SPLENIC ABSCESSSplenic abscesses are uncommon lesions that are usually the result of hematogenous dissemination, as a result of bacteremia or septic embolization. Infected splenic infarcts and contiguous spread of infection are also potential mechanisms.Patients often present with fever, chills, and left upper quadrant abdominal pain. Irritation of the diaphragm may lead to pleuropulmonary symptoms and referral of pain to the left shoulder. A quarter of cases involve a polymicrobial infection. Causative organisms include S. aureus and Streptococcus species (usually in cases of bacterial endocarditis), as well as Salmonella species and other enteric bacteria, including anaerobes. Fungi, especially Candida species, are important causes of splenic abscesses in immunocompromised hosts.Broad-spectrum empiric antimicrobial therapy, as recommended for secondary peritonitis, is required. Although the treatment of choice is generally splenectomy, percutaneous drainage may be considered in some cases.*99/348/5*
HOW BDD AFFECTS LIVES: ANGER AND VIOLENCESometimes anger and violence are directed toward the surgeon or dermatologist who provided unsatisfying treatment. I’m aware of a man who severely assaulted his plastic surgeon because he was so upset over the outcome of his surgery. Another tried to murder his dermatologist after the treatment didn’t work. And there are a number of published reports of people with apparent BDD who threatened, stalked, attempted to kill, or actually killed their dermatologist or plastic surgeon. In a 2001 survey of 265 members of the American Society for Aesthetic Plastic Surgery, 2% said they had been threatened physically, and 10% had been threatened both legally and physically, by a patient with BDD.BDD can spawn illegal behavior. As I discussed above, BDD can lead to illegal drug use. Ian broke into houses across the country so he could get to California to get a tan. Todd shoplifted from drug stores. “I don’t like to do it,” he said, “but I have to get stuff for my skin, and I don’t have any money.” Over several months, he’d stolen nearly $1000 worth of items. “I’m afraid I’ll get caught,” Todd said, “and I feel guilty doing it. But I can’t resist. My acne is destroying my life. I have to make my skin look better!”Another man had done many illegal things—such as assaulting people and breaking and entering—in the hope that he’d go to jail. He explained, “That way, no one would see me except the other inmates. And it’s too hard for me to keep a job because I look so bad, and I wouldn’t have to worry about it in jail. Jail would be better than this hell I live in every day.” *142\204\8*
COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: PROPHYLACTIC DRUGS
by admin Posted in Asthma
COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: PROPHYLACTIC DRUGSCromolyn. It is a white powder derived from a plant called Khellin. It prevents an attack by inhibiting the production or release of substances that create allergic reaction. It does not act as a bronchodilator and is never used, and should never be used, during an attack. Cromolyn cannot treat or reverse bronchoconstriction once it has occurred, but is useful in preventing attacks when taken regularly.Cromolyn can be taken by an inhaler, either as a dry powder or as a solution. In some children, inhalation of the powder may cause coughing. It is important to remember that cromolyn has to be taken regularly for one to two months before it is effective.If cromolyn is effective, which it is in 20-40 per cent of children, then it can be used as an alternative to inhaled steroids. But if asthma is not controlled fully then a low dose of an inhaled steroid can be given to children.Inhaled steroids in low doses is much more effective than cromolyn. It is, therefore, important to have the best possible level of control for each child.*68\260\8*
Parallels between the modes of transmission of HIV infection and hepatitis
В and the development of effective hepatitis В vaccines have made the community much more aware of hepatitis B.
Another development has been the recognition of the frequency of human
papilloma virus (HPV) infection. An association between HPV infection and the development of carcinoma of the cervix is now accepted.
In keeping with the tradition established in the previous editions of the Handbook, the third edition is written primarily for general medical practitioners and medical students with the emphasis on the presentation of practical guidelines. References have not been given in the text but a brief bibliography is included.
*3/56/1*
Discount medications online
The importance of Chlamydia trachomatis in the aetiology of pelvic
inflammatory disease and tubal damage with consequent infertility and ectopic pregnancy has been increasingly recognised. Co-infection with chlamydia in patients with gonorrhoea is common and many venereologists recommend that patients receiving treatment for gonorrhoea should also be treated for chlamydia. The incidence of gonorrhoea has been falling, although the proportion which is penicillin resistant continues to rise. Penicillin resistant gonorrhoea is now considered endemic in Australia.
The National Health and Medical Research Council has recently published Pelvic inflammatory disease — an NHMRC working party report which contains recommendations for the management of this important problem.
*2/56/1*
Dvpharm.com – Pharmacy Information
Play is a very important part of childhood and is an indispensable part of learning from an early age. Joining in allows the parent to spend time with the child in a mutually rewarding and enjoyable way, and this ‘quality time’ strengthens the parent/child relationship. As the child gets older, play stimulates curiosity and creativity, and is an important part of the socialisation process whereby the child learns to relate to peers. It can be both a source of relaxation and an outlet for excess energy.
You can do much to facilitate creative and educational play for your child. In infancy, mobiles and bright toys will stimulate the baby to be aware of surroundings. Some babies seem to enjoy music, and will certainly respond to the sound of mother’s voice.
As your baby develops eye/hand manipulative skills, rattles, squeaky toys, large plastic blocks and shapes are all useful. Just make sure that they are safe. Later, play dough, pots and pans, sand play and finger painting will provide the child with an increasing range of experiences (see Toys, below and Books, p. 104). Most toddlers love being read to, and this provides a wonderful opportunity to create a special quiet time between parent and child.
As your child grows older, play becomes increasingly social, and he will involve peers, siblings and parents, although many children still like to spend time playing alone as well.
Make sure you provide a range of play materials appropriate to the child’s age and preferences. All children are different and they will have different preferences for play. What suits one child will not suit another. Parents can obtain information about play materials from a number of sources, including the kindergarten teacher and daycare provider. The local library will certainly have books about play with children, and some have organised reading sessions for young children. Some communities have toy libraries. Remember that toys do not have to be expensive to be creative and enjoyable.
*113\90\8*
A SEXUAL HEALTH EXAM: ARE YOU ABLE TO RETAIN SELF-RESPONSIBILITY AND RESPONSIBILITY FOR OTHERS?
by admin Posted in General health
“I hate that she has to undress me. I can’t undress myself anymore,” reported the husband experiencing multiple sclerosis. “Mhink that’s the worst part of this whole thing. I know that doesn’t make much sense, but I feel like a child being undressed and dressed.”
PARAPLEGIC HUSBAND
All disease requires some sacrifice of autonomy as much as it requires self-responsibility for healing. We all have to turn to someone for help, support, covering for us at work, bringing the chicken soup, pushing the wheelchair in some hard-to-go places, holding the door while we struggle with a cane or crutch. Disease reminds us firmly that we all belong together, and healing depends on acting as if we really believe that.
“Is it that you are being undressed or that you can’t undress your wife, too, that really seems to bother you the most?” was my question to this husband.
“Well, she undresses herself, and I watch her, but when she turns to me and has to do me, too, that’s what gets me,” he answered.
“I have two suggestions, and they both may seem crazy,” I answered. “First, why take your clothes off every time anyway? Dress in clothing sometimes that is comfortable and allows for stimulation you enjoy. Maybe some clothing might even feel good to you. Ask your wife to do the same. Some couples wear jogging suits of a material they like and they don’t wear any underwear. Then, when you feel like sex, no dressing or undressing may be necessary. Second, maybe you have failed to change your sexual pattern to adjust to this disease experience. Making love at the end of the day with your wife getting you undressed was an old pattern. Disease requires change. In fact, some philosophers suggest that this is the purpose of disease, to cause change and growth in the long term. I know it doesn’t matter much in the short term that all disease leads to overall change, but your sex life must reflect this fact. If you are undressed at night, then sleep naked and have s in the morning when no dressing or undressing is necessary. And, remember, you spent much of courtship undressing her. Mayi this disease can cause some role reversal you might enjoy once you get used to it.”
“All of those ideas are crazy but one,” he answered. “I never thought of staying dressed for sex. I guess that could work out, think we’ll try it. Maybe I’ll market these things. Instead of jogging suits, we’ll start a new yuppie fad. Sex suits. It might feel neat.’
The process of reconsideration of the relationship between sexuality and illness starts in just this simple fashion. Talking, sharing modifying, being creative, and designing and redesigning your sexual patterns is part of the healing process.
Since all disease happens within a system, it is important to look at the responsibility issue from the perspective of both partners.’ don’t know what he’s talking about,” said the wife of the man in the example above. “I love undressing him. I just wish he would make more of an effort to solve our problems instead of surrendering of deferring to me. It’s not the undressing part that makes him seem childish, it’s his attitude. I married him for his brains, not hi wardrobe-changing skills.”
*264\97\8*
SUPER LOVE FOR SUPER SEX/LOVE-MAP LANDMARKS: DESCRIBE YOUR FEELINGS ABOUT
by admin Posted in General health
AUTOEROTIC BEHAVIOR
Masturbation is one of the most difficult of all topics for couples to discuss. If your own religious orientation forbids it, it is still an area in which you most likely have strong feelings. I will discuss this further in Chapter Twelve, but for now, discuss it with your partner. You do not have to share what you do, just how you feel.
Remember, autoeroticism is not limited to self-stimulation of the genitals. Taking a long, sensuous bath or shower is a form of autoeroticism. Feeling the wind in your hair (no matter how thin it is) can be erotic. Do not let the genital orientation of our society trap you into the same limited view of you enjoying you, of giving you permission to stimulate yourself.
“I think it is disgusting, unnatural, and a complete waste of time,” said the wife. “I don’t know why anybody does it, and certainly people don’t do it if they have someone.”
Her husband said in his private interview, “Sure I do it. Three or four times a week. It has nothing to do with her or our sex. I just like to look at a few pictures and get off.”
The impact of such different views, totally unshared, is clearly important to marital sex. “At least it’s a cheap date,” said one man during the interviews. “No risk of disease, and you don’t have to get up and get dressed afterward. In fact, you don’t have to get undressed at all.” Humor, comfort, fear, shame, and other emotions are evoked when the topic of self-stimulation is raised. Our love maps are influenced strongly by such feelings about our right to self-pleasure. Don’t let fear prevent you from discussing this issue with the one person with whom you should be able to share anything.
*90\97\8*