February 8, 2017

Hidradenitis suppurativa or HS is a skin disease that affects areas bearing apocrine sweat glands and hair follicles; such as the underarms, groin and buttocks, and under the breasts in women.

Also known as acne inversa, HS is a chronic inflammatory disease of the terminal follicular epithelium, often occurring in areas rich in apocrine glands. Originally thought to arise from these glands, the condition is now believed to begin through follicular abnormalities.

It may be associated with other follicular-dysfunction processes such as acne, boils in the scalp (folliculitis decalvans) or pilonidal cyst. The process arises in the mid-to-deep dermis and does not seem to be caused by bacterial agents.

It is typically characterized by erythematous, tender, sterile nodules of various sizes that develop insidiously in the inguinal, perianal, submammary, and axillary regions. These nodules may progress to frank abscesses that not only drain to produce a very foul odor but also further develop tunneling, cavitations and sinus tracts in the affected areas, leading to the development of scars and keloids. Rarely, contractures and immobility may result.

This painful condition can cause social isolation and depression . Depending on the severity of symptoms, HS will often significantly impact the quality of life of patients, begging the need for more effective treatment regimens and therapeutic options.

Causes

No one knows for sure what causes HS. Because it occurs after puberty, hormones likely play a role. The person’s immune system also seems to play a role.

It is possible that HS develops when the person’s immune system overreacts. HS begins in the hair follicles (where hair grows out of the skin). Like everyday acne, HS forms when the hair follicles clog with bacteria and other substances. It is possible that HS develops in people who have an immune system that overreacts to the plugged hair follicle.

Hormones are involved in the control of apocrine sweat glands and certainly play a part in the disease. Hidradenitis suppurativa affects women more often than men. It does not start before puberty or after the menopause. It may get better during pregnancy, but is often worse before menstrual periods. Some patients do well with hormone treatments.

Bacteria play a part too, but a variety of germs, and not just one special type, is found in the spots. It is not clear whether they cause the disease, or just flourish within it.

There may be a link with acne.

Lifestyle also seems to play a role. It seems that smoking, being overweight, or taking lithium may trigger HS. These things do not cause HS. If a person is susceptible to getting HS, any of these could make HS appear for the first time or worsen existing HS.

Although the exact cause is still unknown, dermatologists have learned the following from studying HS –

  • It is not contagious.
  • Poor hygiene does not cause HS.
  • About one-third of people who get HS have a blood relative who has HS

Risk Factors

Hidradenitis affects 2-3% of the US population, but the number may be higher because so few people discuss this painful condition with their doctors. Other factors associated with developing hidradenitis, include being –

  • Female: Hidradenitis affects four times more women than men
  • African American
  • Obese
  • A smoker

Hormonal influences are also thought to influence who will develop the condition, but there is no clear evidence that this is the case.

Symptoms

Hidradenitis suppurativa commonly occurs around hair follicles, where many oil and sweat glands are found, such as in the armpits, groin and anal area. It may also occur in areas where skin rubs together, such as the inner thighs, under the breasts or between the buttocks. Hidradenitis suppurativa can affect a single area or multiple areas of the body.

Signs and symptoms of hidradenitis suppurativa include –

Blackheads – Small pitted areas of skin containing blackheads — often appearing in pairs or a “double-barreled” pattern — are a common feature.

Red, tender bumps – These bumps, or lesions, often enlarge, break open and drain pus. The drainage may have an unpleasant odor. Itching, burning and excessive sweating may accompany the bumps.

Painful, pea-sized lumps – These hard lumps, which develop under the skin, may persist for years, enlarge and become inflamed.

Leaking bumps or sores – These open wounds heal very slowly, if at all, often leading to scarring and the development of tunnels under the skin.

Hidradenitis suppurativa often starts after puberty with a single, painful bump that persists for weeks or months. For some people, the disease progressively worsens and affects multiple areas of their body. Other people experience only mild symptoms. Excess weight, stress, hormonal changes, heat or excessive perspiration can worsen symptoms.

Complications

Hidradenitis suppurativa often causes complications when the disease is persistent and severe. These complications include –

Scars and skin changes – Severe hidradenitis suppurativa may leave rope-like scars, pitted skin or patches of skin that are darker than normal.

Restricted movement – Open sores and scar tissue may cause limited or painful movement, especially when the disease affects the armpits or thighs.

Obstructed lymph drainage  – The most common sites for hidradenitis suppurativa also contain many lymph nodes. Scar tissue can interfere with the lymph drainage system, which may result in swelling in the arms, legs or genitals.

Social isolation – The location, drainage and odor of the sores — singly or in combination — can cause embarrassment and reluctance to go out in public, leading to depression.

Treatment

Antibiotics

  • Topical clindamycin, with benzoyl peroxide to reduce bacterial resistance
  • Short course of oral antibiotics for acute staphylococcal abscesses, eg flucloxacillin
  • Prolonged courses (minimum 3 months) of tetracycline, metronidazole, cotrimoxazole, fluoroquinolones or dapsone for their anti-inflammatory action
  • Six-to-twelve week courses of the combination of clindamycin (or doxycycline) and rifampicin for severe disease

Antiandrogens – Long-term oral contraceptive pill; antiandrogenic progesterones drospirenone or cyproterone acetate may be more effective than standard combined pills. These are more suitable than progesterone-only pills or devices.

Immunomodulatory treatments for severe diseases –

  • Intralesional corticosteroids into nodules
  • Systemic corticosteroids short-term for flares
  • Methotrexate, ciclosporin, and azathioprine
  • TNFα inhibitors adalimumab and infliximab, used in higher dose than required for psoriasis, are the most successful treatments to date

Other medical treatments –

  • Metformin in patients with insulin resistance
  • Acitretin (unsuitable for females of childbearing potential)
  • Isotretinoin – more effective for acne
  • Colchicine

Surgeries –

  • Incision and drainage of acute abscesses
  • Curettage and deroofing of nodules, abscesses and sinuses
  • Laser ablation of nodules, abscesses and sinuses
  • Wide local excision of persistent nodules
  • Radical excisional surgery of entire affected areaa
  • Laser hair removal

Self Help –

  • Weight loss; follow low-glycaemic, low-dairy diet
  • Smoking cessation: this can lead to improvement within a few months
  • Loose fitting clothing
  • Daily unfragranced antiperspirants
  • If prone to secondary infection, wash with antiseptics or take bleach baths
  • Apply hydrogen peroxide solution or medical grade honey to reduce malodour
  • Apply simple dressings to draining sinuses
  • Analgesics, such as paracetamol (acetaminophen), for pain control.

Alternative Treatment

Zinc – One nutrient that may be helpful in this condition is zinc. Zinc may help lower androgen levels that can lead to excess oil production and gland blockage, and have anti-inflammatory properties.

Anti-inflammatory Therapies – From a naturopathic approach, HS may be addressed using nutrients, herbs and dietary strategies that offer anti-inflammatory properties. Lowering any inflammatory triggers and possible contributing compounds like cytokines in the body may improve redness and aggravation of lesions. Identifying food triggers may be a start – in the patients I have seen with this condition decreasing intake of dairy and refined sugar seemed to provide some relief, although triggers are likely patient specific. An IgG food sensitivity test may help guide dietary elimination if triggers are unclear.

Weight Management – There is a high correlation in presence of HS and obesity, and studies suggest that degree of obesity corresponds with severity of disease. In patients who are overweight or obese, body mass may be contributing in several ways this condition. Excess adipose tissue has been shown to increase levels of inflammation and affect hormone levels, which may aggravate the inflammatory lesions involved in HS. Increased body weight may also aggravate friction in folds and predispose to obstruction and irritation of lesions that are present, while another possible explanation for this connection is a common underlying genetic predisposition to obesity and HS that is currently being investigated. (7) Weight loss as a treatment for HS has been investigated in one small study demonstrating a 15% weight loss is associated with significant disease improvement (8). HS is however not uncommon in patients of normal body weight, in whom weight loss would not be likely to influence disease progression, and in some patients weight loss an leave skin folds that increase friction. This observation also suggests that weight could be more of an aggravating factor that a cause of this condition.

 

Reference –

http://familydoctor.org/familydoctor/en/diseases-conditions/hidradenitis-suppurativa/treatment.html

http://www.medicinenet.com/image-collection/hidradenitis_suppurativa_picture/picture.htm

http://dermatologytimes.modernmedicine.com/dermatology-times/news/hidradentitis-suppurativa-therapy-options-progressing?page=0,1

http://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/basics/symptoms/con-20027334

http://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/basics/symptoms/con-20027334

http://www.dailystrength.org/c/Hidradenitis-Suppurativa/support-group

http://www.dermnet.com/images/Hidradenitis-Suppurativa

http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=387

http://www.earthclinic.com/cures/hidradenitis_suppurativa.html

 

Posted in IMMUNITY
February 8, 2017

Guillain-Barré syndrome (GBS) is a rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness. It is an  important cause of acute neuromuscular paralysis.

The term GBS is often considered to be synonymous with acute inflammatory demyelinating polyradiculoneuropathy (AIDP), but with the increasing recognition over the past few decades of variants, the number of diseases that fall under the rubric GBS has grown to include axonal variants and more restricted variants such as Miller Fisher syndrome (MFS).

In GBS the nerve insulation (myelin) and sometimes even the inner covered part of the nerve (axon) is damaged and signals are delayed or otherwise changed. The resultant antibodies attack the myelin sheath, and sometimes the axon, causing paralysis and muscular weakness as well as strange sensations, as the sensory nerves of the skin may be affected.

The syndrome appears to be triggered by acute viral or bacterial illnesses, such as respiratory or gastrointestinal infections, occurring one to three weeks earlier. However, other events such as pregnancy, dengue fever, surgical procedures, insect bites and Bell’s palsy have also been shown to cause GBS. Usually, the symptoms start in the feet or legs and progress up the body over a few days or weeks. The disorder can be mild, moderate or severe, with life support needed in the worst cases. The exact cause is unknown and there is no known cure. Most people spontaneously recover, although some will be left with permanent disabilities.

In the United States, for example, an estimated 3,000 to 6,000 people develop GBS each year on average, whether or not they received a vaccination. Anyone can develop GBS; however, it is more common among older adults. The incidence of GBS increases with age, and people older than 50 years are at greatest risk for developing GBS.

Causes

The precise cause of Guillain-Barre is unknown. Some of the cases have followed a lung infection or a gastrointestinal infection. The following infections have been associated with Guillain-Barre – 

  • Campylobacterjejuni infection. Campylobacteris the most common bacterial cause of diarrhea in the United States. Campylobacterinfection is also the most common risk factor for Guillain-Barre. It is often found in undercooked food, especially poultry.
  • Influenza (the flu)
  • Cytomegalovirus (a strain of the herpes virus)
  • Epstein-Barr virus infection (mononucleosis)
  • Mycoplasma pneumonia (‘atypical pnueumonia’ caused by bacteria-like organisms)
  • HIV or AIDS
  • Hodgkin disease, a malignant disease of the lymphatic system
  • Systemic lupus erythromatosus, an autoimmune disease of the skin and other organs

There is no evidence to suggest that Guillain-Barrè syndrome is contagious.

Symptoms

Symptoms of Guillain-Barré syndrome can develop quickly over a few hours. The muscle weakness often gets progressively worse within a few days or weeks.

Symptoms often start in your feet and hands before spreading to your arms and legs. Initially, you may have:

  • Pain, tingling and numbness
  • Progressive muscle weakness
  • Co-ordination problems and unsteadiness (you may be unable to walk unaided)

The weakness usually affects both sides of your body and may get worse over a period of several days.

In mild cases of Guillain-Barré syndrome, your muscles may only be slightly weakened. However, in more severe cases, the muscle weakness can progress to:

  • Temporary paralysis of the legs, arms and face
  • Temporary paralysis of the respiratory muscles
  • Blurred or double vision
  • Difficulty speaking
  • Difficulty chewing or swallowing (dysphagia), resulting in the need to be fed through a tube
  • Difficulty with digestion or bladder control
  • Fluctuations in heart rate or blood pressure

Some people with Guillain-Barré syndrome don’t experience any pain, while others have severe pain in their spine, arms and legs.

Emergency symptoms (seek medical help right away) –

  • Breathing temporarily stops
  • Cannot take a deep breath
  • Difficulty breathing
  • Difficulty swallowing
  • Drooling
  • Fainting
  • Feeling light-headed when standing

Treatment

Conventional Treatment

  • Plasma Exchange or Plasmapheresis – Plasma exchange is a method by which whole blood is removed from the body and processed so that the red and white blood cells are separated from the plasma, or liquid portion of the blood. The blood cells are then returned to the patient without the plasma, which the body quickly replaces. Scientists still don’t know exactly why plasma exchange works, but the technique seems to reduce the severity and duration of the Guillain-Barré episode. This may be because plasmapheresis can remove antibodies and other immune cell-derived factors that could contribute to nerve damage.
  • Immunoglobin therapy – In this therapy the patient is given intravenous injections of the proteins that, in small quantities, the immune system uses naturally to attack invading organisms. Researchers have found that giving high doses of these immunoglobulins, derived from a pool of thousands of normal donors, to GBS patients can lessen the immune attack on the nervous system. Investigators don’t know why or how this works, although several hypotheses have been proposed.
  • Steroid Hormones (corticosteroids) – This is helpful in reducing the severity of Guillain-Barré, but controlled clinical trials have demonstrated that this treatment not only is not effective but may even have a deleterious effect on the disease.
  • Medications – Muscle and joint pain can be treated with over-the-counter analgesics such as aspirin. If necessary, stronger pain medication (e.g., acetaminophen with hydrocodone) may be prescribed. Muscle spasms can be controlled with relaxants such as diazepam (Valium). Unpleasant sensation problems, such as painful tingling, can be treated with tricyclic antidepressants (TCAs) or anticonvulsants such as gabapentin (Neurontin). Corticosteroids, which often effectively treat the symptoms of autoimmune disorders, actually worsen GBS and should not be used. However, they often are used to treat CIDP.

 

 

Posted in IMMUNITY
February 8, 2017

Herpes is one of the most common sexually transmitted infections. It is caused by the herpes simplex virus (HSV). Genital herpes is usually spread by having vaginal, oral, or anal sex. One in five women ages 14 to 49 has genital herpes.

There are two types of HSV –

  • HSV-1 most often causes infections of the mouth and lips, called cold sores or “fever blisters.” Symptoms are often milder than genital herpes, and you may get fewer outbreaks.2 It can spread to the genital area during oral sex and cause genital herpes. If HSV-1 spreads to the genital area, it is still HSV-1.
  • HSV-2 is the most common cause of genital herpes. It is spread through vaginal, oral, or anal sex. HSV-2 can spread to the mouth during oral sex. If HSV-2 spreads to the mouth or lips during oral sex, it is still HSV-2.

Genital herpes is characterized by recurrent clusters of vesicles and lesions at the genital areas or below the waist. The female genital areas are on or near the pubis, vulva, labia, clitoris, buttocks or rectum. The areas for male genital herpes include on or around the penis, the inner thigh, buttocks, or rectum. Proctitis, or inflammation of the rectum, can be due to HSV.

The herpes simplex virus (HSV) is easily human transmissible. It is passed from one person to another by close, direct contact. The most common mode of transmission is through vaginal, anal or oral sex. When somebody becomes infected with HSV, it will generally remain dormant.

Most people who are infected with HSV do not know it because their symptoms are so slight – many people have no discernible symptoms.

Causes

HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to be broken or to have a sore.

Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection, but you can get herpes from kissing. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.

HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips – so-called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

The following can be ways of becoming infected –

  • Having unprotected vaginal or anal sex
  • Having oral sex with a person who gets cold sores
  • Sharing sex toys
  • Having genital contact with an infected person.

Infection of a baby can occur during vaginal delivery if the mother has genital herpes, particularly if it is the first attack. Babies infected in this way can become severely ill. The obstetrician and midwife should be told of past genital herpes infections so the risk of this complication can be minimised.

Risk Factors

People are at risk if they –

Are a woman – Women are more likely to have genital herpes than are men. The virus is sexually transmitted more easily from men to women than it is from women to men.

Have multiple sexual partners – Each additional sexual partner raises the risk of being exposed to the virus that causes genital herpes.

Symptoms

Many people with genital herpes never have sores. Or they have very mild symptoms that go unnoticed or are mistaken for insect bites or another skin condition.

If signs and symptoms do occur during the first outbreak, they can be severe. This first outbreak most often happens within 2 days to 2 weeks of being infected.

General symptoms may include –

  • Decreased appetite
  • Fever
  • General sick feeling (malaise)
  • Muscle aches in the lower back, buttocks, thighs, or knees
  • Swollen and tender lymph nodes in the groin

Genital symptoms include small, painful blisters filled with clear or straw-colored fluid. Areas where the sores may found include –

  • Outer vaginal lips (labia), vagina, cervix, around the anus, and on the thighs or buttocks (in women)
  • Penis, scrotum, around the anus, on the thighs or buttocks (in men)
  • Tongue, mouth, eyes, gums, lips, fingers, and other parts of the body (in both genders)

Before the blisters appear, there may be tingling, burning, itching, or pain at the site where the blisters will appear. When the blisters break, they leave shallow ulcers that are very painful. These ulcers crust over and heal in 7 to 14 days or more.

Other symptoms may include-

  • Painful urination
  • Vaginal discharge (in women) or inability to empty the bladder that requires a urinary catheter

A second outbreak can appear weeks or months later. It is usually less severe and it goes away sooner than the first outbreak. Over time, the number of outbreaks may decrease.

Complications

Other sexually transmitted infections – Having genital sores increases the risk of transmitting or contracting other sexually transmitted infections, including AIDS.

Newborn infection – Babies born to infected mothers can be exposed to the virus during the birthing process. This may result in brain damage, blindness or death for the newborn.

Bladder problems – In some cases, the sores associated with genital herpes can cause inflammation around the tube that delivers urine from the bladder to the outside world (urethra). The swelling can close the urethra for several days, requiring the insertion of a catheter to drain the bladder.

Meningitis – In rare instances, HSV infection leads to inflammation of the membranes and cerebrospinal fluid surrounding the brain and spinal cord.

Rectal inflammation (proctitis) – Genital herpes can lead to inflammation of the lining of the rectum, particularly in men who have sex with men.

Treatment

Medications – Antiviral medication, such as acyclovir or valcyclovir, can lessen the severity of an outbreak, lower the chances of passing the virus to a partner and shorten the time it takes for a sore to heal. Medication works best if it is started as soon as possible after an outbreak begins.

As recurrent outbreaks are milder, treatment is not usually necessary.

Episodic treatment and suppressive treatment

  • Episodic treatment – This is generally for patients who have less than six recurrences in one year. A five-day course of antivirals is prescribed each time symptoms appear.
  • Suppressive treatment – If a patient has more than six recurrences in a year, or if symptoms are very severe, antiviral treatment may last longer. The aim here is to prevent further recurrences. Some patients may have to take acyclovir twice daily for several months. Although suppressive treatment significantly reduces the risk of passing HSV to a partner, there is still a risk.

Pregnant women may be treated for herpes during the last month of pregnancy to reduce the chance of having an outbreak at the time of delivery. If there is an outbreak around the time of delivery, a C-section will be recommended to reduce the chance of infecting the baby.

Tenofovir vaginal gel protects women from herpes simplex – tenofovir, an anti-HIV mediation, when formulated as a vaginal gel, was found to reduce herpes simplex infection risk, scientists from the USA, Belgium and Italy reported in the journal Cell Host & Microbe. They explained that when in the vaginal gel formulation, higher concentrations of the drug reach the vaginal cells compared to tenofovir’s orally administered equivalent.

To reduce the risk of developing or passing on genital herpes:

  • Use condoms when having sex – although condoms are recommended, they provide a “modest” reduction in the risk of acquiring HSV-2, compared to other STIs, researchers reported in Archives of Internal Medicine (July 13th, 2009 issue).
  • Do not have sex while symptoms are present (genital, anal, or skin-to-skin)
  • Do not kiss when there is a cold sore around the mouth
  • Do not have many sexual partners
  • Male circumcision cuts risk of genital herpes infection, as well as HPV

Some people find that stress, being tired, illness, friction against the skin, or sunbathing may trigger recurrences of symptoms. Avoiding such triggers, if they can be identified, may help reduce the number of recurrences.

Alternative Treatment

Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work. Some are capsules taken by mouth. Others come in the form of ointment that is applied to the skin. Popular herbal and supplement remedies for herpes simplex include –

  • Echinacea ( Echinacea purpurea )
  • Siberian ginseng ( Eleutherococcus senticosus )
  • Aloe ( Aloe vera )
  • Bee products that contain propolis, a tree resin collected by bees
  • Lysine
  • Zinc

Supplements

  • Lysine – Studies suggest that lysine may help reduce the number of recurring outbreaks of cold sores. A few studies also suggest that lysine may help shorten the length of an outbreak. Lysine can increase the amount of calcium that the body absorbs.
  • Propolis – A resin made by bees, propolis is loaded with antioxidants that help fight infection and boost immune function. Studies show that, it can stop HSV-1 and HSV-2 from reproducing.
  • Zinc – Zinc is effective against HSV-1 and HSV-2. In one small study, people who applied zinc oxide cream to cold sores saw them heal faster than those who applied a placebo cream.
  • Vitamin E – Topical application of vitamin E helps to relief pain and aid the healing of oral herpetic lesions.
  • Vitamin C – Ascorbic acid has been shown to inactivate a wide range of viruses in vitro, including Herpes simplex virus, and to enhance immune function.
  • Lithium – Preliminary evidence suggests that oral or topical lithium is beneficial. Lithium inhibited the replication of HSV-1 and HSV-2 in vitro at concentrations that did not inhibit host cell replication.

Herbs

  • Lemon balm – Several studies suggest that topical ointments containing lemon balm may help heal cold sores.
  • Aloe (Aloe vera) – Preliminary evidence suggests that aloe gel used topically may improve the symptoms of genital herpes in men.
  • Rhubarb cream (Rheum palmatum) – A topical cream made from sage (Salvia officinalis) and rhubarb was as effective as Zovirax in healing cold sores.
  • Eleutherococcus or Siberian ginseng – Siberian ginseng reduced the frequency, severity, and duration of outbreaks. People with high blood pressure, certain heart conditions; diabetes; obstructive sleep apnea; hormone-related cancers such as breast cancer, ovarian cancer, or uterine cancer; narcolepsy (frequent day time sleeping); mania; or who are pregnant or breastfeeding should not take Siberian ginseng.
  • Peppermint oil (Mentha x piperita) – Peppermint oil helps to stop a number of viruses from reproducing, including herpes.
  • Tea Tree Oil – This substance has been hailed as a veritable cure-all when it comes to any ailment that involves open sores.
  • Samento extract – This substance is available in both pill and liquid form. It is extracted from a plant found in many rain forests around the world and is thought to be a major immune system booster. Most herpes outbreaks happen when the immune system is at a low point and the virus is able to cause an outbreak.

Mind Body Treatment

Having genital herpes can impact your social and emotional life. In fact, if you have herpes, it is common to feel depressed, angry, and even guilty. Worrying about possible rejection by someone with whom a person wants to be intimate is also common. Joining a support group where members share experiences and problems can help relieve the stresses associated with having genital herpes. This may also include –

  • Relaxation Techniques
  • Self Hypnosis
  • Emotional Support

There are a number of natural options available for the prevention and treatment of Herpes simplex infections. These medications can be used to alleviate the symptoms of an outbreak and shorten its course or to suppress recurrences, reduce the number outbreaks and prevent spreading the disease.

 

Reference –

http://kidshealth.org/teen/sexual_health/stds/std_herpes.html

http://www.nhs.uk/conditions/genital-herpes/Pages/Introduction.aspx

http://www.womenshealth.gov/publications/our-publications/fact-sheet/genital-herpes.html

http://www.medicalnewstoday.com/articles/151739.php

http://patient.info/health/genital-herpes

http://smartsexresource.com/topics/herpes-simplex-virus

http://www.pamf.org/teen/sex/std/std/herpes.html

http://www.dermnetnz.org/viral/genital-herpes.html

http://www.fpa.org.uk/sexually-transmitted-infections-stis-help/genital-herpes

https://www.dred.com/uk/signs-of-genital-herpes.html

http://www.thebody.com/content/art6539.html

https://www.aad.org/public/diseases/contagious-skin-diseases/herpes-simplex

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes

http://www.herpes.com/genitalinfo.shtml

http://www.eadv.org/patient-corner/leaflets/eadv-leaflets/genital-herpes/

http://www.medicalnewstoday.com/articles/151739.php?page=2

http://articles.mercola.com/sites/articles/archive/2010/08/07/honey-works-better-than-drugs-for-herpes.aspx

http://www.medicinenet.com/genital_herpes_in_women_overview/article.htm

http://www.myhomeremedies.com/topic.cgi?topicid=237

http://health.howstuffworks.com/wellness/natural-medicine/home-remedies/home-remedies-for-genital-herpes.htm

 

Posted in IMMUNITY
February 8, 2017

Edema is swelling or puffiness of parts of the body caused by fluid retention i.e. excess fluid is trapped in the body’s tissues. Edema happens most often in the feet, ankles, and legs, but can affect other parts of the body, such as the face, hands, and abdomen. It can also involve the entire body.

Normally the body maintains a balance of fluid in tissues by ensuring that the same of amount of water entering the body also leaves it. The circulatory system transports fluid within the body via its network of blood vessels. The fluid, which contains oxygen and nutrients needed by the cells, moves from the walls of the blood vessels into the body’s tissues. After its nutrients are used up, fluid moves back into the blood vessels and returns to the heart. The lymphatic system (a network of channels in the body that carry lymph, a colorless fluid containing white blood cells to fight infection) also absorbs and transports this fluid. In edema, either too much fluid moves from the blood vessels into the tissues, or not enough fluid moves from the tissues back into the blood vessels. This fluid imbalance can cause mild to severe swelling in one or more parts of the body.

There are many types of edema. The most common ones are –

  • Peripheral edema – In the feet (pedal edema), ankles, legs, hands and arms.
  • Cerebral edema – In and around the brain (cerebral edema).
  • Eye edema – In and around the eyes, e.g. macular edema, corneal edema, periorbital edema (puffiness around the eyes. Macular edema is a serious complication of diabetic retinopathy.

Pregnant women and older adults often get edema, but it can happen to anyone. Edema is a symptom, not a disease or disorder. In fact, edema is a normal response to injury. Edema becomes a concern when it persists beyond the inflammatory phase. Widespread, long-term edema can indicate a serious underlying health problem.

Causes

Edema has many possible causes –

  • Blood clots – Clots can cause pooling of fluid and may be accompanied by discoloration and pain. In some instances, clots may cause no pain.
  • Edema can occur as a result of gravity, especially from sitting or standing in one place for too long. Water naturally gets pulled down into your legs and feet.
  • It can happen from a weakening in the valves of the veins in the legs (a condition called venous insufficiency). This problem makes it hard for the veins to push blood back up to the heart, and leads to varicose veins and a buildup of fluid in the legs.
  • Certain diseases — such as congestive heart failure and lung, liver, kidney, and thyroid diseases can cause edema or make it worse.
  • Some drugs, such as medications that you are taking for your blood pressure or to control pain, may cause or worsen edema.
  • An allergic reaction, severe inflammation, burns, trauma, clot(s), or poor nutrition can also cause edema.
  • Too much salt from your diet can make edema worse.
  • Being pregnant can cause edema in the legs as the uterus puts pressure on the blood vessels in the lower trunk of the body.
  • Edema can be a side effect of some medications, including:
    • High blood pressure medications
    • Nonsteroidal anti-inflammatory drugs
    • Steroid drugs
    • Estrogens
    • Certain diabetes medications called thiazolidinediones
  • Menopause – Around the period of the menopause, as well as after, hormone fluctuations can cause fluid retention. Hormone replacement therapy after the menopause can also cause edema.
  • Malnutrition and/or bad diet – Dietitians say low consumption of thiamine (vitamin B1), as well as insufficient vitamins B6 and B5, may contribute toward fluid retention. Low levels of albumin may also play a part – low albumin levels can also be caused by kidney disease.

Symptoms

The fluid build-up may cause swelling in one particular part of the body, after an injury, for example, or may be more general. Generalized edema is usually seen in health disorders such as heart failure or kidney disease. Symptoms include –

  • Swollen and puffy skin
  • Skin discoloration
  • Skin that “pits” when pressed
  • Stiff, tender and painful joints
  • Weight gain or weight loss
  • Raised blood pressure and heart rate

Complications

If left untreated, edema can cause –

  • Increasingly painful swelling
  • Difficulty walking
  • Stiffness
  • Stretched skin, which can become itchy and uncomfortable
  • Increased risk of infection in the swollen area
  • Scarring between layers of tissue
  • Decreased blood circulation
  • Decreased elasticity of arteries, veins, joints and muscles
  • Increased risk of skin ulcers

Treatment

Diuretics – These are drugs that raise the rate of urination, providing a means of forced diuresis. Diuresis is the increased production of urine by the kidney. There are several types of diuretics – they increase the excretion of water from the body in various different ways. Diuretics are not suitable if the patient is pregnant, or has chronic venous insufficiency (weakened valves in the veins of the legs).

Oxygen therapy – Oxygen delivered through the nose may improve poor vision caused by diabetic macular edema.

Antiangiogenesis therapy (controlling blood vessel growth) – The beneficial effects of anti-angiogenesis drugs in the treatment of the glioblastomas (deadly brain tumors) appear to result primarily from the reduction of edema.

Alternative Treatment

Pycnogenol was shown in both pre-clinical and clinical studies to strengthen capillary walls and prevent edema. Research has shown Pycnogenol actually seals the brittle capillaries and stops the outflow of blood into tissue which causes the swellings, edema and microbleedings. Coupled with its anti-inflammatory properties and patent for reducing platelet aggregation, these are the fundamental mechanisms of action behind Pycnogenol for edema.

B vitamins are essential for proper functioning of several metabolic processes in the body and for red blood cell formation. Deficiency of B vitamins, especially vitamins B-1 and B-2, can lead to edema and swelling.

Flavonoids – A new class of largely unstudied vitamins are referred to as flavonoids. They provide the intense flavors in food, such as capsacin in cayenne, and the pigments, such as anthocyanin in blueberries. High doses of flavonoids are demonstrated by controlled studies to effectively reduce edema and aid in many potential causes. The best sources are fresh herbs and spices combined with colored vegetables and fruits.

Thiamine – B1 deficiency is one known cause of fluid retention. The presence of other deficiency side effects suggest positive diagnosis. These include aching and stiff jointed in the swollen areas.

Pantothenic Acid – Vitamin B5 is directly linked to edema. One of the primary functions of this vitamin is the excretion of excess fluids. Deficiency also results in such symptoms as nausea, insomnia, and muscle cramping.

Vitamin B6 is another vitamin linked directly to heart and circulatory health. Failure of the heart and vessel walls to maintain the right amount of pressure results in fluid retention.

Magnesium is needed for nerve conduction and to provide muscular strength. Because it can close some calcium channels on the membranes of neurons, high levels of magnesium can reduce the activity of nerves in the nervous system. Loop diuretics and thiazide diuretics can promote magnesium loss in the kidneys. This is an unfortunate side effect involving another unwanted side effect of diuretics: potassium loss.

Alfalfa – Provides necessary minerals. Has chlorophyll which detoxifies the body.

Calcium – Replenishes minerals lost in the edema correction process.

Cornsilk – Combination of herbs and corn silk that have been known to reduce the formation of sediments in the kidneys and helps to reduce water retention.

Horse Chestnut – Horse Chestnut seed contain Aescin which has helped to effectively reduce post-surgical edema.

Dandelion leaf is itself a diuretic, so it should not be used while taking diuretic medications.

Grape seed extract for antioxidant support. Evidence suggests that using grape seed extract may improve chronic venous insufficiency, which causes swelling when blood pools in the legs.

Acupuncture – Acupuncture may improve fluid balance.

Massage– Therapeutic massage can help lymph nodes drain.

 

Reference –

https://www.nlm.nih.gov/medlineplus/edema.html

http://www.medicalnewstoday.com/articles/159111.php

https://my.clevelandclinic.org/health/diseases_conditions/hic_Edema

http://www.cancer.net/navigating-cancer-care/side-effects/fluid-retention-or-edema

http://www.healthline.com/symptom/swollen-ankle

https://umm.edu/health/medical/altmed/condition/edema

http://www.medscape.com/viewarticle/524606

http://www.cvphysiology.com/Microcirculation/M010.htm

http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/edema.aspx

http://www.drugs.com/health-guide/edema.html

http://www.msdmanuals.com/professional/cardiovascular-disorders/symptoms-of-cardiovascular-disorders/edema

http://www.fpnotebook.com/renal/Edema/Edm.htm

http://www.news-medical.net/health/What-is-Edema.aspx

http://www.strokecenter.org/professionals/brain-anatomy/cellular-injury-during-ischemia/edema-formation/

 

 

Posted in IMMUNITY
February 8, 2017

Cytomegalovirus or CMV is a common virus that infects people of all ages. Most CMV infections are “silent,” meaning most people who are infected with CMV have no signs or symptoms. However, CMV can cause disease in people with a weakened immune system and in babies infected before birth. About 1 in 150 children is born with congenital (present at birth) CMV infection. The word “Cytomegalovirus” comes from the Greek word cyto meaning “cell”, and the Greek word megalo meaning “large”.

Other members of the herpes virus family cause chickenpox, infectious mononucleosis, fever blisters (herpes simplex type I) and genital herpes (herpes simplex type II). Like other herpes viruses, CMV infection can become dormant for a while and may reactivate later. The virus is carried by people and is not associated with food, water or animals.

Although the virus is not highly communicable, it can be spread from person to person by direct contact. The virus is shed in the urine, saliva, blood, breast milk, semen and to a lesser extent in other body fluids. Transmission can also occur from an infected mother to her fetus or newborn and by blood transfusion and organ transplants. People who have received an organ transplant are particularly susceptible to CMV infection because they are given drugs that suppress the immune system (immune-suppressants) to prevent rejection of the transplant. In people with a weakened immune system, disease often results from reactivation of the dormant virus.

Types of CMV

  • Acquired CMV, or primary CMV – a first-time infection.
  • Recurring CMV – the patient is already infected, the virus is dormant and then becomes active due to a weak immune system.
  • Congenital CMV – CMV infection occurs during pregnancy and affects the fetus (unborn baby).

Causes

CMV can spreads from person- person in Acquired or Primary CMV, through – Saliva – includes coughs and sneezes

  • Semen
  • Blood
  • Urine
  • Vaginal fluids
  • Breast milk – the benefits of breastfeeding far outweigh CMV risks. If the baby is born premature the medical team will advise on how the baby should best be fed.
  • Sexual Contact

If the surface was infected with saliva or urine, somebody touches it and then touches the inside of their nose or mouth,  there’s a possibility of getting infected with CMV by touching the infected surface.

Recurring CMV is possible under following cases –

  • Organ transplant recipients who are taking immunosuppressant medication
  • Patients with HIV
  • Patients receiving chemotherapy
  • Patients who have been taking oral steroid for over three months.

Congenital CMV cases occur when the woman is infected with CMV for the first time, either during her pregnancy or shortly before it starts.

At times the mother may have a previously dormant CMV infection, which recurs during pregnancy. The mother most likely has a weakened immune system. In such cases the virus may be transmitted to the developing embryo/fetus.

Symptoms

In Primary CMV

  • An elevated body temperature (fever), often prolonged
  • Night sweats
  • Tiredness, general feeling of illness, uneasiness
  • Sore throat
  • Swollen glands
  • Joint pain
  • Muscle pain
  • Lack of appetite
  • Weight loss.

Symptoms may normally go away after two weeks.

In Recurring CMV –   Symptoms of recurring CMV vary, depending which organs are affected. The most likely affected areas are the eyes, lungs or digestive system. Symptoms may include –

  • An elevated body temperature – fever
  • Diarrhea, gastrointestinal ulcerations, and gastrointestinal bleeding
  • Panting – shortness of breath
  • Pneumonia with hypoxemia – low blood oxygen
  • Ulcers in the mouth; sometimes they can be fairly large and unpleasant
  • Problems with vision, including floaters, blind spots and possibly blurred vision. In some cases symptoms may be more severe.
  • Hepatitis – inflamed liver, often characterized by prolonged fever
  • Encephalitis – brain inflammation, which may include behavioral changes, seizures, and even coma.

Congenital CMV –

  • Hearing Loss
  • Jaundice
  • Pneumonia
  • Purple Skin splotches or a rash (possibly both)
  • Enlarged liver
  • Enlarged spine
  • Below-normal birth weight
  • Seizures – uncontrolled electrical activity in the brain, which may cause a physical convulsion.
  • Red spots under the skin

Rare symptoms may include –

  • Autism
  • Central vision loss, scarring of the retina, uveitis (swelling and irritation of the eye)
  • Cognitive difficulties (including learning difficulties)
  • Deafness (varying degrees)
  • Epilepsy
  • Impaired vision
  • Problems with physical coordination
  • Seizures
  • Small head. 

Treatments

Healthy people who are infected with CMV but who have no symptoms usually do not require medical treatment.

Medications – Antiviral medicine may be needed to treat congenital CMV or active CMV in someone with a weakened immune system. The antiviral medications against CMV include the following:

  • Ganciclovir (Cytovene) – Side effects include fever, rash, diarrhea, anemia, and low white blood cell and platelet counts.
  • Valganciclovir (Valcyte)
  • Foscarnet (Foscavir) – It is toxic to the kidneys and can cause seizures due to an imbalance of minerals and electrolytes.
  • Cidofovir (Vistide)

Patients infected for the first time who experience symptoms may find that OTC (over-the-counter, no prescription required) painkilling medications, such as Tylenol (paracetamol), ibuprofen or aspirin (patient must be over 16 years of age for aspirin) will help relieve symptoms. Newborns may need to stay in hospital until their organ functions return to normal. Adults with weakened immune systems may also have to be hospitalized if there is extensive organ damage.

Alternative Medicine

  • Minerals are important especially Zinc, Magnesium and Selenium. However taking Colloidal minerals is highly recommended as they generally supply good amounts of all necessary minerals.
  • Lysine can help stop viruses replicating and is an excellent defense.
  • Vitamin C is useful but needs to be taken in large amounts to be effective against a herpes type infection.
  • All B vitamins are necessary to support the immune system as is Vitamin A and should be taken daily. Vitamin A often also needs reasonably high amounts to be effective against viruses. Often extra Vitamin B12 is necessary.
  • Supplements containing Paris polyphylla, Dandelion, Woad, and Licorice appears safe and effective in reducing cytomegalovirus infection activity in pregnant women.
  • Garlic extract has potent antiviral activity against human cytomegalovirus. Garlic contains a compound known as allitridin which has therapeutic activity comparable to the antiviral drug ganiciclovir in a mouse model of cytomegalovirus hepatitis.
  • Supplements containing Jinye Baidu granule significantly increase the negative conversion rate of HCMV-IgM.
  • Ascorbic acid reduces the infectivity of herpesviruses and paramyxoviruses.
  • Astragalus may have a therapeutic role in combating cytomegalovirus infection.
  • Geum japonicum, Syzygium aromaticum (Clove), and Terminalia chebula inhibit Cytomegalovirus infection.
  • The brown seaweed known as Leathesia difformis contains fucoidan fractions with antiviral activity against cytomegalovirus and herpes simplex virus type 1 and 2.
  • Various extracts of ginger inhibit Cytomegalovirus, HSV-1, and HIV virus.
  • Artemisinin, a compound found within the herb wormwood, inhibits a broad range of viruses.
  • Bamboo compounds have anti-cytomegalovirus activity.
  • Calcium spirulan, an inhibitor of enveloped virus replication, from a blue-green alga Spirulina, exhibits activity against a variety of viruses.
  • Flavonoids belonging to the kaempferol series exhibit antiviral activity against cytomegalovirus.
  • Other very useful herbs for any viral infection are Echinacea, Astragalus, Phyllanthus and Reishi mushroom.

 

Refernence –

http://www.ncbi.nlm.nih.gov/pubmed/10611727

http://www.greenmedinfo.com/disease/cytomegalovirus-infections

http://www.aidsmeds.com/articles/CMV_6771.shtml

http://www.thebody.com/content/art6017.html

http://www.medicinenet.com/cytomegalovirus_cmv/page5.htm

http://kidshealth.org/parent/infections/bacterial_viral/cytomegalovirus.html#

http://www.mayoclinic.org/diseases-conditions/cmv/basics/treatment/con-20029514

http://www.nhs.uk/Conditions/Cytomegalovirus/Pages/Treatment.aspx

 

 

Posted in IMMUNITY
February 8, 2017

Cryoglobulins are proteins found in the blood that precipitate (clump together) in the cold and cause inflammation and organ damage. However, these proteins can occasionally be present in low levels in the blood without any symptoms. When there are symptoms due to the cryoglobulins, the disease is called “cryoglobulinemia.”

Immunoglobulins are the class of proteins that make antibodies in response to foreign substances – antigens introduced into the body. In the case of cryoglobulinaemia, the abnormal immunoglobulins form complexes – cryoglobulins and precipitate (leach) out of the blood at cold temperatures. This causes restricted tissue blood flow and systemic inflammation, which leads to many clinical signs and symptoms including skin lesions, arthralgia (joint pain), arthritis, vascular purpura (purple skin marks), livedo (marbling pattern), and bleeding conditions.

Types of Cryoglobulinemia

Cryoglobulinemia may be classified based on cryoglobulin composition with the Brouet classification, which is as follows –

Cryoglobulinemia is basically classified into three types, Type-I, Type-II, and Type-III.

  • Type I Cryoglobulinemia – This is caused by monoclonal immunoglobulin. This type is usually related to cancerous conditions of the blood or the immune systems.
  • Types II Cryoglobulinemia – This is caused by IgM, IgG and IgA monoclonal immunoglobulin. These types of Cryoglobulinemia are most commonly found in people who have chronic inflammatory conditions like hepatitis C.
  • Types III Cryoglobulinemia – This disease is caused by IgM and IgG polyclonal immunoglobulin.

Cryoglobulinaemia is thought to be rare. Essential mixed cryoglobulinaemia occurs in about 1 in 100,000 people. Most cases of cryoglobulinaemia have an underlying cause. The type of cryoglobulinaemia found in patients is roughly 25% with type I, 25% with type II and 50% with type III.

Each type is associated with different diseases and disorders, which may include cancer involving white blood cells, infections, autoimmune disorders, rheumatic diseases, vasculitis, kidney disease, hepatitis C virus infection, and peripheral neuropathy. More than 90% of people with cryoglobulinemia also have a hepatitis C infection. Hepatitis C virus infection is primarily acquired by needle sharing and tainted blood products, and only rarely transmitted sexually. Treatment of the underlying hepatitis C virus infection may be an effective therapy for an associated peripheral neuropathy

Causes

  • Hyper-Viscosity– Cryoglobulins circulates in blood and become thick and precipitate at low body temperature. The cause of change in physical characteristics at low temperature is not known.
  • Antibodies– Cryoglobulins are proteins that function as antibodies. Cryoglobulin increases in autoimmune disease.
  • Infection- Cryoglobulin is found in higher concentration in hepatitis C infection.
  • Blood Cancers– Cryoglobulin is abnormally increased in patient suffering with lymphoma and multiple myeloma
  • Connective Tissue Disease– Concentration of Cryoglobulin is at higher level in patients suffering with connective tissue disorder like lupus.

Risk Factors

Infections associated with cryoglobulinemia include the following:

  • Viral – Hepatitis A, B, and C (see Differentials); HIV; Epstein-Barr virus (EBV); cytomegalovirus (CMV); adenovirus; chikungunya
  • Bacterial – Endocarditis, streptococcal infections, syphilis, Lyme disease, leprosy, Q fever, brucellosis
  • Fungal – Coccidioidomycosis
  • Parasitic – Malaria, toxoplasmosis, others

Symptoms         

Most people with cryoglobulins have no symptoms other than elevated levels on lab tests. When symptoms are present, they are most commonly fatigue, joint pain, numbness or weakness, and a rash that looks like red spots or purple bruises, usually over the lower legs.

Other symptoms and signs may include –

  • Change of the color of hands and/or feet (from normal to white to a purplish-blue color) with cold, called “Raynaud’s Phenomenon”
  • Weight loss
  • High blood pressure
  • Swelling of ankles and legs
  • Skin ulcers and gangrene
  • Enlarged liver or spleen
  • Numbness, tingling or weakness
  • Kidney damage

Specific Symptoms of Cryoglobulinemia –

  • Skin- Purple bruises, rash and skin ulcer
  • Skeletal System- Joint pain, muscle ache, ankle swelling (edema feet) and Raynaud’s phenomenon
  • Nervous System- Peripheral neuropathy, numbness and weakness
  • Respiratory System- Dyspnea or short of breath
  • Kidney- Glomerulonephritis causes hematuria, proteinuria and kidney failure
  • Cardiovascular System- Hypertension
  • Gastrointestinal System- Enlarged liver and spleen

Complications

Complications include –

  • Bleeding in the digestive tract (rare)
  • Heart disease (rare)
  • Infections of ulcers
  • Kidney failure
  • Liver failure
  • Skin death
  • Death
  • Ischemic Changes– Serum Cryoglobulin causes thick precipitation of serum at low temperatures. Increased blood viscosity eventually start slowing the blood flow or blocks the smaller vessels. The reduced blood supply to tissue and organs causes ischemia (lack of blood supply) and numerous complications including renal failure.
  • Tissue and Organ Damage– Cryoglobulinemia is a disease, which damages the tissue secondary to ischemia. Blocking of blood supply to normal tissue and organ causes ischemia.

Treatment

Medications –

  • Rituximab is an effective drug and has fewer risks than other medicines.
  • Cyclophosphamide is used in life-threatening conditions where rituximab is not working or available. This medicine was used often in the past.
  • A treatment called plasmaphereis is also used. In this his procedure, blood plasma is taken out of blood circulation and abnormal cryoglobulin antibody proteins are removed. The plasma is replaced by fluid, protein, or donated plasma.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used in patients with arthralgia and fatigue.

Alternative Treatment

Posted in IMMUNITY
February 8, 2017

Chronic granulomatous disease (CGD) is an inherited disorder in which white blood cells lose their ability to destroy certain bacteria and fungi. It is described as a primary immunodeficiency disorder. “Primary” means it is not caused by some other disease or disorder.

CGD is a genetic disease in which the body’s cells that eat certain invaders, also called phagocytes, do not make hydrogen peroxide and other chemicals needed to kill certain bacteria and molds. As a result of this defect, patients with CGD get more infections, and they also get too many immune cells forming “knots” called granulomas, hence the name of the disease. Another problem in CGD is that patients can get excessive inflammation even when there is not an infection, and that inflammation can cause diarrhea, and bladder and kidney problems.

People with CGD are unable to fight off common germs and get very sick from infections that would be mild in healthy people. This is because the presence of CGD makes it difficult for cells called neutrophils to produce hydrogen peroxide. The immune system requires hydrogen peroxide to fight specific kinds of bacteria and fungi. These severe infections can include skin or bone infections and abscesses in internal organs (such as the lungs, liver or brain). Aside from the defective neutrophil function in CGD, the rest of the immune system is normal. People with CGD can be generally healthy until they become infected with one of these germs. The severity of this infection can lead to prolonged hospitalizations for treatment.

Inflammation can occur in many different areas of the body in people with chronic granulomatous disease. Most commonly, granulomas occur in the gastrointestinal tract and the genitourinary tract. In many cases the intestinal wall is inflamed, causing a form of inflammatory bowel disease that can lead to stomach pain, diarrhea, nausea, and vomiting. Other common areas of inflammation in people with chronic granulomatous disease include the stomach, colon, and rectum, as well as the mouth and throat. Additionally, granulomas within the gastrointestinal tract can lead to tissue breakdown and pus production (abscesses). Inflammation in the stomach can prevent food from passing through to the intestines (gastric outlet obstruction), leading to an inability to digest food. These digestive problems cause vomiting after eating and weight loss. In the genitourinary tract, inflammation can occur in the kidneys, bladder, and genitalia. Inflammation of the lymph nodes (lymphadenitis) and bone marrow (osteomyelitis), which both produce immune cells, can lead to further impairment of the immune system.

The exact incidence of chronic granulomatous disease (CGD) is unknown. CGD affects approximately 1 infant per 200,000-250,000 live births.

Causes

In chronic granulomatous disease (CGD), immune system cells called phagocytes are unable to kill some types of bacteria and fungi. This disorder leads to long-term (chronic) and repeated (recurrent) infections. The condition is often discovered very early in childhood. Milder forms may be diagnosed during the teenage years or even in adulthood.

About half of CGD cases are passed down through families as a recessive, sex-linked trait. This means that boys are more likely to get the disorder than girls. The defective gene is carried on the X chromosome. Boys have 1 X and 1 Y chromosome. If a boy has an X chromosome with the defective gene, he may inherit this condition. Girls have 2 X chromosomes. If a girl has 1 X chromosome with the defective gene, the other X chromosome may have a working gene to make up for it. A girl has to inherit the defective gene from both parents in order to have the disease.

Babies and CGD – Female carriers of an X-linked disorder have a 25% chance with each pregnancy to have a carrier daughter like themselves, a 25% chance to have a non-carrier daughter, a 25% chance to have a son affected with the disease and a 25% chance to have an unaffected son. If a male with an X-linked disorder is able to reproduce, he will pass the defective gene to all of his daughters who will be carriers. A male cannot pass an X-linked gene to his sons because males always pass their Y chromosome instead of their X chromosome to male offspring.

Who is at Risk?

  • Race – Chronic granulomatous disease affects persons of all races.
  • Sex – Approximately 80% of patients with CGD are male, because the main cause of the disease is a mutation in an X-chromosome–linked gene. However, defects in autosomal genes may also underlie the disease and cause CGD in both males and females.
  • Age – Symptom onset typically occurs at a young age, although the diagnosis has been at an older age in some patients. Typically, patients with CGD have recurrent pyogenic infections that start in the first year of life. Occasionally, the onset may be delayed until the patient is aged 10-20 years.

Symptoms

  • Bone infections
  • Frequent and difficult-to-clear skin infections
  • Abscesses
  • Chronic infection inside the nose
  • Furuncles
  • Impetiginized eczema (eczema complicated by an infection)
  • Impetigo
  • Perianal abscesses (abscesses around the anus)
  • Joint infections
  • Persistent diarrhea
  • Pneumonia
  • Occurs frequently
  • Difficult to cure
  • Swollen lymph nodes in the neck; those develop early in life, and stay swollen or occur frequently. The lymph nodes may form abscesses that require surgical drainage.

Complications

  • Bone damage and infections
  • Chronic infections in the nose
  • Pneumonia that keeps coming back and is hard to cure
  • Lung damage
  • Skin damage
  • Swollen lymph nodes that stay swollen, occur often, or form abscesses that need surgery to drain them

Treatment

Medications –  Antibiotics are used to treat the disease and may also be used to prevent infections. A medicine called interferon-gamma may also help reduce the number of severe infections. Surgery may be needed to treat some abscesses.

  • Sulfasalazine and azathioprine are useful steroid-sparing agents. Tumor necrosis factor alpha inhibitors such as infliximab are effective anti-inflammatory agents but might significantly increase the risk of severe and even fatal infections.
  • Methotrexate and hydroxychloroquine (Plaquenil) can be effective in those with arthritides or lupuslike problems.

Surgery – Bone marrow transplant is another treatment option for some people with severe symptoms of CGD.

Alternative Treatment

 

 

Posted in IMMUNITY
February 8, 2017

The following are summarized symptoms of Chronic Fatigue Syndrome:

  • Muscular pain, Joint pain, and severe headaches
  • Poor short term memory
  • Painful lymph nodes
  • Stomach pain and other problems like constipation, diarrhea, irritable bowel syndrome
  • Insomnia
  • Sensitivity or intolerance to light, loud noise, alcohol, and certain foods
  • Psychological difficulties such as depression, irritability and panic attacks
  • Less common symptoms like dizziness, excess sweating, balance problems and difficulty controlling body temperature

Causes of CFS

Theories abound about the causes of Chronic Fatigue Syndrome.  No primary cause has been found that explains all cases of CFS.

Many people say it started with flu-like illness or other infection like cold or stomach bug.  It also follows infection such as Epstein-Barr virus (the virus that causes mononucleosis or ‘mono’)

Effects of CFS

Infections: The most notorious pattern seen in CFS is when a person suddenly comes down with a flu like illness that does not seem to go away.  These viral or bacterial infections can suppress the body’s master gland, the hypothalamus.

Disturbed sleep:  The suppression of the hypothalamus gland can lead to poor sleep because the body confuses its day/night cycles.  Because of this people with CFS have trouble staying in the deep restorative stages of sleep that recharge their batteries.

Treatments:

Medical treatments:

Medications that provide symptom relief are frequently the first line of treatment chosen by healthcare practitioners for a person with CFS.  These include medication for pain, sleep disturbance, digestive problems such as nausea, depression, anxiety, and flu-like symptoms.

However, medications have not been universally successful because they tend to put a bandage on symptoms instead of killing the root problem.

Alternative Treatment:

  • Nicotinamide Adenine Dinucleotide (NADH): NADH is a naturally occurring molecule formed from Vitamin B3 (niacin) that plays an important role.  Although very promising, larger studies are needed to prove the effectiveness to this supplement.
  • L-Carnitine: Carnitine, found in nearly all body cells, is responsible for transporting long-chain fatty acids into the mitochondria, the energy-producing centers of cells. It allows these fatty acids to be converted to energy.

 

Posted in IMMUNITY
February 8, 2017

Transverse myelitis is a rare disease of the central nervous system involving inflammation in the spinal cord. Transverse’ refers to the inflammation being across the width of the spinal cord and ‘myelitis’ refers to the specific part of the spinal cord affected.

What is Spinal Cord? The spinal cord carries messages (nerve impulses) from the brain to the body and from the body to the brain. It is made up of different types of cells. The cells responsible for transmitting messages are called neurons. Neurons have long extensions called axons which carry the messages up and down the spinal cord. Axons are arranged in bundles called tracts. Some of the tracts carry motor function messages which stimulate muscles to produce movement and some of them carry sensory messages which control sensations such as touch, pain and temperature. To increase the speed at which the messages travel, most axons are surrounded by a whitish fatty substance called myelin which forms a protective covering (sheath) around them. Myelin is produced by specialised cells called oligodendrocytes.

Transverse myelitis is a disease causing injury to the spinal cord with varying degrees of weakness, sensory alterations, and autonomic dysfunction (the part of the nervous system that controls involuntary activity, such as the heart, breathing, the digestive system, and reflexes). The inflammation causes swelling which can block messages (nerve impulses) travelling along the spinal cord. The inflammation can also damage or destroy the myelin sheath surrounding the axons in the spinal cord, probably by damaging the specialised cells which produce myelin (the oligodendrocytes). Messages (nerve impulses) cannot be transmitted properly as myelin is stripped off the axons causing scarring.

The inflammation most commonly occurs in the thoracic section of the spinal cord (the middle section below the neck and above the stomach). The damage affects this area but it can also affect the areas of the spinal cord below the thoracic section: the lumbar section (lower back) and the sacrum (between the hips). Most people with transverse myelitis experience weakness and a change in sensation (unusual feelings) in the lower half of the body and have problems with their bowel and bladder.

Transverse myelitis may be caused by viral infections, spinal cord injuries, immune disorders (including systemic lupus erythematosus, Sjogren’s syndrome, sarcoidosis and multiple sclerosis) or insufficient blood flow through the blood vessels in the spinal cord. It may occur as a complication of such disorders as optic neuromyelitis, multiple sclerosis, smallpox, and measles, or as a complication of chickenpox or rabies vaccinations. Transverse myelitis may be caused by viral infections, spinal cord injuries, immune disorders (including systemic lupus erythematosus, Sjogren’s syndrome, sarcoidosis and multiple sclerosis) or insufficient blood flow through the blood vessels in the spinal cord. It may occur as a complication of such disorders as optic neuromyelitis, multiple sclerosis, smallpox, and measles, or as a complication of chickenpox or rabies vaccinations.

Who gets TM?

Transverse myelitis occurs in adults and children, in both genders, and in all races. Females have a higher risk of transverse myelitis than males. No genetic pattern is known. Transverse myelitis is not related to family history. A peak in incidence rates (the number of new cases per year) appears to occur between\ ages 10 and 19 years and 30 and 39 years. Although only a few studies have examined incidence rates, it is estimated that about 1,400 new cases of transverse myelitis are diagnosed each year in the United States, and approximately 33,000 Americans have some type of disability resulting from the disorder.

Causes

Immune System – Although a cause cannot be established in cases of idiopathic transverse myelitis, the inflammation is thought to be the result of the immune system mistakenly attacking the spinal cord. This is called an autoimmune reaction.

Virus and Infection – Transverse myelitis often develops at the same time as, or soon after, a viral or bacterial infection. The cases of transverse myelitis are also believed to be the result of an autoimmune reaction. Rather than the viral or bacterial infection itself directly causing the inflammation, it is thought that the immune system is stimulated to fight the infection and, mistakenly, also attacks the spinal cord. Viruses that can infect the spinal cord directly are herpes viruses, including the one that causes shingles and chickenpox (zoster) and West Nile virus. Other viruses may trigger an autoimmune reaction without directly infecting the spinal cord.

Vaccinations – Transverse myelitis can also develop after vaccinations, although this is very rare. Again, it is thought that the immune system is triggered to respond to the vaccination and mistakenly attacks the spinal cord.

Multiple sclerosis is a disorder in which the immune system destroys myelin surrounding nerves in the spinal cord and brain. Transverse myelitis can be the first sign of multiple sclerosis or represent a relapse. Transverse myelitis as a sign of multiple sclerosis usually manifests on only one side of your body.

Neuromyelitis optica (Devic’s disease) is a condition that causes inflammation and loss of myelin around the spinal cord and the nerve in the eye that transmits information to thebrain. Transverse myelitis associated with neuromyelitis optica usually affects both sides of the body.

Because some affected individuals also have autoimmune diseases such as systemic lupus erythematosus, Sjogren’s syndrome, and sarcoidosis, some scientists suggest that transverse myelitis may also be an autoimmune disorder. In addition, some cancers may trigger an abnormal immune response that may lead to transverse myelitis.

Symptoms

There are four classic symptoms of transverse myelitis (TM). Patients may have only one symptom, or a combination of the following –

  • Weakness of the legs and/or arms – Some patients report stumbling, dragging one foot or notice that both legs seem heavier than normal. Depending on the level of involvement within the spinal cord, coordination or strength in the hands and arms may also be affected.
  • Sensory alteration – Patients who are experiencing altered sensitivity usually report numbness, tingling, coldness or burning. Up to 80% of patients experience heightened sensitivity to touch. Some even report that wearing clothes or a light touch with a finger causes significant pain.
  • Pain – Up to half of those with TM report pain as the first symptom of the disorder. It can be localized to the back, or appear as sharp, shooting pain that radiates down the legs, arms or around the torso. Loss of the ability to experience pain or temperature sensitivity is one of the most common sensory changes.
  • Bowel and bladder dysfunction – Some patients report bowel or bladder dysfunction as their first symptom of TM. This may mean an increased frequency or urge to urinate or defecate, incontinence, difficulty voiding, and sensation of incomplete evacuation or constipation.

Treatment

  • Intravenous Steroids – Although there are no clinical trials that support a unique approach to treat patients experiencing TM, it is well recognized as a standard of care that patients suspected to have acute myelitis receive high-dose intravenous methyl-prednisolone for 3-5 days, unless there are compelling reasons not to. The decision to offer continued steroids or add a new treatment is often based on the clinical course and MRI appearance at the end of 5 days of steroids.
  • Plasma Exchange (PLEX) This is often used for those patients with moderate to aggressive forms of TM who don’t show much improvement after being treated with intravenous and oral steroids. Again, there has not been a clinical trial that proves PLEX effectiveness in TM but retrospective studies of patients with TM treated with IV steroids followed by PLEX showed a beneficial outcome. PLEX also has been shown to be effective in some patients with other autoimmune or inflammatory central nervous system disorders. Patients particularly benefit from early treatment, and will typically be started on PLEX within days of starting steroids. Particular benefit has been shown if started within the acute or subacute stage of the myelitis or in those patients who exhibit active inflammation on MRI. However, because of the risks implied by this procedure this intervention is determined by the treating physician on a case-by-case basis.
  • Antiviral medication – Some people who have a viral infection of the spinal cord may be treated with antiviral medication.
  • Pain medication – Chronic pain is a common complication of transverse myelitis. Medications that may lessen muscle pain include common pain relievers, including acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
  • Cyclophosphamide – It is a chemotherapy drug that is often used to treat lymphomas or leukemia, is sometimes used. Patients receiving this treatment are carefully monitored for potential complications that may arise from immunosuppression.

Alternative Treatment

 

 

Posted in INFECTIOUS
February 8, 2017

Sjogren’s syndrome (pronounced Show- grins) is an auto immune disease – a disease in which the immune system turns against the body’s own cell. Sjögren’s syndrome is also known as “Mikulicz’s disease” and “Sicca syndrome”.

In Sjorgren’s Syndrome (SS) the immune system attacks the moisture producing glands and causes dryness in the mouth and eyes. In some cases, other parts of the body can be affected as well, resulting in multiple possible symptoms. It was first identified by a Swedish physician, Dr. Henrik Sjögren in 1933.

The immune system is responsible for protecting the body from various diseases by destroying harmful invaders like viruses and bacteria. In SS, the immune system attack the glands that produce tears and saliva (the lacrimal and salivary glands). Damage to these glands keeps them from working properly and causes dry eyes and dry mouth. Dry eyes are called kerato-conjunctivitis sicca, or KCS, and dry mouth is called xero-stomia. This disease can affect other glands too, such as the glands in the stomach, pancreas, and intestines, and can cause dryness in other places that need moisture, such as the nose, throat, airways, and skin. Since, SS causes inflammation in joints, muscles, skin, or other body tissue, it is considered to be a  rheumatic disease. Sjögren’s is also considered a disorder of connective tissue, which is the framework of the body that supports organs and tissues (joints, muscles, and skin).

Between 400,000 to 3.1 million Americans, i.e. about one to two percent of the population is affected by Sjogren’s syndrome. It generally affects people between 45 and 55 years old, although it can affect anyone regardless of age. It is also found mostly in women – women are 10 times more likely to have Sjögren’s than men.

Causes

While it’s not known exactly what causes Sjogren’s syndrome, a combination of the following may be to blame:

  • Abnormal immune response
  • Sex hormones
  • Inheritance or genetics
  • Environment (although the exact environmental factors aren’t known)

It is classified in the following :

  • Primary – The syndrome is developed by itself and not as the result of another condition. For example, certain people are born with specific genes that make them more vulnerable to a faulty immune system. Then, many years later, an environmental factor, possibly a common virus, triggers the immune system to stop working properly.
  • Secondary – The syndrome is developed in combination with another autoimmune disorder, such as lupus or rheumatoid arthritis

The causes are listed as below –

  • Autoimmune Factor – Salivary glands that produce saliva exist in “grape-like” clusters. There are no or few lymphocytes in the normal salivary gland but are present in Sjogren’s syndrome. Lymphocytes are part of the immune system that normally protect the body from infection and tumors. When they appear to attack the body’s tissue (as in Sjögren’s syndrome, systemic lupus, or in rheumatoid arthritis), the term “autoimmunity” is used. Lymphocytes originate in the bone marrow. Two types of lymphocytes, termed “T cells” and “B cells” are responsible for mediating immune reactions. The entire lymphoid system is precisely regulated, largely by messenger molecules that instruct cells to “turn on” or “turn off.” Autoimmunity, the excessive reaction against one’s own tissues, then results from a failure of the normal regulation of T cells and B cells. This may be due either to an excessive production of helper signals or a failure to respond to suppressor signals. As a consequence, lymphocytes infiltrate the tissues and attack normal cellular structures.
  • Virus & Infections – Studies suggest that a virus is involved. One possible candidate is the Epstein-Barr virus (EBV), which causes infectious mononucleosis, a condition characterized by swollen salivary glands, joint aches and fatigue. Virtually all adults have been infected with EBV by age 20 years. After the initial infection, this virus normally resides in the salivary glands for life but causes no problems. We and others have speculated that this virus (or a closely-related virus) may trigger an autoimmune response in genetically susceptible individuals.

It is thought that an as yet unknown infectious agent damages the salivary gland and attracts the “immune” lymphocytes into the salivary gland. These lymphocytes release specific autoantibodies such as rheumatoid factor (RF) and antinuclear antibodies; antibodies are directed against proteins termed Sjögren’s-associated antigens A and B (or SS-A and SS-B). These antibodies can enter the bloodstream and are measured in the blood tests that we obtain to confirm the diagnosis of Sjögren’s syndrome.

  • Hereditary Factor – Particular genes (such as human leukocyte antigen or HLA genes) are inherited in the same manner from parents as are genes for hair color or eye color; that is, one gene from each parent. The HLA genes are important in controlling the immune response and many current research studies are trying to determine exactly how they perform this task. A specific gene named HLA-DR3 is found in high frequency in Caucasian patients with primary Sjögren’s syndrome.
  • Evironmental Factors – These include:
    • Toxic Metal Exposure – Studies have shown that exposure to toxic metals such as mercury, cadmium, lead, arsenic, aluminum, nickel and other heavy metals can be linked to the autoimmune process: The heavy metals induce autoantibodies, which then create autoimmune diseases, including Sjogren’s syndrome. These free radicals then alter the body’s pH (which must be kept constant). An altered pH allows viruses, bacteria, candida and other pathogens to thrive, which then sets the stage for more free radicals. The free radicals damage the cells, making it impossible for the cells to communicate with each other. Autoimmunity results when the immune system attacks the damaged cells.
    • Toxic Chemical Exposure – Toxins such as pesticides, solvents, industrial chemicals, even household cleaners and hair dyes are being implicated in autoimmune diseases. These toxins are everywhere, and they greatly increase the risk of all diseases in general.
    • Smoking – Smoking increases the risk of several autoimmune diseases, primarily because of the chemicals in cigarettes. 
  • Nutritional Deficiencies – Poor diet is an important factor in autoimmunity because poor nutrition compromises the immune system. Processed foods are loaded with chemicals, hormones, steroids, trans-fats and sugars, which promote the creation of free radicals in the body, which in turn damage the cells.

Symptoms

The main symptoms are

  • Dry eyes—Your eyes may be red and burn and itch. People say it feels like they have sand in their eyes. Also, your vision may be blurry, and bright light, especially fluorescent lighting, might bother you.
  • Dry mouth—Dry mouth feels like a mouth full of cotton. It’s difficult to swallow, speak, and taste. Your sense of smell can change, and you may develop a dry cough. Also, because you lack the protective effects of saliva, dry mouth increases your chances of developing cavities and mouth infections.

Both primary and secondary Sjögren’s syndrome can affect other parts of the body as well, including the skin, joints, lungs, kidneys, blood vessels, and nervous system, and cause symptoms such as –

  • Dry skin
  • Skin rashes
  • Thyroid problems
  • Joint and muscle pain
  • Pneumonia
  • Vaginal dryness – painful sexual intercourse
  • Numbness and tingling in the extremities

When Sjögren’s affects other parts of the body, the condition is called extraglandular involvement because the problems extend beyond the tear and salivary glands. Finally, Sjögren’s can cause extreme fatigue that can seriously interfere with daily life.

Less common features of Sjögren’s syndrome are:

  • Irritation of the nerves in the arms, hands, legs, or feet (neuropathy)
  • Feeling of numbness or tingling
  • Thyroid gland abnormalities
  • Skin rashes
  • Memory loss, difficulty concentrating or confusion
  • Gastrointestinal problems, such as acid reflex, bloating, abdominal pain, or diarrhea
  • Inflammation of the lungs, kidneys (unlike lupus nephritis), liver, or pancreas
  • Cancer of the lymphatic tissue (occurs in up to 5% of patients with the disease)

Treatment

The goals of treatment are to decrease discomfort and reduce the harmful effects of dryness. Generally, physicians use medications to control symptoms (symptomatic treatment). The type of treatment will be tailored to each patient’s symptoms and needs.

  • Good oral hygiene – Good mouth/dental care may prevent or reduce dental decays, infections, or tooth loss:
    • Toothpastes (biotene type) and oral gels are available for people with dry mouth These products may also have antibacterial action to reduce the severity of dental cavities over a long period of time.
    • Chewing sugar-free gums can be helpful.
    • Taking frequent sips of water without swallowing (spitting it out) may improve dry mouth.
  • Increasing Eye Moisture
    • Dry eyes are mainly treated with the use of artificial tears. A wide variety of over-the-counter products is available. Artificial tears can be used regularly and more often in dry environmental conditions such as on airplanes, in air-conditioned buildings, and on windy days.
    • While artificial tears are helpful, they often do not last long enough. Thicker      preparations (gel form) that last longer are available. These are often used at bedtime because they can sometimes cause blurry vision. Eye doctors can prescribe an eye drop called Restasis to treat more severe form of dry eyes. A small procedure called punctal plugs, to slow the disappearance of tears, is another treatment option when artificial tears are not sufficient.
  • Medications – Medications that tend to reduce body fluids should be avoided.
    • Mild pain-relieving medications (analgesics), including acetaminophen, such as Tylenol or non-steroidal anti-inflammatory drugs – NSAIDs, such as Motrin and Aleve, can reduce muscle or joint pain.
    • In some patients, the anti-rheumatic drug hydroxychloroquine has been beneficial in decreasing pain and salivary gland swelling and improving fatigue, muscle pain, joint pain, or rash. This drug generally does not help with dry symptoms, however.
    • For patients with internal organ symptoms (particularly when the disease affects internal organs), steroids and immunosuppressive medications may be used. These include medicines such as prednisone (a steroid) and, rarely, chemotherapy-type medications.
    • Systemic corticosteroids and/or immunosuppressive agents like cytotoxic drugs have been used for various extra glandular symptoms of SS, such as: vasculitis, lung involvement kidney involvement. However, cytotoxic agents should be used with great care as they may increase the risk of lymphoma.
    • Water-based vaginal lubricants (K-Y Jelly, Astroglide, Replens, Luvena) can ease vaginal dryness and painful intercourse. Estrogen creams or other preparations may be helpful for women who have vaginal dryness due to reduced estrogen levels related to menopause.

It is important to know that the medications also involve numerous side effects that can prove harmful and may result in creating additional complications.

  • Balance of rest and exercise – Guided exercise programs can help patients overcome fatigue, maintain flexibility, and overcome joint and muscle pain. Good sleep hygiene is helpful for improving fatigue and body pain.

Alternative Treatment

Alternative medicine definitely has more treatment options. The model of simply fixing the gut, stabilizing the blood sugar level, balancing the hormones, taking enough essential fatty acids and anti-inflammatory protocols, and so forth, are effective. However, they are not any different than treating any type of autoimmune disorders.

  • Detoxification Therapy – Detoxification thrapy utilizes clinical procedures that safely reduce the body’s burden of toxic chemicals, including chemicals stored following occupational, accidental, and/or chronic airborne exposures. Chemicals bind to human tissues on the basis of their lipophilic properties — meaning literally “attracted to fats.”
  • Green tea and EGCG for Sjogren’s syndrome – Green tea polyphenols reduce autoimmune symptoms in a murine model for human Sjogren’s syndrome and protect human salivary acinar cells from TNF-alpha-induced cytotoxicity. Green tea contains several antioxidants that have been shown to curb inflammation, prevent cell death, and possibly even ward off cancer. EGCG reduced the severity and delayed the onset of salivary gland damage associated with Sjogren’s syndrome.
  • Fish oils, Wheat Germ oil & flax seeds – Effect of omega-3 and vitamin E supplementation on dry mouth in patients with Sjögren’s syndrome. Omega3 Fatty acid rich fish oil (FO) and vitamin E may delay the progress of certain autoimmune diseases. omega-3 (n-3) increases saliva production in patients with Sjögren’s syndrome. Wheat germ oil helps in stimulating saliva production in patients with Sjögren’s syndrome.
  • DHEA – Low serum levels of sex steroids are associated with disease characteristics in primary Sjogren’s syndrome; supplementation with dehydroepiandrosterone restores the concentrations. It also helps in stimulating saliva production.
  • Flavonoids – Plant-derived flavonoids are inhibitors of various intracellular processes, notably phosphorylation pathways, and potential inhibitors of cellular autoimmunity. This includes – apigenin and luteolin, fisitin, quercetin, morin and hesperitin. It acts as strong inhibitors for T cells.
  • Rose hip herbal remedy for SS, Probiotic for gut
  • Vitamin D – Vitamin D inhibits pro-inflammatory processes by suppressing the enhanced activity of immune cells that take part in the autoimmune reaction. Supplementation may be therapeutically beneficial particularly for Th1 mediated autoimmune disorders. Some reports imply that vitamin D may even be helpful in multiple sclerosis and diabetes type 1.

Integrated Treatment

Integrated medical practitioners treat the whole body as a single system and work with interdependent, oscillating energies and seek to achieve balance and integration of the entire body. There are natural, non-invasive, and wholistic approaches that incline toward discovering the imbalances, and integrate to correct them through diet and nutrition, exercise, acupuncture, massage, and individual customized education.

With the variety of symptoms that encompass Sjogren’s syndrome, it is very important to have a plan and helpful practitioner who works with full oversight and a set of complimentary skills under one roof, i.e. our center.

 

Posted in INFECTIOUS
February 8, 2017

Sinusitis is an inflammation or infection of the sinuses, the air-filled chambers in the skull that are located around the nose. Symptoms of sinusitis include thick nasal discharge, facial pain or pressure, fever, and reduced sense of smell. Depending on how long these symptoms last, sinusitis is classified as acute, subacute, chronic, or recurrent. Viruses are the most common cause of acute sinusitis, but bacteria are responsible for most of the serious cases.

Sinusitis, also called rhinosinusitis, affects about 1 in 8 adults annually and generally occurs when viruses or bacteria infect the sinuses (often during a cold) and begin to multiply. Part of the body’s reaction to the infection causes the sinus lining to swell, blocking the channels that drain the sinuses. This causes mucus and pus to fill up the nose and sinus cavities.

What are Sinuses?

Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows air from the nose to enter the sinuses and mucus made in the sinuses to drain into the nose.

Four pairs of sinuses, known as the paranasal air sinuses, connect to the nasal passages (the two airways running through the nose):

  • Frontal sinuses (behind the forehead)
  • Maxillary sinuses (behind the cheekbones)
  • Ethmoid sinuses (behind the nose)
  • Sphenoid sinuses (behind the eyes)

Sinusitis occurs if obstruction or congestion cause the paranasal sinus openings to become blocked. When the sinus openings become blocked or too much mucus builds up in the chambers, bacteria and other germs can grow more easily, leading to infection and inflammation.

Types of Sinusitis

  • Acute sinusitis gives rise to severe symptoms but is usually short-lived. Acute sinusitis usually occurs following a cold. Typically a green-yellow nasal discharge occurs a week or more after the onset of the cold and this is associated with severe pain around the cheeks, eyes and/or forehead. This may be associated with swelling and a high fever along with toothache.
  • Chronic sinusitis is sinusitis that continues for many weeks. Chronic sinusitis may be caused by an acute sinus infection which fails to resolve or as a result of an underlying allergy affecting the lining membranes of the nose and sinuses. Common symptoms include nasal obstruction, headache, nasal discharge, low grade fever, reduced sense of smell, facial pain and halitosis.

Causes

Infections – Most adults will get colds and upper respiratory tract infections up to three times a year. Children get them more frequently. Bacterial infections often follow the common cold. When the mucus changes from clear to yellow or green it usually means a bacterial infection has developed. Both viral and bacterial infections cause swelling of the tissues inside the nose and thickening of the normal mucus. This slows down or even stops proper sinus drainage and infection in the sinus may ensue.

Irritants – Air pollution, smoke and chemical irritants, for example some sprays containing pesticides, disinfectants and household detergents, may cause swelling and blockage of the lining of the nose causing a narrowing of the drainage opening from the sinuses. This can once again lead to impairment of sinus drainage and consequent infection.

Allergies – Allergies can cause inflammation inside the nose. Common symptoms of an allergic reaction include nasal stuffiness, runny nose, sneezing and itchy watery eyes. Chronic sinusitis is sometimes associated with asthma. Allergies are responsible for asthma in some patients and may also cause nasal stuffiness making the asthma more difficult to control.

Structural problems – Occasionally structural problems within the nasal cavity can cause a narrowing. Some of these can be caused as a result of trauma while others may develop during the growth period. Occasionally the structural narrowing can be so severe that mucus builds up behind these areas of blockage giving rise to sinus infection.

Risk Factors

  • Certain factors increase a person’s susceptibility to sinusitis, including:
  • Frequent colds (especially for young children)
  • Cigarette smoking (active or passive)
  • Regular use of nasal decongestant sprays (for more than two to three days)
  • Untreated hay fever or other allergies
  • Structural abnormalities of the nose
  • Nasal polyps (swellings in the linings of the nose or sinuses)
  • Dental disease, such as untreated tooth abscess.

Symptoms

Common symptoms of sinusitis include

  • Postnasal drip
  • Discolored nasal discharge (greenish in color)
  • Nasal stuffiness or congestion
  • Tenderness of the face (particularly under the eyes or at the bridge of the nose)
  • Frontal headaches
  • Pain in the teeth
  • Coughing
  • Fever
  • Fatigue
  • Bad breath

Sinus disease is often confused with rhinitis, a medical term used to describe the symptoms that accompany nasal inflammation and irritation. Rhinitis only involves the nasal passages. It could be caused by a cold or allergies.

Allergies can play an important role in chronic (long-lasting) or seasonal rhinitis episodes. Nasal and sinus passages become swollen, congested, and inflamed in an attempt to flush out offending inhaled particles that trigger allergies. Pollen are seasonal allergens. Molds, dust mites and pet dander can cause symptoms year-round.

Asthma also has been linked to chronic sinus disease. Some people with a chronic nasal inflammation and irritation and/or asthma can develop a type of chronic sinus disease that is not caused by infection. Appropriate treatment of sinus disease often improves asthma symptoms.

Complications

Asthma flare-ups – Chronic sinusitis can trigger an asthma attack.

Meningitis – This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.

Vision problems – If infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.

Aneurysms or blood clots – Infection can cause problems in the veins surrounding the sinuses, interfering with blood supply to your brain and putting you at risk of a stroke.

Osteomyelitis – Adolescent males with acute frontal sinusitis are at particular risk for severe problem. n such cases, the patient usually experiences headache, fever, and a soft swelling over the bone known as Pott’s puffy tumor.

Treatment

Antibiotics – Antibiotics are standard treatments for bacterial sinusitis. Antibiotics are usually taken from 3 to 28 days, depending on the type of antibiotic. Because the sinuses are deep-seated in the bones, and blood supply is limited, longer treatments may be prescribed for people with longer lasting or severe cases. Antibiotics help eliminate sinus disease by attacking the bacteria that cause it, but until the drugs take effect, they do not do much to alleviate symptoms. Some over-the-counter medications can help provide relief.

Nasal decongestant sprays – Topical nasal decongestants can be helpful if used for no more than three to four days. These medications shrink swollen nasal passages, facilitating the flow of drainage from the sinuses. Overuse of topical nasal decongestants can result in a dependent condition in which the nasal passages swell shut, called rebound phenomenon.

Antihistamines – Antihistamines block inflammation caused by an allergic reaction so they can help to fight symptoms of allergies that can lead to swollen nasal and sinus passages.

Nasal decongestants and antihistamines – Over-the-counter combination drugs should be used with caution. Some of these drugs contain drying agents that can thicken mucus. Only use them when prescribed by your doctor.

Topical nasal corticosteroids – These prescription nasal sprays prevent and reverse inflammation and swelling in the nasal passages and sinus openings, addressing the biggest problem associated with sinusitis. Topical nasal corticosteroid sprays are also effective in shrinking and preventing the return of nasal polyps. These sprays at the normal dose are not absorbed into the blood stream and could be used over long periods of time without developing “addiction.”

Nasal saline washes – Nasal rinses can help clear thickened secretions from the nasal passages.

Surgery – If drug therapies have failed, surgery may be recommended as a last resort. It is usually performed by an otolaryngologist. Anatomical defects are the most common target of surgery.

Alternative Treatment

Bromelain – Several studies suggest that bromelain, an enzyme derived from pineapples, may help reduce inflammation and swelling and relieve symptoms of sinusitis.

Quercetin – Quercetin is a flavonoid, a plant pigment responsible for the colors found in fruits and vegetables.

Probiotics – Probiotics, or “friendly” bacteria, may be helpful if you are taking antibiotics for sinusitis. They may also reduce your chances of developing allergies. Probiotics may not be appropriate for certain people who are extremely immunocompromised or who take immunosuppresent drugs.

N-acetylcysteine – NAC is a modified form of a dietary amino acid that works as an antioxidant in the body. It also helps thin mucus.

Sinupret – The herbs it contains may work by thinning mucus and helping the sinuses drain, and they may also help strengthen the immune system.

Chiropractic – Although no studies have examined using chiropractic to treat sinusitis, some practitioners suggest it may decrease pain and improve sinus drainage for some people.

Posted in INFECTIOUS