Blog Posts

Here’s to Having Healthy Lungs

October 5th, 2021

Lung disease kills 4 million people every year. It kills more people than any other disease worldwide. Lung disease is a broad term that encompasses multiple conditions that prevent your lungs from working properly. October is Healthy Lung Month. Let’s use this time to learn more about our lungs and some of the disorders that threaten their health.

Your lungs are a pair of air-filled organs located in your chest. Each lung is made up of smaller sections called lobes. Your right lung has three lobes and your left lung has two lobes. The lungs are part of your respiratory system, a group of organs and tissues responsible for bringing fresh air into your body and expelling waste gases, mainly carbon dioxide, out of your body.

There are many conditions that can affect your lungs, but they are typically divided into three main categories: airway diseases, lung tissue diseases and lung circulation diseases. Each group of diseases impacts the lungs in a different way.

Airway diseases primarily affect the tubes, or airways, that carry oxygen and waste gases into and out of the lungs. Asthma and chronic obstructive pulmonary disease, or COPD, are examples of airway diseases of the lungs.

With asthma, your airways become inflamed and swell, and often produce excess mucus, making it difficult to breath. The most common conditions associated with COPD are chronic bronchitis and emphysema. Chronic bronchitis is inflammation of the bronchial tubes, the airways that carry air to and from the air sacs, or alveoli, in the lungs. Emphysema involves the destruction of the alveoli. Smoking is the most common cause of COPD.

Lung tissue diseases affect the structure of the lung tissue. With these diseases, the lungs are unable to fully expand as you breathe due to inflammation and scarring. This makes it difficult for your lungs to take in oxygen and remove carbon dioxide. Pulmonary fibrosis and sarcoidosis are examples of lung tissue diseases.

Pulmonary fibrosis is a condition in which the lung tissue becomes scarred, thickened and stiff. The scar tissue makes it difficult for the lungs to open up and take in air. With sarcoidosis, your immune system cells clump together and form granulomas, or small areas of inflammation. This can occur in any organ of your body, but it most commonly affects the lungs.

Lung circulation diseases impact the blood vessels in the lungs. They most often involve clotting, scarring or inflammation of the blood vessels. Pulmonary hypertension is a common lung circulation disease. Pulmonary hypertension develops when the pressure in the arteries leading from the heart to the lungs increases. If the pressure becomes too high, the arteries in the lungs can become narrow, restricting blood flow to the lungs.

Lung cancer is another common disease that affects the airways and tissues of the lungs.

Lung cancer is the leading cause of death in the US. It makes up almost 25 percent of all cancer deaths. It is the second most commonly diagnosed cancer in both men and women in the US, excluding skin cancer. In men, prostate cancer is more common, and in women, breast cancer is more common. People who smoke are at the highest risk for developing lung cancer.

Each lung disease has its own set of signs and symptoms, but there are some symptoms that are common to several disorders. These include: shortness of breath with activity; chronic cough; chest tightness; wheezing; rapid, shallow breathing; hoarseness; recurring respiratory infections and fatigue. In rare cases, lung cancer can grow into the nearby blood vessels and cause severe bleeding.

To determine if you have a lung disease, your doctor will perform a physical exam during which he or she will listen to your lungs and breathing. The doctor will review your personal and family history, including your smoking status, risk factors and the severity of your symptoms. Your doctor may use certain tests and procedures to help in making the diagnosis.

Tests and procedures your doctor may employ include: chest x-ray, CT scan, pulmonary functions tests, pulse oximetry, arterial blood gas, bronchoscopy and lung cancer screening.

Treatment depends on the type of lung disease, but it may include medications such as inhaled corticosteroids, which reduce swelling and inflammation of lung tissue, and oral or intravenous medications. Treatment for lung cancer may include surgery, chemotherapy, radiation therapy, targeted drug therapy and immunotherapy.

There are some steps you can take to reduce your risk for lung disease and keep your lungs healthy:

  • Don’t smoke – Smoking cause chronic inflammation in the lungs, destroys lung tissue and may trigger changes that develop into lung cancer.
  • Avoid exposure to indoor pollutants – Secondhand smoke, chemicals in the home and workplace and radon can cause or worsen lung disease.
  • Minimize exposure to outdoor pollutants – Avoid being outdoors for long periods when pollution is high and air quality is poor.
  • Prevent infection – Wash your hands often and avoid crowds during cold and flue season. Get vaccinated against the flu and ask your doctor if the pneumonia vaccine is right for you.
  • Exercise – Regular physical activity can help keep your lungs – and heart – healthy.

It’s National ITP Awareness Month. What’s ITP?

September 19th, 2021

ITP is immune thrombocytopenia, a fairly common blood disorder. People with ITP have a lower than normal number of platelets in their blood. Platelets are blood cell fragments that clump together at the site of an injury to form a clot and help stop bleeding..

“Thrombocytes” is another word for platelets, and “penia” means “lack” or “deficiency.” So the term thrombocytopenia literally means “a deficiency of platelets.” ITP is “immune” because your immune system is stimulated to attack your own platelets by mistake, most often as a result of antibodies produced against them.

This immune system mistake may be due to medications that can cause an allergy that cross-reacts with your platelets. It can be due to infections that set off an immune reaction, commonly viral infections such as chickenpox, hepatitis C and AIDS. Pregnancy can cause the immune system to react, as can immune disorders such as rheumatoid arthritis and lupus. Low-grade lymphomas and leukemias may make abnormal antibodies that attack platelets.

In some case, the cause of ITP is not known. In the past, little was understood about the potential causes of ITP, so the condition was previously named idiopathic thrombocytopenia purpura. “Idiopathic” means “of unknown cause.” “Purpura” refers to the bruises or purplish areas that often appear on the skin of people with ITP.

There are two forms of ITP: acute and chronic. Acute ITP is more common in young children. It often appears after a viral infection such as chickenpox, which triggers the immune reaction that leads to ITP. Symptoms of acute ITP generally appear suddenly and last less than six months. In most cases, treatment is not needed for acute ITP, and it generally does not recur.

Chronic ITP can affect people of any age, but is more common in adults than children. Symptoms last six months or longer; they may last for your entire life. Chronic ITP can go away and recur many times. It requires ongoing treatment with a hematologist, or blood specialist. Women are two to three times more likely than men to develop chronic ITP.

Symptoms of ITP are associated with increased bleeding. They include purpura; tiny red dots under the skin, called petechiae, that look like a rash; spontaneous nosebleeds that are difficult to stop; bleeding from your gums; heavier than normal menstrual periods; prolonged bleeding from cuts; profuse bleeding during surgery; and blood in your urine or stool.

A serious complication of ITP is bleeding into your brain, which can be life threatening.

To diagnose ITP, your doctor will perform a complete physical exam and review of your medical history, including all the medications you take. The doctor will likely order blood tests to check your platelet count. These tests include a complete blood count (CBC) and a blood smear. A blood test to check for antibodies that attack platelets may also be ordered by your doctor.

If the blood tests indicate a low platelet count, your doctor may recommend more tests to confirm the diagnosis of ITP. These tests may include a bone marrow aspiration. Platelets are made by your bone marrow. An aspiration can reveal whether your bone marrow is making a sufficient number of platelets.

There is no cure for ITP. Treatment is based on your platelet count, your age, your general health and your symptoms. The goal of treatment is to increase your platelet count to a safe level, enabling you to live a normal life while you wait for your ITP to go into spontaneous or treatment-induced remission. ITP can recur, however, even after successful treatment.

Medications are generally the first line of treatment. A corticosteroid, such as prednisone, is commonly used to help increase your platelet count by reducing the rate of platelet destruction. Unfortunately, steroids have many side effects, including irritability, weight gain and high blood pressure, and can only be used for short periods.

Other medications may be used to treat ITP as well. These include rituximab, an antibody therapy that targets the immune cells that produce the proteins that attack platelets; intravenous immunoglobulin (IVIg), which increases platelet count by decreasing destruction of platelets by your spleen; and thrombopoietin receptor agonists, which help prevent bruising and bleeding by causing the bone marrow to produce more platelets.

If your ITP symptoms are severe and medication doesn’t improve your platelet count, your doctor may recommend a splenectomy, the surgical removal of your spleen. Your spleen, which is located in the upper left section of your abdomen, is responsible for the destruction of platelets that are coated with antibodies.

Severe or widespread cases of ITP require emergency treatment, which is typically a transfusion of concentrated platelets along with the IV administration of a corticosteroid.

A Study of Sickle Cell Disease

September 10th, 2021

Sickle cell disease is a group of inherited disorders affecting the red blood cells. Healthy red blood cells are disc-shaped and smooth, and glide easily through even small blood vessels to provide oxygen to the body’s tissues. Red blood cells affected by sickle cell disease are rigid, sticky and crescent-shaped, resembling the farm implement called a sickle.

The exact number of people living with sickle cell disease in the US is unknown, but it’s estimated that approximately 100,000 Americans, mainly African-Americans, are affected. The disorder occurs in about one out of every 365 Black or African-American births and one out of every 16,300 Hispanic-American births.

People with sickle cell disease have abnormal hemoglobin, called hemoglobin S, or sickle hemoglobin, in their red blood cells. Hemoglobin is a protein that carries oxygen from the lungs through the arteries to the rest of the body. Sickle cell disease is caused by mutations to the beta globin gene that helps make hemoglobin. To have sickle cell disease, you must inherit two defective genes, one from each parent.

There are several types of sickle cell disease. The most common is HbSS. This type is also called sickle cell anemia. It is typically the most severe form of the disease.

People with sickle cell disease typically start to show signs of the disease during their first year of life, usually around 5 or 6 months of age. Signs and symptoms are different for each person and can range from mild to severe. Early signs of sickle cell disease include jaundice (a yellowish color to the skin), fatigue or fussiness, and painful swelling of the hands and feet.

Sickle cell disease can be diagnosed with a simple blood test. It is generally discovered at birth during a routine newborn screening at the hospital. Doctors can also diagnose sickle cell disease before a baby is born using a sample of amniotic fluid or placental tissue. The prenatal screening looks for the defective beta globin gene rather than abnormal hemoglobin.

Couples who are planning to have children and know that they carry the sickle cell gene mutation may want to meet with a genetic counselor to discuss the potential risks as well as their options.

Early diagnosis is important to help prevent complication of sickle cell disease. Complications develop when the sticky, sickle-shaped red blood cells clog the blood vessels. This can result in episodes of pain and cause the organs and tissues to be deprived of the oxygen they need to survive, damaging them. In addition, sickle cells have a much shorter lifespan than healthy red blood cells, and the body typically cannot make enough new cells to keep pace. This results in anemia.

Other potential complications of sickle cell disease include increased infections, leg ulcers, bone damage, joint problems, vision problems, heart problems, chronic pain, gallstones, developmental delays and stroke.

Currently, the only cure for sickle cell disease is a blood and bone marrow transplant. But there are treatments available to manage symptoms and complications, including chronic pain. Your doctor may recommend certain medications or transfusions to help with this.

Voxelotor is an FDA-approved medication for treating sickle cell disease in adults and children 12 years and older. It prevents red blood cells from forming the sickle shape and binding together, thereby decreasing the destruction of red blood cells and lowering the risk for anemia. It also improves blood flow to the organs.

The FDA approved another medication called crizanlizumab-tmea for adults and children 16 years and older with sickle cell disease. It is given by IV and it helps prevent blood cells from sticking to blood vessel walls and causing blood flow blockage, inflammation and pain.

Hydroxyurea is an oral medication that has been shown to reduce or prevent sickle cell disease complications. It is used in adults and children but not in pregnant women. Hydroxyurea can cause the blood’s white blood cell or platelet count to drop, or in rare cases, cause anemia to worsen. These side effects typically go away when the medication is stopped. After that, your doctor will usually prescribe a lower dose to avoid the side effects.

Your doctor may recommend a whole blood or red blood cell transfusion to help provide more healthy red blood cells to your circulatory system.

Considering Your Cholesterol

September 2nd, 2021

Consider this. Most people can tell you the number attached to their cholesterol level, but do they really understand what it means? What’s behind all those terms, and what is cholesterol anyway?

What’s your cholesterol IQ? To help raise it a few points, here’s a quick refresher course in honor of National Cholesterol Education Month.

Cholesterol is really not that complicated. It’s basically a waxy, fat-like substance made naturally by the body, in the liver. The liver alone makes enough of it for the body to function and thrive. But we also get cholesterol from animal-based foods we eat, such as meat, eggs and full-fat dairy products. Now we have more than we need, and that can turn into a problem.

For one thing, the extra cholesterol can combine with fat and other elements in the blood to form plaque. This can build up on the sides of artery walls – a condition known as atherosclerosis – which can eventually start interfering with the smooth flow of blood through the vessels. Sometimes, a piece of plaque will even break off and form a clot that can block blood flow to areas of the body such as the heart and brain, causing a heart attack or stroke.

The thing is, cholesterol doesn’t travel through the bloodstream by itself. It has to be attached to a protein; and together, they’re called a lipoprotein. Here’s where the LDL and HDL come in.

LDL stands for low-density lipoprotein, which means there is a lower amount of protein compared to cholesterol; essentially, a low density of protein. It’s often called the “bad” cholesterol because it tends to help form the plaque that builds up in the arteries.

On the other hand, HDL is high-density lipoprotein because there is more protein than cholesterol. It’s considered the “good” cholesterol because it can help pull cholesterol out of the artery walls and send it to the liver to be excreted.

Doctors want their patients to have a higher HDL level in their blood compared to LDL, although lower cholesterol levels in general are usually the goal. If you’re cholesterol level is high – 240 is defined as “high” – your doctor might consider some interventional strategies to lower it. If you have other risk factors for heart disease and stroke, action might be taken with an even lower cholesterol level.

So, if your cholesterol level is running a little on the high side, your doctor might start by recommending a few key lifestyle changes, sometimes called Therapeutic Lifestyle Changes (TLC). Simply, TLC includes those common sense practices we should be doing anyway: eating a healthy diet, managing our weight and engaging in regular physical activity.

In some cases, lifestyle changes alone are enough to lower cholesterol to a healthy level. But if they’re not enough, your doctor might prescribe a cholesterol-lowering medication. Statins are a common type of medication used for this purpose, but they’re not the only type. Your doctor will work with you to find the drug that works best for you.

The thing to keep in mind is that there are no signs or symptoms of high cholesterol, so there’s no way of knowing you have it without a blood test. Your doctor will determine how often you need to be tested, but most healthy adults should have their cholesterol checked at least every four to six years.

A good idea is to get tested for a baseline reading so your doctor knows where you stand. That way, if you are on the high side, you can get started with the lifestyle changes that will, hopefully, get you level in check.

Reduce your risk of heart attack and stroke. Consider your cholesterol!

Catching Up On Children’s Eye Health

August 10th, 2021

Newborns can see colors and objects up to 12 inches away, and their vision gets progressively sharper as they get older. By the time they reach school age, children should possess clear, comfortable vision at all distances. But problems can develop as your child’s vision matures. Most childhood vision problems emerge between 18 months and 4 years old.

The most common vision problems affecting children are refractive errors, amblyopia and strabismus.

Refractive errors occur when the eye can’t focus light entering the eye onto the retina, the thin layer of nerve tissue lining the back of the eye. The retina organizes the light into nerve signals, which it sends to the brain to create visual images. When light isn’t focused on the retina properly, the images appear blurry. There are three main refractive errors: myopia, hyperopia and astigmatism.

With myopia, the eyeball is longer than normal or the cornea, the clear front part of the eye, is curved too steeply. This causes the light to focus in front of the retina instead of directly on it. As a result, your child sees near objects more clearly than objects far away. Myopia is also called nearsightedness.

With hyperopia, or farsightedness, the situation is reversed. Your child can see objects in the distance clearly but near object6s are blurry. In cases of hyperopia, the eyeball is shorter than normal or the cornea isn’t curved sufficiently, and the point of focus falls behind the retina.

Astigmatism is an imperfection in the shape of the cornea or lens of the eye. Instead of being round like a ball, the cornea with astigmatism is shaped more like a football, which distorts the light focusing on the retina. With astigmatism, vision is blurry at all distances.

Refractive errors are typically corrected with glasses or contact lenses. Your child’s eye doctor can prescribe the lenses that will give your child the clearest vision.

Sometimes, there’s a breakdown in the way the brain and eyes work together, and the brain doesn’t accept the visual images coming from one eye. The brain relies on the stronger eye, and the vision in the weaker eye gets worse. This condition is called amblyopia, or lazy eye, and it is the most common cause of vision loss in children.

Amblyopia can be caused by crossed eyes (strabismus) or a difference in the refractive error between the two eyes. If that’s the case, your child’s eye doctor will likely correct those conditions first. Treatments for amblyopia include patching the stronger eye, which forces the weaker eye to work harder, and putting special eye drops in the stronger eye, which temporarily blurs the vision in that eye, forcing the weaker eye to work harder.

Strabismus, or crossed eyes, is a condition in which the eyes are misaligned; they don’t point in the same direction. One eye may point inward, outward, upward or downward. To prevent double vision, the brain may ignore the images from the misaligned eye, and that eye may not develop properly as a result. Strabismus occurs in about four out of 100 children or 4 percent.

Strabismus is caused by problems with the eye muscles, the nerves that transmit signals to the muscles or the control center in the brain that directs eye movement. It has been associated with uncorrected refractive errors, poor vision in one eye and certain medical conditions, such as cerebral palsy and hydrocephalus. Strabismus is often inherited. About 30 percent of children with strabismus have a family member with a similar problem.

Strabismus in children can result in amblyopia and can lead to permanent vision loss if not treated. Potential treatments include prescription glasses, special prism glasses, eye patching, BOTOX® injections and surgery to strengthen the weakened eye muscles.

Most vision problems, such as refractive errors, cannot be prevented. But there are steps you can take to safeguard the health of your child’s vision. Start by scheduling routine eye exams. This will enable the eye doctor to follow your child’s visual development at every stage and be there if there are any changes along the way.

Encourage healthy eating habits with a diet rich in fruits and vegetables. Fruits and vegetables contain many vitamins and nutrients that are necessary for maintaining healthy bodies, including healthy eyes.

Spend at least an hour outside every day. Playing outdoors, or even just taking a walk, helps the muscles in your child’s eyes to relax. This goes hand-in-hand with limiting screen time. Prolonger time staring at screens can cause blurry vision, focusing problems and may even increase your child’s risk for developing myopia.

Have your child wear sunglasses outdoors to protect their eyes from the harmful effects of the sun’s UV rays. They should also wear protective eyewear during sports and activities to prevent serious eye injuries. Eye injuries account for more than 1.5 million visits to the emergency room in the United States.

These are easy ways to protect your child’s vision. But if you notice that your child constantly rubs their eyes, has excessively watery eyes, is extremely sensitive to light, has trouble focusing on moving objects or has chronically red eyes, see an eye doctor. These are common signs of vision problems that may need correction.

Safe in the Summer Sun

August 3rd, 2021

July and August are the hottest months of the year. That’s when the amount of solar energy hitting the earth is at its peak. Many people like to be active outdoors during these hot, humid months: taking vacations, enjoying backyard barbecues, visiting the beach or simply strolling through our neighborhoods. But we must protect ourselves from the scorching summer sun.

August is Summer Sun Safety Month, so let’s explore some ways to stay safe while enjoying the outdoors this month.

Everyone knows that exposure to the sun is a risk factor for skin cancer, so cover as much of your skin as possible to limit that exposure. Wear slacks and a long-sleeved shirt made of material that blocks sunlight to protect your arms and legs. A wide-brimmed hat will shade your face, ears and head as well as the back of your neck. Always wear sunglasses with full UVA and UVB protection to protect your eyes from the sun’s rays.

You should use sunscreen every day of the year, but it’s most important to use sunscreen during the summer months, when the sun’s rays are strongest. The American Cancer Society offers tips for selecting a sunscreen. Here are a few highlights:

  • Choose a sunscreen with “broad spectrum” protection. These products protect against both UVA and UVB rays.
  • Select a sunscreen with a sun protection factor (SPF) of 30 or higher. Sunscreens with an SPF of 30 filter out about 97 percent of harmful UVB rays.
  • “Water resistant” does not mean “waterproof.” No sunscreen is waterproof. For best results, reapply sunscreen every two hours, more often if you’re swimming or sweating.

Don’t forget your lips. Use a lip balm containing a sunscreen with an SPF of at least 30.

Even if you follow these recommendations, the sunscreen you choose will be less effective if you don’t use it properly. Here are a few sunscreen tips from the publication Summer Sun Essentials: Foolproof Tips for Staying Safe in the Sun to help you get the best protection:

  • Always rub in spray-on sunscreen. If you don’t, you’ll get uneven protection.
  • Apply sunscreen at least 30 minutes before exposure to the sun.
  • Pay attention to expiration dates. Sunscreen loses much of its potency when its’s expired.
  • Apply an SPF lotion under your makeup every day.
  • Use sunscreen even when it’s cloudy outside. The sun’s ultraviolet rays pass through the clouds.

Avoid doing activities in the sun when its light is at its strongest, between 10 a.m. and 4 p.m. If you get a sunburn, follow the American Academy of Dermatology’s recommendations for treating it. Some of the AAD’s suggestions include:

  • Take frequent cool baths or showers to help relieve pain.
  • Use a moisturizer containing aloe vera or soy to soothe sunburned skin.
  • Drink extra water.
  • If your skin blisters, allow the blisters to heal.

If you’re going to be outdoors in the sun, stay hydrated with cool water and be aware of how your body is responding to the heat to prevent heat illness. The most common heat-related illnesses are heat rash, heat cramps, heat exhaustion and heat stroke. Heat rash and heat cramps are considered mild conditions. Heat exhaustion and heat stroke are severe.

The Cleveland Clinic describes the symptoms, diagnosis and treatment for heat rash, heat cramps, heat exhaustion and heat stroke in detail. Here’s a brief summary:

Symptoms of heat rash include red, itchy skin, tingling or prickling pain and small bumps or blisters on areas that stay wet when you sweat. To treat heat rash, go to a cool place, gently dry off your skin and put cold compresses on your affected skin. If your symptoms don’t improve, see your doctor.

Symptoms of heat cramps include muscle pain or spasms in the arms, legs or abdomen. Your skin will likely feel cool and moist, but your temperature will probably remain normal. To treat heat cramps, drink water and rest.

With heat exhaustion, you’ll likely experience quick, shallow breathing; heavy sweating; headache; irritability; elevated temperature and heart rate; and a weak, quick pulse. Muscle cramps are also a symptom of heat exhaustion.

To treat heat exhaustion, go to a cool, shaded area or go indoors, drink small sips of cold water, put cold cloths on your skin, and call 911 or go the emergency department.

Symptoms of heat stroke include a quick, strong pulse; slurred speech, confusion or an altered mental state; dry, red, hot skin; nausea; temperature of 105 degrees or higher, muscle twitching; seizures; lack of sweating despite the heat; and dizziness, fainting or loss of consciousness.

If you suspect heat stroke, get out of the hot sun and get treatment right away. Call 911 or go to the emergency room immediately. In the meantime, start to cool down by spraying yourself with water or applying cool compresses, loosen or remove your clothing and elevate your feet. Don’t drink any fluids.

If you plan to be active outdoors this month, follow these suggestions and stay safe in the summer sun!

The Scoop on Group B Strep

July 27th, 2021

Group B Streptococci, or group B strep (GBS), are bacteria that naturally live in your body’s gastrointestinal, urinary and reproductive systems. In most cases, these bacteria come and go and are harmless. They don’t cause you to feel sick or experience symptoms. But for some infants and adults with certain medical conditions, GBS can cause a serious illness called GBS disease.

GBS disease is most common in newborns who contract it from their mothers during childbirth. About 1 in 4 pregnant women carry GBS bacteria in their body. When infants get GBS disease within six hours of birth, it is called early-onset GBS disease. When they develop it days, weeks or months later, it is referred to as late-onset GBS disease.

Infants with early-onset GBS disease often display symptoms on the day of birth. Babies with GBS disease may show some of these symptoms: unstable body temperature (may be high or low), pale skin or bluish tint to the skin, difficulty breathing, difficulty feeding or refusing food, abnormal heart rate and listlessness or irritability.

Infants with GBS disease are at risk for serious complications, such as meningitis, an infection of the fluid and membranes protecting the brain and spinal cord; pneumonia, an infection of the lungs; and sepsis, an infection of the blood. Long-term complications include developmental disabilities and hearing loss. Two to three of every 50 babies, or 4 to 6 percent, who develop GBS disease will die.

The best ways to prevent GBS disease in infants are to test mothers for GBS bacteria during pregnancy and give IV antibiotics during labor to women at increased risk. The American College of Obstetricians and Gynecologists recommends testing women for GBS bacteria when they’re 36 to 37 weeks pregnant. IV antibiotics given during labor help protect babies from infection.

In adults, most cases of GBS disease occur in those who also have other medical conditions such as diabetes, heart disease, congestive heart failure, HIV, liver disease and cancer or a history of cancer. Being obese also increases your risk for developing GBS disease. In addition, adults 65 years of age and older are at increased risk compared with adults under 65.

GBS disease can cause sepsis and pneumonia in adults as well. It can also cause skin and soft tissue infections, and bone and joint infection. Rarely in adults, GBS can cause meningitis.

Symptoms of GBS disease in adults vary depending on which part of the body is affected. Symptoms of sepsis include fever, chills and low alertness. With pneumonia, you may experience fever, chills, cough, difficulty breathing and chest pain.

Skin and soft tissue infections often appear as a bump or area on the skin that may be red, swollen or painful. It may also be warm to the touch and be full of pus or other drainage. You may also have a fever with these infections. Symptoms of bone and joint infections include pain in the affected area, fever, chills, sweating and stiffness or inability to use the affected joint.

To definitively diagnose GBS disease, your doctor will take a sample of your blood or cerebrospinal fluid (CSF), the clear liquid that surrounds and protects the brain and spinal cord. To obtain a sample of CSF, your doctor will perform a lumbar puncture, or “spinal tap.” GBS disease is diagnosed if GBS bacteria grow from laboratory cultures of these body fluids.

Infections due to GBS disease are typically treated with antibiotics such as penicillin and ampicillin. Sometimes, people with soft tissue and bone infections due to GBS disease may need additional treatment, such as surgery.

In most cases, there’s no way to prevent GBS disease in adults. The GBS bacteria generally ebb and flow in your body and cause no problems. However, prevention is extremely important in cases of newborn GBS disease.

According to the US Centers for Disease Control and Prevention, a woman carrying GBS bacteria who receives antibiotics during labor has only a one in 4,000 chance of delivering a baby who develops GBS disease. Without antibiotics, the risk increases to one in 200.

Currently, there’s no vaccine for GBS disease, but researchers are working on developing one.

Simply Sarcoma

July 20th, 2021

Sarcoma is a type of cancer that develops in connective tissue, the tissue that holds the body together. Connective tissue is located everywhere in the body, so sarcoma tumors can arise anywhere. But they most often form in the bones, muscles, tendons, cartilage, nerves, fat and blood vessels of the arms, legs, chest and abdomen.

There are two main types of sarcomas: soft tissue sarcomas and bone sarcomas, also called osteosarcomas. There are many different subtypes of soft tissue sarcomas based on the tissues in which they originate, but these cancers share certain microscopic characteristics, produce similar symptoms and are typically treated in the same ways.

Osteosarcoma is a primary bone cancer; it develops in new tissue in growing bone. Many other cancers found in the bones are cancers that have spread, or metastasized, from other cancerous organs, such as the breast, kidney, lung, prostate and thyroid. Osteosarcoma often affects the long bones of the arm or leg, or the bones of the pelvis. Osteosarcomas are most commonly diagnosed in children.

Sarcoma is rare in adults, accounting for about 1 percent of all adult cancers, but rather common in children, making up about 20 percent of childhood cancers.

The American Cancer Society estimates about 13,460 new soft tissue sarcomas will be diagnosed in the US in 2021 and about 5,350 Americans will die from the cancer. According to the National Cancer Institute, an estimated 3,610 people of all ages in the US will be diagnosed with primary bone sarcoma this year, with an estimated 2,060 deaths.

The cause of most sarcomas is unknown, but several factors have been identified that put you at a higher risk for developing a sarcoma. These include a history of radiation therapy; history of genetic disorders such as neurofibromatosis, tuberous sclerosis, Li-Fraumeni syndrome or retinoblastoma; exposure to chemicals such as phenoxyacetic acid in herbicides and chlorophenols in wood preservatives; and history of lymphedema (swelling) in your arms or legs.

Sarcoma symptoms vary depending on the type of sarcoma and where in the body it develops. Often, it causes no noticeable symptoms in its early stages. The first sign may be a painless lump under the skin, but as the lump grows, it may press against nerves or muscles and cause pain. You may experience trouble breathing if the tumor is located in your chest or abdomen.

Symptoms of osteosarcoma include intermittent pain in the affected bone, which may be more intense at night; swelling; fever; a fracture for no apparent reason; and a limp if the tumor is located in your leg. If your child experiences bone pain that doesn’t get better, gets worse at night, or is in one arm or leg rather than both, see a doctor for an evaluation.

Adults who experience this type of pain should visit a doctor eight away.

To diagnose sarcoma, your doctor will first perform a thorough medical history and physical examination. Your doctor may also order certain tests to help in making a diagnosis. These tests may include x-rays, CT or MRI scans, bone scans, PET scans and/or biopsies.

The most common forms of treatment for sarcomas are surgery, radiation therapy and chemotherapy. Most sarcoma tumors are removed with surgery. The goal is to remove the tumor and a safe margin of healthy tissue surrounding it so that no obvious or microscopic cancer cells remain.

Radiation therapy uses high-energy x-rays to kill cancer cells while minimizing damage to healthy cells. It may be used before surgery to shrink tumors or after surgery to kill any cancer cells that may have been left behind. Radiation therapy can be internal (placed inside the body) or external (delivered by a machine outside the body).

Chemotherapy is a systemic treatment that uses anti-cancer drugs to kill or slow down the growth of rapidly multiplying cancer cells. It may be used with radiation therapy before surgery to shrink tumors or after surgery to kill remaining cancer cells. Chemotherapy is also used when the cancer has metastasized to other areas of the body to reduce pain and discomfort.

The outlook for people with sarcomas depends on several factors including the type, extent and location of the cancer. Many people live for longer than five years after diagnosis and thanks to new medical discoveries, the survival rate continues to improve. As with other cancers, your outlook is better if the sarcoma is diagnosed and treatment is started when the cancer is in its early stages.

Unlike other types of cancer, lifestyle factors such as exercise and diet don’t appear to play a significant role in the development or prevention of sarcoma. But adopting healthy lifestyle habits is still a good idea for maintaining your overall health, so do it anyway!

Arthritis: Not Just a Seniors’ Disease

July 12th, 2021

It’s probably pretty common for people to equate the term arthritis with osteoarthritis, the wear-and-tear form of arthritis that’s common in adults as we get older. But that’s just one type of arthritis. There are many more, including types that specifically affect children. In general terms, that group of disorders is referred to as childhood arthritis or juvenile arthritis.

The most common type of juvenile arthritis is juvenile idiopathic arthritis or JIA. JIA affects approximately one in 1,000 children under age 16 in the United State or about 300,000 children. JIA is an autoimmune disorder in which the body’s own immune system attacks a joint’s cells and tissues, specifically the synovium, the tissue lining the inside of the joint.

In response to the immune system attack, the synovium makes more fluid than needed inside the joint, and that excess fluid leads to swelling, pain and stiffness. This inflammation can eventually damage cartilage and bone, causing joint dysfunction. Without appropriate treatment, JIA can affect a child’s overall growth and development. JIA can also affect a child’s eyes.

There are several subtypes that fall under the JIA umbrella. They all involve chronic or long-lasting joint inflammation. To be considered chronic, the inflammation must have been affecting the joints for more than six weeks. The three main subtypes are characterized by their symptoms and number of joints involved.

Systemic JIA. This type affects about 10 to 20 percent of children with JIA. It generally begins with a high fever that can be accompanied by a rash. This type may cause inflammation of internal organs such as the heart, liver, spleen and lymph nodes as well as the joints. It affects boys and girls equally and rarely affects the eyes.

Oligoarticular JIA. This is the most common type of arthritis in kids and teens. It involves fewer than five joints in its first stages, most often the knee, ankle and wrist joints. It affects about 50 percent of children with arthritis and is more common in girls than in boys. It may spread to involve more joints and can also cause inflammation of the eyes. Many children outgrow this type by adulthood.

Polyarticular JIA. About 30 percent of children with JIA have this type. It affects five or more joints, often the same joints on both sides of the body. This type can affect the neck and jaw joints, as well as the small joints of the hands and feet. It can begin at any age and is more common in girls than in boys.

Symptoms vary depending on the type of JIA the child has, but there are some general symptoms, including:

• Joint stiffness, especially in the morning or after resting
• Pain or tenderness in the joints
• Joint swelling
• Limping
• Persistent fever
• Rash
• Fatigue or reduced activity level
• Eye redness, eye pain or blurred vision

The exact cause of JIA is unknown. Researchers believe that some children possess certain genes that make them more susceptible to developing the disease, then exposure to something in the environment, such as a virus, triggers the disease to begin. It’s not hereditary, however. It’s rare for more than one child in a family to develop JIA.

Early diagnosis and treatment are key to controlling inflammation, preventing joint damage and keeping the child as healthy and functional as possible. There is no one test for JIA. Doctors diagnose the condition using a variety of methods. They generally begin their assessments by taking a thorough medical history of the patient and performing a full physical examination.

Doctors may also order certain tests. These may include laboratory tests on blood, joint and tissue fluids to rule out other conditions as the cause of the symptoms. X-rays may be taken as well to look for any injuries or unusual development of the bones of the joints.

The goal of treatment for JIA is to reduce swelling, relieve pain, prevent damage and maintain function of the joints. There is typically a team of health care professionals involved in the child’s treatment, including physical and occupational therapists, dietitians, social workers and even school nurses working in concert with the child’s doctor.

Because JIA is an autoimmune disorder, medication is often used in its treatment. If only a few joints are involved, doctors may begin by injecting steroids directly into the affected joints to reduce inflammation and relieve pain. Another option is adding a group of medications called disease modifying drugs or DMARDS.

DMARDS may be used when many joints are involved or when the JIA doesn’t respond to the steroids. DMARDS include drugs such as methotrexate and the biologics such as Enbrel, Remicade and Humira. These medications cause side effects and children taking them must be monitored closely.

Physical and occupational therapy also play a role in the treatment of JIA. Physical therapy exercises are important because they help in recovering and preserving range of motion and function of the joints. They also maintain muscle tone, and strong muscles aid smooth joint movement. Occupational therapy teaches the child ways to perform daily activities with limited joint function.

It’s clear that arthritis is not just for seniors. Many children struggle with painful, swollen and inflamed joints as well. If you know a child struggling with arthritis, be understanding and supportive. Help them if they ask for it, but for the most part, allow them to perform activities on their own. With treatment, children with arthritis can live normal, healthy lives.

Close Up On Cleft and Craniofacial Disorders

July 5th, 2021

July is National Cleft and Craniofacial Disorders Awareness and Prevention Month. This observation was established to educate Americans about the cleft and craniofacial conditions that affect more than 600,000 people in the US.

Cleft and craniofacial disorders are a diverse group of abnormalities in the growth and development of the head and face. Most of these disorders develop during pregnancy and are present at birth.

There are multiple variations of cleft and craniofacial disorders, and they can be mild, moderate or severe. They often affect the physical appearance of the child, but can also impact important functions, including eating, hearing and seeing.

The exact cause of these disorders is unknown. Most physicians believe there is no single cause but multiple factors contribute to their development. These factors include a combination of genes; environmental factors, such as viruses and exposure to dangerous chemicals in the workplace; and a deficiency of the B vitamin folic acid during pregnancy.

The most common of the cleft and craniofacial disorders are cleft lip and cleft palate. These conditions are the most common birth defects in the US. It’s estimated that 2,650 babies are born with a cleft palate each year in the US, and 4,440 are born with a cleft lip with or without a cleft palate.

A cleft lip is a separation of the two sides of the lip. It can range in severity from a small split in the lip to a large opening that goes from the lip up through the nose. A cleft palate is an opening in the roof of the mouth. These disorders occur because the two sides did not fuse during development. The lip and palate develop separately, so children can have a cleft lip, cleft palate or both.

Certain risk factors have been identified that may make you more likely to have a baby with a cleft lip or cleft palate. These include family history; exposure to certain substances during pregnancy, such as cigarettes, alcohol or certain medications; having diabetes; and being obese during pregnancy.

Cleft lip and cleft palate, also called orofacial clefts, are generally diagnosed at birth through a visual assessment and physical examination. In many cases, these defects can be diagnosed during pregnancy using ultrasound. Cleft lip and cleft palate are typically treated with surgery to restore the child’s appearance and function.

Affecting one in every 3.500 to 4,000 births, hemifacial microsomia is the second most common cleft and craniofacial disorder after cleft lip and cleft palate. With hemifacial microsomia, one side of the face is underdeveloped and does not grow properly. Most often, this condition affects the jaw, mouth and ear.

Common signs of hemifacial microsomia include facial asymmetry; reduced size of facial muscles; abnormalities of the outer ear; narrowed jaw or absence of half of the jaw; abnormalities in shape or number of the teeth, or significant delay in the development of the teeth; cleft lip and/or cleft palate; and extremely small eyes.

The cause of hemifacial microsomia is unknown. It is believed that vascular problems in the first trimester of pregnancy result in poor blood flow to the baby’s face during development. Treatment often involves surgery to treat your child’s various facial abnormalities. Speech therapy may also be required.

The spaces between a baby’s skull bones, called sutures, are filled with a flexible material that allow the skull to grow as the baby’s brain grows. A craniofacial anomaly called craniosynostosis results when the sutures close and the skull bones fuse too early. If the brain doesn’t have enough room to grow to its full size, pressure builds up in the skull as well.

Craniosynostosis is common. It occurs in one out of 2,200 live births and affects males slightly more often than females.

The first sign of craniosynostosis is an unusually shaped skull. Other signs include no “soft spot” on the baby’s head, a raised firm edge where the sutures closed and the slow growth or no growth of the baby’s head over time.

Your baby’s doctor can generally diagnose craniosynostosis on a physical exam but may order a CT scan to get a closer look at your baby’s brain as well as the sutures to determine whether or not they are fully closed.

The cause of craniosynostosis is unknown, but most researchers believe it is the result of a combination of genetic and environmental factors. Treatment often involves surgery to relieve the pressure on the brain, correct the deformities of the craniosynostosis and allow the brain to grow properly. In some mild cases, surgery may not be needed. Medical therapies can be used to help mold the skull into a more normal shape.

While most cleft and craniofacial disorders cannot be prevented, you can reduce your risk by quitting smoking, not drinking alcohol while you’re pregnant, maintaining a healthy weight during pregnancy and taking prenatal vitamins containing plenty of folic acid.

Page 6 of 34