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#buerger’s disease symptoms
A person with Raynaud's disease experiences pain in the extremities, for example, the fingers, when temperatures drop.
Blood vessels narrow and almost completely shut down. Fingers or toes turn from white to blue and, then, as the blood returns, they flush red.
Also known as Raynaud's syndrome or Raynaud's phenomenon, As per research females are an estimated nine times more likely to be affected than males.
Fast facts on Raynaud's disease are followings:
• Raynaud's disease is caused by peripheral blood vessels overreacting to cold.
• Maurice Raynaud first described the disease in 1862.
• Females and people living in colder climates are more often affected.
• A capillaroscopy can help diagnose Raynaud's disease.
Living with Raynaud's
People who are prone to Raynaud's can take measures to avoid some triggers.
The National Heart, Lung, and Blood Institute (NHLBI) suggest:
• wrapping up and keeping the house warm when temperatures are cold
• as far as possible, avoiding emotional stress
• exercise to promote a healthy lifestyle and reduce stress
• avoiding medicines and substances that trigger the symptoms
• limiting consumption of caffeine and alcohol
• not smoking
Homeopathy has good treatment for it. Getting medical help may prevent a worsening of symptoms and serious complications.
Causes
Exactly what causes Raynaud's remains unclear, but a hyperactivation of the sympathetic nervous system is known to cause an extreme narrowing of the blood vessels, known as vasoconstriction.
It can happen when the person enters a cold place, opens a freezer, or puts their hands in cold water.
Some people experience symptoms when faced with stress, even without an associated drop in temperature.
In healthy individuals, the circulatory system in the extremities, such as the fingers and toes, reacts to conserve heat in cold conditions. The small arteries that supply the skin with oxygen narrow to minimize the amount of heat lost through the exposed skin surface.
In people with Raynaud's disease, this narrowing is excessive. This is what causes the blood vessels almost to shut down.
Types
There are two types of Raynaud's disease: Primary and secondary.
Primary Raynaud's, or Raynaud's disease, is more common, and it affects people who do not have a secondary medical condition.
Secondary Raynaud's, or Raynaud's phenomenon or syndrome, results from an underlying medical issue. It is less common and tends to be more serious.
Causes of secondary Raynaud's
Causes of secondary Raynaud's include:
Diseases of the arteries: Atherosclerosis, a build-up of plaque in blood vessels, or Buerger's syndrome, a disorder where blood vessels in the hands and feet become inflamed, can cause Raynaud's symptoms. Primary pulmonary hypertension has also been linked to the disease.
Diseases of the connective tissue: Most people with scleroderma, a disease leading to hardened skin, have Raynaud's disease. The symptoms are commonly linked to lupus, rheumatoid arthritis, and Sjogren's syndrome, an autoimmune disease affecting glands.
Repetition or vibration: People whose hobbies or jobs require repetitive movements, such as typing or playing the guitar or piano, are at risk of developing Raynaud's symptoms. Those whose jobs involve using vibrating tools, such as a jackhammer, are also at risk.
Carpal tunnel syndrome: This condition puts pressure on the nerves traveling to the hand, and it increases susceptibility to Raynaud's symptoms.
Medications: Drugs that can induce Raynaud's include beta blockers, migraine medications containing ergotamine or sumatriptan, ADHD medications, some chemotherapy drugs, and some over-the-counter cold remedies.
Exposure to certain substances: Smoking narrows blood vessels and is a possible cause of Raynaud's. Other chemicals, such as vinyl chloride, may also play a role.
Injuries: Raynaud's can start after injuries such as frostbite, a broken wrist, or local surgery.
Raynaud's tends to affect females more than males. Primary Raynaud's normally starts between the ages of 15 years and 25 years, and secondary Raynaud's between 35 and 40 years.
The condition appears to run in families. A person a first-degree relative with Raynaud's is more likely to develop it.
Possible pathways of Raynaud's disease
The exact pathways of Raynaud's disease are not known, but it probably results from a combination of factors, and the combination of factors probably differs between individuals.
Other possibilities
Platelet activation appears to be higher in people with Raynaud's. Platelets are components in blood that clump together to help prevent bleeding.
Fibrinolysis is a natural reaction that takes place in the body to reduce clotting. Some studies have linked low levels of fibrinolysis with Raynaud's.
Oxidative stress is caused by an increase in free radicals, and it could be involved in Raynaud's.
Symptoms
Raynaud's disease causes blood vessels in the hands or feet to overreact to the cold, causing numbness and pain.
Raynaud's disease affects some people when they are exposed to the cold.
When temperatures drop, the blood vessels contract in the fingers or toes. This contraction causes hypoxia, or lack of oxygen, to the affected tissues. Fingers and toes will feel cold to the touch and possibly numb.
Often, the affected area will turn white, then later turn blue. Once the area is warmed and blood flow returns, a tingling sensation may accompany a red flush and, possibly, swelling. There may also be a painful, throbbing sensation.
Toes and fingers are most commonly affected, but Raynaud's can affect the nose, lips, and ears.
Some women may experience Raynaud's phenomenon of the nipples, especially during breastfeeding. It causes severe throbbing, similar to that experienced with a fungal Candida albicans infection, which can lead to misdiagnosis.
An episode normally lasts around 15 minutes, including the time it takes for the body to normalize.
Raynaud's feet
Raynaud's syndrome can affect either the hands or feet, or both.
To reduce the risk of an attack, it can help to keep the feet and hands warm, avoid smoking, and get enough exercise.
www.thehomeopathyclinic.co.in
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If an attack starts, it may be reduced or prevented by warming the hands and feet at once, for example, by massaging them.
The feet and hands should be protected from cuts, bruises, and other injuries as far as possible, because the lack of circulation can make it harder for them to heal. Use lotion to prevent the skin from cracking, and make sure you have comfortable, well-fitting shoes.
Complications
Raynaud's is not normally life-threatening, but complications can occur.
Chilblains happen when there is a problem with the blood circulation, and Raynaud's is one possible cause. The skin becomes itchy, red, and swollen and it may feel hot, burning, and tender. Chilblains usually resolve in 1 to 2 weeks, but they can come back. Keeping the extremities warm can help prevent them. If the hands and feet become cold, warm them slowly, as too much heat can cause further damage.
If symptoms worsen and blood supply is substantially reduced for a long time, fingers and toes can become deformed.
If oxygen is completely cut off from the area, skin ulcers and gangrenous tissue can develop. Both of these complications are difficult to treat. They may eventually require amputation.
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phonemantra-blog · 7 months
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Buerger's Disease: Managing, and Living Well Buerger's Disease, also known as Thromboangiitis Obliterans, is a rare and complex vascular condition that primarily affects the small and medium-sized arteries of the arms and legs. While it is relatively uncommon, understanding this disease is crucial, especially for those at risk. In this comprehensive guide, we will explore the causes, symptoms, and risk factors associated with Buerger's Disease. Causes and Risk Factors The precise cause of Buerger's Disease remains elusive, but there are well-established risk factors that increase one's vulnerability to this condition. Among these, smoking is the primary culprit. Tobacco use, particularly in the form of cigarettes or chewing tobacco, significantly raises the likelihood of developing Buerger's Disease. However, there are other contributing factors as well, such as genetics and environmental influences. [caption id="attachment_53882" align="aligncenter" width="489"] Berger's disease[/caption] Buerger's Disease is more common in individuals aged 20 to 40 and is often seen in populations with a history of tobacco use. It is essential to recognize these risk factors and understand how they relate to the disease. Signs and Symptoms Early detection of Buerger's Disease is vital for effective management and preventing complications. This disease typically manifests with distinct symptoms, including pain, particularly in the hands and feet. Pain can be severe and may occur even at rest or with minimal exertion. Other common symptoms include inflammation of the affected limbs, skin ulcers, and gangrene. Diagnosis and Medical Evaluation Diagnosing Buerger's Disease involves a multi-faceted approach that combines clinical assessments, diagnostic tests, and imaging. The healthcare team plays a crucial role in determining the presence and extent of the disease. Here's what you can expect during the diagnostic process: Clinical Assessments During your medical evaluation, your healthcare provider will conduct a thorough examination, focusing on the affected limbs. They will assess the severity of pain, any skin changes, and the presence of arterial pulses. The absence of pulses in the affected limbs is a characteristic feature of Buerger's Disease. Diagnostic Tests and Imaging Various diagnostic tests can aid in confirming the diagnosis of Buerger's Disease. These may include: Doppler Ultrasound: This non-invasive test uses sound waves to measure blood flow in the affected arteries, helping identify blockages or constrictions. Angiography: A contrast dye is injected into the arteries, and X-ray imaging is used to visualize blood flow, revealing any narrowing or blockages. Blood Tests: These may include tests to rule out other conditions that could mimic Buerger's Disease, such as autoimmune disorders. Ankle-Brachial Index (ABI): This test measures the blood pressure in your ankles and compares it to the blood pressure in your arms, helping to assess blood flow in the limbs. Living with Buerger's Disease Receiving a diagnosis of Buerger's Disease can be challenging, but it's essential to understand that effective management strategies exist. Living well with this condition involves a combination of lifestyle modifications, pain management techniques, and emotional support. Lifestyle Modifications and Smoking Cessation Quit Smoking: If you are a smoker, the most crucial step you can take is quitting smoking immediately. Smoking cessation is the cornerstone of managing Buerger's Disease. It can slow the progression of the disease and reduce the risk of complications. Healthy Lifestyle Choices: Adopting a heart-healthy lifestyle is essential. This includes maintaining a balanced diet, engaging in regular physical activity, and managing stress. These measures can improve overall circulation and reduce the strain on your arteries. Avoiding Cold Temperatures: Exposure to cold temperatures can exacerbate symptoms. Dress warmly, especially during colder months, and keep extremities well-covered to maintain adequate circulation. Pain Management and Improving Circulation Managing pain associated with Buerger's Disease is a critical aspect of living well. Your healthcare team may recommend: Medications: Depending on the severity of your symptoms, your doctor may prescribe medications to help relieve pain and improve blood flow. Wound Care: If you develop skin ulcers or gangrene, proper wound care is essential to prevent infection and promote healing. Physical Therapy: Engaging in physical therapy exercises can help maintain muscle strength and improve circulation in the affected limbs. Emotional and Psychological Support Living with a chronic condition like Buerger's Disease can be emotionally challenging. Seek emotional support from friends, family, or support groups. Talking to a mental health professional can also be beneficial in coping with the emotional aspects of managing a chronic illness. Treatment Options for Buerger's Disease The management of Buerger's Disease typically involves a combination of treatments aimed at relieving symptoms, improving circulation, and preventing complications. Your healthcare team will tailor your treatment plan to your specific needs. Here are some common treatment options: Medications Vasodilators: These medications help relax and widen blood vessels, improving blood flow to the affected limbs. Examples include calcium channel blockers. Pain Management: Over-the-counter pain relievers or prescription medications may be prescribed to alleviate pain associated with Buerger's Disease. Antiplatelet Drugs: These medications reduce the risk of blood clots and improve blood flow. Surgical Interventions Sympathectomy: In some cases, surgical sympathectomy may be recommended. This procedure involves cutting or clamping specific nerves to improve blood flow to the affected limbs. Bypass Surgery: If severe blockages are present, bypass surgery can reroute blood flow around the blocked arteries, often using veins from other parts of the body. Amputation: In advanced cases where tissue death (gangrene) is extensive and uncontrollable, amputation of the affected limb may be necessary to prevent further complications. Emerging Therapies and Research Advancements Medical research continues to explore innovative therapies and treatments for Buerger's Disease. Clinical trials and studies aim to uncover new approaches to managing the disease, which may include stem cell therapies and targeted drug treatments. It's essential to work closely with your healthcare team to determine the most suitable treatment plan for your condition. Regular follow-up appointments and ongoing monitoring are crucial to track progress and make necessary adjustments. Prevention and Risk Reduction While Buerger's Disease can be challenging to prevent entirely, there are proactive steps you can take to reduce your risk and manage the condition effectively: Strategies for Quitting Smoking Seek Support: Enlist the help of healthcare professionals, support groups, or smoking cessation programs to increase your chances of successfully quitting. Explore Nicotine Replacement Therapies: Nicotine replacement products like patches, gum, or lozenges can help alleviate withdrawal symptoms. Identify Triggers: Recognize situations or emotions that trigger the urge to smoke, and develop alternative coping strategies. Lifestyle Changes to Lower Risk Regular Exercise: Engage in regular physical activity to promote healthy blood circulation. Consult your healthcare provider for exercise recommendations. Balanced Diet: Adopt a diet rich in fruits, vegetables, whole grains, and lean proteins. Limiting saturated fats and sodium can support overall heart health. Stress Management: Practice stress-reducing techniques such as meditation, deep breathing exercises, or yoga to help maintain a calm and balanced state of mind. Importance of Regular Check-ups Routine check-ups with your healthcare provider are essential for monitoring your overall health and identifying any early signs of Buerger's Disease or related conditions. Regular assessments of blood pressure, cholesterol levels, and circulation can aid in early detection and intervention. Frequently Asked Questions (FAQs) about Buerger's Disease Q: What is Buerger's Disease? A: Buerger's Disease, also known as Thromboangiitis Obliterans, is a rare vascular condition that primarily affects the arteries in the arms and legs. It's characterized by inflammation and blockages in these blood vessels. Q: Who is at risk of developing Buerger's Disease? A: The primary risk factor for Buerger's Disease is smoking. However, it can also be influenced by genetic factors and is more common in individuals aged 20 to 40 who use tobacco products. Q: What are the early symptoms of Buerger's Disease? A: Early symptoms may include pain, especially in the hands and feet, skin inflammation, and skin ulcers. These symptoms often occur or worsen with tobacco use. Q: How is Buerger's Disease diagnosed? A: Diagnosis involves clinical assessments, such as examining affected limbs and assessing arterial pulses, along with diagnostic tests like Doppler ultrasound and angiography. Q: Is there a cure for Buerger's Disease? A: While there is no cure for Buerger's Disease, effective management strategies can help control symptoms and prevent complications. Quitting smoking is a crucial step in managing the condition. Q: What are the treatment options for Buerger's Disease? A: Treatment may include medications to improve blood flow and manage pain, surgical interventions to bypass blocked arteries, and, in severe cases, amputation. Q: Can lifestyle changes help manage Buerger's Disease? A: Yes, lifestyle modifications such as quitting smoking, maintaining a healthy diet, and staying physically active can significantly improve the management of Buerger's Disease. Q: What should I do if I suspect I have Buerger's Disease? A: If you experience symptoms like persistent pain, skin ulcers, or color changes in your extremities, seek immediate medical attention. Early diagnosis and treatment are crucial. Q: Can Buerger's Disease be prevented? A: While it may not be entirely preventable, quitting smoking and adopting a healthy lifestyle can significantly reduce the risk of developing Alzheimer's Disease. Q: Are there support resources for individuals with Buerger's Disease? A: Yes, support groups, patient communities, and healthcare professionals can provide valuable support and guidance for individuals living with Buerger's Disease. Conclusion In conclusion, Buerger's Disease, though challenging, is a condition that can be effectively managed and controlled with the right knowledge and proactive approach. By taking steps to quit smoking, embracing a healthy lifestyle, seeking appropriate medical care, and staying informed about the latest advancements i
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doctorfoxtor · 3 years
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Shit What I Got Wrong
Did some practice tests and qbanks. Got a lot of shit wrong. LMAO!
Medicine
Myasthenia can affect young women much like any other autoimmune conditioon. Just because thymomas almost invariably presents with myasthenia doesn't mean the absence of a thymoma precludes myasthenia.
Evaluate for ↑ICP before you take an LP always always always. If you can't fundoscopy, take a CT.
Acute gout: NSAIDs (nonselective > selective) > steroids > colchicine.
ALS electrophysiology: fibrillation potentials = recent denervation. Sustained long-duration complexes = chronic denervation.
HAV vaccine is indicated in MSM, chronic hepatitis or IVDU patients and travellers to endemic regions. Immunodeficiencies/HIV is NOT a direct indication.
Don't assume that a horrible haematocrit is the reason why a patient is in CHF.
Intubation is a big no-no in cervicofacial fractures. Opt for a cric instead if an emergency airway is indicated.
Smoking history does not immediately mean that the patient's cough is COPD. It can still be due to asthma, and really only reversibility on spirometry (or a cholinergic challenge test) can differentiate.
Reserve 3% NaCl for only severe symptomatic hyponatraemia (seizures, coma). Otherwise, salt tabs and water restriction are good.
Allergic/acute interstitial nephritis still continues to fucking evade my understanding omfg. Eosinophils eosinophils eosinophils
Agranulocytosis is caused by clozapine, olanzapine AND carbamazepine. Open and close the carbs.
Psych/Community Medicine/Biostats
Episodes of dementia symptoms that are successfully treated with medication is certainly pseudodementia (usually depression).
If a question has 'ask about suicidal feelings' as an option, THAT'S THE ANSWER DON'T PICK ANYTHING ELSE LITERALLY JUST FUCKING PICK THAT
Surgery
Swelling in the superior aspect of the scrotum + signs of SBO = obstructed (or worse, strangulated) hernia. DON'T bother with the doppler, take the patient to the OT ASAP!
ERCP for post-cholecystectomy pain syndrome, there could be a missed stone in there.
Radial subluxation: flexed elbow, pronated forearm. Tx by hyperpronating or flexed supinating.
Achalasia is characterised by decreased peristaltic activity, especially in longstanding disease, because of sustained ineffectual contraction.
Eczema vs Paget's disease of the breast: a mammography is nonconfirmatory. Only biopsy will truly differentiate between the two. In general tho eczema tends to be B/L and Paget's U/L, and long-standing eczema would extend to the skin over the breast, not just the nipple/areola.
Before starting PRA👏ZO👏SIN therapy for BPH rule out pre-existing orthostasis. Especially in a diabetic with possible autonomic neuropathy!
Spontaneous bacterial peritonitis can happen in any condition that causes ascitis, not just cirrhosis. This includes peritoneal dialysis!
Common areas of massive internal haemorrhage: chest, abdomen, pelvis, THIGHS APPARENTLY
Calcifications anterior to the vertebrae can apparently pop you aorta like a balloon, what the actual fuck
If you have an ABPI measurement, no need to go for arteriography. Can straightaway treat with Buerger's exercises (supervised graded exercises)
Paediatrics
I will never, and I DO mean NEVER, get the hang of milestones. I think I'll just have to eat those mistakes
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Necrotizing Sialometaplasia of Palate by Radka Cholakova in Open Access Journal of Biogeneric Science and Research
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Abstract
Necrotizing sialometaplasia (NS) is a rare, benign, inflammatory condition, occasionally with ulcers, which is self-limiting and affects mainly salivary tissue. Purpose: To present a case of NS associated with a systemic connective tissue disease in a female patient. Material/Methods: A 56-year-old female patient with ulcers of the palate, surrounded by a red halo, for 2 weeks, which did not resolve when treated with topical antiseptics. Clinical and radiological methods, together with pathohistological analysis, were used to make the diagnosis. Immunohistochemical analyses to diagnose patient's systemic disease were performed at a rheumatology clinic. Results: The definitive diagnosis was made based on a pathological examination and the tests performed in the rheumatology clinic, which found that this was a case of necrotizing sialometaplasia of the minor salivary glands and a concomitant systemic connective tissue disease. Conclusions: NS is a rare disease, with an excellent prognosis, without any possible preventive strategies.
Keywords: Necrotizing sialometaplasia; diseases of the minor salivary glands; tumour-like lesion
Introduction
Necrotizing Sialometaplasia (NS) is a rare, benign, inflammatory condition, sometimes with ulcers, which is self-limiting and affects mainly salivary tissue. This disease is classified as a “tumour-like lesion” in the WHO classification of salivary gland tumours. It was first described in 1973 by Abrams, Melrose and Howell [1], and in the following year, Dunlap and Barker reported five diagnosed cases [2]. This lesion can be confused with a malignant disease, thus resulting in unnecessary radical surgery.
Materials and Methods
A female patient of visible age of 56, corresponding to her calendar age, with complaints of a non-healing “aphthous ulcer”, which appeared 2 weeks earlier. Treatment with antiseptic mouthwashes and topical application of propolis was administered. The aphthous ulcer did not resolve, but the pain subsided over time. The initial examination showed two ulcers with dimensions of about 2 mm, located on either side of the median palatine suture, with a red halo around them. After treatment with SOLCOSERYL (MEDA Pharma GmbH & Co. KG, Germany), the ulcers resolved, but the red spots remained (Figure 1). The patient was referred for a CBCT in order to detect erosions in the palatine bone under the ulcers (Figure 2). The size of the formation did not decrease and, therefore, an excisional biopsy was performed in full thickness of one of the lesions, and then was provided for histopathological examination. The wound was covered with a PRF membrane and healed without complications. Pathological examination showed that there were cords of the lining multilayered squamous non-keratinizing epithelium, deep below it, without atypicality, and with rapid proliferation of granulation tissue, which covered the minor salivary gland ducts, with squamous cell metaplasia. The patient was a moderate smoker (up to 10 cigarettes/day). She had cholelithiasis without clinical manifestations. She had had surgery for a benign neoplasm of the breast several years before. Intermittent complaints of swelling and rash on the upper eyelids, erythematous rash on the nasal dorsum and photosensitivity were present, for which the patient had been admitted to a rheumatology clinic for examination. A systemic connective tissue disease was suspected there, as elevated total AHA, Anti-SS-A and Anti-SSB antibodies with very high titers and low C4 complement level, without significant proteinuria, were found. The dermatological examination showed pathological skin lesions of the nose with erythematous-edematous plaque, 6 cm in diameter. Sjögren's syndrome or systemic lupus erythematosus were suspected in this patient. The pathohistological examination of the minor salivary glands from the lower lip mucosa found that this was not a case of Sjögren's syndrome. Biopsy of the plaque of the nasal lesion was recommended.
Results
The definitive diagnosis was made based on a pathological examination and the tests performed in the rheumatology clinic, which found that this was a case of necrotizing sialometaplasia of the minor salivary glands and a concomitant systemic connective tissue disease.
Discussion
Necrotizing sialometaplasia is extremely rare, accounting for less than 1% of oral lesion biopsies [3]. The mean age of onset is 46 years, and the male:female ratio is 2.7:1 [4]. The disease is prevalent among the Caucasian race, with Caucasian:African American ratio of 5:1, according to Brannon [5]. In most cases (80%), the minor palatine salivary glands are affected. Although rarely, it can occur in the retromolar space, gingiva, lips, tongue, cheeks, and nasal cavity [1,6]. This disease can also affect the large salivary glands in more than 10% of the cases [3]. The etiopathogenesis of necrotizing sialometaplasia is unknown, but it is thought that the lesion develops as a result of previous ischemia in the salivary gland. In experimental models, disruption of the arterial blood supply to the salivary glands in rodents results in a NS-like histopathological picture. This disease is found in patients with sickle cell disease, Buerger's disease and Raynaud's phenomenon, which are all vasculopathies that predispose to ischemia. Other risk factors for the development of NS include: smoking (and alcohol consumption), use of cocaine and anabolic steroids, hot food, fellatio, traumatic vascular injury, and bulimia [7-9]. The synergistic action of NSAIDs and alcohol over a long period of time results in a change in the oral mucosa functions due to suppression of prostaglandin production and reduction in the blood supply to the minor salivary glands, which causes ischemic events [10]. The iatrogenic factors for the development of NS are the use of local infiltration anesthesia with an anesthetic with a higher concentration of correctives, intubation, bronchoscopy, local radiotherapy, as well as surgical procedures in the vicinity of the affected area [3,7,11,12], which, in the case described by us, had not been conducted for a period of more than 6 months. Senapati et al. [13] reported that NS is a manifestation of local vasculitis. It may be associated with other tumours, in particular Warthin's tumour, Abrisokov's tumour, lip cancer, rapidly growing malignant mesenchymal disease and salivary gland tumours. There is also a connection with previous upper respiratory tract diseases (chronic sinusitis and allergies) in the past few weeks. It is possible that ischemia is due to immune complexes, resembling the pathogenesis of erythema multiforme or benign trigeminal sensory neuropathy. In our case, levels of immune complexes in the body were elevated.
Anneroth and Hansen described the following five clinical stages in the development of necrotizing sialometaplasia: infarction, sequestration, ulceration, repair and healing [6]. A subacute variant of this condition was also described in the literature. Histological features are ischemic lobular necrosis of seromucinous glands, with maintenance of intact lobular architecture, despite coagulative necrosis of the mucinous acini. Pale acinar outlines often persist, but the cell nuclei are hypochromatic or absent. Mucin extravasation into the adjacent tissues triggers an inflammatory reaction dominated by histiocytes and granulation tissue. Within the necrotic lobules, the inflammatory component is often minimal, but is usually found in the surrounding tissues. Although squamous metaplasia of ducts and acini is typical (which makes the diagnosis challenging due to its similarity to malignancies), the metaplastic cells have benign nuclear morphology, with minimal pleomorphism or hyperchromatism and few mitotic figures. Nests of squamous epithelium, which usually have smooth contours, occasionally may have an irregular outline.
Pseudoepitheliomatous hyperplasia, where the overlying or adjacent epithelium is markedly hyperplastic, together with extensive ductal metaplasia, may resemble malignant condition of the epithelium, which could be the reason for misdiagnosis and radical ablative surgery. It may be difficult to distinguish NS from squamous cell carcinoma, low-grade mucoepidermoid carcinoma and oncocytic tumours. Specific histopathological characteristics may have some relation to the “age” of the lesion at biopsy. Coagulative necrosis is more common in “new” lesions, whereas fibrosis and squamous metaplasia are typical of “older” lesions. In our case, biopsy was taken nearly 2 weeks after the onset of the first symptoms, and therefore the changes correspond to an “old” lesion. Management of this disease includes monitoring, use of topical antiseptics, and pain control until recovery [3]. In the presence of predisposing factors, their correction is necessary.
Conclusion
This work was supported with grants from the URPC, University of Benin, Benin City.
More information regarding this Article visit: OAJBGSR
https://biogenericpublishers.com/pdf/JBGSR.MS.ID.00155.pdf https://biogenericpublishers.com/jbgsr.ms.id.00155.text/
For more open access journals click on https://biogenericpublishers.com/
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hccheart789 · 3 years
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HCC - Heart & Vascular Consultants
Address:
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Heart & Vascular Care Consultants World-Class care, a heartbeat away. When it comes to cardiac care, seconds count. That’s why it’s good to know that wherever you find yourself,  exceptional coronary and circulatory expertise is moments away at a nearby office of Heart & Vascular Care consultants. At Heart & Vascular Care Consultants, our practitioners treat every symptom, from the most commonplace to the most acute, with the same exacting diagnostic discipline. And we approach every patient and family with the same compassionate concern. It’s never been more important to have an experienced, trusted and responsive cardiologist nearby. Yet even a concern as common as spider veins, varicose veins, leg pain, leg swelling, leg discoloration, lymphedema can be the sign of a more critical underlying cardiac condition. Heart Catheterization. A now common and useful diagnostic procedure, heart catheterization allows your medical team to evaluate the condition of your heart. This is achieved by inserting a small tube into a blood vessel and injecting a dye that will allow them to see the flow through your arteries and identify any blockages. In most cases, you will be awake and resting comfortably throughout, complications are very rare and you will be home that evening. Preparation for this procedure is simple and begins 12 hours beforehand. Your Heart & Vascular Care doctor or nurse-practitioner will provide complete instructions beforehand.
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HCC - Cardiology Consultants & Vein Experts
Address:
40 Fuld St Suite 300, Trenton, NJ 08638
Phone:
(609) 695-4422
Website URL:
https://heartcareconsultants.com/
About US:
Whether your symptoms are superficial or serious, here you can be certain that your heart is in the right hands. At HCC - Cardiology Consultants & Vein Experts, our practitioners treat every symptom, from the most commonplace to the most acute, with the same exacting diagnostic discipline. And we approach every patient and family with the same compassionate concern.
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symptomfrom786 · 3 years
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Address: 2137 Welsh Road, Suite 2E, Philadelphia, PA 19115
Phone: 215-698-1995
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http://www.heartcareconsultants.com/
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Cardiologist, vascular surgeon, medical clinic
About US
At HCC - Cardiology & Vascular Consultants our practitioners treat every symptom, from the most commonplace to the most acute, with the same exacting diagnostic discipline. And we approach every patient and family with the same compassionate concern.
As more and more adults in our region experiencing symptoms of serious conditions such as heart failure, heart rhythm disorder, atherosclerosis, heart attacks, atrial fibrillation, chest pain, cardiomyopathy, palpitation, fast heartbeats, slow heartbeats, carotid artery disease, coronary artery disease, heart murmur, chronic obstructive pulmonary disease, peripheral arterial disease pericarditis, myocarditis, rheumatic heart disease, sudden cardiac death and women heart health.
It’s never been more important to have an experienced, trusted and responsive cardiologist nearby. Yet even a concern as common as spider veins, varicose veins, leg pain, leg swelling, leg discoloration, lymphedema can be the sign of a more critical underlying cardiac condition.
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mcatmemoranda · 4 years
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Peripheral Arterial Disease lecture from 10/16/19 by Anantha Ramanathan MD
Many people are asymptomatic. Arterial insufficiency: claudication, rest pain, tissue loss. Claudius had a limp, so that's the etymology of "claudication."
D/dx: neurogenic (e.g., sciatica), venous, MSK, joint pain.
Arterial claudication = no pain at rest, pain on walking, pain disappears with rest, pain is in muscle groups (calf, quadriceps, gluteal muscles), the pain is the same at any given point (i.e., the pain recurs with the same distance of walking).
Pain at rest is NOT rest pain. Rest pain = pain due to lack of perfusion. It’s a dull ache that worsens with elevation (nocturnal), pain in metatarsal heads/toes. Venous pain is alleviated with elevation. Rest pain is relieved temporarily with dependency (Buerger’s exercise).
D/dx of rest pain: infection, diabetic neuropathy, arthropathy.
Atypical ischemic pain: tingling/numbness on elevation; at atypical sites.
Tissue loss: gangrene, especially at great toe (whereas venous ulcers occur at medial malleolus). Neuropathic ulcers occur at pressure points (bottom of metatarsal heads). Arterial ulcers occur in the toes. Venous ulcers are around the malleoli and have pigmentation. Neuropathic ulcers are at pressure points (like where shoes rub).
Fontaine stages: stage I (asymptomatic), stage II (mild claudication)... I didn't get all of what he said, but here's a table of the classification systems for PAD.
Other arterial territories besides peripheral arteries are affected (coronary, cerebrovascular, mesenteric arteries are also involved).
Atherosclerotic disease risk factors = risk factors for PAD.
What you want to know about the presenting symptom: How long has it been going on? Improving or worsening? How it affects the pt’s life? Critical limb ischemia.
25% will deteriorate, 2% lose limbs in 5 years, 30% die within 5 years (d/t concomitant diseases), 50% die in 10 years.
Critical limb ischemia: rest pain/tissue loss. At 1 year, 25% will be dead.
Mesenteric arterial disease-> pain after eating. 72% of PAD pts have CAD. CAD, cerebrovascular disease, and PAD overlap.
Smoking, diabetes, hypertension, hyperlipidemia = risk factors for PAD.
Framingham risk score (assesses the 10-year risk for atherosclerotic CVD event).
More than 60% of non-traumatic amputations occur in diabetics. Smoking increases risk. Smokers likelier to develop DM2.
You need to know where the pain is, how it progresses, look for arterial disease in other vascular territories.
Vascular exam:
-Radial pulse (compare B/L pulses). Is it present? Does pt have atrial fibrillation?
-Arm pressures (compare B/L; should be within 20 mmHg of each other. If 20 mmHg or more, there’s a problem).
-Carotid arteries (listen along entire length for carotid bruit). Turn pt’s head to opposite side and have pt hold breath while you listen.
-Listen to heart (aortic stenosis can cause bruits heard in carotid artery).
-Palpate abdominal aorta. If diameter is more than 3 cm, it could be an AAA.
-Listen to iliac/femoral arteries for bruits. Iliac = inflow, femoral = outflow.
-Palpate popliteal pulses (bend knee slightly and have pt relax, palpate above and below the knee). If it’s strong, there may be a popliteal aneurysm. Look for AAA especially if you ring B/L (not sure what I was trying to type here).
-Posterior tibial pulse (it helps you to feel the pulse if you dorsiflex the foot).
-Dorsalis pedis (helps to plantar flex).
-Ankle Brachial Index = measure with manual BP cuffs; inflate the cuff until the signal in the hand held doppler disappears, then increase 10 to 20 mmHg. Then deflate. Pressure ratio ankle/arm should be 0.9 or greater.
Chilblains (red bumps on toes d/t cold exposure) mimic ischemia, erythromelalgia, livedo reticularis, phlegmasia cerulea dolens (venous ischemia) also mimic ischemia. Phlegmasia alba dolens (arterial thrombosis).
Pulse Volume Recording (PVR) is monophasic and flattened when there is ischemia. Loss of dicrotic notch and flattened upstroke on PVR = ischemia.
Treadmill & exercise Doppler can unmask subclinical disease. When you exercise, the pressure in the leg should increase as blood flows into it. If there is stenosis, the pressure in the affected limb will go down. Rutherford classification.
Acute limb ischemia = “6 P’s” = pulselessness, pallor, pain, paresthesia, paralysis, poikilothermia. The order actually matters, because it's progressive. Once the tissue is cold, that's really bad; the muscles are dead.
Pain occurs first in stage 1 when limb is viable. You need pressure index to say that circulation is normal. So Doppler only shows if artery is patent, not that the blood is flowing; need pressure index to see if circulation is normal and blood that the blood is flowing. Doppler signal in the foot doesn’t mean there is no arterial disease. You need pressure index to determine whether vascular disease is present. Stage 2 = threatened limb = sensory loss; sensory loss of toes. Stage 2b = immediately threatened, sensory loss extends to foot/leg. Stage 3 = irreversible damage, profound/anesthetic limb. At stage 3, revascularization is dangerous.
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cbdvapebattery-blog · 5 years
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Harmful Aftereffects of Cigarette Smoking
By smoking a cigarette, the nicotine within the cigarette, affects mental performance within 10 seconds, latter about it gradually affects one other elements of the body. From head to toe its effects are visible. In smoking, the carbon monoxide starts to dissolve in oxygen hence reducing its efficiency. The oxygen degree of the cells started initially to drop. The arteries become narrower and the blood pressure shoots up. A burning cigarette produces nearly four thousands chemical, of which 200 are extremely poisonous. One of them nearly 60 compounds are carcinogens in nature.
Pharmacological aftereffects of nicotine
· Cardiovascular system (C.V.S.): rise in B.P., tachycardia (accelerated heart rate), cutaneous vasoconstriction (skin turns paler because of less supply of blood due to narrowing of blood vessels)
· Ant diuretic: reduces urine volume due to A.D.H. (anti diuretic hormone) release
· Central nervous system (C.N.S.): stimulation, especially respiratory, vasomotor and emetic centres
· Adrenal: discharge adrenaline
· Automatic: transient stimulation, ultimately depression of most ganglia (nerve cells bodies)
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Pharyngeal (throat) and bronchial irritation
· Bronchitis (inflammation of bronchi due to longterm contact with irritants)
· Pneumonia.
Peptic ulcer morality increased
Because of associated alcoholism incident of Cirrhosis increased
Carcinoma of following areas of the body increased
· Oesophagus
· Prostate
· Bronchus
· Bladder
Cardio-vascular disease exacerbated
· Myocardial ischemia (reduced blood supply to heart muscles)
· Buerger's disease (inflammation and clotting of veins and arteries of hands and feet)
Influence on fetus
· Smoking during pregnancy restricts growth and increases prenatal mortality rate
Individual peculiar symptoms
· Tobacco angina
· Atrial extrasystoles (premature electrical impulse in the heart)
· Hypoglycaemia (below normal blood glucose)
Current treatment for: smoking cessation, nicotine addiction, tobacco addiction or stop smoking programs are typical place. The success of these programs varies widely. Bupropion (AKA Zyban, Wellbutrin, Voxra, Budeprion or Aplenzin) is a common smoking cessation aid. Nicotine replacement nicotine blocking agents will also be frequently used. Good outcome statistics are hard to find. Recovery from nicotine addiction, cigarette smoking and tobacco addiction is difficult and on a par with heroin recovery!
There's also alternative medical treatments or therapies for recovery from nicotine or cigarettes addiction. There are herbs and supplements that help with smoking with 510 battery cessation and nicotine addiction. Individuals who are nicotine dependent or involved in smoking cessation can take advantage of these non-addicting, affordable herbal supplements. These herbal supplements are natural and can be used as needed. These therapies to take care of smoking or nicotine addiction, withdrawal, detox and/or cravings should be continued for at least 2 years. It takes that long to normalize the electrical and chemical changes in mental performance that occurred with ongoing nicotine addiction.
Behavioral and cognitive therapy is essential for any smoking cessation program. It would be wise. There are 12-Step programs for almost everything, including AA (Alcoholics Anonymous), NA (Narcotics Anonymous), CA (Cocaine Anonymous), OA (Overeaters Anonymous) and Nicotine Anonymous. Recovery from nicotine and smoking cessation are lifelong journeys.
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Taking The Chill Out Of Raynaud’s Disease
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By Kimberly Wilkes
Raynaud's (pronounced ray-nodes) isn't a disease you hear about very often. Yet, an estimated 28 million people in the U.S.—including 20 percent of all women in their childbearing years—have Raynaud's phenomenon, or Raynaud's syndrome as it's also called. What's more, four out of five people who have the disease suffer without getting medical help for the condition.1
What exactly is Raynaud's phenomenon, who is at risk and how can you reduce the symptoms naturally? Read on to find out.
The Big Chill
Named for a French physician Maurice Raynaud, who first identified the disease in 1862 while he was still a medical student, Raynaud's leaves anyone afflicted with the disorder extremely sensitive to cold temperatures.2 During a Raynaud's attack, smaller arteries that deliver blood to your fingers and toes—and in some cases other areas such as the nose, ears and tongue—narrow when exposed to cold temperatures or emotional stress.3These spasms in the blood vessels decrease circulation. Often, the skin turns white, then blue, then bright red. It's usually painful, too, and a Raynaud's episode also may include numbness, swelling or tingling. Holding a cold drink, reaching into the freezer, stepping into an air-conditioned room or going outside on a cold day all can trigger the attacks, which last anywhere from minutes to hours.  
If you have this disease, you can blame the pain and color changes in your skin on a malfunctioning autonomic nervous system. This part of the nervous system oversees bodily functions that you don't consciously control such as breathing, heartbeat and digestion. When the autonomic nervous system isn't working properly, it directs the blood vessels in affected areas such as the fingers and/or toes to constrict, starving those areas of blood supply. Blood delivers oxygen to tissues, so without the proper blood supply, tissues can undergo damage and in severe cases develop gangrene. Over the years, the small arteries feeding your hands, feet, nose and ears may thicken as they pay the price of the ongoing spasms. Not as much blood can flow through these thickened arteries.4
Who's At Risk?
There are two types of Raynaud's syndrome: primary and secondary. The most common form, primary Raynaud's is not associated with any other diseases. Secondary Raynaud's occurs along with other diseases, often autoimmune diseases such as scleroderma, lupus and rheumatoid arthritis. Secondary Raynaud's is usually a more severe form of the disease than primary, has worse symptoms, is more likely to cause tissue damage, and is less likely to respond to treatment.5However, even the primary form can be disabling in some people.6The primary form also usually affects all fingers, whereas in the secondary form only some fingers might suffer from the vessel spasms.7
Risk factors for Raynaud's are different for each form. Women are more likely to develop primary Raynaud's compared to men. Primary Raynaud's also usually develops in people aged 15 to 30 years old, although it can arise at any age. If you live in a colder climate or have a history of the disease your risk also goes up.8
Having an autoimmune disease such as scleroderma, lupus or rheumatoid arthritis is a risk factor for secondary Raynaud's. Unlike primary Raynaud's, secondary most often develops at a more advanced age, usually around 40 years old. If you have a job where you operate tools or machinery that vibrate such as tipping hammers, jackhammers, chain saws and machinery such as tractors, power shovels and bulldozers you're at a greater risk of developing the secondary form of the disease.9Ditto for any activity you perform regularly at home that involves repetitive movements such as typing or playing the piano. People who have carpel tunnel syndrome also are more susceptible.4
In people older than 60, secondary Raynaud's syndrome is often caused by atherosclerosis obstructing the arteries.3 Other arterial disorders such as Buerger's disease, caused by inflammation of the blood vessels of the hands and feet, and pulmonary hypertension, which impacts the arteries of the lungs, are also associated with secondary Raynaud's.4
In addition, certain drugs are linked to secondary Raynaud's including the drug OROS-methylphenidate used for attention deficit hyperactivity disorder (ADHD),10beta-blockers for high blood pressure, migraine medications containing ergotamine or sumatriptan, some chemotherapy drugs and over-the-counter cold medications that narrow blood vessels.4
Finally, other risk factors include smoking, which narrows blood vessels, hand or foot trauma including wrist fractures, surgery or frostbite, hemodialysis for kidney disease and exposure to certain chemicals such as vinyl chloride, a common environmental pollutant.4,11
The Homocysteine Connection
High levels of the amino acid homocysteine are linked to a number of health concerns, including cardiovascular disease, Alzheimer's, diabetes and osteoporosis. And now you can add Raynaud's to that list. Levels of this amino acid are typically high in both primary and secondary Raynaud's, even in teenage patients with the disease.12-17
Homocysteine injures the blood vessels in part by producing damaging free radicals, so researchers believe it could play a role in the development of Raynaud's. It also causes blood cells to clump together, interfering with circulation.18
Conventional Treatments
Simply dressing warmer during cold weather, and bundling up the feet and hands in warm socks and gloves is often enough for mild forms of Raynaud's. Conventional doctors will usually treat more severe cases by prescribing the class of blood pressure medications known as calcium channel blockers. These drugs act as vasodilators—in other words, they dilate the blood vessels. However, they can cause side effects such as rapid heartbeat, headaches, dizziness, fatigue, nausea, constipation and swelling in the feet and lower legs.19 Calcium channel blockers are also linked to lesions in the esophagus and gastrointestinal reflux disease (GERD).20
Conventional doctors also may prescribe drugs like prazosin (Minipress®) and doxazosin (Cardura®), which belong to a class of blood pressure medications known as alpha-adrenergicblockers. These drugs help dilate the blood vessels by blocking the action of norepinephrine, a blood-vessel-constricting hormone. However, this class of drugs also has its own share of side effects such as nausea, dizziness, headache, heart palpitations and low blood pressure.7 Another class of blood-vessel-dilating drugs are called prostaglandins. But higher doses can cause headaches, flushing and nausea.7For skin ulcers, nitroglycerin cream is used topically on the base of the fingers. In some people, the cream can cause dizziness, flushing, slow heartbeat, chest pain and fainting.21
In some cases, doctors recommend surgery to remove the nerves around the blood vessels. But this surgery doesn't work for everybody.22  Doctors also may inject anesthetics or Botox into the hands or feet to block the activation of nerves in those areas. This comes with its own set of side effects including swelling or bruising at the injection site, headaches or flu-like symptoms and the possibility that the toxin in the medication may spread to other areas of the body leading to symptoms similar to botulism such as muscle weakness, trouble speaking or swallowing, difficulty breathing and inability to control the bladder.22,23
Natural Support for Raynaud's
If you prefer natural options, there are a number of ways you can improve your circulation and keep yourself warm. Here are some suggestions, based on research and what alternative and integrative doctors have found helpful in their practices.
Circulation-Boosting Socks
The first step is to keep your feet warm. Incredisocks are a special type of foot covering invented by a chiropractor. Incredisocks work as thermoregulators to increase or decrease temperature in the feet. They also improve blood flow, feeding the tissues with enhanced oxygen.24This not only results in greater comfort and reduced swelling in people who are concerned about circulation, it also results in healthier skin tone and color in oxygen-deprived areas.
Incredisocks are made with a blend of bamboo charcoal, used in traditional Chinese medicine to improve circulation, and germanium, which has a long history of use in Japan to support healthy blood flow. When this combination is heated by the body anions are released.  An anion is an ion with more negatively charged electrons than positively charged protons, resulting in a net negative charge. These anions increase blood flow and nourish tissues with oxygen—the same process that occurs when a physical therapist uses infrared on an injured knee or body part. Although infrared exposes injured areas to negative ions for only a short time, the circulation socks constantly bathe the feet in these beneficial anions for as long as the socks are worn.
The improved circulation that occurs after anions are generated results in more oxygen being supplied to local tissues. Combined with the increase in blood flow, this allows the body to regulate temperature much easier. Thermographic image testing comparing regular socks to Incredisocks shows that the maximum area temperature of feet not wearing Incredisock was 29.4 degrees while the maximum area temperature of feet wearing Incredisock was 32.6 degrees.25
Acupuncture
There's a mixed bag of research on whether or not acupuncture can help people with Raynaud's. But one study indicates it's something worth looking into to see if it works for you. The controlled, randomized study investigated the effects of acupuncture on patients with primary Raynaud's syndrome for 23 weeks in winter. Seventeen patients were given seven acupuncture treatments during weeks 10 and 11 of the study and compared to 16 controls. Throughout the study, subjects noted in a diary every day whether they had experienced an attack, how long the attack lasted and how severe it was. In the acupuncture-treated subjects, there was a significant drop in the number of attacks experienced per day. The patients undergoing acupuncture also experienced other improvements in their blood flow.26
The study authors concluded, "These findings suggest that traditional Chinese acupuncture is a reasonable alternative in treating patients with primary Raynaud'ssyndrome."
Control Your Stress
Relaxation techniques can help Raynaud's patients chill out in more ways than one. Stress can trigger Raynaud's attacks so it's a good idea to find ways to cope with stress. One option is biofeedback, a mind-body technique that shows you how to control your autonomic nervous system. One randomized study investigated biofeedback in patients who had secondary Raynaud's together with systemic sclerosis. Eight Raynaud's patients participated in biofeedback three times a week for four weeks and experienced reduced scores for disease severity.27
In one review of the medical literature, scientists concluded that thermal biofeedback is effective in reducing the severity and frequency of Raynaud's attacks. The scientists came to this conclusion after reviewing a number of studies, including three randomized controlled trials performed in independent laboratories.28
Basically, anything you can do to reduce or manage your stress, including meditation, not pushing yourself too hard at work or deep-breathing exercises can help keep the Raynaud's attacks at bay.
Hyperbaric Oxygen
In this type of therapy, patients inhale oxygen while in a chamber. Because the tissues of Raynaud's patients are starved of oxygen, it makes sense that a therapy that can boost oxygen levels may reduce symptoms.29,30In one study, researchers treated six women between the ages of 46 and 71 with two, two-hour daily sessions of hyperbaric oxygen for 10 to 14 days. The hyperbaric oxygen not only improved the Raynaud's symptoms—the improvement lasted for more than a month after the treatments ended.30 Alternative practitioners report good success using this type of therapy.
A Circulation-Boosting Botanical
If you want to use nutritional supplements to improve circulation, one of your best bets is Ginkgo biloba, which supports healthy blood flow. A couple of trials show it may help people who have Raynaud's. In one of those studies, even though Ginkgo wasn't as effective as a standard drug, when researchers gave Ginkgo to primary Raynaud's patients for eight weeks, 31 percent of the patients improved.31
In another study, researchers randomly assigned primary Raynaud's patients to receive either Ginkgo bilobaextract or a placebo for 10 weeks. Both before and during the study, the subjects recorded how often the attacks occurred, their severity and how long they lasted. Subjects taking the Ginkgo experienced significantly less attacks down from an average of 13.2 per week to 5.8 per week. There were 56 percent less attacks in ginkgo group and only 27 percent less in the placebo group.32
Homocysteine-Lowering Vitamins
As mentioned earlier in this article, high homocysteine levels are linked to Raynaud's. When your body is deficient in folate, vitamin B12 and vitamin B6, it's not able to easily breakdown homocysteine, leading to high levels of this amino acid. People who have primary Raynaud's syndrome have lower levels of folate.13
To keep homocysteine from building up in the body, it's a good idea to take a good B-complex vitamin, ideally one that contains 5-MTHF, a more bioavailable form of the vitamin.
Help from the Sea
Fish oil protects the blood vessels of Raynaud's patients against low oxygen. In one double-blind, placebo-controlled study in 32 patients with primary or secondary Raynaud's, researchers gave subjects every day either an olive oil placebo or 12 fish oil capsules, which contained a total of 3.96 g eicosapentaenoic acid (EPA) and 2.64 g docosahexaenoic acid (DHA). The researchers evaluated the effects of the fish oil at six, 12 and 17 weeks by measuring the systolic blood pressures and blood flow in the fingers of the subjects at room temperature and in cold water baths. The study authors also timed how long it took for the patients to have a Raynaud's attack after exposure to the cold water.
In the fish oil group, it took longer to have a Raynaud's attack. Prior to supplementing with the fish oil, it took about 31.3 minutes for the subjects to have an attack. After taking the fish oil for six weeks, that time increased to 46.5 minutes. Subjects with the primary form of the disease who took fish oil capsules had the largest increase in the amount of time to an attack compared to patients with the secondary form. In fact, five of 11 patients with primary Raynaud's who took the fish oil capsules no longer had Raynaud's attacks beginning at six or 12 weeks into the study compared to 1 of 9 patients in the olive oil group.33
According to the study authors, "We conclude that the ingestion of fish oil improves tolerance to cold exposure and delays the onset of vasospasm in patients with primary, but not secondary, Raynaud'sphenomenon."
New Use for the Sunshine Vitamin
Vitamin D is another nutrient no Raynaud's patient may want to do without. Researchers have found many Raynaud's patients suffer from vitamin D deficiency. What's more, supplementing with this vitamin may actually improve symptoms. A recent randomized, placebo-controlled study investigated the effects of giving Raynaud's patients 600,000 IU of vitamin D3 per month for two months in the winter. The researchers randomly divided 42 patients deficient in vitamin D into two groups. One group received the vitamin D, the other group received a placebo. The patients receiving the vitamin D3 experienced an increase in their vitamin D levels and an improvement in their Raynaud's symptoms.34
Adding to the evidence that vitamin D deficiency may play a role in Raynaud's is the finding that as many as 80 percent of people with systemic sclerosis are deficient in Vitamin D.35
Raising Nitric Oxide
Nitric oxide is one of the chemicals in your body responsible for dilating blood vessels. However, in secondary Raynaud's, nitric oxide levels are low.7
When trying to boost nitric oxide levels, one good choice is the supplement L-arginine. A couple of medical journal articles have reported upon L-arginine's benefits in people who have secondary Raynaud's. One group of researchers reported uponfour cases in which  L-arginine supplementsimproved symptoms in patients with severe Raynaud's, including reversing the death of tissue.36
In another study, patients with secondary Raynaud's who also had systemic sclerosis, experienced several improvements after taking L-arginine including increased dilation of the blood vessels in their fingers and higher levels of tissue-type plasminogen activator, a protein that helps break down blood clots.37  
Boost Circulation, Warm Your Cold Hands and Feet
Improving blood flow and lowering emotional stress—or finding effective ways to cope with it—can reduce the number of Raynaud's attacks. Acupuncture, biofeedback and hyperbaric oxygen therapy may all help replenish oxygen-starved tissues while certain botanicals, vitamins and nutrients can give your blood vessels a helping hand.  
Originally published in Whole Health Insider.
References:
1. Raynaud's Association. www.raynauds.org
2. Bakst R, et al. J Am Acad Dermatol. 2008 Oct;59(4):633-53.
3. Belch JJ, Ho M. Drugs. 1996 Nov;52(5):682-95.
4. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/causes/con-20022916
5. Herrick A. Curr Treat Options Cardiovasc Med. 2008 Apr;10(2):146-55.
6. Sprynger M. Rev Med Liege. 2004 Jun;59(6):378-84.
7. Baumhäkel M, Böhm M. Vasc Health Risk Manag. 2010 Apr 15;6:207-14.
8. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/risk-factors/con-20022916
9. Matoba T. Ind Health. 2015;53(6):522-32.
10. Bayram Ö, Herg��ner S. J Child Adolesc Psychopharmacol. 2015 Aug;25(6):521-2.
11. Czupryniak A, et al. Kidney Blood Press Res. 2005;28(1):27-31.
12. Lazzerini PE, et al. Autoimmun Rev. 2010 Jan;9(3):181-7.
13. Levy Y, et al. J Rheumatol. 1999Nov;26(11):2383-5.
14. Danese S, et al. J Rheumatol.2000Aug;27(8):2051.
15. Vayá A, et al. Clin Hemorheol Microcirc. 2014;56(2):153-9.
16. Cheng TT, Chiu CK. Clin Rheumatol. 2002 Jun;21(3):251-4.
17. Kutilek S, et al. Rev Bras Reumatol. 2012 Jan-Feb;52(1):128-30.
18. Stanger O, et al. Clin Chem Lab Med. 2003Nov;41(11):1392-403.
19. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/calcium-channel-blockers/art-20047605?pg=2
20. No authors listed. Prescrire Int. 2015 Sep;24(163):210-1, 213.
21. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682346.html  
22. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/treatment/con-20022916
23. Mayo Clinic. http://www.mayoclinic.org/tests-procedures/botox/basics/risks/prc-20009036
24. The test of acceleration in blood circulation by Taiwan Textile Research Institute tells that the speed of blood flowing increases above 50 percent. <The authentication No: FK991116-00.IMG, TFF4G123, TFF4K288>
25.  Tested 4/22/2010 Thermal Imaging Consultants LLC, Reno Nevada <Taiwan Textile Research Authentication: Fk99116-00, TFF4G123, TFF4K288)>
26. Appiah R, et al. J Intern Med. 1997 Feb;241(2):119-24.
27. Sporbeck B, et al. Rheumatol Int. 2012 May;32(5):1469-73.
28. Karavidas MK, et al. Appl Psychophysiol Biofeedback. 2006 Sep;31(3):203-16.
29. Ratner GL, Slutsker GE. Fiziol Zh. 1991 Jul-Aug;37(4):123-7.
30. Dowling GB, et al. Proc R Soc Med. 1967 Dec;60(12):1268-9.
31. Choi WS, et al. Clin Rheumatol. 2009 May;28(5):553-9.
32. Muir AH, et al. Vasc Med. 2002;7(4):265-7.
33. DiGiacomo RA, et al. Am J Med. 1989 Feb;86(2):158-64.
34. Hélou J, et al. Rheumatol Int. 2013 Mar;33(3):751-5.
35. Viswanath V, et al. Indian J Dermatol. 2013 Jul;58(4):255-68.
36. Rembold CM, Ayers CR. Mol Cell Biochem. 2003 Feb;244(1-2):139-41.
37. Agostoni A, et al. Int J Clin Lab Res. 1991;21(2):202-3.
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phgq · 3 years
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Duterte’s ‘cancer’ remark just a joke: Palace
#PHnews: Duterte’s ‘cancer’ remark just a joke: Palace
MANILA – President Rodrigo Duterte was merely joking when he raised the possibility of having cancer, Malacañang said on Friday.
“I think that’s really a joke of the President and should not be taken to mean na may cancer talaga siya (that he really has cancer),” Presidential Spokesperson Harry Roque said in a virtual press conference.
Roque issued the clarification a day after Duterte told his audience in Tacloban City that he might have cancer.
During the joint meeting of the national and regional task forces to end local communist armed conflict in Eastern Visayas, Duterte apologized for coughing in the middle of his speech and said his cough could be a symptom of cancer.
“Pasensiya na kayo. I don’t know, but ‘yung pag-ubo ko, progressive. Baka cancer na ang p***** i** (I apologize. I don’t know but my cough is progressive. This son of a b**** might be cancer.)
Roque said the public need not worry about Duterte’s health, maintaining that the 75-year-old President has no serious illness.
Duterte would inform the public, should he learn that he is seriously ill, Roque reiterated.
“I do not have any information na dapat mag-alala tayo (for us to be worried). Ang Presidente naman po ay abugado. Susunod po siya sa Saligang Batas. Kung merong seryosong karamdaman, ipagbibigay alam niya po iyan sa publiko (The President is a lawyer. He will follow the Constitution. If he has serious illness, he will let the public know),” Roque said.
Article 7, Section 12 of the 1987 Constitution mandates the President to declare the real condition of his health “in case of serious illness.”
No out-of-town events
Quizzed if Duterte has a plan to go on hiatus from public engagements following his remarks, Roque said the Chief Executive’s next activities would be held at Malacañan Palace in Manila.
Roque said Duterte’s weekly public address would also push through on Monday.
He, however, noted that Duterte has no out-of-town meetings.
“Puro Palasyo lang po siya (He will spend more time at the Palace). He will have his regular talk to the people on Monday. At marami pong meetings sa Palasyo lang pero wala na po siyang out of town (Many meetings will be held at the Palace and he has no out-of-town meetings),” Roque said.
In August last year, Duterte said his doctor had advised him to stop drinking as his Barrett’s esophagus was “nearing Stage 1 cancer.”
Barrett’s esophagus is a condition in which tissue that is similar to the lining of the intestine replaces the tissue lining of the esophagus, based on the definition provided by the Washington-based National Institute of Diabetes and Digestive Kidney Diseases.
People with Barrett’s esophagus, the institute noted, are more likely to develop a rare type of cancer called esophageal adenocarcinoma.
Apart from Barrett’s esophagus, Duterte previously bared that he has Buerger’s disease, a rare disease of the arteries and veins in the arms and legs.
Duterte also has myasthenia gravis, a chronic autoimmune neuromuscular disease that weakens skeletal muscles responsible for breathing and moving parts of the body.
He is also suffering from chronic back pains and migraines.
In October 2018, Duterte announced that the supposed “growth” found in his digestive tract tested negative for cancer.
Malacañang has repeatedly assured the public that Duterte continues to be “fit and healthy” despite his age and health condition. (PNA)
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References:
* Philippine News Agency. "Duterte’s ‘cancer’ remark just a joke: Palace." Philippine News Agency. https://www.pna.gov.ph/articles/1134214 (accessed March 20, 2021 at 01:28AM UTC+14).
* Philippine News Agency. "Duterte’s ‘cancer’ remark just a joke: Palace." Archive Today. https://archive.ph/?run=1&url=https://www.pna.gov.ph/articles/1134214 (archived).
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Buerger's disease is a rare disease of the arteries and veins in the arms and legs. In buerger's disease also called thromboangitis obliterans the blood vessels become inflamed,swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in the hands and feet and may eventually affect larger areas of the arms and legs. Virtually everyone diagnosed with Buerger's disease smokes cigarettes or uses other forms of tobacco is the only way to stop Buerger's disease. For those who don't quit, amputation of all or part of a limb is sometimes necessary. CAUSES The exact cause of Buergers disease is unknown. While tobacco use clearly plays a role in the development of Buerger's disease, it's not clear how it does so.It's thought that chemicals in tobacco may irritate the lining of the blood vessels,causing them to swell. RISK FACTORS Tobacco use- Buerger's disease can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand rolled cigarettes using raw tobacco and those who smoke more than a pack and half of cigarettes a day may have the greatest risk of Buerger's disease. Chronic gum disease- Long-term infection of the gums has been linked to the development of Buerger's disease, though the reason for this connection isn't clear. Sex Buerger's disease is far more common in males than in females. Age The disease often first appears in people less than 45 years old. COMPLICATIONS If buerger's disease worsens, blood flow to the arms and legs decreases. This is due to blockages that that makes it hard for blood to reach the tips of fingers and toes. Tissues that don't recieve blood don't get to reach the tips of fingers and toes. Tissues that don't recieve blood don't get the oxygen and nutrients they need to survive. Diagnosis ->Based on signs and symptoms ->Blood tests For blood clotting disorders and diabetes ->Allen's test ->Angiogram TREATMENT -Smoking cessation -Medication to dilate blood vessels -Spinal cord stimulation -Amputation, if infection or gangrene occurs (at Kharkov, Ukraine) https://www.instagram.com/p/CBAgPVupoH9/?igshid=1ri765dcmi6fd
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