Diagnosis and Treatment of Rheumatoid Arthritis

Rheumatoid arthritis can also trigger a variety of symptomsthroughout the body. It is unknown if its exact cause, although many of the various factors (including genetic predisposition) that may influence the autoimmune reaction. About 1% of the populationsuffers from this disease, which affects women two to three times more often than men. Rheumatoid arthritis is presented first inindividuals between 25 and 50 years of age, but may do so at any age. In some cases, the disease resolves spontaneously and treatment alleviates symptoms in three out of four people. However, at least one person in 10 is disabled.

In this disease, the immune system attacks the tissue that lines and protects the joints. Finally, cartilage, bone and ligaments of the jointdeteriorate, causing the formation of scar tissue within the joint, which decays at a rate varies.


Rheumatoid arthritis can be started abruptly with inflammation in many joints at the same time, but more often begins subtly gradually affects many joints. The inflammation is generally symmetrical, ie when affecting an articulation of a side, corresponding to the other side is also affected. The small joints of the fingers, toes, wrists, elbows and ankles tend to ignite in the first place. Inflamed joints are often painful and frequently are rigid, especially immediately after getting up or after a prolonged period of inactivity. Some people feel tired and weak, especially during the early afternoon.

The affected joints and can increase rapidly deform. Can also be a rigid position (contracture), which prevents or opening extending completely. The fingers tend to bend toward the little finger on each hand, causing the displacement of the tendons of the fingers. The swollen wrists may lead to carpal tunnel syndrome. The cysts that develop behind the knees affected may burst, causing pain and swelling in the legs. Nearly 30% to 40% of persons suffering from rheumatoid arthritis hard has swellings (nodules) under the skin, often near zones patients.

Rheumatoid arthritis can cause a slight fever and, in some cases, a blood vessel inflammation (vasculitis) that damages the nerves in the legs or sores (ulcers). Inflammation of the lining around the lungs (pleurisy) or the casing of the heart (pericarditis), or inflammation and scarring of the lungs can cause chest pain, difficulty breathing and an abnormal cardiac function. Some people develop inflamed lymph nodes, Sjögren’s syndrome or ocular inflammation.

Still’s disease is a variant of rheumatoid arthritis in that appears first high fever and other symptoms generalized.


It can be difficult to distinguish rheumatoid arthritis from many other diseases that can cause arthritis. Diseases which appear in some respects with rheumatoid arthritis are the acute rheumatic fevercaused by gonococcal arthritis, Lyme disease, Reiter’s syndrome, psoriatic arthritis, ankylosing spondylitis, gout, osteoarthritis andpseudogout .

Rheumatoid arthritis can produce symptoms very characteristic.However, it may be necessary to analyze the liquid which is extracted with a joint or a biopsy needle (extraction of a sample of tissue is examined under a microscope) of nodes to establish a diagnosis. The characteristic changes in the joints can be detectedon radiographs.

Some typical features of rheumatoid arthritis can be seen on the results of laboratory tests. For example, 9 out of 10 persons suffering from rheumatoid arthritis have a sedimentation velocityhigher red blood cell. Most have a mild anemia. On rare occasions,the value of white blood cells is abnormally low. In the latter case, if the individual spleen also has a large and rheumatoid arthritis, is said to be suffering from the disease called Flety.

Most people with RA have antibodies in their blood characteristic.Seven out of ten individuals have an antibody called rheumatoid factor. This factor also has other diseases (such as chronic liver diseases and certain infections), although in some cases this factorappears without any evidence of disease.

In general, the higher the value of the rheumatoid factor in the blood,the more serious the rheumatoid arthritis and poor prognosis. The value of rheumatoid factor may decrease when the joints are lessinflamed and increase the check on the outbreak inflammatory.


There are various treatments, from classic and simple measuressuch as rest and proper nutrition, to the drugs and surgery. The treatment begins with less aggressive measures, progressing to the more aggressive if necessary.

A basic principle of treatment is to rest the affected joint, as theyuse it worsens inflammation. The regular periods of rest serve torelieve pain. Sometimes a brief absolute rest in bed helps relieve asevere outbreak in its most active and painful step. They may usesplints to immobilize and provide rest to one or several joints, but it will take some of the same systematic movements to preventstiffness.

It is advisable to follow a regular diet and healthy. The increased symptoms appear in some cases after eating certain foods. A dietrich in fish and vegetable oils, but low in red meat, may have minorbeneficial effects on inflammation.

The main categories of drugs used to treat rheumatoid arthritis are the nonsteroidal anti-inflammatory drugs (NSAIDs), medicines fordelayed action, corticosteroids and immunosuppressive drugs. In general, the stronger the drug, the greater its potential side effects.Therefore it requires a very strict monitoring.

Anti-inflammatory drugs

The anti-inflammatory drugs (See Section 2, Chapter 13) and (See Section 6, Chapter 61), like aspirin and ibuprofen, are most often used, because they reduce swelling in affected joints and soothe the pain. Aspirin is the cornerstone of the traditional treatment of rheumatoid arthritis, however, the novel anti-inflammatory drugs may have fewer side effects and are generally easier to administer, but are more expensive.

Generally the treatment of aspirin begins with a tablet (325 mg) four times a day, but the dosage may be increased to give sufficient relief. The tinnitus is a side effect that indicates that the dose is too high. The stomach complaints (a common side effect in high doses) and ulcers can be prevented or eating food taking antacids or other drugs at the same time. Misoprostol can be useful for preventing irritation of the stomach lining and the formation of ulcers of the stomach (gastric) in individuals at high risk of manifesting such conditions, but in turn can cause diarrhea and, furthermore, does not prevent nausea or abdominal pain resulting from taking aspirin or other anti-inflammatory drugs.

In case of intolerance to aspirin, we experience other anti-inflammatory drugs. However, all they can cause stomach disorders and are contraindicated in patients with active ulcers of the gastrointestinal tract (peptic ulcers). Other less common side effects are headache, confusion, increased blood pressure, swelling (edema) and sometimes, renal disease.

Drugs of delayed action

The medicinal action at times delayed alter the course of the disease, although it may be necessary to several months treatment (which may be dangerous side effects) to verify any improvement.The physician should monitor and follow up treatment. These drugs are prescribed to the anti-inflammatory drugs were not effective after two or three months of treatment or in the case of rapid progress of the disease. The delayed action of drugs that are currently used are penicillamine, hydroxychloroquine and sulphasalazine.

The gold compounds (which are often slow the appearance of deformations bone) may also cause a temporary remission of the disease. These compounds are administered at weekly injections, although it has a preparation which is administered orally. Weekly doses remain until it has been administered a total of up to one gram or appearance of side effects or a significant improvement. If the drug is effective, the frequency of injections may be decreased gradually. The improvement may last several years thanks to a maintenance dose.

Compounds of gold tend to affect many organs adversely, so they are contraindicated in people suffering from liver or kidney problems, or certain blood disorders. Therefore, one must carry out analyzes of blood and urine samples before starting the treatment, and often during the same (up to once weekly). The side effects of these medicines consists of potentially dangerous eruption, burnings and decrease of blood cells. Less often, gold compounds affect the liver, lungs, and nerve, and rarely cause diarrhea. The treatment is suspended if it appears any of these serious side effects.

Penicillamine has beneficial effects similar to those of gold compounds and can be used when they are not effective or causes side effects when intolerable. The dosage is gradually increased to see improvement. Side effects are, among others, the inhibition of formation of red blood cells in bone marrow, kidney, muscle disease, rash and a bad taste in the mouth. Treatment should be discontinued if these symptoms appear. Penicillamine also tends to cause certain disorders such as myasthenia gravis, Goodpasture’s syndrome and SLE like syndrome. During treatment, blood tests and urine tests are carried out every 4 weeks or 4 weeks.

For the treatment of less severe rheumatoid arthritis hydroxychloroquine is used in preference to other compounds such as gold or penicillamine. Its side effects are usually mild (rashes, muscle pain and eye problems). However, some eye problems tend to be permanent and that individuals who take hydroxychloroquine should refer to the ophthalmologist before starting treatment and refer to it every six months for the same. If the end of 6 months did not notice any improvement in the drug treatment is stopped, otherwise, one can extend the time necessary.

Sulfasalazine is prescribed for more rheumatoid arthritis, increasing the dose gradually. The improvement is usually occur after 3 months. However, like other drugs of delayed action, usually cause stomach problems liver problems, changes in blood cells and skin rashes.


Corticosteroids (such as prednisone) drugs are surprisingly effective to reduce inflammation in any part of the body. Although steroids are effective in treatments of short, their effectiveness tends to decrease with time as rheumatoid arthritis, usually remains active for years. These medications usually do not slow the progression of the disease, in addition, prolonged use of corticosteroids invariably involves many side effects, affecting almost every organ in the body.

The most common side effects are thinning of the skin, bruising, osteoporosis, increased blood pressure, increased blood sugar and cataracts. Therefore, these drugs reserve for the immediate treatment of outbreaks when several joints are affected or when other medications have proved ineffective. They are also useful to treat inflammation of the joints at different points, for example in the membrane surrounding the lungs (pleuritis) or the housing of the heart (pericarditis). In most cases, we use the minimum effective dose due to the risk of side effects. For a quick relief and short-term, corticosteroids can be injected directly into the affected joint.However, long term generally accelerate the deterioration, especially when using excessively articulation (which does not hurt for some time due to the frequent administration of injections).

Immunosuppressive drugs

Immunosuppressive drugs (methotrexate, azathioprine and cyclophosphamide) are effective in the treatment of severe forms of arthritis. Suppress the inflammation, whereby corticosteroids can be administered in small doses and even be avoided.

However, these drugs have potentially fatal side effects, such as liver disease, lung inflammation, increased susceptibility to infections and withdrawal of blood cell production in bone marrow and, moreover, cyclophosphamide can produce bleeding in the urinary bladder. Finally, both as azathioprine, cyclophosphamide, may increase the risk of cancer.

The methotrexate, administered orally once a week, it is used with increasing frequency to treat rheumatoid arthritis in the early stages, since it is a fast-acting drug, being effective, in some cases, afterseveral weeks. You can also administer this medicine before prescribing drugs delayed action in the event of severe arthritis.People treated with methotrexate tolerate the drug, but must be strictly controlled. Should be avoided alcoholic beverages to minimize the risk of liver injury. Cyclosporin may be prescribed, which suppresses lymphocyte (a type of white blood cell), when other drugs are ineffective in the treatment of a severe arthritis.

Other therapies

A program for treatment for rheumatoid arthritis, together with the drug to reduce inflammation of the joints, may include exercise, physical therapy, application of heat in the inflamed joints, sometimes surgery. The gentle exercise avoids the rigidity of swollen joints. By reducing inflammation, active and regular exercise can be helpful, without the person reaches the extreme fatigue. In some cases, the exercise in the water can be easier.

The treatment of stiff joints consists of intensive exercise and in some instances the use of splints to gradually extend the joint. If drugs were not effective, surgery may be necessary. The surgical replacement of the knee or hip is the most effective way to restore mobility and function, when the joint disease is at an advanced stage.

It is also possible their extraction or fusion, especially the foot, to make walking less painful. It is possible to fuse the thumb and thus allow the person can use it to hold. You can also merge the upper end of the unstable vertebrae from the neck that does not compress the spinal cord.

People disabled by rheumatoid arthritis can use a variety of grants to carry out everyday tasks. For example, there is specially modified orthopedic shoes that can help you walk with less pain and devices such as handles that reduce the need to tighten by hand.

Complete Information on Acquired Angioedema With Treatment and Prevention

Acquired angioedema is a hypersensitivity disorder that presents as edema of the subcutaneous tissues and mucosa, typically involving the upper airways or gastrointestinal tract, and often accompanied by urticaria. Acquired angioedema is characterized by painless, nonpruritic, nonpitting swelling of the rind that is classified into 2 forms: acquired angioedema role I and acquired angioedema role II. It is usually nonerythematous and nonpruritic, and it may be pain-free. It is is caused by extravasation of elegant into interstitial tissue as a result of the exit of combustible mediators that increase permeability and dilate capillaries and venules. In contrast, edema is caused by an alteration in Starling’s forces, such as an increase in intracapillary personnel or decrease in capillary plasma oncotic personnel.

Acquired angioedema can submit with severe airway interference or with abdominal symptoms that mimic an intense stomach. The disease can be either genetic or acquired. Nonimmunologic cases are normally caused by immediate mast cubicle degranulation or intervention with arachidonic acidic metabolism by agents such as aspirin, nonsteroidal anti-inflammatory drugs, or nutrient additives. Other causes of angioedema include physiological stimuli, such as drill, cool, water, or still soft. A tiny dimension of patients with hypereosinophilic syndromes may produce angioedema. It is needed to realize the complement footpath to recognize how genetic and acquired angioedema happen and which tests are proper.

In serious cases, stridor of the airway occurs, with gasping or wheezy inspiratory breather sounds and decreasing oxygen levels. Intubation is required in these situations to forbid respiratory arrest and danger of death. Sometimes, there has been new vulnerability to an allergen, but more frequently the reason is either idiopathic or simply weakly correlated to allergen vulnerability. Cases where acquired angioedema progresses quickly should be treated as a medical emergency as airway interference and suffocation can happen. Epinephrine may be lifesaving when the reason of angioedema is hypersensitive. In the lawsuit of genetic angioedema, handling with epinephrine has not been shown to forbid morbidity or wait the moment needed to treat.

In hypersensitive angioedema, avoidance of the allergen and consumption of antihistamines may forbid subsequent attacks. Cetirizine is an usually prescribed antihistamine for angioedema. Severe angioedema cases may need desensitization to the purported allergen, as mortality can happen. Chronic cases expect steroid therapy, which mostly leads to a better reaction. As an unconventional, drugs known as fibrinolysis inhibitors, such as tranexamic acid, are used, although their consequence is relatively feeble and their prospective for position effects is doubtful. Cinnarizine may too be helpful because it blocks the activation of C4 and can be used in patients with liver disease while androgens cannot.

What Causes Panic Attacks and How You Can Take Control of Them

In order to start to eliminate your panic, it’s important for you to know what causes it. When you know the cause you can be prepared and alert to the signs and symptoms. Awareness is the first step to making any kind of change, for if you are not aware, then you can’t change it.

What Is A Panic Attack?

A panic attack is a sudden flow of severe, overwhelming anxiety and fear. Your heart may pound or it becomes hard to breathe. You feel dizzy and sick to your stomach. You may even think like you’re dying or going crazy. And the worst part of it is that they may occur any time, anyplace, without warning!

Panic is a Body-Mind Phenomenon

Although the exact causes of panic and panic disorders are not well known, both the mind and the body are involved in causing panic attacks.

Stressful life changes such as getting married, having children, getting a job, etc. may cause episodes. The death of a loved one, a divorce, or job loss can also initiate panic attacks.

They may have physical causes. Some research suggests the tendency may be partially genetic, and studies with twins have shown the possibility of inheriting the panic disorder.

There also appears to be a connection with coming down with major illnesses and having panic attacks. An increase in the rate of panic attacks has been seen in some women during pregnancy.

Possible Physical Causes of Panic Attacks

If you’re noticing symptoms of panic, it’s important to visit your doctor to rule out the following physiological conditions as potential causes:

  • Mitral valve prolapse, a minor cardiac problem that happens when one of the heart’s valves doesn’t close properly
  • Hyperthyroidism
  • Hypoglycemia
  • Stimulant use (amphetamines, cocaine, caffeine)
  • Medication withdrawal

Other Known Causes

The following non-exhaustive list is here for your reference.

  • Adjustment disorder
  • Agoraphobia
  • Amphetamine abuse
  • Anxiety disorders
  • Chemical poisoning – Jet Fuel-4
  • Chronic Fatigue Syndrome
  • Cocaine overdose
  • Ecstasy withdrawal
  • Hashimoto’s Thyroiditis
  • Hyperventilation
  • Inborn amino acid metabolism disorder
  • Marijuana abuse
  • Marijuana overdose
  • Myoclonic dystonia
  • Obsessive-compulsive disorder
  • Panic disorder
  • Panic disorder with agoraphobia
  • Panic disorder without agoraphobia
  • Post-traumatic stress disorder
  • Premenstrual dysphoric disorder
  • Rett’s syndrome
  • Separation anxiety disorder
  • Social phobia (affects over 10 million Americans)
  • Specific phobias
  • Stress
  • Substance-induced anxiety disorder

Medications and Drugs Known to Cause Panic Attacks

  • Cannabis
  • Catovit
  • Charas
  • Ecstasy
  • Hash
  • Marijuana
  • Mazindol
  • Prolintane
  • Sanorex

These causes affect over 1 million Americans:

  • Agoraphobia – panic attacks
  • Hashimoto’s Thyroiditis – panic attacks
  • Obsessive-compulsive disorder
  • Panic disorders
  • Post-traumatic stress disorder

In addition – if you have a panic disorder, without treatment, you may develop a fear of having panic attacks! This often actually causes a panic attack and the cycle begins. Often, the sufferer of panic will convince himself/herself so convincingly that they are dying that many feel the need to visit the emergency room!


There are many potential causes of your panic attacks, ranging from stress to life changes to substance abuse and side effects of medication. When they repeat, the sufferer may actually become afraid of having another attack This fear can actually cause one, creating a draining cycle.

By knowing the potential causes of your suffering, you can better control your situation and your state of mind, helping you head off the situations that cause panic in you.

This article cannot, and should not, stand alone as the sole medical or psychological intervention for any disorder. Any individual with a medical or psychological problem should first consult a qualified health care provider for diagnosis and professional advice.

Heart Attack and Medication

A heart attack is a life-threatening event. It is a need to know about the basic things so that it can help you at the sudden causes. The information should be there so that it may enable us to take sudden and correct decisions for curing it when it appears. If we have prior information of it will be a valuable asset to our loved ones and us.

This heart attack occurs when the supply of the blood and oxygen are blocked in to the area of heart muscle, especially the clot in a coronary artery. Due to this blockage of blood and oxygen it leads to the irregular heartbeat which causes severe decrease in the pumping of the heart and may bring about sudden death. This is the initial stage and it should be treated within few hours so that the heart muscles are not affected and are not replaced by the scar tissue. It is a require for us to know the caution signs of this disease and to get the emergency help at the time of need. Some people die because as they do not get the immediate help due to the permanent damage in the heart.

If the primary aid is given soon enough the permanent damage of the heart that is the blocked artery can be restored in time to avoid it. Yet, many of them do not get this medical care within the hours of the symptoms begin and they die. But a prompt treatment can prevent or cure their sudden death.

This is the disease which is caused in both men and women. If the person is already suffering form the coronary heart diseases, or underwent a bypass surgery is at the risk of having this disease. The men who are above 45 and women who are above 55 are exposed to this. If he has a hereditary background that is any of his family member was having this disease.

So it is very essential that these factors should be controlled before they appear. So they should have a control over smoking, high blood pressure, high blood cholesterol, overweight and obesity, physical inactivity, diabetes and we can also visit our health care provider to ask about the reduce of risk of having the heart attack.

This heart attack includes the warning signs and symptoms varies from person the person Some of them symptoms like the chest discomfort, discomfort in other areas if the upper body, shortness of breath, cold sweat, having nausea and vomiting, feeling light headed or dizzy.

As this heart attack is a medical emergency, it should be prevented if we know the warning signs of the attack and can be treated as fast as possible. This should be not delayed as it may cause to the sudden death in the person. The sooner the treatment is given the chances of recovery are more. It is a must and should need that there should be a physical examination periodically after the first treatment as it does not give a way for the second one.

So this heart attack is a chronic disease which once attacks cannot be completely treated but it can be prevented by the regular medications but yet you are in a depression thinking about it and you feel difficult in getting adjusted to this life. So at this time you need the affection of your loved ones which makes you to cure it as early possible.

Take this information as a basic one and not as medical advice. But if you have any more clarifications you can visit our site www.drraomd.com . This site is the site where you can get information of many diseases. You can also meet our Infectious Disease Specialist Dr. Rao.K. for more consult which would help you for further need. You can also hear the videos of the customers who got cured their diseases at our center called Holistic Health Care and Research Center located at New York.

A look back to the history of "heart disease"

Heart disease is now popularly called as a number one killer since it is becoming a major cause of death for both men and women. We all believe that our modern lifestyle and foods are the main reason for heart attack. But the fact is that heart disease is present from ancient era itself. A look back to history can help you to analyze that.


Researchers have submitted their report, telling that even Egyptian Pharaohs Merenptah was plagued by atherosclerosis. Researchers had studied the Egyptian mummies and have got some evidences of heart disease from it. Heart disease may due to the Egyptian diet (lot of fatty meats from cattle, ducks, and geese, and used a lot of salt for food preservation).

It is heard that even Leonardo da Vinci (1452 – 1519) had invested about atherosclerosis (coronary artery disease). William Harvey (1578–1657), who were a physician to king Charles 1 was known as the father of the ‘vascular’ and ‘circulatory’ system. Friedrich Hoffmann (1660–1742), chief professor of cardiology at the University of Halle, noted that coronary heart disease started in the “reduced passage of the blood within the coronary arteries.”

Even 18th and 19th centuries physicians had discussed “Angina” as an indicator of heart disease. William Osler (1849–1919), a cardiologist was the first to indicate that it was a syndrome rather than a disease in itself.  James B. Herrick (1861­–1954) cardiologist latter in 1912 concluded that the slow, gradual narrowing of the coronary arteries could be a cause of angina.

An increased study and understanding of heart disease began during the period of 1900. A few years later, Physicians began to experiment with exploring the coronary arteries with catheters. This would later become coronary angiogram (cardiac catheterization). Today, these catheter procedures are commonly used to diagnose coronary artery disease and to determine whether further treatment is needed or not. Egas Moniz (1874–1955) and Werner Forssman where the two well known scientists, showed excellence in developing catheterization procedures. Mason Sones (1918–1985) perfected the technique for producing high-quality diagnostic images of the coronary arteries. The new test made an accurate diagnosis of coronary artery disease possible for the first time.  

In 1949, the term “arteriosclerosis” (known as “atherosclerosis” today) was added to the International Classification of Diseases, as a major cause for heart disease. During 1950, John Gofman identified cholesterol types (LDL and HDL). And john also stated persons who got atherosclerosis had high levels of LDL and decreased levels of HDL.

best heart surgeon india

In 1950, Ancel Keys stated fat was the reason for heart disease by analyzing Mediterranean populations (people had food with low fat). In 1960s and ‘70s bypass surgery and angioplasty were first used to as a treatment for heart disease. In 1980s, stents are used to assist prop open a narrowed artery became familiar. As a result of advances in technologies, now heart disease is not treated as a complicated disease.




Tuberculosıs and AIDS – partners ın Crıme to start an epıdemy ın Ukraıne?

Tuberculosis creeps ?nto Eastern Europe – A danger for an ep?demy ?s apparent.

Tuberculosis, or TB, was once considered to be on track for global eradication, along with smallpox. By the late 1980s, however, a disturbing upswing in the number of new cases was detected worldwide. A report by the World Health Organization released in March 2005 shows the number of new TB cases stabilizing or even declining in most regions of the world, but not in Africa or Eastern Europe. Today:

  • Every second, a person is newly infected with TB.
  • Around 1/3 of the world’s population—nearly 2 billion people—have TB.
  • An active, untreated TB case can infect up to 15 more people each year.

In Ukraine many factors fuel the TB epidemic. The number of TB strains that are resistant to multiple drugs is higher in parts of Eastern Europe than almost anywhere else, making treatment difficult. The rising rates of HIV infection also are beginning to influence the number of new TB cases (TB is the most common opportunistic infection and the leading cause of death among AIDS patients). In addition, the country’s health systems suffered a setback during years of political, social, and economic transition. As a result, TB detection in Ukraine is based on an outdated screening technique—miniature chest x-rays instead of simpler, less expensive lab tests. Finally, infected individuals who do not get treated may pass the disease to others.

There ?s a need for accurate information to health care providers, patients, the public, and policy- and decision-makers. Ukra?n?an author?t?es need to onduct surveys and focus group discussions with these groups to help better understand their knowledge and attitudes ?n order to g?ve information they need.

Many individuals with TB experience discrimination because TB is considered a disease of poverty, associated with the homeless, drug users, alcoholics, and prisoners. Infected individuals fear that if they are officially diagnosed, they may lose their job. Some women are afraid that their husbands will abandon them. Many also wrongly believe that TB is incurable or that treatment is expensive.

Doctors feel hampered by poor diagnostic equipment, supply shortages, and lack of funding. They also have trouble finding up-to-date information in their native language. Many of them do not have all the information they need about DOTS, a strategy for TB control recommended by the World Health Organization.

Data from Wikipedia are from 2003 ?llustrates the ?ncrease ?n numbers and ?t has become worse s?nce th?s stat?st?cs was revealed to the publ?c.

22 August 2006 ( ranked by 137 nations ) the percentage of adults (aged 15-49) living with HIV/AIDS. The adult prevalence rate is calculated by dividing the estimated number of adults living with HIV/AIDS at year end by the total adult population at year end.
– rank 50 : Ukraine 1.4%
– rank 55 : Estonia 1.1%
– rank 57 : Russia 1.1%
– rank 69 : Latvia 0.6%
– rank 71 : USA 0.6%
– rank 84 : Belarus 0.3%
– rank 94 : Kazahstan 0.2%
– rank 96 : Moldova 0.2%
– rank 100 : Belgium 0.2%

However, it is certainly true that diagnosed cases of AIDS are increasing throughout the FSU. The Russian figures are almost certainly swelled by the high genuine incidence of TB. TB is known to generate large numbers of false positives for HIV tests and is one of the illnesses which is used as a part of the diagnosis of AIDS. (It is almost as simple as stating that if you have TB, you lose weight and show a tendency toward an immune deficiency then one has AIDS. At that point all the symptoms are listed as being AIDS and not the underlying and genuine illnesses. This is the real economic value of AIDS to health systems and why many health services are not unhappy to be told by UNAids that prevalence is high and rising.)

Don’t forget that HIV and AIDS are different things. HIV is a retrovirus that can be detected and AIDS is a cluster of symptoms that is usually, but not always associated with a high count of HIV in the blood.

All the above noted, a concern that we have in Estonia is that up until recently HIV has been almost totally confined to injecting drug users from the very poorest strata of society and also to have been geographically confined. Recently, for the first time ever, the number of cases of HIV/Aids diagnosed in Tallinn was the same as Narva. This may be a serious development. What I do not yet know is whether the geographical change accompanies a socio/economic change as well. If it does, then no matter what the real incidence of HIV, we do have a problem, if one accepts the hypothesis that HIV is a causaton of the symptoms called AIDS.

USAID has Ukraine as one of ?ts top-priority countries in Europe for improved tuberculosis (TB) control. Ukraine’s estimated TB case rate of 106 cases per 100,000 population is the eighth highest in Europe and Eurasia. According to the World Health Organization’s (WHO’s) Global Tuberculosis Control Report 2008, Ukraine had an estimated 49,308 TB cases in 2006, an increase of 4.6 percent from the previous year. Of these, about 44 percent were cases of sputum smear-positive (SS+) TB.

In 2005, WHO called for redoubled efforts to scale up effective TB control using DOTS (directly observed treatment, short course) throughout the European region. In November 2005, the Ministry of Health (MOH) issued an order adopting DOTS as the basis for national TB control policy. The new National TB Control Program (NTCP) for 2007–2011 now supports rapid expansion of DOTS coverage, with the goal of moving from 29 percent in the USAID-supported pilot regions in 2007 to 100 percent by 2011. Although Ukraine currently reports 100 percent DOTS coverage, the quality of DOTS services requires significant improvement in many areas; at present, only approximately 50 percent of the population has access to quality DOTS.

Intensified measures are needed to contain Ukraine’s growing TB problem, which is exacerbated by increasing cases of multidrug-resistant (MDR) TB and one of the fastest-growing HIV epidemics in the world. According to WHO, nearly 16 percent of new TB patients have MDR-TB, the third highest proportion in the world. ¹ By the beginning of 2008, extensively drug-resistant (XDR) TB was also reported in Ukraine. Both TB and HIV are concentrated in the southern and eastern oblasts (provinces) of the country, and TB-HIV co-infection is a growing challenge. Results of surveillance in 2006 in Donetsk Oblast indicate that 16 percent of TB patients in the civil sector are co-infected with HIV. Among prisoners, nearly 24 percent of TB patients are co-infected. More than 60 percent of AIDS deaths are attributable to TB. While outdated practices still exist, recent policy changes indicate a growing government commitment to improved TB treatment standards and coordination with HIV services.

Key USAID partners include PATH, WHO, the World Bank, the MOH, the F.G. Yanovsky Institute of Tuberculosis and Pulmonology of Academy of Medical Sciences of Ukraine, oblast and city authorities in the target regions, the All-Ukrainian Network of People Living with HIV/AIDS, Futures Group International, and numerous local nongovernmental organizations.

Tree Shaping


Amongst the earliest forms of tree-shaping are the living root bridges of Cherrapunji in northeast India. These bridges are made of living tree roots which are gradually trained to grow across a gap until they take root on the other side. There are examples with a span of over 100 feet, and some may be over 500 years old. They are naturally self-renewing and self-strengthening as the component roots grow thicker.

In 1516 Jean Perral painted an allegorical image of nature, “Dialogue between the Alchemist and Nature”, in which a tree shaped as chair is used to symbolise a conduit between mankind and nature The first known modern “living chair” was made by John Krubsack in 1914. Axel Erlandson started shaping trees as a hobby on his farm in Hilmar, California, in 1925, and opened a horticultural attraction called the Tree Circus in 1947.


A sycamore stool grown by Dr. Chris Cattle

Tree shaping relies on the ability of plants (trees) to be united together by approach grafting and the ability to retain a new shape when new layers of wood form to hold a desired shape.

Approach grafting is accomplished by wounding two or more parts of a tree or trees by cutting off the bark to or past the cambium layer and then binding the wounded parts together so good contact is secure while the wounded tree parts grow together.

Stems or branches are shaped and temporarily supported for a year or more, depending on the size of the design and the time frame the supports are need. During that time, the design swells with each additional layer of wood grown. Once the tree is able to support the shaping, the temporary supports can be removed.

Pruning may be required to remove unwanted branches and direct the growth into the desired shape. Pruning may also redirect stem growth. A pruning cut above a leaf or node can steer the plant. If a leaf points to the right, then a cut above that leaf will produce new growth that grows to the right side. Likewise, a cut above a leaf pointing to the left produces new growth that grows to the left.

Another technique is to grow trees in the air rather than in the ground. The roots then remain flexible and may be shaped as they grow to form art or functional structures. It is suggested that such techniques may develop into eco-architecture, which may allow the growing of large structures such as homes.

Using these methods (also used in arboriculture), items like benches, chairs, etc., can be formed from trees by shaping, merging and manipulating plant tissue.

Three approaches to tree shaping

According to US Patent No. 7,328,532, trees grown aeroponically stay “soft” and so can be subsequently shaped into a desired form.

Instant tree shaping is a form of tree shaping in which small trees 68 ft. (22.5 m) long are bent into the desired shape. The time spent shaping these trees may only take from an hour to an afternoon.

Gradual tree shaping is a form of tree shaping where seedlings or saplings 312 in. (7.630.5 cm) long are shaped while the tree is growing to form the desired shape. The design and setup are fundamental to the success of the piece.

Styles[citation needed]

There are several styles contained within the art of tree shaping. These include:

Architectural: planting and shaping trees into structures such as archways, rooms, houses, tunnels, and gazebos. There are two methods within this style: using the trees to form the structures, or using both trees and inclusions to form them.

Living Art: shaping trees with the intention that the design will continue to grow for the duration of their lifespan. This style includes abstract, symbolic, and functional designs.

Intentional Harvest: designs where the tree(s) are cut from the ground, dried and finished.

Inclusion: where an item, often inert, is positioned so the growth of the tree includes and holds the item. Examples include tabletops, stained glass, and mirrors.

Tools[citation needed]

Pruning tools utilized by a pruning and tree-shaping specialist for cutting twigs and branches

A set of bonsai tools, from left to right: leaf trimmer; rake with spatula; root hook; coir brush; concave cutter; knob cutter; wire cutter; small, medium, and large shears. Many of these are pruning tools that may also be employed to prune and develop tree-shaping projects.

A few of the tools used in tree shaping are similar to those used by a gardener, an arborist, or a horticulturist. These tools include handpruners (secateurs) and a pruning saw. Shears (pruning shears or a hedge trimmer) are used less commonly. Shears are used more often for topiary or a hedge. The tools, materials and items for growing and shaping are varied. Basically, this is whatever a tree shaper chooses for creating the design and could include wood boards, pipe, rope, wire, string, tape, etc. Even an item like a metal patio bench could be used as a pattern or mold.

Tree type

Tree shapers generally look for the mature trees that grow well in the area, are less prone to insect damage, and are less susceptible to disease. Any tree species has the potential for shaping. Each type of tree has its own quirks, but they can be understood with time and experience. Some of the trees that have been shaped include, Box elder, Sycamore, Cherry, Maple, Oak and Teak.

Time required

The time to grow and construct a tree-shaping project varies depending on the size of the trees, the species’ rate of growth, cultivation conditions, the height of the design and methods used. It is possible to perform initial grafting and bending on a project in an hour (e.g., the peace sign tree below,), removing tape or material that holds the grafting or shape in as little as a year, and following up with minimal pruning thereafter. With Pooktre’s methods (e.g., the harvested mirror below), it can take as little as one season of guiding the tree’s growth to form the design, and then longer for the tree to thicken to the desired size. Bigger designs like the chair and tree people may take 8 to 10 years to grow. Taller architectural projects (e.g., the archway by Axel Erlandson) may require 10 years or more to grow the trees tall enough to accomplish the grafting.

Different styles of tree shaping have different time requirements. When growing a tree intended for harvest and drying, there is a defined point at which the piece is finished. When growing a piece intended to stay alive, the piece is never finished until it dies.

Tree shapers

John Krubsack

John Krubsack, 1919

John Krubsack planted 32 box elder (Acer negundo) seeds in 1903. He shaped and grafted the first known living chair. Dubbed The Chair that Lived, it is the only known tree shaping that John Krubsack did. He harvested and dried the chair 11 years after planting.

Axel Erlandson

The Needle and Thread tree by Axel Erlandson

Axel Erlandson started shaping trees as a hobby on his farm in Hilmar, California, in 1925. In 1945, he opened a horticultural attraction called the Tree Circus in Scotts Valley, California. He shaped over 70 trees during his life. Erlandson’s trees appeared in the column of “Ripley’s Believe It or Not!” twelve times. Erlandson’s Telephone Booth Tree is on permanent display at the Baltimore, Maryland, American Visionary Art Museum. Erlandson’s Birch Loop tree is on permanent display at the Museum of Art History in Santa Cruz, California.

Dan Ladd

Dan Ladd started shaping trees in 1979. He has a current project where he has grafted eleven trees next to each other up a hillside to form a long banister. He also uses glass, metal and stone as inclusions for trees to grow around and hold in place.

Christopher Cattle

Dr. Christopher Cattle thought of the idea to shape trees in the late 1970s, but it was not until 1996 that he was able to start his first planting of furniture. He has grown 15 three-legged stools to completion using various species of trees. He has multiple plantings in at least four different locations in England. Besides the growing sites, he has taken part in several woodland and craft shows in England and at the Big Tent at Falkland Palace in Scotland. He also displayed his stools at the exhibit in Nagoya, Japan, for the World Expo in 2005. He uses wooden jigs for the shaping of his trees.

His stated goal is to encourage as many people as possible to grow their own furniture. He refers to his shaped trees as “grown furniture” but also calls them “grownup furniture”, as he sees it as a more environmentally mature alternative to traditional furniture.

David Nash

David Nash first began work in the early 1970s on an sh Dome tree sculpture. Nearly 30 years later, the work is now taking on the domed form that he had planned for and intended when he first began.

Richard Reames

An arborsculpture by Richard Reames entitled Peace in Cherry, depicting the CND logo

Richard Reames began his work with trees in 1992. He was inspired by the tree shaping of Axel Erlandson to begin his first experiments with shaping trees into chairs in the spring of 1993. This led him to writing and publishing his first book, How to Grow a Chair: The Art of Tree Trunk Topiary, in 1995. Reames coined the word “arborsculpture” in How to Grow a Chair and the word has since been used in media around the world.

Peter Cook and Becky Northey

A tree person in 2009, planted by Pooktre in 1998

Artists Peter Cook and Becky Northey started tree-shaping in 1987. In 1996, after nine years of experimentation without being aware of any other tree shapers, they called their work Pooktre. Pooktre’s methods involve gently guiding a tree’s growth along predetermined design pathways over long time periods. The most common tree species used is Prunus myrobalan. Pooktre artists shape trees that are harvested, dried, and finished for indoor art, as well as trees that are intended to continue growing.

This mirror was shaped by Pooktre from the roots at planting (in 1997) and shaped as it grew. Harvested in 2004 and finished in 2005, it went to the World Expo 2005 in Aichi, Japan, at the Growing Village Pavilion.

Since it first debuted in public, there has been worldwide Internet and media interest in Pooktre, It first gained widespread attention during the World Expo 2005 at the Growing Village Pavilion in Aichi, Japan, where Peter Cook and Becky Northey showed eight of their art pieces for six months, two of which were people trees. The international interest in these trees continues to grow. including being contacted by Ripley’s Believe It or Not. Pooktre supplied three photos, which Ripley Entertainment Inc later published in their yearly book series.

Pooktre practitioners claim to have created the first shaped trees grown like people. Some examples of functional artwork created in the Pooktre style include a growing garden table, a harvested coffee table, hat stands, mirrors and a gemstone neck piece.

Mr. Wu

Mr. Wu, who lives in China, has successfully grown a harvested chair. He has six more growing in his garden. He uses elm trees, which are pliant and do not break easily. He says that it takes him about five years to grow a tree chair.

Relationship to other methods


Topiary may include the manipulation of stems but is primarily the art and skill of producing shapes with leaves (foliage). By contrast, shaped trees is primarily the practice of manipulating stems and bonding trees together by grafting. Shaped trees may include some topiary effects, but topiary is not the primary feature and consideration of the practice as a whole.

Although it is possible to use grafting for topiary, its use is rare. Shaped trees include furniture and items that were constructed exclusively using plant growth and grafted plant tissue. These items can be severed from the roots or removed from the ground, no longer being living organisms, but topiary is virtually limited to live organisms (plants) with leaves.

Topiary almost always involves regular shearing and shaping of foliage, whereas shaped-tree projects can easily be formed without shearing.


Espalier is the horticultural technique of training trees through pruning and/or grafting to make formal two-dimensional, or single-plane, patterns with branches of trees or shrubs, but shaped-tree projects are not limited to a flat single plane, nor a pattern. Either technique may use species of trees that produce fruit, but espalier-trained trees are not known to be shaped into benches, mirror frames, table pedestals or woven pillars.


Pleaching is more similar to shaped trees than topiary or espalier, but pleaching is limited to flat planes and hedges, and, therefore, it is not a three-dimensional tree shaping. If a person chose to weave and graft several trees into a flat hedge, that hedge would be one individual shaped-trees project.


Bonsai is an art of growing trees in pots and containers using pruning techniques to keep the trees at a miniature size; they also use copper wire to shape the tiny branches. Bonsai avoids woven branch patterns or branches bent to resemble identifiable shapes. A bonsai project is intended to appear as if a human had not shaped it, like a representation of a miniature tree, if one could be found in the wild. Shaped trees is almost the opposite concept, because the project shapes visually “announce” that a human had shaped it.

It is possible to make a miniature shaped tree in a pot like bonsai and keep it reduced to miniature size, but if it were to resemble a pretzel, for example, that would not be the true nature of bonsai. It would just be a miniature shaped tree in a pot or container.

Alternative names

Tree shaping is also known under a variety of names.



Botanical architecture


Living art

Tree trunk shaping

Tree trunk topiary




See also

Fab Tree Hab

Gilroy Gardens


^ a b c Eco-architecture Could Produce ‘Grow Your Own’ Homes, ScienceDaily, August 21, 2008, http://www.sciencedaily.com/releases/2008/08/080821164300.htm 

^ a b c Published Patent No 7,328,532

^ “Circus Trees by Axel N Erlandson”. www.treeshapers.net. http://www.treeshapers.net/axel-n-erlandson.html. Retrieved 2010-02-09. 

^ “Living Root Bridge in Laitkynsew India”. www.india9.com. http://www.india9.com/i9show/Living-Root-Bridge-48779.htm. Retrieved 2010-02-22. 

^ “Cherrapunjee”. www.cherrapunjee.com. http://www.cherrapunjee.com/index.php?mid=66&pid=66. Retrieved 2010-02-22. 

^ Neil Kamil, Fortress of the soul: violence, metaphysics, and material life in the Huguenots’ New World, 1517-1751, Volume 2004, pp 384-385. JHU Press, 2005, ISBN 0801873908. http://books.google.co.uk/books?id=ekSkZXXjVWUC&pg=RA1-PA385&dq=jean+perreal+”Dialogue+between+the+Alchemist+and+Nature”&client=firefox-a&cd=1#v=onepage&q=jean perreal “Dialogue between the Alchemist and Nature”&f=false. Retrieved 2010-02-22. 

^ “Dwell”, Vol. 77, No. 3, page 96. Dwell, LLC, Feb 2007, ISSN 1530-5309. http://books.google.co.uk/books?id=f8YDAAAAMBAJ&pg=PA96&dq=John+Krubsack&as_brr=3&client=firefox-a&cd=2#v=onepage&q=John Krubsack&f=false. Retrieved 2010-02-22. 

^ “Circus Trees by Axel N Erlandson”. www.treeshapers.net. http://www.treeshapers.net/axel-n-erlandson.html. Retrieved 2010-02-09. 

^ Reames, Richard. Arborsculpture Solutions for a Small Planet, p. 196

^ “Arborsculpture”. May 2009. http://garden.ikeepbusy.com/chap/2/4134. Retrieved 2009-05-08. 

^ “Garden Symposium 2008”. http://www.gardencenterassociation.org/garden_symposium_2008.html. Retrieved 2009-05-08. 

^ “How to grow your stool”. http://www.grown-furniture.co.uk/how-to-grow.html. Retrieved 2009-05-08. 

^ “Living Trees, Living Art – Pooktre”. http://www.designshell.com/articles/living-trees-living-art-pooktre.html. Retrieved 2009-05-08. 

^ “Live Art” Society Interiors Magazine September 2009

^ how to grow a chair page 56 and 57

^ Arborsculpture Solutions for a small planet page 193

^ “Arborsuclputre” http://lda.ucdavis.edu/people/2008/TLink.pdf page 15

^ “Artists shape trees in Furniture and Art” Farm show june/august 2008

^ “Wisconsin historical society’s copy of Shawano Leader Newspaper in 19th October of 1922,

^ “The art of Tree shaping” Culture Newspaper 11th May 2009 by Hao Jinyao Chinese Newspaper

^ Turlock Journal p. 15, (Obituary) April 30, 1964

^ “The art of Tree shaping” Culture Newspaper 11th May 2009 by Hao Jinyao Chinese Newspaper

^ Dan Ladd’s home page

^ EXTREME NATURE: The Sculptures of Dan Ladd at Putney Library October 10, 2006.

^ “The art of Tree shaping” Culture Newspaper 11th May 2009 by Hao Jinyao Chinese Newspaper

^ Grown Furniture site

^ ‘Grown up furniture ?’ Woodland Heritage Journal Spring 2001 picture and article by Christopher Cattle (further follow up at approx 1 year intervals)

^ Art News Blog December 11, 2006

^ “How does your garden grow” August 3, 1997 Sunday Telegraph Picture & interview with Catherine Elsworth

^ “Grow-it-yourself furniture” The Futurist February 1999 Visions picture and short article by Dan Johnson

^ Plant your own furniture. Watch it grow The Independent. June 1, 1996, picture and interview with David Davies

^ “Grownup Furniture” GREEN DESIGN by Marcus Fairs published by Carlton Books – page 102.

^ Radio interviews about Grownup Furniture

BBC radio 5 live CC with David Davies. Transmitted in “the Magazine” March 1996

BBC radio Wales CC with Rebecca John. Transmitted in ‘Good morning Wales’ September 12, 1997

CBC radio 1 CC with Arthur Black. Transmitted in “Basic Black” November 6 & 13, 1999

Radio Deutsche Welle (Colne) CC with Paul Chapman. Transmitted in English language service “Science & technology” November 16, 1998

(Sky News in their general interest news syndicated to USA on November 17, 1999, with Lucy Chator and November 3, 2002, with Jonathan Samuels.)

^ “The art of Tree shaping” Culture Newspaper 11th May 2009 by Hao Jinyao Chinese Newspaper

^ David Nash’s Ash Dome

^ Hicks, Rosenfeld. Tricks with Trees, (2007) p.123, Pavilion Books, ISBN 1-86205-734-6

^ Reames, Richard. Arborsculpture Solutions for a Small Planet. pp. 150. 

^ Reames, Richard; Delbol, Barbara (1995). How to Grow a Chair: The Art of Tree Trunk Topiary. pp. 16. ISBN 0-9647280-0-1. 

^ Okenga, S. (2001). Eden on Their Minds: American Gardeners with Bold Visions. Clarkson Potter. pp. 110. ISBN 0-609-605879. 

^ Reames, Richard; Delbol, Barbara (1995). How to Grow a Chair: The Art of Tree Trunk Topiary. pp. 57. ISBN 0-9647280-0-1. 

^ Reames, Richard; Delbol, Barbara (1995). How to Grow a Chair: The Art of Tree Trunk Topiary. pp. 85. ISBN 0-9647280-0-1. 

^ Cassidy, Patti (April/May 2006). Art to Grow. Acreage Life (Canada). pp. 17. 

^ Cassidy, Patti (August, 2008) “A Truly Living Art”. Rhode Island Home, Living and Design, p. 28

^ Cassidy, Patti (January/February 2009) “Planting Your Future”, Hobby Farm Home, p. 74

^ Fore, Joshua. (Issue #20) ow to Grow a Chair. Cabinet, p. 27]

^ May, John (Spring/Summer 2005) “The Art of Arborsculpture” Tree News (UK), p. 37

^ Nestor, James (February 2007). Branching Out, Dwell p. 96]

^ ree Stories, Fantasy Trees show #103

^ ffbeat America #OB310 (First aired Dec. 4, 2006)

^ “TABURET” magazine, 2006 (Russia)

^ Queensland Smart Farmer, Oct./Nov. 2008 (Australia)

^ Farmshow Vol. 32 No. 4, 2008 (America)

^ “The art of Tree shaping” Culture Newspaper 11th May 2009 by Hao Jinyao Chinese Newspaper

^ “Live Art” Society Interiors September 2009

^ “Branching Out” Ripley’s Believe It or Not Seeing is Believing page 32 ISBN 978-1-893951-45-7

^ Reports the China Morning Business View.

^ http://www.accessmylibrary.com/article-1G1-128650642/five-year-deliveries-china.html

^ .WEIRD BUT TRUE New York Post Feb 3 2005 page 23

External links

World Tree shapers, history and links

Designs and photos of Axel N Erlandson art

History of the Tree Circus

Extreme Nature Installations, Lectures, Art and Innovation

Grownup Furniture


Plantware Technology and Art

Arborsculpture: books, tools, installations, history and links

Categories: 2005 books | Horticulture and gardening | TreesHidden categories: All articles with unsourced statements | Articles with unsourced statements from February 2010

Classification of Brain Tumor

Brain Tumor

A brain tumor — primary or secondary — can cause a variety of signs and symptoms because it can directly press on or invade brain tissue. This can damage or destroy areas responsible for sight, movement, balance, speech, hearing, memory or behavior. Brain tumor symptoms vary from patient to patient, and most of these symptoms can also be found in people who do NOT have brain tumors.

Therefore, the only sure way to tell if you have a brain tumor or not is to see your doctor and get a brain scan. The growth of abnormal cells in the tissues of the brain. Brain tumors can be benign (non-cancerous) or malignantA primary brain tumor is a group (mass) of abnormal cells that start in the brain. This article focuses on primary brain tumors in adults. Brain tumors encompass neoplasms that originate in the brain itself (primary brain tumors) or involve the brain as a metastatic site. Brain tumors (metastatic brain tumors), which are malignant, are more common. These tumors result from cancer that started elsewhere in the body and spread (metastasized) to the brain.


HISTOPATHOLOGIC CLASSIFICATION — Primary brain tumors are classified by light microscopy according to their predominant cell type and graded based upon the presence or absence of standard pathologic features. Historical attempts at developing a classification system for brain tumors date back to the 1830s. The German pathologist Rudolf Virchow first introduced the term “glioma” in 1860. Virchow was also the first to attempt a correlation of microscopic to macroscopic features of CNS tumors.

Cellular Classification-He classification of brain tumors is based on both histopathological characteristics and location in the brain. Undifferentiated neuroectodermal tumors of the cerebellum have historically been referred to as medulloblastomas, while tumors of identical histology in the pineal region would be diagnosed as pineoblastomas. The nomenclature of pediatric brain tumors is controversial and potentially confusing. Some pathologists advocate abandoning the traditional morphologically-based classifications such as medulloblastoma in favor of a terminology that relies more extensively on the phenotypic characteristics of the tumor.

Primary Brain Tumor

Astrocytomas — these tumors arise from small, star-shaped cells called astrocytes. They may grow anywhere in the brain or spinal cord. In adults, astrocytomas most often arise in the cerebrum. In children, they occur in the brain stem, the cerebrum and the cerebellum. A grade III astrocytoma is sometimes called anaplastic astrocytoma. A grade IV astrocytoma is usually called glioblastoma multiforme.

Brain stem gliomas — These tumors occur in the lowest, stem-like part of the brain. The brain stem controls many vital functions. Most brain stem gliomas are high-grade astrocytomas.

Secondary Brain Tumor

Metastatic brain tumors originate from malignant tumors located primarily in other organs. Their incidence is higher than that of primary brain tumors. The most frequent types of metastatic brain tumors originate in the lung skin (malignant melanoma, kidney (hypernephroma, breast (breast carcinoma), and colon (colon carcinoma). These tumor cells reach the brain via the blood-stream.
Some non-tumoral masses and lesions can mimic tumors of the central nervous system. These include tuberculosis of the brain, cerebral abscess (commonly in toxoplasmosis), and hamartomas

Eosinophilic Pneumonia – a Severe Atypical Form of Pulmonary Disease

Eosinophilic pneumonia is a very rare, atypical form of pneumonia that generates lung inflammation, pronounced difficulty in breathing and eosinophilic reactions at pulmonary level. Although the actual causes of eosinophilic pneumonia remain unknown, the accumulation of eosinophils inside the lungs triggered by the disease reveals the infectious character of this type of pneumonia. Eosinophils are a type of white cells that have an important role in fighting infectious agents such as bacteria.

Even though medical scientists haven’t yet identified the specific infectious organisms responsible for causing the disease, it is believed that eosinophilic pneumonia is caused by infection with atypical bacteria. This hypothesis is supported by the unusual eosinophilic response triggered by the disease at pulmonary level. Eosinophilic pneumonia is a severe type of pulmonary disease that generates pronounced impairments of the lower respiratory tract. In the absence of proper medical care, this type of pneumonia can even lead to complete respiratory failure, causing death by asphyxiation.

Due to the fact that eosinophilic pneumonia generates a wide range of physical manifestations and due to the variety of its presumptive underlying causes, the disease is also referred to as a syndrome. The unknown etiology of eosinophilic pneumonia and the scarce amount of data regarding the occurence and the progression of the disease render medical scientists unable to timely diagnose this syndrome. There is also no effective, specific cure for eosinophilic pneumonia in present. However, medical reports indicate that most patients with eosinophilic pneumonia can be recovered from the disease with existent medication treatments, prompt diagnosis and medical intervention greatly increasing patients’ chances of survival.

Recent medical reports describing the occurrence and the progression of eosinophilic pneumonia among American soldiers deployed in Iraq may also point to an endemic character of the syndrome. Epidemiologists and biologists theorize that eosinophilic pneumonia may be triggered by infectious factors characteristic to certain territorial regions. The epidemic outbreak among the U.S. military personnel recently deployed in Iraq also suggests a highly contagious nature of eosinophilic pneumonia. Medical reports also incriminate factors such as smoking and prolonged exposure to sand and dust as potential underlying causes of the syndrome.

The medical staff that recently accompanied US military personnel during a set of missions in Iraq described a rapid onset of eosinophilic pneumonia in 18 American soldiers. Although there were only 18 cases of eosinophilic pneumonia identified among 180.000 soldiers, the syndrome generated exacerbated symptoms in all affected persons. The majority of patients were men, and the highest incidence of eosinophilic pneumonia was registered among young patients, with an average age of 22.

Although the actual causes of the outbreak are still unknown, doctors established connections between smoking and the occurrence of eosinophilic pneumonia among the 18 members of military personnel. All the affected people were smokers, most of them recently starting to use tobacco. Apart from this common feature, doctors were unable to identify other potential risk factors of the disease. Strangely enough, epidemiologic tests revealed no signs of pulmonary infection, thus discriminating the implication of bacteria in triggering eosinophilic pneumonia. Despite this fact, all patients presented a pronounced eosinophilic response, most of them developing extra-pulmonary eosinophilia as well.

Two of the affected patients eventually died due to complications, while the other patients responded well to prolonged treatment with corticosteroids. Over a period of three months of treatment, very few patients still presented signs of respiratory problems. All 16 patients were completely recovered from the disease after completing the prescribed treatment. None of the patients remained with permanent impairments of the respiratory system and there were no reported cases of relapse.

You can find great content regarding pneumonia causes, pneumonia symptoms and many moreby visiting http://www.pneumonia-center.com/

Respiratory Diseases Faq

More Respiratory Diseases questions please visit : DiseasesFAQ.com

Adult-onset asthma – suggestion needed?
Last week I went to the doctor with a bad cough and a frozen time breathing – he thought I had bronchitis and prescribed a Z-pack and some hydrocodone cough syrup ($50). w days went by near no relief and tonight I finally went to the ER because I was sick of one miserable…

Hi So on June 30th my doctor switched by advair dosage from 250/50 to 100/50. Ever since then I started to feel very sick. I get flu like symptoms ( nerviousness, nasuea, hot flashes, stomach aches, and loss of appetite). My periods also become super light but I tool a pregnance…

Advanced PTB at home?
we have a household member who’s diagnosed with advanced PTB. he a moment ago had his check up recently and it revealed that its advanced Tuberculosis. it really made me annoy that they didnt let us know of the disease, i purely heard it from the healthworker (since she’s a family friend) where they have the check…

Advice for nouns from pleurisy?
I get recurrent pleurisy (I have some sort of auto immune condition) and I am fancy rather rough today. I’ve taken pain relief but I be wondering if anyone had any other tips to relieve the symptoms? – A friend of mine had it in elevated school and he laid on his side to ease…

Advice for ratification a pulmonary function exam?
Im trying to join the Air National Guards Pararescue program, but i first need to pass a pulmonary function examination scheduled tomorrow. I used to have asthma back as a child but it hasn’t artificial me at all since, i run track and am really active. Im just worried that i wont miss for…

Advice please??
I had tonsillitis two weeks ago and just finished my antibiotics (amoxycillin) on Tuesday (5 days ago). Last nice I wasn’t feeling too resourcefully and this morning I woke up with a really sore throat and I have been coughing up profoundly of phlegm. What should i do? BTW I have had tonsillitis four or five times in the…

Aerosol destruction. Does it hurt?
Also, how long does it take to actually die from it? I saw this propaganda video in subsidiary school basically (on a subconscious level) associating aerosol abuse beside death. here is the question I wondered after seeing that video that I STILL haven’t found the answer to. Every time I asked about it on a…

After a bleak chest infection i still am terribly rackly and im finding breathing really difficult?
If you are having difficulty breathing you necessitate to go to the ER. – It other takes a long time to fully recover. taken me 6 months once to fully recover and to consistency myself, but I do have asthma. If…

After i attain done smoking i get the impression dizzy…is that commonplace?
You might be pregnant. My brother was killed and on the day of his burial i have a cig and i felt dizzy, i even got sick. I found out a week later i be pregnant. Maybe that’s what’s going on. Source(s): personal experience – Because it…

After I cry I breathe funny similar to miss surrounded by my breathe,where on earth I breathe within massively in a hurry 2or3 times?
i thought it was normal i do it too – No obligation for the doctor, a lot of ppl have that after crying hard including me. Don’t verbs! 😀 – it’s hyperventilating, and yeahh sometimes it’s…

After I smoke meth and come down, I see smoke floating around me constantly. Why?
I don’t smoke that often or that much at a time. But ever since the first time coming down/once I was down, I see smoke out of the corners of my eyes, or just looking straight ahead. It’s a trip. Has this happen to anyone else?…

After I vacuum I interest a dusty smell contained by thte nouns which triggers asthma/breathing problems. Any thinking?
I don’t know if the vacuum itself is releasing dust in the air or whats going on but, everytime I start vacuuming I notice a dusty unexpected smell in the air that goes away after several hours but…if I start breathing it even…

After my lung surgery I’m have troubles near gas (burps).?
I just had surgery on my right lung after it collapsed for the second time. Now I’m having frequent urges to burp (often after meals) but its really unyielding to burp because I’m trying to swallow for some reason but even while trying to swallow I hesitate and kind of choke…

After quitting smoking did you experience any breathing problems afterwards, possibly from your lungs?
clearing themselves out? smoked a pack a day for 10 years and I also have asthma. I recently quit over a month ago and my breathing have gotten worse. I am wondering why. – withdrawels – Your lungs have become accustomed to the…

After the April 2009 flood within Houston, Texas?
Our house took on 17” of water which is horrible enough but 2-3 days later I developed a impossible cold and cough that still has not subsided. We’ve had out home fumigated for mold which began to grow two days after the dampen was vacuumed away. I still have bad drainage…

Agree/disagree the object why the personage will hold Tuberculosis is because he is poor?
personality will have tuberculosis because he/she wasn’t immunized and was exposed to the disease. an affect family of any age..poor or rich..and those individuals with weakened immune system including those with AIDS or those infected next to HIV are at increased risk.. kc7655 i think you…

Airconditioner oxygen doubt?
Actually In a window type airconditioner, we have the option to cool the outside nouns and blow it into the room, out any possibility of outside air entering the room except when the doors are opened. So at hand is no way for oxygen to get into the room while sleeping inside. Is it healthy or what is…

Albuterol cross-examine for exercise asthma?
My doctor told me to take 2 puffs of albuterol before running or playing sports, but I already did this morning at 6am for my run, but now I want to run again, would it be undisruptive to take it so much? – Within 4 hours you can have another dose Source(s): http://en.wikipedia.org/wiki/Salbutamol …

All abt physiotherapy..?
**i hv a lil confusion in selectin my course..btwn homeopathy n physiotherapy..culd u plz suggest me wt 2 take wich wud be gud.. **in case of physiotherapy is dere any problem if da physiotherapist’s mitt is small,i mean will she be able 2 treat da patient properly.. ourse u can keep assistant but beside a gud qualification regarding…

All my energy ive have asthma im singular 16 so i thought that be the casing wen i kept getting really sharp chest?
pains and i can only breathe threw my mouth but for a few years ive been really paranoid about things and i lately constantly think about death .but i watch a programme about tourettes and found out that…

All my friends are smoking and want me too… give support to??!?
all my friends, well not all but most of them smoke. or tried smoking. and here really cute.. there guys. and this one guy i like smokes. but not when he has a gf or does sports. and i told them im disappointed surrounded by them. and they say…

All of the following physical and laboratory findings are indicative of a bacterial pneumonia except:?
A. Fever n increased white blood cells D. a dry cough – D. Most people who develop pneumonia initially have symptoms of a cold which are later followed by a high fever (sometimes as high as 104 degree Fahrenheit), shaking chills, and a cough…

Allergies or chest infection?
Okay these days my eyes have been irritated, I hold been sneezing alot, my throat feels dry, and today I was wheezing a bit. I checked my temp. and its resembling 97 to 98 degrees. I am not coughing. So if its allergies then its because of the chemicals that were used to pocket away the termites…

Allopathic Vs. Homeopathic Medicine?
What is the difference between allopathic and homeopathic medicine? ed FACTS, not opinions. I’ve search it up so many times but I still don’t have a specific answer to it’s difference. If you can help, that’d be grrreat. Thanks 🙂 – Allopathy is a residence which the alternative health (sCAM brigade) use to refer to…

Always discern approaching im going to collapse?
I always feel like im going to lightheaded if i stand in the same place to long. Its ruining my liife as I dot even wanna go shopping for fearfulness of standing in queues. what could this be?? thanks within advance. – Sounds like Heart /Blood Pressure problems. You may have fluid…

Am getting this small times next to inability to breath?
I get these little times Very small ones for a second or less with close to my breath get down. this happens specially if I try to sleep. I get so depressed and terrified and I cant sleep ! am only 14 years old. am almost 15 – Maybe you…

Am I a impossible runner or is this asthma?
If I run, I have a hard time catching my breath, I feel a burning sensation contained by my chest, get very thick spit, partiality blood in my mouth, or at least a coppery taste. If I run rock-hard, I think it my breathing sounds wheezy. I hate running because it makes…

Am i artificial by second paw smoke?
my friend smokes around me for like 10mins each day, i try not breathing contained by the stuff and its hard but its been happening merely 2 weeks i have been near him, this just happens if its in the car near him and outside, am i affected by second hand smoke? -…

Am i asthmatic or do i hold a chest infection etc?
earlier on at school my friend was spraying alot of deodrant and hairspray, i be fine at first but now im home im finding my chest is really tight and im finding it a little difficult to breathe, am i asthmatic? – Believe it or not Charlotte it’s actually…

Am i bloodbath myself near plushies?
i have some repository problems, and allergies, i like having the stuffed animals I’m told to ‘acquire rid of them’ (thankfully just shove some in a box) so enjoy a cozy mat in my room, but i’m that is a terrble idea for someone beside asthma and indoor and outdoor allergies (which also is…

Causes, Symptoms, Prevention and Treatment for Common Cold

Viral infectious disease of the upper respiratory system is known as common cold by common folk.  Medical term for this disease is acute viral nasopharyngitis. Among human diseases, this is the most common and contagious disease that affects adults and its recurrence rate is average of two to four times per year. Recurrence rate can go up to twelve times in a year if it attacks school children. When weather changes from one season to another season in tropical countries, common cold will become widespread, and it usually occurs after school holidays. November to January and March to August are the two alarming periods.  Common cold in bodies can be aggravated by haze, which is released from the open burning of biomass such as paddy and wheat straws. A weakened immune system, which is mostly due to not enough sleep or rest, can do the same harm as the haze. Secondary bacterial infection of the sinuses, pneumonia and asthma is due to the untreated prolonged cases of common cold. 

Most common colds are caused by the infection of virus known as rhinovirus. Coronavirus, human parainfluenza viruses, or human respiratory syncytial virus are the other types of viruses that also can cause a common colds. Types of viruses that can cause cold can go up to 200 types and most of them are already present in the environment. A resistance is never built up against to these viruses in our body is due to the variety of these viruses and also the development of new viruses. Because of this, cold quite often recurs. Before the body’s immune system defeats the cold virus, it can infect the next person.  

Sneezing or coughing can spread virus particle through air and when a person breathes in these particles, it can cause that person catches cold. The second ways, where a person can catch cold is through person to person contact such as shake hand, hug and etc. A cold can also be spread by accidentally touching the mouth or nose with a rhinovirus contaminated hands. Nevertheless, the most threatening is sneezing because a significantly high concentration of virus can be expelled from sneezing. The falling rate of the virus cloud expelled from sneezing can last for hours in air. The virus cloud is invisible because parts of the droplet nuclei evaporating in air. Due to the evaporating of parts of the droplet nuclei and leaving much smaller and invisible droplet nuclei in the air, the virus cloud is unable to be visualized with bare eyes. Droplets from turbulent sneezing or coughing, which have been spat on any surface, can last for hours. Surface that has been contaminated by droplets through hand contact also can last for a few hours. When the virus enters the cells of the lining of the nasopharynx , which is the area between the nose and throat, it will multiply rapidly. 

One to three days is the incubation period, which is the time between becoming infected and developing symptoms. About one day before symptoms begin, that is the infectious period begins. During this time, the infected person can infect others and the infectious period will continue for the first five days of the illness. In a crowded room with the close proximity of an infected person will cause the virus spread more rapidly. That’s why children get infected easily in class-rooms or playgrounds. 

Sore, scratchy, and phlegmy throat together with congestion and runny nose, sneezing and coughing is the first indication of cold.   Side symptoms such as muscle aches, fatigue and weakness may accompany sometimes. Heavy fever or headache, which leads to extreme exhaustion is rarely caused by colds but mostly caused by influenza, a very virulent virus. Cold in severe and rare cases may accompany symptoms of conjunctivitis such as red, itchy, or watery eyes.  If infants or young children catch cold, the symptoms mentioned above may be more severe. For a sufferer who has recovered from common cold will develop immunity in his or her body to the particular virus.  However, different kind of cold virus still can easily infect this person. Generally, cold usually will end after five to seven days, but residual symptoms such as coughing and sneezing can last up to one to fourteen days depending to infected person health condition. 

When someone with a cold coughs or sneezes, the virus particles can travel up to 12 feet (3.7 meters) through the air.  Hence, to prevent ourselves from contracting a cold from this person, the best way is to avoid contact with such person and also stay far from this person. Moreover, we should not share towels or eating utensils such as glass, bottle with someone who has a cold. If you are the one who catches cold, try to practise good hygiene such as washing your hands thoroughly and frequently after blowing your nose. Besides, you should try to avoid touching your mouth and face in order that your hands will not contaminate with droplet. To prevent from transmitting the disease to other unaffected people, you should cover your nose and mouths with handkerchief when coughing or sneezing. 

However, there are medications we can take to relieve the symptoms of the cold. For the last 50 years, herbal formulation to treat common cold already available in Europe. This herbal formulation can help to ward off viral attacks and relieving the symptoms by strengthening the body’s immune system. The key components of this formulation are Herba Thujae Occidentalis (white cedar leaf herb), Radix Baptisiae Tinctoriae (wild indigo root), and two Echinacea extracts, which are Radix Echinaceae Purpureae (purple coneflower root) and Radix Echinaceae Pallidae (pale coneflower root).  Thujae and Baptisiae can stimulate our immune system, while Echinacea possesses antiviral properties. Our body immune system can be activated with the help of this unique herb combination. Activated immune system can increase its resistance to disease and viral or bacterial infections. This medication has been going through many clinical trials and 20 of them already published. Currently, this combination of herbs is the only phytomedicine, which is able to treat common cold. Two scientists in Germany, Erich Schaper and Albert Brummer, developed this formulation in 1923, which has been used  to treat millions of patients throughout the world. There is no side-effects and safe for consumption for both babies and adults.

Chronic Bronchitis Natural Treatment

Recent estimates has pegged the figure of persons suffering from chronic bronchitis more than seven million in United States alone.

Presented below are few natural treatments to alleviate chronic bronchitis and help avoid exacerbations. Just a word of advice before starting any of the natural treatments discuss with your health care provider.

Increase the Ingestion of Vitamins and Minerals

One way to effectively counter the deleterious effects of long term inflammatory response is to promote healing of the bronchi by increasing intake of vitamins A and vitamin C. research has shown doses of 5000IU vitamin A and 1000 mgs of Vitamin C as giving salubrious effects during severe episodes in individuals suffering from chronic bronchitis. Another group of researchers have found a positive effect between cayenne pepper and bronchitis.


Use of different aromatic oils possessing eucalyptus extracts and oils as a base, is also said to give desired effects in individuals suffering from chronic bronchitis, the basis of this therapy is the beneficial effect of steam and fragrant oils which cause widening of the bronchi as a result of heat which also affects the thickness of cough and after such a session it can be easily cleared out.


Like many other lung conditions there has been found a correlation between bronchitis and foodstuffs and there are some foods that are a strict no no, at the very top of the list are milk products. dietary items labeled fit for consumption include of cayenne pepper and its supplements, Vitamins specifically Vitamin A, C, E for their anti free radical and immunity properties.


One of themethods to achieverespite from chronic troubles is to use herbs, naturally occurring herbs and plants form the basis of ancient Indian and Chinese medicinal therapies. Herbs that can be used are easy to procure and include thyme, eucalyptus, ginko, echinacea tincture to name a few. Mix each herb with hot water drain it and drink the water for beneficial effects, steam inhalations with these herbs can also helpmove tenacious mucus plugs.

Exercises and breathing

Increasing numbers of individuals suffering from chronic bronchitis are finding relief by adopting some or different form of exercise protocols. This technique helps by improving ventilation perfusion ratio by expanding the chest wall as a result of enhanced physical activity levels even the Pa 02 indicators show a marked improvement. Those suffering can choose from a number of breathing exercises ranging from protocols as simple as running and correct stretching to complex methods like yogic asnas and tai chi. A recent survey found reduced use of bronchodilators in those following regular exercise protocols.

Shoulder Injury and Workers’ Compensation Transitional Duty

How do shoulder injuries affect transitional duty?
Recently Dr. Dave was asked to provide some information about shoulder injuries, a fairly common workplace injury, and how this type of injury may affect transitional duty.
 Dr. Dave says: The shoulder has a larger range of motion than any other joint in the body and as such, is highly susceptible to instability and injury. (There are even wall paintings in Egyptian tombs showing accurate drawings of how to reduce a dislocated shoulder.) One of the most common shoulder injuries we see in the workplace is the rotator cuff tear. The rotator cuff is a group of four muscles attached to the shoulder blade and the upper humerus. Tears in the tendons are called rotator cuff tears.
 The first key point is there is a typical sequence of injuries leading up to a tear. Tendonitis is the mildest form. This can progress to bursitis, which can ultimately lead to a tear, which often requires surgery. This happens more easily with age and degenerative arthritis, often by bone spurs rubbing on the tendons.
The second key point is recognizing rehabilitating a shoulder after surgery takes considerably longer than most people realize. Rehabilitation may often take up to six months and sometimes longer before normal function is regained. Because this is so, don’t be too impatient and order an IME every four or five weeks or assume a worker is not trying hard enough to get better because normal function does not return as quickly as everyone would like.
So, find a transitional duty assignment to accommodate the injured employee while recuperation takes place and remember, most likely it will be a little longer than you expected.
Workers Comp KIt® (www.ReduceYourWorkersComp.com) is a web-based online Assessment, Benchmarking and Cost Containment system for employers. It provides all the materials needed to reduce your costs significantly in 85% less time than if you designed a program from scratch.
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.

 ©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com

David Dubin, MD. is an emergency room physician who serves as a medical advisor for several companies. Formerly president of Aon Medical Consultants, he has been helping employers and insurance companies develop innovative cost containment programs and reduce workers comp costs for over 20 years. He can be reached at: MD@WorkersCompKit.com or 860-553-6604 

Car Accident Shoulder Injuries – What You Must Know

Shoulder injuries in a car accident are common. They are caused mostly by the jerking movements that occur in an accident and may be further aggravated by seat belt shoulder straps. Shoulder injuries may also be related to neck injuries. Understanding more about shoulder injuries will allow you to recognize them quickly and seek treatment to prevent further discomfort and problems.

Causes of Shoulder Injuries

In a car accident shoulder injuries can be caused in three main ways. The first is as a result of a neck injury. A neck injury can radiate pain down the arm due to nerves being injured. The injury to the neck will then cause problems in the shoulder.

The next cause is direct damage to the shoulder from impact during the crash. This causes immediate pain and is easily recognized.

The last cause is from whiplash. Whiplash is usually associated with the neck, but it can cause pain in the shoulders as well. It may not cause pain right away after the crash, but may develop over time.


Shoulder injuries are usually found through an x-ray or and MRI. Most shoulder injuries are not severe and merely require rest and pain medication for proper healing. If the injuries are more severe then surgery or extensive therapy may be needed.

The earlier treatment is sought for a shoulder injury, the better. Early recognition of a shoulder injury and early treatment help to insure the problem is cared for correctly and prevents further damage from occurring. You should always make sure that any medical care you receive is documented and that you keep a copy for your records.

What to do After an Accident

Since some shoulder injuries may not develop symptoms right away it is always smart to have a complete medical check following the accident. If you fail to get checked out and have your medical attention documented then you may not be able to recover damages later on if symptoms do appear.

When you are in an accident it is smart to exchange information with the other driver. You should get their name, address, telephone, number, insurance information and license information. Make sure that you do not speak with them about the actual accident. You should only speak with the police to give your statement. You may also wish to gather information from witnesses.

You want to document everything about the accident so that any shoulder injury found in the future that can be linked to the accident can be claimed. If you are careful in how you handle an accident you should be able to make a claim against the other person for your shoulder injury.

Shoulder injuries from a car accident are usually not too severe, but they are severe enough to make you lose time at work and to rack up medical bills that can be costly. It is important that if you suffer from a shoulder injury resulting from a car accident that you report it to the insurance and make a claim so you can recover your costs.

How to Tell If Your Toe is Sprained or Fractured

It can be difficult to tell the difference between a broken toe and a sprained toe.  Sometimes you will hear the bone break, or you will see that the toe has been knocked out of its socket (i.e., dislocated).  These signs and symptoms usually point to a traumatic toe fracture and not a sprain.  But stress fractures, which are not usually caused by a single traumatic event, can be harder to distinguish.  

Both strains and stress fractures result in swelling and pain in the injured area.  Both are often not diagnosed by a doctor because the pain comes and goes, and the injured person is able to walk and continue with his usual daily activity.  However, this mobility can be misleading.  Untreated sprains or stress fractures on the toes can lead to chronic foot pain, deformity and arthritis as well as ankle, knee and hip pain.  For example, the Jones fracture (a special type of fracture that occurs at the base of the fifth metatarsal, or the little toe) is often misdiagnosed as a sprained ankle.  But treating a Jones fracture as a sprained ankle can lead to serious complications in the future.

In order to properly distinguish a sprained toe from a fractured toe, it is necessary to visit your doctor.  Stress fractures often require x-rays to arrive at a confident diagnosis (this kind of “hairline” fracture shows up as a faint line on the metatarsal bone in the x-ray).  Another distinguishing factor is the localization of the pain.  Both traumatic and stress fractures most often result in what doctors refer to as “pinpoint” pain.  That is the pain occurs exactly at the point of the fracture.  Sprains, on the other hand, result in more general pain and swelling in the affected region.  

Toe fractures and sprains are often treated by icing the injury, wearing comfortable shoes that protect the toes and, most importantly, resting the foot.  Fractures (particularly traumatic fractures) are often also treated by splinting the toe in order to keep it immobile.  Sometimes the injured toe is taped to toe next door also in an effort to stabilize the injured toe.  This treatment is referred to as “buddy taping.”  A stiff-soled shoe also can be used as a sort of splinting device.  In more serious cases, surgery may be necessary.  All of these treatments are, of course, subject matter to be discussed with your general practitioner or podiatrist.