Um estudo da Universidade Federal de São Paulo (Unifesp) mostrou que a natação é tão eficaz quanto a caminhada na redução da dor e na melhoria da qualidade de vida de pacientes com fibromialgia.
Os resultados do ensaio clínico randomizado foram divulgados na revista Archives of Physical Medicine and Rehabilitation, editada pela American Congress of Rehabilitation Medicine.
“A atividade física está em todas as diretrizes de tratamento da fibromialgia e o que comprovadamente traz mais benefícios são os exercícios aeróbicos de baixo impacto. Mas nem todo mundo gosta ou pode fazer a mesma atividade física, então nosso grupo tem testado alternativas”, contou Jamil Natour, professor da Disciplina de Reumatologia da Unifesp e coordenador da pesquisa apoiada pela FAPESP.
Em um artigo publicado em 2003 no The Journal of Rheumatology, a equipe de Natour havia mostrado que a caminhada é melhor que o alongamento não apenas para reduzir a dor como também para melhorar a depressão e outros aspectos emocionais de pacientes com fibromialgia – além de, como esperado, aumentar a função cardiorrespiratória.
Já em um estudo de 2006, divulgado na revista Arthritis & Rheumatism, o grupo mostrou que a corrida aquática também era uma boa opção para o tratamento da doença.
“A natação ainda não havia sido avaliada com o devido rigor científico e, neste ensaio clínico, apresentou resultados tão bons quanto os da caminhada, que tem benefícios comprovados. Pode ser uma opção mais interessante para uma pessoa que, além de fibromialgia, tem artrose no joelho, por exemplo”, avaliou o pesquisador.
O estudo foi feito com 75 mulheres com fibromialgia e com idade entre 18 e 60 anos. Todas eram sedentárias no início da avaliação.
Foram aleatoriamente divididas em dois grupos: 39 submetidas a um treino de natação durante 12 semanas, e outras 36, a um treino de caminhada moderada pelo mesmo período.
As sessões de atividade física eram realizadas três vezes por semana, com acompanhamento de profissionais da área de educação física, e duravam 50 minutos. O trabalho foi feito durante o mestrado de Giovana Fernandes, orientanda de Natour.
Antes do início do treinamento, e após as 12 semanas, as voluntárias passaram por diversas avaliações. O nível de dor foi medido por meio de uma régua numérica que varia de 0 a 10 centímetros (cm). Cada paciente dava uma nota para o nível de dor que estava sentindo no momento.
No grupo submetido a caminhada, em média, o nível de dor caiu de 6,2 cm para 3,6 cm, enquanto no grupo que treinou natação os valores foram de 6,4 cm para 3,1 cm. Segundo Natour, é considerada clinicamente relevante uma redução de pelo menos 2 cm na escala de dor.
Já a qualidade de vida foi avaliada por dois questionários clinicamente validados, sendo um específico para pessoas com fibromialgia (FIQ – Fibromyalgia Impact Questionnaire) e outro de uso na população em geral (SF-36 – Medical Outcomes Study 36-Item Short-Form Health Survey).
Melhoras estatisticamente significativas foram encontradas em todas as oito subescalas do SF-36 em ambos os grupos. No aspecto interação social, por exemplo, a pontuação saltou de 56 para 80 no grupo que praticou natação e de 52 para 72 no grupo caminhada.
No quesito saúde mental, o grupo natação passou de 55,7 para 68, enquanto o grupo que exercitou caminhada foi de 51,1 para 66,8. O escore varia de 0 a 100 pontos, sendo que, quanto maior a pontuação, melhor a qualidade de vida da pessoa avaliada.
A melhora nos resultados no questionário FIQ foi equivalente nos dois grupos, bem como o resultado da análise ergoespirométrica – que mede o consumo máximo de oxigênio (VO2 máx.) e o limiar anaeróbico (LA).
Tratamento multimodal
Conforme explicou Natour, pacientes com fibromialgia apresentam uma amplificação dolorosa, decorrente de uma falha no sistema que transmite e modula os estímulos nervosos que vão da periferia do corpo até o cérebro.
“Um simples cutucão na perna ou apertão no braço do fibromiálgico pode ser interpretado como um estímulo doloroso. Além dessa amplificação dolorosa, esse paciente também pode ter dor espontânea. É característica da doença uma sensação de dor difusa, sem explicação anatômica, e que perdura por pelo menos três meses”, explicou o pesquisador.
O problema é cerca de 10 vezes mais comum em mulheres do que em homens e pode ser incapacitante.
Além da dor, os portadores costumam sofrer com distúrbios de sono, redução nos níveis de serotonina (neurotransmissor importante para a regulação do humor) e alterações no sistema nervoso autônomo, que controla a contração de vasos e o batimento cardíaco, entre outras coisas.
O conjunto de sintomas impacta fortemente a qualidade de vida de pessoas nessa condição.
“Muitas vezes, o paciente não tem nenhum defeito anatômico, como artrose, mas tem um comprometimento até mais grave na qualidade de vida e na função do que as pessoas com doenças articulares.
Alguns estudos compararam a situação de pessoas com fibromialgia com portadores de espondilite anquilosante ou artrite reumatoide, ambas doenças deformantes articulares. Além disso, cerca de 30% dos fibromiálgicos também apresentam depressão”, disse Natour.
Na avaliação do pesquisador, por acometer cerca de 5% das mulheres, a doença representa um relevante problema de saúde. “Mas como não mata, acaba aparecendo pouco nas estatísticas governamentais”, disse.
O consenso entre os especialistas atualmente é que o tratamento da fibromialgia deve ser multimodal, ou seja, aliar medicamentos para dor crônica e antidepressivos com exercícios físicos e o controle de doenças concomitantes, como artrose, que podem ser fonte de dor.
“O tratamento com medicamento, na maioria das vezes, não controla a dor por completo e pode ter efeito passageiro”, disse Natour.
Em relação aos exercícios físicos, acrescentou o pesquisador, há mais evidências dos benefícios de atividades aeróbicas, embora exercícios de força também possam apresentar bons resultados. Na opinião de Natour, devem ser evitadas modalidades que possam causar dor.
“Lutar boxe não me parece uma boa ideia. Não tem nenhum estudo mostrando isso, mas é uma questão de bom senso”, opinou.
How much sleep children and adolescents need to sleep to have a healthy development? Specialists in sleep disorders created new recommendations on how minors should sleep. They are based on the stage of life where young people meet and have been published in the Journal of Clinical Medicine.
HOURS OF SLEEP RECOMMENDED BY AGE
4 to 12 months 12 to 16 hours daily
1 to 2 years 11 to 14 hours daily
3 to 5 years: 10 to 13 hours daily
6 to 12: 9 to 12 hours daily
13 to 18: 8 to 10 hours
The new guidelines from the American Academy of Sleep Medicine (American Academy of Sleep Medicine) were based on previous studies that examined the relationship between sleep duration and child health, ranging from 16 hours for infants and eight hours for adolescents.
According to the academy, minors benefit physically, mentally and emotionally adequate amounts of sleep. Getting enough sleep results in better attention, behavior, learning and memory, experts say.
In contrast, children who do not get enough sleep are at greater risk of injury, hypertension, obesity and depression. Among adolescents, sleep deficit was associated with greater risk of self-harm and even suicide - the researchers said.
The team behind the new guidelines pointed out, however, that children and adolescents who sleep more than the recommended are also subject to adverse events, including, high blood pressure, diabetes, obesity and mental health problems.
For children and adolescents who are too little or too much sleeping, the guidance is that parents consult their doctor to determine if it is a sleep disorder that can be treated.
The guidelines do not include recommendations for babies under 4 months because the patterns and sleep duration of such young children vary widely and there is not enough scientific evidence to establish links between sleep and health.
The American Academy of Pediatrics (American Academy of Pediatrics) makes recommendations it believes to be beneficial for good sleep of children and adolescents - among them, that all screens - such as televisions and computers - half an hour to be turned off before going to bed. And parents do not allow their children to keep this type of device in their rooms.
Doença que ganhou atenção na semana passada pelo diagnóstico do ator Edson Celulari, o linfoma não-Hodgkin tem se tornado mais incidente e matado mais brasileiros do que há uma década. A boa notícia é que, com a chegada de novos tratamentos, a chance de cura desse tipo de câncer aumentou e, mesmo nos casos em que o tumor é incurável, o paciente pode viver mais de dez anos com a doença sob controle.
Segundo dados do Instituto Nacional de Câncer (Inca), a taxa de mortalidade por linfoma não-Hodgkin cresceu 17% entre 2004 e 2013 (último dado disponível). Entre os homens, o índice passou de 2,06 mortes por 100 mil habitantes do sexo masculino para 2,42 no período. Já entre as mulheres, a mesma taxa cresceu de 1,59 para 1,87. Em dados absolutos, o número de óbitos pela doença cresceu de 3.255 para 4.154 nos dez anos analisados.
Especialistas explicam que o aumento do índice não está associado a uma maior agressividade da doença, mas, provavelmente, ao envelhecimento da população.
"A incidência do linfoma está aumentando em todo o mundo. Embora a doença possa atingir todas as idades, ela é mais comum entre pessoas com mais de 60 anos e a idade média dos brasileiros vem aumentando", explica o médico Carlos Chiattone, diretor da Associação Brasileira de Hematologia e Hemoterapia e coordenador do Centro de Linfomas do Hospital Samaritano. Segundo o Inca, 62% dos mortos pela doença em 2013 eram idosos.
Oncologista clínico do A. C. Camargo Cancer Center, Vladmir Cordeiro de Lima diz que os dados devem ser analisados com cuidado.
"Globalmente tem havido uma melhora no desfecho dos tratamentos de linfoma não-Hodgkin, mas no Brasil temos de considerar que o sistema de notificação não é bom e nem todos os pacientes têm acesso ao melhor tratamento. Se tivessem, a mortalidade seria menor", diz.
Segundo os especialistas, surgiram na última década novas opções de tratamentos quimioterápicos e imunoterápicos que melhoraram o prognóstico do paciente com linfoma.
No caso dos tumores não-Hodgkin, Chiattone explica que eles são divididos em dois grandes grupos - os agressivos e os indolentes. Os primeiros podem ser curados em 60% dos casos. Já os outros são considerados incuráveis, mas, como crescem muito lentamente, o paciente pode viver anos ou décadas com a doença sob controle.
"É como se fosse uma doença crônica. Faz-se o tratamento, o linfoma é controlado, mas pode voltar após alguns anos. E outro tratamento é feito", diz.
O administrador de empresas Jaime Waiswol, de 51 anos, recebeu o diagnóstico de um linfoma não-Hodgkin em 1997, e, após tentar, sem sucesso, três diferentes tratamentos quimioterápicos, ouviu da equipe médica que a chance de estar vivo em três anos era menor que 10%.
"Mesmo assim eu sempre acreditei muito, sentia que daquela doença não ia morrer", conta.
No início de 1998, foi lançado um novo medicamento para linfoma, que acabou curando Waiswol. Em 2012, 15 anos após o tratamento, ele percorreu 94 quilômetros até o Monte Roraima para estimular outros pacientes que estão enfrentando a mesma batalha. "Ainda temos muita coisa para viver."
Dificuldades
Para Merula Steagall, presidente da Associação Brasileira de Linfoma e Leucemia (Abrale), entidade que dá apoio a pacientes, um dos maiores entraves à redução da mortalidade pela doença é a demora no diagnóstico e no início do tratamento. "Pelo SUS, às vezes a pessoa tem uma suspeita e só para agendar uma biópsia demora seis meses", diz ela.
Erros de diagnóstico e dificuldade de agendamento da quimioterapia atrasaram o início do tratamento da auxiliar administrativa Roseane Oliveira Gomes, de 29 anos.
"Comecei a ter sintomas em setembro de 2014 e passei em dois médicos. Uma disse que era virose e o outro falou que era tendinite, porque eu tinha dores no ombro", diz ela, que só iniciou o tratamento em março de 2015. "O linfoma cresceu tanto que eu fiquei deformada de inchaço, não conseguia abrir o olho. Estava sentindo a morte chegar", conta ela, que conseguiu finalizar o tratamento em setembro de 2015 e, embora ainda precise fazer acompanhamento, teve o tumor eliminado. As informações são do jornal O Estado de S. Paulo.
Bad breath can have multiple sources. You know you can have bad breath because of stomach problems? About half of the population suffers from bad breath caused by different factors food, drinks and cigarettes. Of these, only ten percent are caused by other health problems eat diabetes, kidney and liver problems. The number of people who suffer from bad breath because of stomach problems is even lower. But surely this is a major concern for these people.
Ulcer
In some cases, ulcers are caused by bacteria that cause bad breath. Researchers reported in ScienceDaily, important scientific journal in the world, confirming that the bacteria known as Helicobacter pylori (H. pylori) that causes stomach ulcers, can cause bad breath in the mouth. Fortunately antibiotics offer an effective treatment for eliminating bacteria that cause stomach ulcer.
There are conflicting reports of the ulcer itself does not cause bad breath, since the H. pyori has no unpleasant odor. However, the above study showed that patients with H. pylori were also Prevotella intermedia, one of the known periodontal bacteria. If you have bad breath and ulcers, check with your doctor if they are related.
reflux Problems
Another cause of bad breath due to the stomach is the problem of gastroesophageal reflux. This problem is caused by acid from the stomach causing a burning sensation in the chest and throat. According to Nemours, one of the symptoms of GERD (gastroesophageal reflux) is bad breath. It can also cause demineralization tooth because the acid from the stomach to go mouth and weaken the teeth. The damage caused to the throat and mouth structures can also cause bacteria to grow in the mouth.
Patients with GERD have other symptoms as well, so a parallel treatment in dental treatment is needed. For those who have a suspect GERD, you must seek the help of a doctor to evaluate the reflux problem. With proper treatment you can usually end up with bad breath.
Is it really that bad?
Many people think they have bad breath, but do not actually have. Although a test to detect the presence of sulfur can be done, typically clinicians assess the situation based on location odor. If there is bad breath, check for decay or periodontal disease. The treatment of these problems usually end up with bad breath.
Although there are different types of ear infections, the most common is called acute otitis media, involving inflammation and infection of the middle ear - located behind the eardrum. This is a brief and painful infection caused by viruses or bacteria that reaches more children.
causes
An ear infection is caused by bacteria or viruses present in the middle of the individual ear. Often this type of inflammation arise as a symptom of other diseases, such as flu or allergies, but other causes can result in the onset of symptoms.
One of these causes is the obstruction of the Eustachian tube, a tube leaving the middle ear and reaches the back of the throat, responsible for the drainage of the fluid normally produced by the middle ear. If this tube is blocked, fluid will accumulate, also generating the accumulation of bacteria or virus in the region, thus causing the infection. ear inflammations are common in infants and children precisely because the eustachian tube can easily become congested.
Similarly, inflammation of the adenoids can also cause acute otitis media. Adenoids are small pieces of tissue located in the back of the nose, very near the Eustachian tube. Inflammation or enlarged adenoids can also block the tube and thus cause otitis.
Ear infection may also be caused by effusion. It is exactly like the inflammation of joint, where an accumulation of fluid in the middle ear, but without infection by bacteria or viruses. This type of inflammation may occur because even after being cured otitis, fluid accumulation persists, causing again the infection.
The best way to have healthy teeth and a beautiful smile is to continue with good oral hygiene habits acquired in childhood.
Regardless of the use of orthodontic appliances, the important thing is:
Brushing teeth at least three times a day using a fluoride toothpaste for removing plaque, which is the major cause of gingivitis and caries.
Floss daily to remove plaque installed between the teeth and under the gum line. If plaque is not removed daily, it can harden into tartar, a yellowish substance and unsightly.
Limit your intake of sugar and foods containing starch, especially gooey (that stick to the surface of the teeth).
Consult your dentist regularly for professional examination and cleaning or prophylaxis.
A neat and well cared for mouth not only prolongs the life of the teeth but also makes the individual feel good, with fresh breath and a more beautiful smile.
On what special issues related to the teeth, young people should be informed?
Dental problems can occur in adolescence and, unfortunately, they do happen. With more information on topics that affect oral health, the choices become easier.
Orthodontics - Many pre-teens and teens require braces to correct misplaced teeth or too close together, and poor jaw alignment. It is more difficult to care for teeth that do not fit well. These teeth are at risk need to be extracted and cause extra stress on muscles of mastication. The evaluation of an orthodontist can determine if you need braces, and what the correct treatment. The use of brushing apparatus requires even more stringent.
mouthguards If you play sports, these guards are essential to protect your smile. Mouth guards typically cover the upper teeth and are made to prevent them from being traumatized, the lips suffer cuts or other possible damage from occurring in your mouth. If you use braces or prosthesis in the lower jaw, your dentist may suggest that you also use a guard for the lower teeth.
Nutrition - Nutrition plays a key role in your dental health. The sugars and starches in many foods and beverages contribute to the formation of bacterial plaque, which destroys tooth enamel. Reduce the intake of snacks and soft drinks. Each time you consume foods and drinks that contain sugars or starches, acids attack your teeth for 20 minutes or more. The adoption of a balanced diet, based on the five food groups can make a big difference to the health of your mouth. As snack, choose nutritious foods, such as cheese, raw vegetables, yoghurt or fruit.
Smoking - If you do not smoke or chew tobacco or, resist and do not start these habits. They can stain your teeth and gums become stronger tartar stain that builds up on the teeth and produce bad breath, and other health problems. Over time, smoking and tobacco chewing habits increase the risk of gum disease and mouth cancer. If you do use tobacco, let your dentist and your doctor and let him know if there is any dental problem.
"Piercing" in the mouth - despite its popularity, this kind of "piercing" can cause complications such as infections, uncontrollable bleeding or damage to a nerve. You also run the risk of choking on pins and rings. Metal jewelry can damage your teeth and your gums. If you are thinking of doing "piercing" oral, talk to your dentist. It can help you make a safer choice.
eating disorders - bulimia (overeating and vomiting) and anorexia (excessive fear of gaining weight often resulting in vomiting) are serious health issues that directly affect the appearance of teeth by eroding the enamel. The dentist can correct the deteriorated enamel, but it can not treat the eating disorder, which can lead even to death and should be treated with a psychologist. If you have - or think you have - a disorder of this kind, talk to your doctor.
What to do to make my teeth whiter?
A good cleaning or prophylaxis, made by your dentist, remove most external staining caused by food and tobacco. The use of a special whitening toothpaste can also help remove these stains until the time of your next appointment. If your teeth are stained for a long time, you may have to make a professionally whitened to them.
Internal stains can be bleached or covered (crown). All these methods are safe and bring good results. Your dentist may recommend the appropriate treatment depends on the state of your teeth and the desired results.
Um inquérito realizado pelo ISHRS - International Society of Hair Restoration Surgery concluiu que 60% dos homens não consegue descobrir e detectar pessoas que foram sujeitos a transplantes capilares. As técnicas de transplante evoluíram bastante e o aspecto final é muito natural e real.
Idade da Calvície
Não existe nenhuma idade mais favorável para se começar a ficar careca, o processo pode até iniciar-se desde muito cedo, antes dos 20 anos, ou começar apenas na 3ª idade. O que as estatísticas dizem é que nos homens de faixa etária dos vinte anos, 20% sofrem já de calvície, nos de trinta anos 30% e assim sucessivamente. Concluí-se pois que quanto maior for a idade maior a probabilidade de ser calvo. Com a idade de 35 anos 66% dos homens já sofreu algum problema capilar relacionado com queda.
Ponta do Icebergue
Quando um homem se olha no espelho e detecta que têm falta de cabelo, neste fase já perdeu aproximadamente 50% dos seus fios. Por isso a detecção precoce é muito importante pois quanto mais cedo se iniciar o tratamento mais eficaz ele será.
Propensão Genética
Em estudos efectuados pela farmacêutica GlaxoSmithKline em homens com rarefação capilar, os cientistas descobriram que estes tinham uma variante genética nos seus cromossomas que agravava a sua condição em 7 vezes.
Falta de Informação
O que as estatisticas indicam é que a maioria dos homens tem falta de informação e que muitos baseiam os seus conhecimentos em mitos sobre a calvície. No que respeita à saúde e beleza 90% dos homens consideram a perda de cabelo como a sua maior preocupação.
There have been a belief that after a few years without any hair born hair follicles are dead, that is to say incapable of generating wires and produce new cells.
This idea has been reinforced by many specialists, doctors and researchers. In fact the common observation is that especially men when they start to get bald for reduction and quality of the hair, the process is almost always irreversible. Over time the bald areas increase and never grow again wires.
However some cases we know of this theory deny the death of hair roots, strengthened now by this new study carried out at the Department of Internal Medicine at the University of Nevada School of Medicine.
This case published in a specialty journal reveals a man of 73 years old, bald from 28 years fully recovered his hair.
This man developed cirrhosis in the liver and has been treated over 6 years with spironolactone. The spironolactone is a diuretic and an antiandrogen moderate effect for systemic use in men. In the last three months his hair began to grow in all its head after 45 years of baldness. The photos of the study show impressive growth and hair abundance, in a similar style to that of former US President Ronald Reagan.
The androgenic effect leads to the decrease of the wire to the point where they cease to be visible and have no cosmetic effect induce a progression of capillary fibrosis, i.e., hardening of collagen by chronic inflammation that occurs in root in the presence high levels of the hormone / hormone DHT (See our previous articles for a better understanding of the causes and effects of DHT).
The longer the time is more advanced the state of the capillary fibrosis and more difficult to become the reversible process, but in this case 6 years that this man made spironolactone permit to eliminate the causes and backward hardening the collagen.
The problem of hair loss can be mitigated and treated using antiadrogénicos oral medications as:
Propecia finasteride active ingredient;
Avodart active ingredient dutasteride;
spironolactone;
Flutamide.
Almost all have some less desirable side effects, and in our case the spironolactone is very toxic causing loss of muscle mass, decreased libido, breast growth, fatigue etc.
.
In our other articles we have also published some studies with a more natural approach to this problem, with fewer adverse effects and some promising results, particularly if used early.
Green tea acts hormone level on the mechanisms that lead to hair loss. Regulates and normalizes the SHBG levels (sex hormone-binding globulin), which has extremely low levels in those suffering from male pattern baldness. Besides many benefits, this plant is a powerful anti-inflammatory reducing inflammation in the roots of the scalp.
Other investigations have advise the intake of soy isoflavones, probiotics and algae simultaneously with the Camellia Sinensis to reduce DHT levels.
The general conclusions are broader and suggest that oral administration of green tea is effective in preventing cancer, acne, eczema, rosacea, hirsutism, baldness, keloids, Candidiasis and warts. The results are promising for various dermatological problems are however not effectively scientifically proven its effectiveness.
This review was conducted by the Department of Dermatology, University of Medical Sciences in Iran and is published in http://www.ncbi.nlm.nih.gov/pubmed/23346663
The trick was revealed to us from the champion swimmers Spanish synchronized swimming who spend every day training hours submerged full of chlorine water and chemicals.
To be able to maintain the beauty of your hair using powdered fish gelatin is sold in sachets, usually for cooking.
This powder is obtained industrially from the bladders cod, sturgeon and carp, sold in packages of its contents dry powder.
Every day before entering the pool, mixing in a container a small amount of gelatine with hot water and stirring strongly applied on the hair, smearing the locks with the mixture.
a brilliant film, rubber kind that not only protects the chlorine and chemicals as nourishes and brightens the wires are obtained.
Some varieties may have a small disadvantage compared to a slight odor that goes with habituation, if not the case, you can resort to commercial products or own swimming caps.
carbon atoms, oxygen, hydrogen and nitrogen. In nature there are over a hundred thousand kinds of amino acids, but our body uses only 20 kinds of them. By peptide bonds, amino acid molecules form proteins, therefore the cells of our body needs these twenty kinds of amino acids to produce proteins that we need to maintain the proper functioning of our body.
Some types of amino acids are produced by our own body, and are called non-essential; others must be acquired through food and, if needed, supplements. They receive the essential names. Be aware that the essential or non-essential name is not determined by the nutritional value of each, just the way it is produced.
Currently, the amino acids go well known to people who practice physical exercises and want to gain more muscle, because as our muscles need certain types of protein to grow and restore, many people turn to food with a high concentration of protein, such as meat and yoghurts, or supplements that contain leucine, isoleucine and valine (BCAA or called), which are amino acids that have this function.
The world today asks people to be thin, beautiful and young. On the other hand, it provides them with high-calorie, delicious and desirable food. So around the world, there is more than one and a half billion obese, which generates great discontent in these people. Thus, increasing cases of eating disorders, which are primarily generated by psychological reasons. So, know the main ones:
Types of Eating Disorders
The most common types of eating disorders are bulimia, anorexia and Obsessive Compulsive Disorder (OCD) for food. Not all of these disorders have the effect of slimming, but also obesity because cause patients never feel satisfied.
Bulimics feel a great urge for food, usually by caloric. So eat excessively. But after all the gorging, appears the feeling of guilt and do everything to eliminate the calories ingested as induction of vomiting, the use of laxatives, diuretics or enemas and excessive physical exercise.
Consequences
Anyone who suffers from bulimia maintains the same weight because despite eating excessively, free up the calories ingested quickly. However, with continued long-term problem, they may suffer from lesions in the esophagus and teeth, constipation, pancreatitis, hemorrhoids, tooth decay and dehydration.
Treatment
Treatment for bulimia should be multidisciplinary, involving three professionals: psychologist to verify traumatic origins, nutritionist to help in the formulation of healthy menus and endocrinologist for treatment of the regions affected by the disorder.
Anorexia
Anorexia is an eating disorder that can lead to death with their consequences. This disorder causes people, usually teenagers and young women, think always being overweight, even though well below the ideal for their age and height.
So, they stop to feed or eat very little and force so that the food is excreted by the body, either through vomiting or stool. To do so, place your finger in the throat or use laxatives. Some patients refuse to eat around other people and do many physical activities to lose weight.
Borderline Personality Disorder is a serious and complex mental condition whose unstable and poignant symptoms can invade the sudden way of individual, chaotic, overwhelming and unbridled. The personality disorder diagnostic criteria for Borderline DSM-V (Diagnostic and Statistical Manual of Mental Disorders 5th Ed. 2013) comprise a pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity that appears early in life adult and is present in various contexts.
The term Borderline Personality Disorder was first used in 1884 and has since undergone several concepts over the years. Originally designated a group of patients who lived in the edge of sanity (hence the term borderline), ie at the border (edge, borderline) between neurosis and psychosis. Some authors of the time used this diagnosis when there was severe neurotic symptoms. It was only in the 1980s that the diagnosis became more accurate. Until then, many doctors believed, mistakenly, that the personality of a person was unchangeable.
The average prevalence of Borderline Personality Disorder in the population is estimated at 1.6%, although it can reach 5.9%. This prevalence is approximately 6% in primary care settings, approximately 10% of patients in psychiatric clinics and mental health clinics and about 20% in psychiatric inpatients. The prevalence of Borderline Personality Disorder may decrease in the higher age groups (DSM-5). Borderline personality disorder is diagnosed primarily in females.
The word kleptomania has its roots in kléptes Greek and literally means "to steal mania". The term was created more than two centuries to describe the impulse to steal unnecessary or small valuables. Jean Etienne Esquirol, French psychiatrist, disciple of Philippe Pinel, noted in 1838 that the individual often tries to avoid this behavior, but by its nature, it is irresistible. He wrote: "voluntary control is deeply committed: the patient is required to perform acts which are not dictated nor its reason, nor your emotions, acts which his conscience disapproves, but he has no intention.
Stealing is one of the most socially unacceptable crimes. There are even countries where the theft is punished with penalties ranging from flogging to death in severe cases.
There are famous kleptomaniac who steal without as eg. the case of American actress Winona Ryder 36, who in 2006 stole clothes at Saks Fifth Avenue, the Brazilian Rabbi Henry Sobel, who stole ties, the Brazilian designer Ronaldo Ésper who stole vessels in the cemetery and Haydée character of the novel " America "(Brazil), (played by Christiane Torloni), who suffered from kleptomania and sensitize the population and motivated people who suffered this problem to seek help.
The Bipolar Disorder, traditionally called manic depression, is a psychiatric disorder characterized by sharp mood variations, with repeated bouts of depression and "manic". Any of the two types may predominate in a crisis same person with its highly variable rate. The crises can be severe, moderate or mild.
The turns of humor, one way or another have an important effect on feelings, emotions, ideas and behavior of the person, with a significant loss of health and autonomy of personality.
Also known as monoliasis vaginal, vaginal candidiasis is an infection caused by fungus, Candida or Monilia, which causes a discharge thick, lumpy, whitish, usually accompanied by irritation at the site.
For some experts, candidiasis is not a sexually transmitted disease, it can occur even without intimate contact. Some studies indicate that the fungus may be in the vagina, so that when the body resistance falls or when the vaginal resistance is low can occur for fungal growth and the manifestation of symptoms.
Studies show that some factors are facilitators of this mycosis:
antibiotics;
Pregnancy;
Diabetes;
Other infections (e.g., HIV viruses);
immune deficiency;
Medications such as contraceptives and steroids;
unprotected sex with infected partner;
inappropriate clothing (tight clothes and wet bikinis, lycra and gym clothes that increase vaginal temperature);
vaginal douches in excess.
Between 20% to 25% of cases of genital discharge of an infectious nature are caused by Candidiasis. It is said that 75% of women have this infection at least once in life.
The mental disorder is changing the functioning of the mind that impair the person's performance in various aspects of your life such as family, social, professional environment, at school, in the understanding of self and others, the possibility of self-criticism, tolerance to the problems and the possibility to take pleasure in life in general.
Mental disorders such as anxiety, depression, eating disorders, drug addiction, dementia and schizophrenia, can affect anyone at any time in your life. In fact, they can cause more suffering and disability that many health problems.
What is urinary infection?
The Urinary Tract Infection (UTI), popularly known as urinary tract infection, is an infection that can occur anywhere in the urinary system, such as kidneys, bladder, urethra and ureters. This type of infection is most common in the lower urinary tract, which includes the bladder and urethra.
Fatigue is a word often used in daily life. Often it is used as a synonym for "fatigue", but its real significance goes beyond that.
In fact, fatigue is the name given to a symptom that, in fact, is very present in the daily life of the population, but it can have several causes. Means "fatigue" as a feeling of wear, fatigue and lack of energy. As you might expect, this is a fairly frequent symptom among the different types of diseases and conditions.
causes
Take a moment and rethink all their life habits. What may be behind your fatigue? this question be done is the first step to identify the possible causes of a very common symptom: fatigue. In general, most cases of fatigue can be attributed to three major factors: lifestyle, health and psychological problems. Check out the main possible causes for each of these factors:
Lifestyle
Excessive consumption of alcohol
Excessive consumption of caffeine
Use and abuse of recreational drugs
Excessive physical activity
Physical inactivity and inactivity
Lack of sleep in general
Medications such as antihistamines and cough syrups
Unhealthy eating habits and unbalanced diets
Thyroid disorders are conditions that affect the thyroid, a butterfly-shaped gland located at the bottom of the neck. The thyroid has an important role in the regulation of numerous metabolic processes of the body. Different types of disorders can affect the structure or function of the thyroid.
A thin area of tissue within the gland, known as the isthmus joins the two lobes of thyroid on each side. The thyroid uses iodine to produce vital hormones, and the main ones are thyroxine (T4) and triiodothyronine (T3). These hormones are responsible for our basal metabolism, or is it that stimulates the cells to work and ensures that everything works properly in the body.
The function of the thyroid gland is regulated by a mechanism of self control that surrounds the brain. When the thyroid hormone levels are low, the hypothalamus in the brain produces a hormone known as releasing thyrotropin (TRH) which causes the pituitary gland (located at the base of the brain) release the thyroid stimulating hormone (TSH).
Thyroid disorders occur when this gland stops working properly, can produce more or less hormones than normal. Since the thyroid gland is controlled by the pituitary gland and the hypothalamus of these disorders in these tissues may also affect thyroid function.
Conjunctivitis is an inflammation of the conjunctiva, transparent and thin membrane covering the front of the eyeball (whites of the eyes) and inner eyelids. In general, conjunctivitis attacks both eyes can last for a week to 15 days and usually no sequelae. Conjunctivitis can be acute or chronic, affect one eye or both.
causes
Conjunctivitis can be caused by allergic reactions to pollutants or irritants (pollution, smoke, chlorine pools, cleaning products or makeup, etc.). The most common of these is vernal conjunctivitis or hay fever, usually caused by pollen spread in the air.
Sinusitis is an inflammation of the mucosa of the sinuses, skull region formed by bone cavities around the nose, cheeks and eyes. The disease can be secondary to an infection, allergy or any factor that hinders proper drainage of secretions of the sinuses. The name most commonly used for this problem is rhinosinusitis because the inflammatory process affects both the mucosa of the sinuses and nasal mucosa.
causes
Sinusitis can be either caused by infectious agents such as bacteria, fungi and viruses, as for allergic factors. Dust, heat shock and smells assets are listed as triggers of allergic rhinitis. Exposure to certain chemicals and changes in nasal anatomy and paranasal sinuses are part of another group responsible for sinusitis. There are also rare cases leading to the sinuses, as the presence of a tumor.
Sinusitis can be:
Acute when symptoms are present for a period of less than 12 weeks
Chronic, when the swelling and inflammation of the sinuses are present for more than 12 weeks.
Nasal polyps: tissue growth in the area that can block the nasal passages or sinuses
Allergic reactions: sinusitis can be caused by the patient's exposure to airborne substance, such as dust mites and dust, pollution, pollen, mold, animal dander, cigarette smoke and insect particles. chemicals such as paint, disinfectants and cleaning products can also trigger the picture
Allergies: other allergic diseases such as rhinitis and asthma, may favor one of sinusitis. The inflammation that occurs with allergies may block your sinuses
nasal septum deviation: when the wall between the nostrils is not aligned, there may be restriction or blocking of passages in the sinus
Trauma to the face: a fractured or broken facial bone can cause blockage of the nasal passages
Diseases affecting immunity: cystic fibrosis complications, gastroesophageal reflux disease, AIDS, and other diseases involving the immune system can result in nasal obstruction
Respiratory infections: flu, colds and other respiratory tract diseases can inflame and thicken the sinus membranes, blocking the drainage of mucus and creating favorable conditions for the growth of bacteria. These infections can be viral, bacterial or fungal
Cells of the immune system: in certain health conditions, immune cells called eosinophils can cause inflammation of the breasts
Diseases that prevent the cilia sinuses are adequately move, as Kartagener syndrome or immotile cilia syndrome
altitude changes (flying or diving)
smoking
dental infections that cause obstruction of the sinuses.
Symptoms of Sinusitis
Chronic sinusitis and acute sinusitis have similar signs and symptoms, but acute sinusitis is a temporary infection of the sinuses often associated with a cold. Have chronic rhinosinusitis corresponds to an inflammatory process with long-term (greater than 12 weeks) may also be classified as chronic rhinosinusitis with polyposis and chronic rhinosinusitis without polyposis. For the diagnosis of chronic rhinosinusitis should have two or more of the following signs:
nasal congestion or nasal secretions associated with at least one of the symptoms:
Pressure or facial pain
Reduction or loss of smell
Associated with CT findings or evidenced by fiberoptic laryngoscopy
Lasting more than 12 weeks.
Other signs and symptoms may include:
Earache
Pain in the upper jaw and teeth
Cough, which may be worse at night
Sore throat
Bad breath (halitosis)
Fatigue or irritability
Nausea.
Signs and symptoms of chronic sinusitis are similar to acute sinusitis, but they last longer and often cause more fatigue. Fever is not a common sign of sinusitis.
Diagnosis of Sinusitis
You can have multiple episodes of acute sinusitis lasting less than 12 weeks before developing chronic sinusitis. You can be referred to ENT specialist for evaluation and treatment.
Schedule an appointment with your doctor if:
Do you have pictures of acute sinusitis constants that do not respond to treatment
Do you have sinusitis symptoms that last more than seven days
Your symptoms do not improve after consulting your doctor.
The doctor will examine your sinuses, eyes, ears, nose and throat. Be prepared to answer detailed questions about your symptoms. The doctor may want to know:
What are the symptoms you have
When the symptoms started
What seems to improve or worsen symptoms
If you have or have had a recent respiratory infection
If you have allergies
If you smoke, you are exposed to secondhand smoke or other allergens agents
What medications you are taking, including herbal remedies and supplements
Any other health problems you have.
nasal endoscopy
A thin, flexible tube (endoscope) with a fiber optic light on the end is inserted through the nose, allowing the physician to visually inspect the inside of her sinuses. This is also known as rhinoscopy.
imaging
computed tomography (CT) and can show details of your sinuses and nasal area. They can identify a deep inflammation or physical obstruction that is difficult to detect using an endoscope. Moreover, these tests evaluate the anatomy of the sinuses, which may indicate the need for surgery. sinus RX does not allow a proper assessment of rhinosinusitis frames.
nasal cultures
They are generally unnecessary for the diagnosis of chronic sinusitis. However, in cases where the condition does not respond to analyze the nasal tissues can help to identify the cause, such as bacteria or fungi. Examine the nasal cilia and if they work properly is also an option.
Allergy testing
If the doctor suspects that the disease is caused by allergies, a skin allergy test can be recommended. They are tests that help identify the allergen responsible for your sinusitis.
other tests
The doctor may also order blood tests to detect diseases that affect immunity, and chlorine tests in sweat, to detect cystic fibrosis.
Treatment of Sinusitis
Some treatments are recommended to help relieve the symptoms of sinusitis. These include:
Saline solution
The mixture of water and salt helps to dissolve nasal secretions. You can inhale the saline or drip it on his nose. The ideal is to mix a teaspoon of salt per liter of water.
nasal steroids
nasal sprays help prevent and treat inflammation. Examples include fluticasone, budesonide, triamcinolone, mometasone, and beclomethasone. You may need to use these medications for several days or weeks before they reach their maximum benefit. Unlike oral corticosteroids, these drugs have a relatively low risk of side effects and are generally safe for continuous use, since they act directly on the nasal bells, instead of passing first through the bloodstream.
oral or injectable corticosteroids
These medications are used to relieve the inflammation of severe sinusitis, especially if you also have nasal polyps. Examples include prednisone and methylprednisolone. Oral corticosteroids can cause serious side effects when used for prolonged periods, so they are given only to treat severe symptoms.
decongestants
These drugs are available in pharmacies in the form of tablets, liquids or nasal sprays. These drugs are usually given for a few days at most, otherwise they can cause rebound effect, leading to the emergence of a more serious congestion.
antibiotics
Antibiotics are necessary for sinusitis if you have a bacterial infection. However, chronic sinusitis is often caused by something other than bacteria, therefore, antibiotics do not always help. When in doubt, talk to your doctor.
Surgery
Where sinusitis resists treatment, endoscopic surgery may be an option. For this procedure, the doctor uses an endoscope (thin, flexible tube with a light on the end) to explore your nasal passages. Then, depending on the source of obstruction, the doctor may use various instruments to remove tissue or shave a polyp that's causing nasal obstruction. Enlarge the opening of the narrow sinus may also be an option.
Prevention
The best way to prevent acute sinusitis is to keep the nasal mucosa hydrated, treat allergic rhinitis, a doctor to accompany colds and flu:
Eat a healthy diet
Maintaining a diet that includes all food groups is essential to strengthen immunity. Proteins, carbohydrates, fats, vitamins and minerals can not miss the daily diet of anyone.
According to research, the essential micronutrients for strengthening immunity are vitamins A, B6, B12, C, D, E, folic acid, zinc, iron, selenium and copper. They restore protection against infections, reinforce the immune cells and increased antibody production.
A fractional power, with five to six meals a day and the presence of all the food groups, not only protects the immune system against colds and other infections, as well as helps maintain ideal weight and quality of life in general.
Avoid Fast
Spend many hours without food is harmful to the body in any situation, and not only during an episode of flu. This is because the body begins to work on high alert, prioritizing the maintenance of vital functions; and, therefore, combating infection becomes secondary and inefficient.
Drink water
A good hydration can prevent the occurrence of infections. One should eat about two liters of water per day to allow for proper hydration of the mucosa. The use of inhaled or insufflated saline also improves drainage of secretions, the micro-organisms and impurities from the nose into the stomach.
Wash the hands
Our hands are always likely to come into contact with the flu virus and other various allergens. So we should always wash before handling food, take them to the mouth or the eyes and when you get home or at work, after driving or using public transport.
Other tips to control episodes of acute sinusitis and chronic include:
Make a test for allergies
The tests for respiratory allergies are made to detect which is the causative agent of sinusitis. Enter this list mites, fungi, mold, animal dander, and others. With the test, you can avoid exposure to the agent, preventing crises. Furthermore, it is common that asthma is associated with other allergic diseases such as allergic rhinitis and eczema. Controlling the cause of these allergies can prevent asthma attacks.
Bet on hygiene
Mold, animal dander, insects, mites and house dust should be carefully removed. It is important that the bedding is washed weekly and dried in the sun. the use of pillowcases and mite mattress covers, which reduce the possibility of crises also is recommended. The carpet should be replaced by other types of flooring, carpets should be removed from the room and humidifiers should be banned, since the humidity favors the appearance of some allergens.
Avoid strong odors
Candles, Flavours and essences sprays. These products may even let your fragrant home, but are a danger to those who have sinusitis. strong smells and smoke irritates the airways and can trigger asthma attacks. If you are or have any asthmatic family, delete all those products or, at least, opt for versions that do not have scent.
Invest in flu vaccine
The viruses that cause respiratory infections - among which is the flu virus - also inflame the airways and can cause sinus crises. So take the flu vaccine can help control the disease. Also, always remember to wash your hands or sanitize them with alcohol gel, which helps guard against the virus.
Look after your pet
If contact with animals does not make you right, it would be advisable, at least do not have them in your own home. But if this is out of the question, at least not let him enter or sleep in your room. Another important measure is to bathe the animal at least once every two weeks. The place where the pet stays most of the time must be cleaned every week.
Dress warmly up
It is normal to move from a closed environment to an external, cold air, allergic soon present the respiratory system reactions such as sneezing and nasal swelling. So the ideal is always to leave home well wrapped and with a scarf or handkerchief covering his nose so that the cold air does not come into direct contact with it.
Put out the cigarette
Cigarette is harmful for everyone, but for the allergic it can be even more destructive. Smoking promotes development of allergies and asthma. The peculiarity of the winter in relation to its use is the fact that the station further highlighted that worsens, since the station is usually characterized by dry air and the concentrated pollution. Allergic smokers have great chances to become future bearers of asthma, and the habit of the stay will cause the crises become increasingly stronger and more difficult to treat.
Exercises
Overdo the exercise can affect the organs involved in breathing and trigger sinusitis attacks. However, the practice of physical activity is very important to control respiratory diseases. Any aerobic activity promotes the improvement of the cardiorespiratory system, reducing the number of seizures. The exercises should be started slowly and steadily, gradually increasing the intensity of activity to avoid any possible crisis or breathlessness.
Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system). This is because the body's immune system mistakes healthy cells to "intrusive" and attacks causing brain damage. The immune system of the patient erodes the protective sheath covering the nerves, called myelin.
Damage to myelin causes interference in communication between the brain, spinal cord and other areas of your body. This condition may result in deterioration of the nerves themselves in an irreversible process. Over time, degeneration of the myelin caused by the disease will cause brain damage which can lead to atrophy or loss of brain weight. In general, patients with multiple sclerosis show brain volume loss of up to five times faster than normal.
Symptoms vary widely, depending on the amount of damage and the nerves are affected. Multiple sclerosis (MS) is characterized by being a potentially debilitating disease. People with severe cases of multiple sclerosis may lose the ability to walk or speak clearly. Multiple sclerosis can be difficult to diagnose early, once symptoms appear at intervals and the patient becomes months without any sign of disease.
Multiple sclerosis affects about 2.5 million people worldwide. The disease has no cure, but treatments can help control the symptoms and reduce disease progression.
causes
The exact causes of multiple sclerosis is not known, but there are interesting data suggest that the genetic the environment where one lives and even a virus may play a role in disease development. While the cause is still unknown, multiple sclerosis has been the focus of many studies around the world, which has enabled a constant and significant improvement in the quality of life of patients.
Genetics and environment
It is believed that multiple sclerosis may in part be inherited. Thus, second and third degree relatives of people with MS are at increased risk of developing the disease. Siblings of a person with the disease has a 2% risk to 5% more likely to have multiple sclerosis.
However, experiments with identical twins indicates that heredity may not be the only factor involved. If multiple sclerosis was determined exclusively by genetic, identical twins have similar risks. However, an identical twin has only 30% higher chance of developing multiple sclerosis its dual already have the disease.
Some researchers theorize that multiple sclerosis develops in people born with a genetic predisposition that, when exposed to an environmental agent triggers an autoimmune response excessive, giving rise to multiple sclerosis. The lack of sun exposure in the first months or years of life is also considered by experts as an environmental factor that predisposes the onset of multiple sclerosis.
Viruses and Multiple Sclerosis
Some studies suggest that some viruses, such as Epstein-Barr virus (mononucleosis), varicella-zoster and those present in the hepatitis vaccine may be related to multiple sclerosis. So far, however, this belief has not been proven.
Other factors
There is increasing evidence suggesting that hormones, including sex, can affect and be affected by the immune system. For example, both estrogen as progesterone, two important female sex hormones, can suppress some immune activity. Testosterone, the principal male hormone, can also act as a suppressor of immune response.
During pregnancy, estrogen and progesterone levels are very high, which may help explain why pregnant women with MS usually have less disease activity. The higher levels of testosterone in men may partly explain the fact that women are more likely to develop the disease than men, since testosterone can also inhibit the immune system.
Risk factors
Several factors can increase the risk of multiple sclerosis, including:
Age: multiple sclerosis can occur at any age, but most commonly affects people aged 20 to 40 years. In this age group are made 70% of diagnoses
Gender: Women are more likely than men to develop MS. The actual proportion is three women for every man
Family history: If one of your parents or siblings have multiple sclerosis, you have a chance of 1 to 3% of developing the disease - compared to the risk in the general population
Race: Caucasians, especially those whose families originate from northern Europe, are at greater risk of developing multiple sclerosis. People of Asian, African or American descent have lower risk
Geographical regions: multiple sclerosis is more common in areas such as Europe, southern Canada, northern United States, New Zealand and southeastern Australia. It is not known why
Other autoimmune diseases: you can be a little more likely to develop multiple sclerosis have another disease that affects the immune system as thyroid disorders, type 1 diabetes or inflammatory bowel disease.
Symptoms of multiple sclerosis
People with multiple sclerosis tend to show the first symptoms between the ages of 20 to 40 years. Some may come and go, while others remain.
There are two people who strictly have the same symptoms of multiple sclerosis. This is because the events will depend on the nerves that are affected. However, the first symptoms of multiple sclerosis in general are:
blurred or double vision
Fatigue
tingles
Power loss
Lack of balance
muscle spasms
chronic pain
Depression
sexual problems
Urinary incontinence.
You can have a single symptom and then spend months or years without any. The problem can also happen just once, go away and never come back. For some people, the symptoms become worse within weeks or months.
These are the most common symptoms of multiple sclerosis:
muscle symptoms
Feeling of "pins and needles" in the skin
dormancy
itch
burning
Loss of balance
muscle spasms
Problems to move arms and legs
Difficulty walking
coordination problems and to make small movements
Tremor one or more members
Weakness in one or more limbs.
Symptoms bladder and intestine
To urinate several times a day
Urgency to urinate, especially at night
Difficulty emptying the bladder completely
constipation.
nervous symptoms
Dizziness or lightheadedness
Attention and decreased judgment
Memory loss
Difficult to reason and solve problems
Depression or feelings of sadness
Hearing loss.
sexual symptoms
dryness vaginal
Erection problems
Less sensitivity to touch
lower sex drive
Problems reaching orgasm.
speech problems
Long pause between words
slurred speech or difficult to understand
speaks nasally
swallowing problems at later stages.
Symptoms eyes
double vision
Nuisance eyes
rapid, uncontrollable eye movements
Loss of vision (usually affects one eye at a time).
Fatigue
About eight in 10 people with MS feel always very tired. This sensation usually occurs during the afternoon and makes the muscles become weaker, slower thinking and leaves the sleepy person.
This fatigue is generally not associated with the amount of work you do. Some people with MS feel tired even after a good night's sleep.
Severity of symptoms
The symptoms of multiple sclerosis are divided into three groups: primary, secondary and tertiary:
primary symptoms: caused by damage to the protective sheath of the nerves in the spine or brain (myelin). This process can lead to poor bladder or bowel, loss of balance, numbness, paralysis, tingling, tremors, vision problems or weakness
Secondary symptoms: are close to the primary symptoms, but more serious. For example, the person is no longer able to empty the bladder, and this can cause an infection in the body
Tertiary symptoms: social, psychological and work-related. For example, multiple sclerosis can be difficult to walk or drive.
Because the symptoms of multiple sclerosis varies greatly, it is better not to compare with others who have the disease. His experience is probably different. Most people learn to control their symptoms and can lead a full and active life.
Diagnosis of Multiple Sclerosis
The diagnosis of multiple sclerosis can be difficult, since there is a great variety and remission of symptoms. In general, the first medical range to be searched according to the presenting symptom. Why only after different symptoms the patient is referred to a neurologist, who with the help of additional tests can make the diagnosis. The criteria for diagnosing MS are:
Symptoms and signs indicating disease brain or spinal cord
Evidence of two or more injuries - or abnormal areas in the brain - from a magnetic resonance imaging
objective evidence of disease of the brain or spinal cord in medical examination
Two or more episodes with symptoms lasting at least 24 hours and place in at least one month interval
No other explanation for the symptoms.
The diagnosis is primarily clinical and should be complemented by MRI. It may be, however, that medical workpiece several tests to exclude other conditions that may have similar symptoms:
Bloodtests
A blood test can help rule out some infectious or inflammatory diseases that have symptoms similar to multiple sclerosis.
Lumbar puncture
In this procedure, a doctor or a nurse inserts a needle into the lower back in order to remove a small amount of spinal fluid for laboratory analysis. The fluid is tested to identify anomalies associated with multiple sclerosis, such as abnormal levels of white blood cells.
This procedure can also help rule out viral infections and other conditions that can cause neurological symptoms similar to multiple sclerosis.
Magnetic resonance imaging (MRI)
An MRI produces detailed images of the brain, spinal cord and other areas of your body. An MRI may reveal lesions related to loss of myelin in the brain and spinal cord. However, these types of lesions can be caused by rare conditions such as lupus, or even in communal conditions such as migraine and diabetes. The presence of these lesions is not definitive proof that you have multiple sclerosis.
evoked potential test
This test measures the electrical signals sent by the brain in response to stimulation. A potential test evoked can use visual stimuli or electrical stimuli applied to their legs or arms. This test can help detect injuries or damage to the eye nerve, brainstem or spinal cord, even when you do not have any symptoms of nerve damage.
Multiple Sclerosis Treatment
Multiple sclerosis has no cure but can be controlled. Treatment generally focuses on handle crises, controlling the symptoms and reducing disease progression. Today, in Brazil, since there are several treatment options, through daily oral capsule or daily, weekly and monthly injections. Some people have mild symptoms and so do not require treatment.
interferon
Interferon is a group of proteins - alpha, beta and gamma - produced by the body and part of the immune system. They act by controlling the activities of this system in various ways, besides having antiviral properties. (Remember the theories about the relationship between multiple sclerosis and viral infections). Until now, experts have found that interferon-beta is effective in the treatment of multiple sclerosis.
How does it work: slowing the process of MS by reducing the number of seizures and decreasing its complications. Interferon is administered via intramuscular injection, it may be applied daily, once a week or three times per week. The medicament may be used in conjunction with other treatments such as fingolimod.
Interferon can cause many side effects, including:
flu symptoms (fatigue, chills, fever, muscle pain and sweating during the initial weeks of treatment)
Reactions at the injection site (redness, swelling, discoloration and pain). Contact your doctor if the injection site gets dark and not inject more in this area
Sadness, anxiety, irritability and guilt. People with a history of depression should be carefully monitored
Lack of concentration and confusion
Trouble sleeping or eating.
All symptoms should be reported to a health care professional as soon as they occur.
Women who are pregnant, nursing or trying to conceive should not use drugs interferon base. Express this wish to the doctor so they can be discussed other forms of treatment. For those using interferon, for birth control measures should be used.
Interferon can affect liver function. Some drugs have been linked to serious liver damage and failure. The drug can also affect the blood cells and the function of the thyroid gland. Therefore, you should perform regular blood tests to ensure that the liver is functioning normally and monitor your blood cells and thyroid.
Interferon-beta is distributed by the Unified Health System (SUS) for the treatment of multiple sclerosis since 2001.
Glatiramer acetate
Glatiramer acetate is a protein administered via infection with the aim of reducing the number of multiple sclerosis attacks. It is not known exactly how it works, but doctors believe it to be able to block the attack of the immune system on myelin.
You will inject this drug under the skin (subcutaneously) once per day. This treatment is approved for relapsing forms of multiple sclerosis. It is administered subcutaneously (under the skin) three times a week. As interferon, this drug is able to reduce the frequency of recurrence of the crisis. It can be used in conjunction with other medications, according to medical advice.
Side effects are rare but may include:
Pain, swelling and redness at the injection site. The injection sites should be rotated according to a schedule provided by the health care provider
Pain or chest tightness, heart palpitations, anxiety, flushing, and difficulty breathing.
Do not use this product if you are pregnant. If you are planning to become pregnant, talk to your doctor to seek other forms of treatment. If you are breastfeeding, discuss the security to continue using this medicine.
Glatiramer acetate is distributed by the Unified Health System (SUS).
fingolimod
The fingolimod is an oral drug, the first active principle of a new therapeutic class, modulators of sphingosine-1-phosphate receptors (S1PR). These drugs act in the selective trapping of lymphocytes "sick" in the lymph nodes known as buboes, preventing them from entering the central nervous system and destroy the cells responsible for transmitting electrical impulses throughout the body.
It has an effective 52% increase in the reduction of outbreaks caused by the disease compared to interferon. To be oral, the product also facilitates adherence to treatment. More than 100,000 patients have been treated with fingolimod in the world.
After migrate from the injection therapy with interferon for the treatment with oral fingolimod, about 50% of the patients were free of disease activity, and even those with active disease had decreased brain volume loss sustained for up to 4.5 years .
Oral treatment with fingolimod offers improvement in key metrics of multiple sclerosis: loss of brain volume; activity of the lesion as measured by magnetic resonance imaging; relapse rates (outbreaks); and progression of disability.
Today, in Brazil, since there are several treatment options, through daily oral capsule or daily, weekly and monthly injections.
For taking this drug, the patient needs to have his heart rate monitored for six hours after the first dose, because the first dose may slow down your heart rate (bradycardia). The patient will also need to be immune to the chickenpox virus (varicella-zoster virus). Other side effects may include diarrhea, coughing and headache.
The Ministry of Health approved the merger of fingolimod in the treatment of multiple sclerosis in July 2014 and, therefore, the product will be offered for free by the Unified Health System (SUS).
natalizumab
Natalizumab drug is administered by intravenous infusion once every 4 weeks. It is believed that their effectiveness is in blocking the interaction of adhesion molecules expressed by inflammatory cells and molecules in blood vessels and the brain parenchyma cells. However, the specific mechanism by which natalizumab exerts its effects in multiple sclerosis is not fully defined.
In multiple sclerosis, the lesions occur when cells called leukocytes cross the brain barrier protection. For leukocytes to pass through this barrier interaction is required between special molecules called adhesion molecules found on the surface of inflammatory cells and cells lining the blood vessel wall. Natalizumab is able to prevent this interaction.
Headache, joint pain, redness at the injection site, swelling hands, feet and ankles or changes in the menstrual cycle may occur with the use of natalizumab. If any of these effects persist or worsen, notify your doctor immediately. Natalizumab also increases the risk of infection rare but very serious brain. This risk may be greater the more you use natalizumab and if you recently used or are using medicines that weaken the immune system. Natalizumab drug is distributed by the Unified Health System for the treatment of multiple sclerosis.
mitoxantrone
This immunosuppressant medication is usually used to treat severe multiple sclerosis. It is administered intravenously and can be used once every three months or four times a year. Because it can be harmful to the heart and is associated with the development of blood cancers such as leukemia, it is prescribed based on clinical assessment and MRI scans. This drug can be used individually or in combination with other treatments, as medically indicated.
Vitamin D: Efficacy divided expert opinion
Vitamin D is already being used to treat autoimmune diseases, a condition that occurs when the immune system attacks and destroys healthy tissues of the body by mistake. Vitamin D is an immunoregulatory that selectively inhibits the type of immune response that causes the response against the organism itself. The treatment of autoimmune diseases with vitamin D is a recent phenomenon, but is seen by experts as a breakthrough medicine.
A survey at Harvard and published in January 2014 in JAMA Neurology showed that vitamin D contributes to a slower progression of multiple sclerosis. The authors of the study show that patients in early stage had a lower 57% risk of new brain lesions if they had adequate levels of vitamin D. They also had a 25% lower to suffer from the worsening of existing lesions. Another study by the Harvard School of Public Health made in 2006 suggests a decrease of 41% risk of multiple sclerosis for each 50 nmol / L increasing levels of vitamin D. In addition to these, there are about five thousand publications in the world about the benefits of vitamin D in multiple sclerosis. However, still lack conclusive studies showing that vitamin D may be administered as the sole treatment for multiple sclerosis.
In order to achieve the necessary effect in the treatment of multiple sclerosis, vitamin D should be administered at doses above the recommended daily. The sooner it is used, the best benefit, since vitamin D in large doses can reverse recent sequelae, but not those prints. The certain extent depends on each case, but can vary 20 thousand to 150 thousand units for most patients, while the recommended daily requirement for adults are 10 thousand units a day.
It is not known whether low levels of vitamin D may be related to the cause of multiple sclerosis. One hypothesis is that multiple sclerosis patients metabolize vitamin D that differently than healthy population.
This form of treatment, however, does not have scientific evidence, and therefore the medical community is divided as to its application. One of the concerns is the risk that an overdose can cause the body once the nutrient strength exaggerated calcium absorption from food, may calcify the kidneys and impair kidney function. Thus, along with appropriate supplementation is required and strict diet with the accompanying doctor.
The Brazilian Academy of Neurology (ABN) has developed a medical consensus on the therapeutic use of vitamin D in patients with multiple sclerosis. According to the publication, it is recommended to carry vitamin D dosing in patients with multiple sclerosis, regardless of the stage of the disease, particularly in patients that make frequent use of corticosteroids and anticonvulsants. However, vitamin D levels above 100 ng / mL in the peripheral blood should be avoided until new settings are established for vitamin D daily recommendations Finally, the consensus of the Brazilian Academy of Neurology affirms that there is no scientific evidence that justifying the use of vitamin D as the sole treatment for multiple sclerosis.
Strategies to treat symptoms
Physiotherapy: a professional can teach you stretching and strengthening exercises, and show how to use devices that can make performing tasks easier
Muscle relaxants: if you have multiple sclerosis, you may experience painful muscle stiffness or uncontrollable spasms, particularly in the legs. Muscle relaxants can improve these symptoms
Drugs to reduce fatigue: drugs such as amantadine can help reduce fatigue due to multiple sclerosis
Other medicines may be prescribed drug treatments for depression, pain and bladder control or bowel that may be associated with multiple sclerosis.
Living / Prognosis
Take a rest
Fatigue is a common symptom of multiple sclerosis. Although it is generally not related to your activity level, the rest can make you feel more willing.
Practice exercises
Regular exercise such as walking, swimming, weight training and other physical activities, may offer some benefits if you have mild to moderate multiple sclerosis. Benefits of physical activity include improved strength, muscle tone, balance and coordination, bladder control and bowel, and less fatigue and depression.
Maintain a balanced diet
Eating a healthy and balanced diet can help you maintain a healthy weight, strengthen the immune system and maintain healthy bones.
Relieve stress
Stress can trigger or worsen the symptoms of sclerosis, so try to find ways to relax. Activities such as yoga, tai chi, massage, meditation, deep breathing or just listen to good music can help.
Adapt the workplace
Because of fatigue and motor difficulties, may be more complicated for a person with multiple sclerosis perform their activities at work the same way as healthy people. The adaptations that may be offered are:
Greater schedule flexibility
Possibility of regular breaks
varied tasks
Matching the skills, limitations and function performed
guarantee of confidentiality of sensitive and private information.
Avoid heat
Patients with multiple sclerosis are highly sensitive to heat. Therefore, it is important to avoid hot baths and excessive sun exposure when possible. Wear light clothing and keep the body refreshed can also help.
seek support
There are several support groups, both in-person and online, patients with multiple sclerosis. If you interest, look for these communities to exchange experiences and better understand the disease.
possible complications
In some cases, people with multiple sclerosis may also develop:
Muscle spasms and chronic weakness
Paralysis, usually in the legs
permanent bladder problems
permanent sexual difficulties
Forgetfulness and difficulty of permanent concentration
Depression
Epilepsy.
.jpg)
