolism, and it may be fatal. The good news is there are things you can do to protect your health and reduce your risk of blood clots during a long-distance trip.

Understand What Can Increase Your Risk for Blood Clots

Even if you travel a long distance, the risk of developing a blood clot is generally very small. Your level of risk depends on the duration of travel as well as whether you have any other risks for blood clots. Most people who develop travel-associated blood clots have one or more other risks for blood clots, such as:
Have You Got Any of the Risk Factors for DVT?
Have You Got Any of the Risk Factors for DVT?
• Older age (risk increases after age 40)
• Obesity (body mass index [BMI] greater than 30kg/m2)
• Recent surgery or injury (within 3 months)
• Use of estrogen-containing contraceptives (for example, birth control pills, rings,patches)
• Hormone replacement therapy (medical treatment in which hormones are given to reduce the effects of menopause)
• Pregnancy and the postpartum period (up to 6 weeks after childbirth)
• Previous blood clot or a family history of blood clots
• Active cancer or recent cancer treatment
• Limited mobility (for example, a leg cast)
• Catheter placed in a large vein
• Varicose veins

The combination of long-distance travel with one or more of these risks may increase the likelihood of developing a blood clot. The more risks you have, the greater your chances of experiencing a blood clot. If you plan on traveling soon, talk with your doctor to learn more about what you can do to protect your health. The most important thing you can do is to learn and recognize the symptoms of blood clots.

Recognize the Symptoms of DVT
Symptoms and Signs of DVT
Symptoms and Signs of DVT
Deep Vein Thrombosis (DVT)

About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body (usually the leg or arm):

1. Swelling of your leg or arm
2. Pain or tenderness that you can't explain
3. Skin that is warm to the touch
4. Redness of the skin

If you have any of these symptoms, contact your doctor as soon as possible.

Pulmonary Embolism (PE)

You can have a PE without any symptoms of a DVT. Symptoms of a PE can include:

1. Difficulty breathing
2. Faster than normal or irregular heartbeat
3. Chest pain or discomfort, which usually worsens with a deep breath or coughing
4. Anxiety
5. Coughing up blood
6. Lightheadedness, or fainting

If you have any of these symptoms, seek medical help immediately.

Protect Yourself and Reduce Your Risk of Blood Clots During Travel

Protect Yourself From DVT During Travel
Protect Yourself From DVT During Travel
• Know what to look for. Be alert to the signs and symptoms of blood clots.
Talk with your doctor if you think you may be at risk for blood clots. If you have had a previous blood clot, or if a family member has a history of blood clots or an inherited clotting disorder, talk with your doctor to learn more about your individual risks.

• Move your legs frequently when on long trips and exercise your calf muscles to improve the flow of blood. If you've been sitting for a long time, take a break to stretch your legs. Extend your legs straight out and flex your ankles (pulling your toes toward you). Some airlines suggest pulling each knee up toward the chest and holding it there with your hands on your lower leg for 15 seconds, and repeat up to 10 times. These types of activities help to improve the flow of blood in your legs.

• If you are at risk, talk with your doctor to learn more about how to prevent blood clots. For example, some people may benefit by wearing graduated compression stockings.

• If you are on blood thinners, also known as anticoagulants, be sure to follow your doctor's recommendations on medication use.
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Venous Thromboembolism, Blood Clots

What Is Deep Vein Thrombosis, DVT
What Is Deep Vein Thrombosis, DVT
Venous thromboembolism, VTE, also known as blood clots, is an underdiagnosed and serious but preventable medical condition. It is important to know about VTE because it can happen to anybody at any age and cause serious illness, disability and in some cases, death. The good news is that VTE can be prevented and treated if discovered early.

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

Deep Vein Thrombosis, DVT and Pulmonary Embolism, PE are also known as venous thromboembolism, VTE. DVT and PE are both often underdiagnosed and serious but preventable medical conditions.

About Deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh or pelvis, but they can also occur in the arm.

It is important to know about DVT because it can happen to anybody and can cause serious illness, disability and in some cases, death. The good news is that DVT is preventable and treatable if discovered early.
Symptoms of DVT
Symptoms of DVT
Complications of DVT

The most serious complication of DVT happens when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage called pulmonary embolism (PE). If the clot is small, and with appropriate treatment, people can recover from PE. However, there could be some damage to the lungs. If the clot is large, it can stop blood from reaching the lungs and is fatal.

In addition, nearly one-third of people who have a DVT will have long-term complications caused by the damage the clot does to the valves in the vein called post-thrombotic syndrome (PTS). People with PTS have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the affected part of the body. In some cases, the symptoms can be so severe that a person becomes disabled.

For some people, DVT and PE can become a chronic illness. About 30% of people who have had a DVT or PE are at risk for another episode.

Risk Factors for DVT

Almost anyone can have a DVT. However, certain factors can increase the chance of having this condition. The chance increases even more for someone who has more than one of these factors at the same time.

Following is a list of factors that increase the risk of developing DVT:

Injury to a vein, often caused by:

• Fractures
• Severe muscle injury or
• Major surgery (particularly involving the abdomen, pelvis, hip, or legs)

Slow blood flow, often caused by:

• Confinement to bed (e.g., due to a medical condition or after surgery)
• Limited movement (e.g., a cast on a leg to help heal an injured bone)
• Sitting for a long time, especially with crossed legs or
• Paralysis

Increased Oestrogen, often caused by:

• Birth control pills
• Hormone replacement therapy, sometimes used after menopause
• Pregnancy, for up to 6 weeks after giving birth

Certain chronic medical illnesses, such as:

• Heart disease
• Lung disease
• Cancer and its treatment
• Inflammatory bowel disease (Crohn's disease or ulcerative colitis)

Other factors that increase the risk of DVT include:

• Previous DVT or PE
• Family history of DVT or PE
• Age (risk increases as age increases)
• Obesity
• A catheter located in a central vein
• Inherited clotting disorders

Preventing DVT

The following tips can help prevent DVT:

Move around as soon as possible after having been confined to bed, such as after surgery, illness, or injury.

If you're at risk for DVT, talk to your doctor about:

• Graduated compression stockings (sometimes called "medical compression stockings")
• Medication (anticoagulants) to prevent DVT.

When sitting for long periods of time, such as when traveling for more than four hours:

• Get up and walk around every 2 to 3 hours.

Exercise your legs while you're sitting by:

• Raising and lowering your heels while keeping your toes on the floor
• Raising and lowering your toes while keeping your heels on the floor
• Tightening and releasing your leg muscles
• Wear loose-fitting clothes.

You can reduce your risk by maintaining a healthy weight, avoiding a sedentary lifestyle, and following your doctor's recommendations based on your individual risk factors.

Symptoms of DVT

Everybody should know the signs and symptoms of DVT/PE, their risk for DVT/PE, to talk to their health care provider about their risk, and to seek care immediately if they have any sign or symptom of DVT/PE.

DVT

About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body:

• Swelling
• Pain
• Tenderness
• Redness of the skin

If you have any of these symptoms, you should see your doctor as soon as possible.

About Pulmonary Embolism (PE)

You can have a PE without any symptoms of a DVT.

Symptoms of PE
Symptoms of PE
Signs and symptoms of PE can include:

• Difficulty breathing
• Faster than normal or irregular heart beat
• Chest pain or discomfort, which usually worsens with a deep breath or coughing
• Coughing up blood
• Very low blood pressure, lightheadedness, or fainting

If you have any of these symptoms, you should seek medical help immediately.

Diagnosis of DVT and PE

The diagnosis of DVT or PE requires special tests that can only be performed by a doctor. That is why it is important for you to seek medical care if you experience any of the symptoms of DVT or PE.

Treatments for DVT and PE

DVT

Medication is used to prevent and treat DVT. Compression stockings (also called graduated compression stockings) are sometimes recommended to prevent DVT and relieve pain and swelling. These might need to be worn for 2 years or more after having DVT. In severe cases, the clot might need to be removed surgically.

PE

Immediate medical attention is necessary to treat PE. In cases of severe, life-threatening PE, there are medicines called thrombolytics that can dissolve the clot. Other medicines, called anticoagulants, may be prescribed to prevent more clots from forming. Some people may need to be on medication long-term to prevent future blood clots.
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Tuesday, August 15

Invasive Candidiasis

Invasive Candidiasis, A Hematogenous Dissemination of Candida
Invasive Candidiasis, A Hematogenous Dissemination of Candida
What is Invasive Candidiasis?

Invasive candidiasis is an infection caused by a yeast (a type of fungus) called Candida.  Unlike Candida infections in the mouth and throat (also called "thrush") or vaginal "yeast infections", which are localized to one part of the body,  invasive candidiasis is a serious infection that can affect the blood, heart, brain, eyes, bones, or other parts of the body.

Candida normally lives in the gastrointestinal tract and on skin without causing any problems. However, in certain patients who are at risk, Candida can enter the bloodstream and cause an infection. A Candida bloodstream infection, which is the most common form of invasive candidiasis, is called candidemia. Candidemia is one of the most common causes of bloodstream infections in hospitalized patients and it often results in long hospital stays, high medical costs and poor outcomes.

Invasive candidiasis can be treated with antifungal medication. Antifungal medication is often given to prevent the infection from developing in certain patient groups.

Symptoms of Invasive Candidiasis

Fever and chills are the most common symptoms of invasive candidiasis. People who develop invasive candidiasis are often already sick from other medical conditions, so it can be difficult to know which symptoms are related to a Candida infection. However, the most common symptoms of invasive candidiasis are fever and chills that don't improve after antibiotic treatment for suspected bacterial infections. Other symptoms can develop if the infection spreads to other parts of the body, such as the heart, brain, eyes, bones or joints.

Invasive Candidiasis Risk and Prevention

Who gets Invasive Candidiasis?

Most cases of invasive candidiasis occur in people who have recently been admitted to a hospital or been in contact with other healthcare settings such as nursing homes. People who are at high risk for developing invasive candidiasis include:
• Patients who have a central venous catheter
• Patients in the intensive care unit (ICU)
• People who have weakened immune systems (for example, people who have had an organ transplant, have HIV/AIDS, or are on cancer chemotherapy)
• People who have taken broad-spectrum antibiotics
• People who have a very low neutrophil (a type of white blood cell) count (neutropenia)
• People who have kidney failure or are on hemodialysis
• Patients who have had surgery, especially gastrointestinal surgery
• Patients who have diabetes
Diagnosis and Testing for Invasive Candidiasis

Invasive Candidiasis Causes
Invasive Candidiasis Causes
How is invasive candidiasis diagnosed?

Healthcare providers rely on your medical history, symptoms, physical examinations, and laboratory tests to diagnose invasive candidiasis. The most common way that healthcare providers test for invasive candidiasis is by taking a blood sample and sending it to a laboratory to see if it will grow Candida in a culture.

How long will it take to get my test results?

Results from a blood test will usually be available in a few days.

Sources of Invasive Candidiasis

Candida lives in and on the body. Candida, the fungus that causes invasive candidiasis, normally lives in the gastrointestinal tract and on skin without causing any problems. In people who are at higher risk for the infection, invasive candidiasis may occur when a person's own Candida yeasts enter the bloodstream, for example, where an intravenous (IV) catheter was inserted or during surgery.

Medical equipment or devices, particularly intravenous catheters, can also become contaminated with Candida and allow the fungus to enter the bloodstream. Healthcare workers can also carry Candida on their hands. There have been a few outbreaks of candidemia linked to healthcare workers' hands, so hand hygiene in healthcare settings is important for preventing the spread of infections.

Types of Candida

There are over 150 species of Candida, but only about 15 of these are known to cause infections. The most common species that cause infections are C. albicans, C. glabrata, C. parapsilosis, C. tropicalis and C. krusei.

Risk for Invasive Candidiasis is a Continuum
Risk for Invasive Candidiasis is a Continuum
Treatment for Invasive Candidiasis

How is invasive candidiasis treated?

The specific type and dose of antifungal medication used to treat invasive candidiasis usually depends on the patient's age, immune status, and location and severity of the infection. For most adults, the initial recommended antifungal treatment is an echinocandin (caspofungin, micafungin, or anidulafungin) given through the vein (intravenous or IV). Fluconazole, amphotericin B, and other antifungal medications may also be appropriate in certain situations.

How long does the treatment last?

For candidemia, treatment should continue for 2 weeks after signs and symptoms have resolved and Candida yeasts are no longer in the bloodstream. Other forms of invasive candidiasis, such as infections in the bones, joints, heart, or central nervous system, usually need to be treated for a longer period of time.
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About Vaginal Candidiasis

Definition of Vaginal Candidiasis
Candida Albicans On The Vaginal Wall
Candida Albicans On The Vaginal Wall
Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on skin without causing any problems. Sometimes Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. Candidiasis in the vagina is commonly called a "vaginal yeast infection." Other names for this infection are "vaginal candidiasis," "vulvovaginal candidiasis," or "candidal vaginitis."

Symptoms of Vaginal Candidiasis

The symptoms of vaginal candidiasis include:
• Vaginal itching or soreness
• Pain during sexual intercourse
• Pain or discomfort when urinating
• Abnormal vaginal discharge
• Although most vaginal candidiasis is mild, some women can develop severe infections involving redness, swelling, and cracks in the wall of the vagina.
Contact your healthcare provider if you have any of these symptoms. These symptoms are similar to those of other types of vaginal infections, which are treated with different types of medicines. A healthcare provider can tell you if you have vaginal candidiasis and how to treat it.

Risk & Prevention

Who gets Vaginal Candidiasis?
Vaginal Candidiasis Is A Yeast Infection
Vaginal Candidiasis Is A Yeast Infection

Vaginal candidiasis is common, though more research is needed to understand how many women are affected. Women who are more likely to get vaginal candidiasis include those who:
• Are pregnant
• Use hormonal contraceptives (for example, birth control pills)
• Have diabetes
• Have a weakened immune system (for example, due to HIV infection or medicines that weaken the immune system, such as steroids and chemotherapy)
• Are taking or have recently taken antibiotics
How can I prevent Vaginal Candidiasis?

Wearing cotton underwear might help reduce the chances of getting a yeast infection. Because taking antibiotics can lead to vaginal candidiasis, take these medicines only when prescribed and exactly as your healthcare provider tells you. Learn more about when antibiotics work and when they should be avoided.

Sources OF Infection with Candida

Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on skin without causing any problems. Scientists estimate that about 20% of women normally have Candida in the vagina without having any symptoms. Sometimes, Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. This can happen because of hormones, medicines, or changes in the immune system.

Diagnosis and Testing
Take a Sample of Vaginal Discharge For Testing

A laboratory test is usually needed to diagnose vaginal candidiasis because the symptoms are similar to those of other types of vaginal infections. A healthcare provider will usually diagnose vaginal candidiasis by taking a small sample of vaginal discharge to be examined under a microscope or sent to a laboratory for a fungal culture. However, a positive fungal culture does not always mean that Candida is causing the symptoms because some women can have Candida in the vagina without having any symptoms.

Treatment OF Vaginal Candidiasis

Vaginal candidiasis is usually treated with antifungal medicine. For most infections, the treatment is an antifungal medicine applied inside the vagina or a single dose of fluconazole taken by mouth. For more severe infections, infections that don't get better, or keep coming back after getting better, other treatments might be needed. These treatments include more doses of fluconazole taken by mouth or other medicines applied inside the vagina such as boric acid, nystatin, or flucytosine.

Vaginal candidiasis is common. It is the second most common type of vaginal infection after bacterial vaginal infections. More research is needed to determine the number of women who are affected and how many have vaginal candidiasis that keeps coming back after getting better (more than three times per year). Vaginal candidiasis can be more frequent in people with weakened immune systems.
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Candidiasis of the Mouth, Throat and Oesophagus

Definition of Candidiasis
Oral Candidiasis, Candida Infection In The Mouth
Oral Candidiasis, Candida Infection In The Mouth

Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives in the digestive tract and on skin without causing any problems. Sometimes, Candida can multiply and cause an infection if the environment inside the mouth, throat, or oesophagus changes in a way that encourages fungal growth.

Candidiasis in the mouth and throat is also called "thrush" or oropharyngeal candidiasis. Candidiasis in the esophagus (the tube that connects the throat to the stomach) is called esophageal candidiasis or Candida esophagitis. Oesophageal candidiasis is one of the most common infections in people living with HIV/AIDS.

Symptoms of Candidiasis

Candidiasis in the mouth and throat can have many different symptoms, including:

• White patches on the inner cheeks, tongue, roof of the mouth, and throat (photo showing candidiasis in the mouth)
• Redness or soreness
• Cottony feeling in the mouth
• Loss of taste
• Pain while eating or swallowing
• Cracking and redness at the corners of the mouth
• Symptoms of candidiasis in the esophagus usually include pain when swallowing and difficulty swallowing.

Oral Thrush
Oral Thrush
Contact your healthcare provider if you have symptoms that you think are related to candidiasis in the mouth, throat, or esophagus.

Risk and Prevention

Who gets Candidiasis in the Mouth, Throat or Oesophagus?

Candidiasis in the mouth, throat, or esophagus is uncommon in healthy adults. People who are at higher risk for getting candidiasis in the mouth and throat include babies, especially those younger than one month old, and people who:

• Wear dentures
• Have diabetes
• Have cancer
• Have HIV/AIDS
• Take antibiotics or corticosteroids, including inhaled corticosteroids for conditions like asthma
• Take medications that cause dry mouth or have medical conditions that cause dry mouth
• Smoke

Most people who get candidiasis in the esophagus have weakened immune systems, meaning that their bodies don't fight infections well. This includes people living with HIV/AIDS and people who have blood cancers such as leukemia and lymphoma. People who get candidiasis in the esophagus often also have candidiasis in the mouth and throat.

How can I prevent candidiasis in the mouth, throat, or esophagus?

Oesophageal Candidiasis
Oesophageal Candidiasis

Ways to help prevent candidiasis in the mouth and throat include:

Maintain good oral health

Rinse your mouth or brush your teeth after using inhaled corticosteroids
Some studies have shown that chlorhexidine mouthwash may help to prevent oral candidiasis in people undergoing cancer treatment

Sources

Candida normally lives in the mouth, throat, and the rest of the digestive tract without causing any problems. Sometimes, Candida can multiply and cause an infection if the environment inside the mouth, throat, or esophagus changes in a way that encourages its growth. This can happen when a person's immune system becomes weakened, if antibiotics affect the natural balance of microbes in the body, or for a variety of other reasons in other groups of people.

Diagnosis and Testing

Healthcare providers can usually diagnose candidiasis in the mouth or throat simply by looking inside. Sometimes a healthcare provider will take a small sample from the mouth or throat. The sample is sent to a laboratory for testing, usually to be examined under a microscope.

Healthcare providers usually diagnose candidiasis in the esophagus by doing an endoscopy. An endoscopy is a procedure to examine the digestive tract using a tube with a light and a camera. A healthcare provider might prescribe antifungal medication without doing an endoscopy to see if the patient's symptoms get better.

Treatment of Candidiasis
Treatment of Oral Candidiasis
Treatment of Oral Candidiasis
Candidiasis in the mouth, throat, or esophagus is usually treated with antifungal medicine. The treatment for mild to moderate infections in the mouth or throat is usually an antifungal medicine applied to the inside of the mouth for 7 to 14 days. These medications include clotrimazole, miconazole, or nystatin. For severe infections, the treatment is usually fluconazole or another type of antifungal medicine given by mouth or through a vein for people who don't get better after taking fluconazole.

The treatment for candidiasis in the esophagus is usually fluconazole. Other types of prescription antifungal medicines can also be used for people who can't take fluconazole or who don't get better after taking fluconazole.
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Friday, August 11

The Health Effects of Cigarette Smoking

The Health Effects of Cigarette Smoking

Cigarette smoking harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general.

Quitting smoking lowers your risk for smoking-related diseases and can add years to your life.

Smoking and Death

Cigarette smoking is the leading preventable cause of death in the USA and Worldwide.

Cigarette smoking causes more than 480,000 deaths each year in the United States alone. This is nearly one in five deaths.

Smoking causes more deaths each year than the following causes combined:

Human immunodeficiency virus (HIV)
Illegal drug use
Alcohol use
Motor vehicle injuries
Firearm-related incidents
More than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States.
Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths. More women die from lung cancer each year than from breast cancer.
Smoking causes about 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease (COPD).
Cigarette smoking increases risk for death from all causes in men and women.
The risk of dying from cigarette smoking has increased over the last 50 years in the U.S.

Smoking and Increased Health Risks

Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.

Estimates show smoking increases the risk:
For coronary heart disease by 2 to 4 times
For stroke by 2 to 4 times
Of men developing lung cancer by 25 times
Of women developing lung cancer by 25.7 times
Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost.

Smoking and Cardiovascular Disease

Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular disease).

Smoking causes stroke and coronary heart disease, which are among the leading causes of death in the United States.
Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.
Smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. Clots can also form.

A stroke occurs when:

A clot blocks the blood flow to part of your brain;
A blood vessel in or around your brain bursts.
Blockages caused by smoking can also reduce blood flow to your legs and skin.
Smoking and Respiratory Disease

Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.

Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis.
Cigarette smoking causes most cases of lung cancer.
If you have asthma, tobacco smoke can trigger an attack or make an attack worse.
Smokers are 12 to 13 times more likely to die from COPD than nonsmokers.
The health consequences causally linked to smoking

The Risks Of Smoking

Smoking and Cancer

Smoking can cause cancer almost anywhere in your body: (See figure above)

• Bladder
• Blood (acute myeloid leukemia)• Cervix
• Colon and rectum (colorectal)
• Esophagus
• Kidney and ureter
• Larynx
• Liver
• Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
• Pancreas
• Stomach
• Trachea, bronchus, and lung
• Smoking also increases the risk of dying from cancer and other diseases in cancer patients and survivors.

If nobody smoked, one of every three cancer deaths in the United States would not happen.

Smoking and Other Health Risks

Smoking harms nearly every organ of the body and affects a person's overall health.

Smoking can make it harder for a woman to become pregnant. It can also affect her baby's health before and after birth. Smoking increases risks for:

• Preterm (early) delivery
• Stillbirth (death of the baby before birth)
• Low birth weight
• Sudden infant death syndrome (known as SIDS or crib death)
• Ectopic pregnancy
• Orofacial clefts in infants
Smoking can also affect men's sperm, which can reduce fertility and also increase risks for birth defects and miscarriage.
Smoking can affect bone health.
Women past childbearing years who smoke have weaker bones than women who never smoked. They are also at greater risk for broken bones.
Smoking affects the health of your teeth and gums and can cause tooth loss.
Smoking can increase your risk for cataracts (clouding of the eye's lens that makes it hard for you to see). It can also cause age-related macular degeneration (AMD). AMD is damage to a small spot near the center of the retina, the part of the eye needed for central vision.
Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30-40% higher for active smokers than nonsmokers.
Smoking causes general adverse effects on the body, including inflammation and decreased immune function.
Smoking is a cause of rheumatoid arthritis.
Quitting Smoking and Reduced Risks

• Quitting smoking cuts cardiovascular risks. Just 1 year after quitting smoking, your risk for a heart attack drops sharply.
• Within 2 to 5 years after quitting smoking, your risk for stroke may reduce to about that of a nonsmoker's.
• If you quit smoking, your risks for cancers of the mouth, throat, esophagus, and bladder drop by half within 5 years.
• Ten years after you quit smoking, your risk for lung cancer drops by half.

Diseases Caused By Smoking

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Thursday, August 10

Why You Need Zinc and How to Get It

What Is Zinc?

It's a mineral your cells need to fight off bacteria and viruses and make the genetic material, called DNA, that tells your body how to work the way it should. It helps you heal wounds, aids your senses of smell and taste, and is important for infants and children as they grow.

Why You Need Zinc and How to Get It

How Much Do You Need?

An adult man needs 11 milligrams a day, and an adult woman, 8 milligrams. If you're pregnant or breastfeeding, you'll need more - around 12 milligrams. Children need 2 to 11 milligrams depending on their age and gender. Talk to your pediatrician about how much is right for your child.

Do You Get Enough Zinc?

Probably, yes - most people do. But some things can make it hard for your body to use it, including surgery on your stomach or intestines, alcohol abuse, and digestive diseases like ulcerative colitis or Crohn's disease. And people who don't eat meat or animal products can have a harder time getting enough zinc from food.

What Happens If I Don't Get Enough Zinc?

It can make children grow more slowly and delay puberty in teens. Adults who are low on zinc can have hair loss, diarrhea, sores on their eyes and skin, and loss of appetite. It also can affect a man's sexual desire. Talk to your doctor before taking a supplement, though. These issues can be caused by something other than a lack of zinc.

Zinc May Help Prevent Age-Related Macular Degeneration

Zinc May Help Prevent Age-Related Macular Degeneration (AMD)

This is an eye disease that causes vision loss over time. A large study of people at higher risk of getting AMD showed that taking a daily multivitamin with zinc - along with vitamins A and C, beta-carotene, and copper - may help avoid it. But other studies haven't had the same results. If you're at higher risk, talk to your doctor to see if a vitamin would be a good idea for you.

Healthy Skin

Zinc helps your skin do what it's supposed to: protect you from heat and cold, bacteria, and viruses. Your doctor might prescribe a zinc supplement or ointment to treat certain skin problems, like acne.

Can Zinc Cure the Common Cold?

Some studies suggest that if you take zinc lozenges or syrup - but not pill supplements - within 24 hours of feeling a cold coming on, your symptoms won't be as bad or last as long. (Nasal sprays and gels that have it are linked to the loss of sense of smell.) More research is needed to figure out if it really works and, if so, how you should take it.

Sources Of Zinc

Zinc Rich Foods

Cashews

How about a zinc-rich snack? Cashews have 1.6 milligrams of zinc per 1-ounce serving. Keep them at your desk for a healthy treat instead of candy or chips. Just watch your portions. While they're healthy, cashews are also full of calories and fat.

Chuck Roast

Too much red meat - especially fatty meat - has been linked to health problems, but it can deliver some essential nutrients, including zinc. Just keep your portions small and eat plenty of green vegetables on the side. A 3-ounce serving has about 7 milligrams of zinc.

Alaska King Crab

Slice a lemon and melt a little butter, and you'll have a feast fit for a king. A 3-ounce serving has 6.5 milligrams of zinc. It takes a bit of practice to get the meat out of the shell, but that's half the fun. Plus, it makes you eat more slowly, which is healthier because you're less likely to overeat.

Dark Meat Chicken

It has 2.4 milligrams of zinc per 3-ounce serving, compared with less than 1 milligram in a skinless chicken breast. Try some pan-roasted chicken thighs with sautéed kale for a healthy, tasty meal.

Oysters Are A Source Of Zinc

Oysters

Nothing beats oysters for zinc. A 3-ounce serving has 74 milligrams. That's five times more than you need per day. Eat them raw with a lemon or bake them Rockefeller-style with spinach, onions, breadcrumbs, and Parmesan cheese.

Zinc Supplements

Even though most Americans get enough zinc from their meat-rich diet, some people take more - as a supplement by itself or as part of a multivitamin. This can be helpful if you don't get enough in your diet or you have certain medical conditions, but it's not always safe. Check with your doctor first.

Too Much Zinc Can Be Bad for You

It can cause diarrhea, stomach cramps, headache, and nausea. And if you take too much for too long, you may have lower levels of copper (another essential nutrient), a weaker immune system, and less HDL - or "good" - cholesterol. You shouldn't get more than 40 milligrams a day unless your doctor has told you otherwise. Talk to your pediatrician before giving a zinc supplement to your child.

Interactions With Other Medication

Zinc supplements can weaken the effects of antibiotics, and antibiotics can make it harder for your body to use zinc. The supplements also can make it harder for your body to absorb some drugs, like the arthritis drug penicillamine. Talk to your doctor before taking a zinc supplement.
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