Tuberculosis—How Do You Get It?

Let us suppose for discussion purposes that a middle-aged lady comes to the physician’s office for her annual physical exam.  She has been feeling well and essentially has no physical complaints.  Her physical exam is within normal limits.  Because she has been doing volunteer work at the homless center the physician recommends that she have a T.B. skin test.  Either a TB tine test or a PPD (Purified protein derivative) skin test is administered.  In both rest a small amount of TB protein is injected into the subcutaneous layer of the skin.  In order to read it, the patient must return in 72 hours.  It cannot be read reliably prior to that time duration.  The physician evaluates the skin at the injection site.  He is not just looking for redness alone, but for an elevating reaction that feels sort of like a coin in size of 1 cm or larger under the skin. If it is there, the presumption is that the patient has inhaled some Tuberculosis since her last negative skin test.  The physician may order a gamma interferon assay blood test because it is much more accurate and can help sort out a false-positive skin test.  Now, it’s time to really intensify the history review.  Does she have an unusual cough, and if so, has there been any blood in her sputum?  Has she had fevers, felt hot at unusual times, or had nightsweat? Has she lost any weight without intending to do so? Has she felt fatigued, had difficulty breathing, had chest pain or wheezing? This is very important information. Finally, the doctor orders a chest x-ray and looks for any evidence of active disease.

 At this point there are three possibilities. The patient may have had a false-positive skin test. The gamma interferon assay blood test would reiterate this fact. The second possibility is that the patient inhaled T.B. germs which have attacked her body defenses, and forced into a quiet and dormant form for decades waiting for the chance to overwhelm the body defenses. This is called latent infection. The germs can persist in their dormant form for decades waiting for the chance to overwhelm the body defenses. The patient could have active disease, as evidenced by an abnormal chest x-ray and sputum positive for germs on microscopic exam or by culturing the sputum for several weeks. Now the physician must weigh all the facts at hand. Does the patient have latent or active disease? If all findings suggest dormant disease, the patient is placed on isoniazid (INH) antibiotics for one year. The patient must come in monthly for blood tests to make sure her liver is not being adversely affected. If she has active infection she is placed on four drug therapy including INH, rifampin, pyrazinamide, and ethambutol. This is continued for at least two months until the cultures come back. She is usually non-infectious after two months of this therapy, and medications can be deleted or added according to the culture results. The treatment should bring resolution of the infection in six to nine months but sometimes as long as 2 years. This latter situation would, by law, require a report to the local Health Department so they could test all contacts and ensure resolution of the spread of disease.

The problem with T.B. therapy is that patients, world-wide, do not take their medicines as prescribed. Sometimes they don’t feel bad anymore and just stop taking them. In some places the drugs are expensive and are stopped for that reason. Whatever the cases, if the drugs are stopped too soon, the bacteria can rebound with a vengeance. It can become resistant to drugs, and in the extreme case, they become resistant to all the drugs, usually with fatal consequences. The drug resistant bacteria may be passed along to others. The infection is spread by the micro-droplets in a cough or sneeze. Each droplet can contain enormous number of the bacteria. It is usually carried into lungs. Usually the lower part of the lower lobe is first infected and then it moves to the lower part of the upper lobe. It sets up in the air sacs called alveoli and enters cells called macrophages. The body sends many types of defensive cells to combat it, and these may bring about a walling off of the infection into its dormant phase. If this doesn’t happen the infection can grow into abscesses in the lung or spread to other organs by way of the bloodstream.

The developed countries of the world become pretty comfortable with tuberculosis during the 80’s and 90’s. Gwinnett County, Georgia in the last 5 years  has dramatically increased its T.B. population. It was generally thought of as a disease of developing countries, you know, “over there.” No new drugs came on the market and the resistance problem began to grow. Now, with the developing of “globalization”, anything which happens in any part of the world is a concern to us all. Travel into and out of endemic areas is increasing in frequency. A lot of infection is associated with the arrival of immigrant populations. The other phenomenon is the development of H.I.V., in which infection can be more severe, more drug-resistant, and require more intensive plans of treatment.

Face it: Tuberculosis is out there. Eight million people world-wide become sick each year with infection.  Fourteen million have active disease at any given time. Over a million die with it every year. Cases in developed countries are increasing due to H.I.V., immunosuppressant drugs, and drug abuse. Many things increase the chances of infection like silicosis, cigarette smoking, and nutritional deficiencies such as inadequate vitamins B12 or D. It is seen with increased frequency with the homeless, in infants and the elderly, or with people who live in crowded unsanitary conditions. Remember our patient who volunteered at the homeless center: The more you are around people with the disease, the more likely you are to become infected.

A lot of research is going into vaccines, possibly including one with intranasal dosing. There are new antibiotics in trials right now for multi-resistant strains. Research is being directed toward increasingly accurate and inexpensive blood tests for dormant or active disease. International efforts are underway to bring effective treatment to the ill in developing countries. We can increase our personal awareness and knowledge about this infection. We can make skin or blood testing a part of regular physical exams. We can support causes and organizations whose goal it is to eradicate tuberculosis from the planet. We can practice the courtesies of hygiene to prevent the spread of infectious diseases to other people. We can identify segments of our population most in need of infection surveillance. By research, political commitment, and dedication to facing this human condition, we can move toward the day that we are making progress in the prevention and treatment of this horrible disease.

How to Make Hair Grow Faster – FAQs

Ladies and Gentleman, this article is relevant to both of you, so have a quick read. Are you having problems with thinning hair? Do you not have as much self confidence as a few years ago? Well why dont you get off your backside and take some action? Within this article I will answer a few of the most common questions on how to make hair grow faster. After all, its a pretty widely discussed topic, with many unanswered questions.


1. Do the so called ‘experts’ know what they are talking about? – The answer is of course yes. Some of the methods they are using are revolutionary. But remember, all that research, expensive equipment costs and advertising has to be paid by someone. And it will be the consumer. The other thing you have to remember is that its not in these guys best interest to sell you a cheap product which works. They will want to sell you an expensive product which works, most likely with ongoing payments similar to Rogaine!

2. What should I do with Split Ends? – This mostly applies to women (and men with thinning long hair). These need to be removed, and the hair trimmed as much as possible within the first few weeks. The split ends will run all the way down to budding hair follicles and inhibit new growth. This will be your first step to help make hair grow faster.

3. I have heard of Mira Hair Oil, what is it, and how can it help? – Mira hair oil contains 15 herbs, two of which are Jaswand (Hibiscus) extract and fenugreek extract. These two alone have been proven to have very successful results. The oil will help banish split ends, protect and restore damaged hair and promote fast hair growth by nourishing you hair and scalp, just to name a few! Its a miracle oil to be honest. Very popular in this day and age.

4. What about diet and exercise? – Its a bit of a no brainer really. Of course a healthy diet and frequent exercise will help! Plus you will feel much better about yourself physically and mentally. Your diet will need to consist of plenty of keratinized protein, whilst popping an amino acid capsule each day will also help make hair grow faster.

5. I have heard some of the expensive products contain chemicals, is that true? – Due to the fact there is a massive demand for people wanting to to make hair grow fast, there has been a huge influx of prescription type drugs available to the average Joe Bloggs. Most use pretty harsh chemical to clean the scalp, which in turn helps promote blood circulation and hair growth. Personally, I think its a much better idea to use natural products to do the same thing, even if it takes a touch longer. Less risk of something going wrong and causing more harm than good!

6. What about Money back guarantees? I would make sure (if you are purchasing a product or ebook) that a full moneyback guarantee is available. If an eBook confirm that the product is backed by Clickbank. They will chase money if there is a dispute, and wont promote ‘rip off’ merchants.

People, there you have it. Six FAQs which will hopefully help you on your way. But honestly, they are only scratching the surface.

Spinal Cord Tumors – Information on Spinal Cord Tumors

A spinal cord tumor is a benign or cancerous growth in the spinal cord, between the membranes covering the spinal cord, or in the spinal canal. A tumor in this location can compress the spinal cord or its nerve roots; therefore, even a noncancerous growth can be disabling unless properly treated. Spinal cord parenchyma consists of both gray (neurons and supporting glial cells) and white matter (axonal) and tracts that transmit impulses between the brain and body. These tracts, or circuits, control posture, movement, sensation, and autonomic system function, including bowel and bladder and sexual function.

Spinal cord tumors are abnormal growths of tissue found inside the skull or the bony spinal column, which are the primary components of the central nervous system (CNS). Benign tumors are noncancerous, and malignant tumors are cancerous. The CNS is housed within rigid, bony quarters (i.e., the skull and spinal column), so any abnormal growth, whether benign or malignant, can place pressure on sensitive tissues and impair function. Tumors that originate in the brain or spinal cord are called primary tumors. Most primary tumors are caused by out-of-control growth among cells that surround and support neurons.

Spinal cord tumors – and most cancers – remain a mystery. Scientists do not know exactly why and how cells in the nervous system or elsewhere in the body lose their normal identity as nerve, blood, skin, or other cell types and grow uncontrollably. Research scientists are looking for clues to this process with the goals of learning why and how cancer begins and developing new tools to stop it. Some of the possible causes under investigation include viruses, defective genes, and chemicals.

Spinal cord tumors are much less common than brain tumors. Spinal cord tumors may be primary or secondary. Primary spinal cord tumors originate in the cells within or next to the spinal cord. Only about 10% of primary spinal cord tumors originate in the cells within the spinal cord. The rest originate in cells next to the spinal cord. For example, some tumors develop on spinal nerve roots—the parts of spinal nerves that emerge from the spinal cord (see Biology of the Nervous System: How the Spine Is Organized). Primary spinal cord tumors may be cancerous or no cancerous.

Most spinal cord cancers are metastatic or secondary cancers, meaning that they arise from cancers that have spread to the spinal cord. Cancers that may spread to the spine include lung, breast, prostate, head and neck, gynecologic, gastrointestinal, thyroid, melanoma, renal cell carcinoma and others.

Spinal cord tumors are abnormal growths of tissue found in or near the spinal cord. Because the spinal cord is housed within a rigid, bony structure (the spinal column), any abnormal growth can exert pressure on sensitive tissues and impair function. Also, any tumor located near sensitive spinal cord nerves can cause pain and weakness. Spinal cord tumors affect people of all ages, but are most commonly found in young to middle-aged adults.

Structurally, the spinal cord is a double-layered tube: The butterfly-shaped inner layer (gray matter) contains nerve cells, supporting cells called glia and blood vessels. The outer layer is primarily white matter — nerve fibers (axons) that relay sensory information such as pain and temperature from your body to your brain and conduct motor impulses from your brain to your muscles, organs and glands. The axons are bundled into 31 pairs of spinal nerves, with one sensory nerve root and one motor nerve root in each pair. The paired nerves extend out from the spinal cord between each vertebra.

Pneumonia and its management

Pneumonia (pronounced: noo-mow-nyuh) is an infection of the lungs. When someone has pneumonia, lung tissue can fill with pus and other fluid, which makes it difficult for oxygen in the lung’s air sacs to reach the bloodstream. With pneumonia, a person may have difficulty breathing and have a cough and fever; occasionally, chest or abdominal pain and vomiting are symptoms, too.

Pneumonia is commonly caused by viruses, such as the influenza virus (flu) and adenovirus. Influenza H1N1 (swine flu) can also become a significant cause of pneumonia. Other viruses, such as respiratory syncytial virus (RSV), are common causes of pneumonia in young children and infants. Bacteria such asStreptococcus pneumoniae can cause pneumonia, too. People with bacterial pneumonia are usually sicker than those with viral pneumonia, but can be effectively treated with antibiotic medications.

You may have heard the terms “double pneumonia” or “walking pneumonia.” Double pneumonia simply means that the infection is in both lungs. It’s common for pneumonia to affect both lungs, so don’t worry if your doctor says this is what you have — it doesn’t mean you’re twice as sick.

Walking pneumonia refers to pneumonia that is mild enough that you may not even know you have it. Walking pneumonia, which has also been called atypical pneumonia because it’s different from the typical bacterial pneumonia, is common in teens and is often caused by a tiny microorganism known as Mycoplasma pneumoniae. Like the typical bacterial pneumonia, walking pneumonia also can be treated with antibiotics.

Signs and Symptoms

There are many symptoms of pneumonia, and some of them, like a cough or a sore throat, are associated with many other common infections. Often, people get pneumonia after they’ve had an upper respiratory tract infection like a cold.

Symptoms of pneumonia can include:

  • fever
  • chills
  • cough
  • unusually rapid breathing
  • wheezing
  • difficulty breathing
  • chest or abdominal pain
  • loss of appetite
  • exhaustion
  • vomiting

The symptoms of pneumonia vary from person to person, and few people get all of them.

When pneumonia is caused by bacteria, the person tends to become sick quickly and develops a high fever and has difficulty breathing. When it’s caused by a virus, symptoms generally appear more gradually and may be less severe.

A person’s symptoms can help the doctor identify the type of pneumonia. Mycoplasma pneumoniae, for example, often causes headaches and sore throats in addition to the symptoms listed above.

How Can We Prevent Pneumonia?

The routine vaccinations that most people receive as kids help prevent certain types of pneumonia and other infections. If you have a chronic illness, such as sickle cell disease, you may have received additional vaccinations and disease-preventing antibiotics to help prevent pneumonia and other infections caused by bacteria. People who have diseases that affect their immune system (like diabetes, HIV infection, or cancer), are 65 or older, or are in other high-risk groups should receive a pneumococcal vaccination.

People with immune system problems also may receive antibiotics to prevent pneumonia that can be caused by organisms they’re especially susceptible to. In some cases, antiviral medication might be used to prevent viral pneumonia or to lessen its effects.

Flu vaccination is also recommended since pneumonia often occurs as a complication of the flu. In addition to the standard flu vaccine, the newer H1N1 (swine flu) vaccine is also recommended. You can contact your doctor’s office to see when these vaccines are available.

Because pneumonia is often caused by contagious germs, a good way to prevent it is to keep your distance from anyone you know who has pneumonia or other respiratory infections. Use separate drinking glasses and eating utensils; wash your hands frequently with warm, soapy water; and avoid touching used tissues and paper towels.

You also can stay strong and help avoid some of the illnesses that might lead to pneumonia by eating as healthily as possible, getting a minimum of 8 to 10 hours of sleep a night, and avoiding smoking.

How Is Pneumonia Treated?

If a doctor suspects pneumonia, he or she will perform a physical exam and might order a chest X-ray and blood tests. People with bacterial or atypical pneumonia will probably be given antibiotics to take at home. A doctor also will recommend getting lots of rest and drinking plenty of fluids.

Some people with pneumonia need to be hospitalized to get better — usually babies, young kids, and people older than 65. However, hospital care may be needed for a teen who:

  • already has immune system problems
  • has cystic fibrosis
  • is dangerously dehydrated or is vomiting a lot and can’t keep fluids and medicine down
  • has had pneumonia frequently
  • has skin that’s blue or pale in color, which reflects a lack of oxygen

When pneumonia patients are hospitalized, treatment might include intravenous (IV) antibiotics (delivered through a needle inserted into a vein) and respiratory therapy (breathing treatments).

Antiviral medications approved for adults and teens can reduce the severity of flu infections if taken in the first 1 to 2 days after symptoms begin. They’re usually prescribed for teens who have certain underlying illnesses such as asthma or who have pneumonia or breathing difficulty. If you have been exposed to either type of influenza and you begin to develop symptoms of pneumonia, call a doctor.

How Can We Feel Better?

If your doctor has prescribed medicine, be sure to follow the directions carefully.

You may feel better in a room with a humidifier, which increases the moisture in the air and soothes irritated lungs. Make sure you drink plenty of fluids, especially if you have a fever. If you have a fever and feel uncomfortable, ask the doctor whether you can take over-the-counter medicine such as acetaminophen or ibuprofen to bring it down. But don’t take any medicine without checking first with your doctor — a cough suppressant, for example, may not allow your lungs to clear themselves of mucus.

And finally, be sure to rest. This is a good time to sleep, watch TV, read, and lay low.

Constant Back Pain Under Left Rib Cage

Back pain under the left rib cage is a dilemma for all patients suffering from it. Any constant pain is viewed by doctors as a very serious disorder or disease and requires immediate attention and cure. The rib cage is a formation that is composed by the thoracic vertebrae and ribs, sternum-breastbone, and the coastal cartilages that links the ribs to the sternum. The term cage is defined as a structure to house animals. The rib cage is a similar structure which houses and also protects the animal heart and lungs, also known as a thoracic cage in medical terms.

In the chest-thorax region, nerves spring out from the spine and divide into two parts. The first part goes to just under the skin and further sends fibers to the surface and also travels around half way around the chest. This is a probable reason for the feeling of pain in the back to the side of the chest. The second part travels to the bottom of the rib around the sternum bone, and also surfaces to the skin and then goes back towards the side on the same level as the first nerve. Rib cage pain can be any pain or discomfort in the area of the ribs.

A fractured or cracked rib can cause rib cage pain, costochondritis, inflammation of the cartilage near the breastbone, osteoporosis and pleurisy. If you do encounter such ribcage you must first get the area x-rayed so as to determine if your ribs are fractured. In the event of a fractured rib an immediate surgery should be scheduled. If you’ve been suffering this pain for a long period of time (3 months or more) it’s necessary to go for an MRI or CT scan and consult a professional to check for nerve damage, tumor or cancer.

Pain due to inflammation of cartilage between ribs and breastbone can radiate around the back and down the arms. Such type of pain could be enormous enough to give you a syndrome that you are having a heart attack or lung problems. Though this condition is benign but it is very painful and uncomfortable during the period it lasts.

There are instances when constant back pain under left rib cage makes you visit a specialist in gastroenterology since the problem starts with your stomach. Your stomach feels empty and you feel that a big growl wants to come out, nothing that you end to eat makes it better, you often get heart burn and a pain in the left side underneath rib cage. Routine blood pathology should be conducted to eliminate any infection of the intestine or pancreas. Digestive, gastro and bowel disorders must be ruled out by seeking medical advice. Such symptoms might make you start wondering that it is due to twisted bowel, you might have to go for a check up of colon.

Constant pain under the left rib cage is very uncomfortable for pregnant women especially those in advanced stages of pregnancy. They experience extreme pain near the area where the ribcage and breast meet. The pain causes extreme trauma and sometimes makes it difficult to sleep.

Say goodbye to your problems of thoracic back pain. Download your NO COST report on how to rid your back pain now! Also discover if lower back pain and high heels can be a reason for back pain.

What is Pneumonia and What are the Main Causes of Pneumonia?


Pneumonia is an inflammation of the lungs most often caused by infection with bacteria or a virus. Pneumonia can make it hard to breathe because the lungs have to work harder to get enough oxygen into the bloodstream.

People with pneumonia usually complain of coughing, fever, shortness of breath, and chest pain.

Your body’s immune system usually keeps bacteria from infecting your lungs. In bacterial pneumonia, bacteria reproduce in your lungs, while your body tries to fight off the infection. This response to bacterial invaders is called inflammation.

When the inflammation occurs in the alveoli (microscopic air sacs in the lungs), they fill with fluid. Your lungs become less elastic and cannot take oxygen into the blood or remove carbon dioxide from the blood as efficiently as usual.When the alveoli don’t work efficiently, your lungs have to work harder to satisfy your body’s need for oxygen. This causes the feeling of being short of breath, which is one of the most common symptoms of pneumonia. Inflammation causes many of the other symptoms, including fever and chest pain.

What are the main types of pneumonia?

Pneumonia is often divided into two main categories (‘community-acquired pneumonia’ and ‘hospital-acquired pneumonia’) depending on whether you were infected while living at home (in the community) or while staying in hospital.

What are the main causes of pneumonia?

There are about 30 different causes of pneumonia. However, they all fall into one of these categories:

Infective pneumonia: Inflammation and infection of the lungs and bronchial tubes that occurs when a bacteria (bacterial pneumonia) or virus (viral pneumonia) gets into the lungs and starts to reproduce.

Aspiration pneumonia: An inflammation of the lungs and bronchial tubes caused by inhaling vomit, mucous, or other bodily fluids. Aspiration pneumonia can also be caused by inhaling certain chemicals.

White blood cells (leukocytes), a key part of your immune system, begin to attack the invading organisms. The accumulating pathogens, white cells and immune proteins cause the air sacs to become inflamed and filled with fluid, leading to the difficult breathing that characterizes many types of pneumonia. If both lungs are involved, it’s called double pneumonia.

Viruses, bacteria, or (in rare cases) parasites or other organisms cause pneumonia.

In most cases, the specific organism (such as bacteria or virus) cannot be identified even with testing. When an organism is identified, it is usually the bacteria Streptococcus pneumoniae.

Other bacteria that may cause pneumonia include Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila (the bacteria that cause Legionnaires’ disease), Staphylococcus aureus, Moraxella catarrhalis, Streptococcus pyogenes, Neisseria meningitidis, or Klebsiella pneumoniae. Mycoplasma pneumonia is sometimes mild and called walking pneumonia.

Some other reasons of causing pneumonia:

Viral infection
Bacterial infection:
Streptococcus pneumonia
Staphylococcus aureus
Chlamydia pneumoniae
Mycoplasma pneumoniae
Pneumocystis carinii
Toxoplasma gondii
Fungal infection
Lung cancer- can cause recurrent pneumonia
AIDS- can lead to recurring lung infections
hemophilus influenza
mycoplasma pneumonia
staphyloccus aureus
streptococcus pneumonia
pneumocystis carinii
acid fast bacillus

Bronchitis Treatment – Cure yourself at Home

If you keep taking antibiotics for Bronchitis you find that after awhile they become less affective. In normal medical practice you don’t have much option as that hacking cough tries to remove the infected phlegm that the infection causes.

Some people are unlucky enough to keep catching the Bronchitis infection and will end up at the Doctors time and time again every year. Paying for prescription like this can put a strain on your budget, yet there is a natural bronchitis treatment available you can use safely at home.

This is all down to one man who being a smoker kept getting bronchitis himself, and as he was a medical researcher he began to look into what caused bronchitis in the first place. What he found was that he needed to get rid of the germs that caused the infection in the first place, and using himself as a guinea pig he eventually came up with the answer.

Each time he caught bronchitis he would try out his new bronchitis treatment on himself until the point he told several of his friends about his new bronchitis cure. At first they laughed at him but agreed to try his new cure next time they became infected as they were also prone to constant attacks themselves.

As it happens the new bronchitis treatment worked, and since that day thousands of people have tried this new cure and the testimonials are sound proof that it works.

If you are a smoker you are a prime target to get an infection and by using this natural cure you will find that you no longer need those antibiotics from your Doctor.

If your like me and truly believe that Alternative medicine is in a lot of cases better than some of the drugs we are given from the Doctors you find that this one comes highly recommended.

Please note that I am not a Doctor or am I in any way qualified to give opinion in medical matters, and that I only write on what I call common sense and that the patient should make their own mind up with regard to these things. (If you’ve ever had side affects from drugs prescribed to you I think you will understand what I mean.)

Shoulder Models Learning How Your Shoulder Functions

The shoulder is one of the most complex parts of the human anatomy. Though basically nothing more than a ball and socket joint created by the intersection of the humerus (upper arm bone) and scapula (shoulder blade), evolution has transformed the human shoulder into an intricate fulcrum and lever that allows us to do everything from swing a baseball bat to paint a wall. This evolution, which began when mankind first stood on two legs, allows the shoulder to move in all planes and also rotate simultaneously. In the animal world, only primates share this amazing ability.

Four muscles hold the shoulder together and support these actions. Together they are called the rotator cuff. Additional muscles like the pectoralis, deltoids and trapezius surround the shoulder to provide additional strength, stability and motion. The shoulder joint itself contains a bursa, or fluid-filled sac that reduces friction between the moving parts. If not for the bursa, the shoulder would wear out before we were thirty!

Even then, stressful activities involving repetitive motion – like swimming, tennis, pitching, batting and weight lifting – can cause significant shoulder injuries, even among the young and fit. As we age, even simple tasks like painting, hanging curtains or gardening can cause problems. In 2003, approximately one in every twenty adults went to a doctor’s office or a hospital emergency room for shoulder injuries ranging from a rotator cuff injury, which can cause permanent loss of range of motion, to a dislocated shoulder, which can become chronic.

Orthopedic surgeons, whose job it is to repair these injuries, use anatomical models to explain shoulder-related problems to their patients. One of the simplest yet best teaching models is the functional joint model, which shows both the anatomy and the mechanics of the shoulder. Life-sized and fully flexible, this model consists of the shoulder blade, the collar bone, the upper portion of the humerus and all attendant ligaments. It can be used to demonstrate the full range of motion of which the shoulder joint is capable, including abduction, adduction, anteversion and retroversion.

An even more detailed model, showing the upper humerus, clavicle and scapula also displays the musculature of the rotator cuff and the origin (red) and attachment points (blue) of the large shoulder muscles. The muscles – subscapularis, supraspinatus, infraspinatus and teres minor – can be detached for more detailed explanation, and, once detached, all the movements of the shoulder joint mentioned in the above paragraph can be fully demonstrated.

The most complex model has an exclusive, removable ligament system which allows physicians and surgeons to display each bone, ligament and cartilaginous structure of the shoulder. The ligaments, made of a durable, elastic polymer, provide years of trouble-free demonstration, and the entire model comes on a removable stand.

Being able to use anatomical models to demonstrate the amazing ability of the shoulder to move in 360 degrees of rotation through all planes of the body is a boon to orthopedists, physicians, surgeons, teaching professionals and sports medicine practitioners. The latter, in particular, will find these models an endless source of instruction, and caution, to their teams as players get larger, contact sports more dangerous, and the costs of injuries more unaffordable, both in terms of money and time lost.

Discover An Effective Way to Deal With Chronic Kneecap Dislocation – Brace Yourself

How is your patella holding up?

Do you have problems with it being unstable?

Chronic knee dislocation is a term often used to describe a dislocation or displacement of the knee cap. It is not equal to a traumatic dislocation, which is a very serious matter, usually due to a trauma to the knee. With a traumatic knee dislocation, the upper and lower leg bones are separated at the knee, and significant damage is usually sustained to the structures both in and around the knee joint (i.e. torn ligaments, vascular injury, etc.). A traumatic dislocation is extremely painful, generally requires immediate medical attention, and often requires surgery to repair the damage to the joint. If you feel like you have had a traumatic knee dislocation, there is no doubt that you should speak with your physician right away. A chronic knee dislocation, on the other hand, is also quite painful, but in many instances, can be treated more conservatively.

With chronic knee dislocation, the knee cap (otherwise called the patella) slips out of place and generally causes irritation, inflammation and a sensation that the knee is weak or “giving out”. Basically, the triangular bone we know as the kneecap is designed to move smoothly over the top of the femur (upper leg bone), staying within a certain groove which nature designed for that purpose. When chronic knee cap dislocation occurs, the cap strays outside of that groove, adversely affecting the other structures (i.e. muscles, tendons, ligaments, etc.) in and around the knee. As a result, the knee does not bend as fluidly, and can feel more stiff. Fluid build up (edema) and discomfort may set in as well. Your knee may also make a “popping” sound upon movement. This condition may come and go as the cap slips in and out of the groove, and the pain from chronic knee dislocation may vary in intensity.

Generally, if the condition becomes severe enough and if it significantly interferes with your activities, you may need to discuss your options, including possible surgery, with your physician. However, in the interim, the use of a brace may help relieve the condition and allow you to function more normally without experiencing frequent chronic knee dislocation.

Knee braces come in a variety of styles and types. Generally, though, one of the main purposes of a knee brace in this instance, is to keep your kneecap in its proper position within the femoral groove. A knee brace can also help lend support to the knee joint so that the pressure and stress that might contribute to chronic knee dislocation are somewhat relieved, making it less likely that the kneecap will be pulled out of alignment. Many well designed knee support allow for a vast range of mobility, and depending on your injury level, they can allow you to perform many if not all of your previous activities of daily living. Sometimes it is important to keep the leg in a straight position, while other times you can move it more naturally. They are adjustable to fit most knees, are easy to use, and are relatively affordable, especially when compared to other treatment options, such as surgery or extensive therapy.

An extra, helpful aspect of knee supports is that they will help you feel more support physically, which transfers over to a more secure mental outlook as well. The mental support a brace can help provide is very helpful when you are trying to get on with your daily activities, instead of focusing on your disclocating kneecap.

Fosamax femur fractures : Fosamax lawsuits

The Osteoporotic Drug Fosamax is Linked to Rare Femur Fractures:

Fosamax (alendronate) is a bisphosphonate that slows down the break down of bone by inhibiting osteoclasts and thereby allowing for bone restoration.  This drug is manufactured by Merck and is used to treat and prevent osteoporosis in postmenopausal women by increasing bone mass and decreasing the possibility of fractures of the hip and spine.  Women most at risk include Caucasians and Asians or those who have a family history of osteoporosis.  Fosamax is also used to treat osteoporosis in men and women who have received glucocorticoids and who have low bone density.  This drug is also used to treat Paget’s disease which a chronic bone disease that involves abnormal bone remodeling.  As a result, bone becomes enlarged, less dense, brittle and subject to fractures.  The cause of Paget’s is not well understood but there is some evidence of an abnormal gene on chromosome 5, which provides for susceptibility to disease.  Secondarily, a virus is suspected of triggering the bad gene bringing about all the symptoms of Paget’s.     

It is important to take Fosamax properly as it has a number of side effects associated with taking it.  You should take Fosamax at least 30 minutes before the first food of the day, beverage, or other medication.  You must take it with a full glass of water only at the beginning of your day.  All of this is to make sure Fosamax makes it to your stomach and doesn’t get caught in your esophagus to prevent throat irritation and possible ulceration.  You should not lie down for 30 minutes after taking Fosamax to prevent reflux.  If you have inadequate calcium and vitamin D, you will have to take supplements.  Your doctor will discuss this with you.

A number of side effects have been reported with Fosamax that include osteonecrosis of the jaw (death of the jaw-bone), muscle pain, joint pain and rare femur fractures.

Early on the FDA received reports of Fosamax side effects necessitating the FDA to release a letter to healthcare providers to use this drug with caution with some patients.  These reports included side effects of osteonecrosis of the jaw (ONJ), esophageal irritation, musculoskeletal pain, and Fosamax femur fractures.  The femur fractures occurred from a sitting or standing position and considered low trauma injuries.  One study in 2009 published in the medical journal Clinical Orthopedics and Related Research, reports on four women who experienced femoral stress fractures who had taken Fosamax for more than 5 years.  X-rays showed atypical transverse fracture lines.  After discontinuing use, three of the women required surgeries to stabilize their femur bones.

More Studies Implicate Fosamax with Femur Fractures:

A study done by Columbia University investigated 111 women taking bisphosphonates including Fosamax.  Their studies demonstrated that early on in therapy patients showed marked improvement in bone structure but after long-term use bone structure diminished.  Further studies conducted at the Hospital for Special Surgery in New York observed 21 women who had femur fractures. Twelve of these patients who had been on bisphosphonates for over eight years demonstrated reduced bone mass as compared to the other 9 patients who did not take bisphosphonates.   Additionally, the Annals of Internal Medicine reported that bisphosphonates like Fosamax behave more like a bone hardener than a bone builder.  They have also observed that bone becomes brittle over time with the use of Fosamax.

On March 2010, the FDA began a safety review of Fosamax to determine whether or not there is an increase in the risk of bone fractures.  The agency is investigating the possible link between Fosamax and fractures that occur below the hip joint on patients who have been on bisphosphonates for several years.  The investigation is still on going but the FDA suggests that for patients who are currently on bisphosphonates should continue therapy but should make sure they talk to their healthcare providers if they develop any symptoms.

If you have experienced a Fosamax femur fracture or any other bone related illness while on Fosamax, you may be entitled to financial compensation for pain and suffering, lost wages and medical expenses.  You might want to speak with a Fosamax attorney to see if you qualify for a Fosamax lawsuit.  Fosamax lawsuits are currently being filed across the country.

Known Cerebral Palsy


Cerebral Palsy (CP, Big Brain Paralysis) is a condition characterized by poor muscle control, stiffness, disability and other neurological dysfunction.

CP is not a disease and not progressive (getting worse).
In infants and premature babies, part of the brain that controls muscle movement are particularly vulnerable to CP injury occurs in 1-2 from 1000 infants, but 10 times more often found in premature infants and more frequently found in very small infants.


Cerebral Palsy can be caused by a brain injury occurs when the baby is still in the womb, the birth place, newborn and children younger than 5 years. But not most the cause is unknown.

10-15% of cases occur due to birth injury and reduced blood flow to the brain before, during and immediately after birth. Premature infants are particularly vulnerable to CP, probably because the blood vessels to the brain has not developed comprehensively, and easy bleeding or because the oxygen can not flow in sufficient quantities to the brain.

  • Brain injury may be caused by high levels of bilirubin in the blood (often found in newborns), can cause kernikterus and brain damage.
  • Severe disease in the first year of baby’s life (eg encephalitis, meningitis, sepsis, trauma and severe dehydration)
  • Head injury due to subdural hematoma
  • Injury of blood vessels.


Symptoms usually appear before the 2-year-old child and in severe cases, can appear at 3-month-old child.

Symptoms vary, ranging from the irregularities that are not apparent until severe stiffness, which causes changes in the form of arms and legs so the child must use a wheelchair.

CP is divided into 4 groups:

1. Spastic type (50% of all cases of CP), the muscles become stiff and weak.

Rigidity is happening can be:

  • Kuadriplegia (both arms and both legs)
  • Diplegia (both legs)
  • Hemiplegia (arm and leg on one side of the body)

2. Type Deskinetik (Koreoatetoid, 20% of all cases of CP), muscular arms, legs and body spontaneously moves slowly, writhing and uncontrollable, but can also arise rough movements and twitching. Outburst causes worsening situation, the movement would disappear if the child slept

3. Type Ataxic, (10% of all cases of CP), consisting of tremors, unsteady steps with both legs far apart, interference coordination, and abnormal movements.

4. Mixed type (20% of all cases of CP), is a combination of 2 types above, which is often found is a combination of spastic and koreoatetoid type.

Other symptoms can also be found in the CP:

  • Below normal intelligence
  • Mental retardation
  • Seizures / epilepsy (especially in spastic type)
  • Sucking or eating disorders
  • Breathing irregular
  • The development of motor skills disorders (such as reaching for something, sit, roll over, crawl, walk)
  • Disturbance speaking (disartria)
  • Disturbance of vision
  • Hearing loss
  • Joint contractures
  • Movement is limited.


In the examination will be found in delayed development of motor skills.

Infantile reflexes (eg sucking, and surprise) still exists even supposed to have disappeared.

Muscle tremors or stiffness was clearly visible, and children tend to fold his arms to the side, his legs moving like scissors or other abnormal movements.

  • Various laboratory tests can be done to rule out other causes: MRI of head showed structural abnormalities or congenital abnormalities
  • CT scan showed the head of structural abnormalities and congenital abnormalities
  • Check hearing (to determine the status of auditory function)
  • Check vision (to determine the status of visual function)
  • EEG
  • Muscle biopsy.


CP is incurable and is a disorder that lasts a lifetime. But many things can be done to enable the child to live independently as possible.

Treatment usually depends on the symptoms and can include:

  • Physical therapy
  • Braces (buffer)
  • Glass eye
  • Hearing aids
  • Education and special schools
  • Anti-seizure drugs
  • Drugs to relax the muscles (to reduce tremors and rigidity)
  • Occupational therapy
  • Orthopedic surgery
  • Speech therapy to clarify speech and to help children overcome eating problems
  • Treatment (for severe cases).

If there is no physical disturbance and severe intelligence, many children with CP will grow normally and go to regular school. Another child requires extensive physical therapy, special education and always need help in living their daily activities.

In some cases, to free the joint contractures due to deteriorating muscle rigidity, may need surgery. Surgery is also necessary to install the feeding tubes and to control reflux gastroesofageal.


The prognosis usually depends on the type and severity of CP. More than 90% of children with CP survived to adulthood.

Could it be Analysis Paralysis?

I did lunch with a great guy last week and as we sat discussing some of the many complexities of dating, he mentioned a term that I just loved – ‘Analysis Paralysis’! It got me wondering to what extent this term affects our lives and in particular the selection process we go through when looking for a spouse.

Okay, let’s start at the beginning. According to Wikipedia the term ‘analysis paralysis’ or‘paralysis of analysis’ refers to over-analysing (or over-thinking) a situation, so that a decision or action is never taken, in effect paralysing the outcome. It goes on to define it further by saying, ‘A person might be seeking the optimal or “perfect” solution upfront, and fear making any decision which could lead to erroneous (in simple English, wrong) results, when on the way to a better solution’.

WOW!  Okay, so maybe it’s just me but when I look around it isn’t hard to identify what a massive problem this has become. It’s not that all the good guys are taken or all the girls you would take home to meet the parents are married. Is it possible that we are just over analysing things to the extent that we have stopped taking risks?  No, I’m not saying go out and just randomly start handing out your number to every person of the opposite sex but what I am asking is, “Why not take a risk?”  Why is it that we have to psychoanalyse them, their family and even their dog before we would even put ourselves out there?

Okay, so I need to backtrack here slightly and say that I totally believe in having core principles that you should never wander from when dating.  Your values and beliefs are vital and no matter how nice the package is on the outside, no relationship can grow to last without core principles being shared. So know what is most important to you. Personally, when I hear people say, “I’m looking for someone who’s tall, dark and handsome'”or “cute, petite and blonde” I just want to shake them.  I know of endless relationships where both partners would admit to the other not being ‘their type’ at first but that over time and through getting to know each other this changed and now if you were to ask them, “What is your type?” they would all agree to their husband or wife being it.

So, basically, what I am saying is, “TAKE SOME RISKS!”  There are no set ways or rules to dating. If it was that easy then John, who loves tennis, could just go down to his local tennis club to meet Sally. Personally, I think dating is a bit like going for job interviews. You are put on the spot, asked all sorts of questions and made to sweat but the more you go through, the better you get.

So next time you start analysing a potential date and they come up short because they aren’t into hiking, like you are, ask yourself, “Is this analysis paralysis?” If your answer is yes, then you need to remind yourself that life is all about taking risks. If we willingly take chances every day, whether driving, eating or even sleeping, why not take a risk on something that could have one of the greatest rewards?!

Just something to think about.

Hiatal hernia surgery success rate

If you are like me and suffering from a Hiatal hernia, I don’t have to tell you what kind of problem this can cause. I have spent about 6 months now trying to figure out what was wrong with me because I had heartburn so bad I didn’t know what to do. I would try my usual medicine like Tums, Mylanta, and Rolaids but the heartburn kept coming back. Finally, on the advice of my wife, I went to the doctor to see what else I could do to get rid of the darn heartburn. To my surprise after a couple of tests, I was told that I have a hernia, and I should undergo an operation called  hiatal hernia surgery to fix the problem.

Well, I don’t have to tell you I almost fell off of the examine table when the doc gave me the news! I need hiatal hernia surgery ? I have never been sick a day in my life, now all of a sudden I have to have surgery? I can’t tell you how nervous I am, I wanted to come and share my fears here with you.

I know that surgery is a big deal, and I asked the doctor if there was any other choice. He told me that the longer I wait, the worse it can become. I will actually start to have problems in my esophagus (throat) because the acid reflux I have will start to break down the tissue and cause me even more problems.

Ok, so the first thing I did is what anyone would do, I drove home and hopped on the internet to find out more about hiatal hernia surgery. What I found out was that at least 90% of the people who have it, are cured, so that gave me a big sigh of relief. Of course I’m a little scared, but I have my surgery coming up in two weeks now and want you guys to know there is hope out there. Once I finally found out what was wrong, I have to tell you, I was a little relieved because there were times I thought I was losing my mind.

Alright, so hiatal hernia surgery was not on my list of things I wanted to do this summer, but if it will help me get rid of heartburn, I’m all for it. I am going to have laparoscopic hiatal hernia surgery, and I think my recovery time will be about a month according to my doctor.
My doctor has had a lot of patients who have had hiatal hernia surgery, and I’m glad I went to him before I caused more damage in my throat. The surgeon was pretty cool and explained the procedure. I will go in the hospital as an outpatient, so I don’t even have to stay the night there, I get to come home and be treated like a king! Well maybe not a king, but my wife will be extra nice she said.

Vertebral Compression Fracture Information

Compression fracture of the vertebral body is common, especially in older adults. A vertebral compression fracture occurs when the bones of the spine become broken due to trauma. Vertebral compression fractures affect approximately 25 percent of all postmenopausal women in the United States. Vertebral compression fractures usually are caused by osteoporosis, and range from mild to severe. Osteoporosis most commonly occurs in women who have gone through menopause, but it can also occur in elderly men and in people who have had long-term use of a steroid medication such as prednisone. The prevalence of this condition steadily increases with advancing age, reaching 40 percent in women 80 years of age. Vertebral compression fractures are recognized as the hallmark of osteoporosis.

Risk factors are categorized as those not modifiable and those that are potentially modifiable. Nonmodifiable risk factors include advanced age, female gender, Caucasian race, presence of dementia, Sensibilities to falling, history of fractures in adulthood, and history of fractures in a first-degree relative. Vertebral Compression Fracture Symptoms include pain-some people may also have hip, abdominal, or thigh pain. Numbness, tingling, and weakness. Losing control of urine or stool or inability to urinate: If these symptoms are present, the fracture may be pushing on the spinal cord itself. Traditional treatment is nonoperative and conservative. Treatment for the vertebral fracture will typically include non-surgical care, such as rest, pain medication and slow return to mobility.

Calcitonin-salmon (Miacalcin) nasal spray can be used for treatment of pain. Muscle relaxants, outside back-braces, and physical therapy modalities also may help. Nonsteroidal anti-inflammatory drugs have been shown to significantly increase gastrointestinal bleeding in the elderly and must be used with caution. Hormone replacement therapy for women also helpful. A well-balanced diet, regular exercise program, calcium and vitamin D supplements, smoking cessation, and medications to treat osteoporosis (such as bisphosphonates) may help prevent additional compression fractures. Apply ice to the injured area for the first week, then heat or ice, whichever feels better. Ice should be applied in the following fashion. Heat applied in the first week after an injury draws more fluid to the area.

Vertebral Compression Fracture Treatment and Prevention Tips

1. Apply ice to the injured area for the first week.

2. Heat applied in the first week after an injury draws more fluid to the area.

3. A well-balanced diet, regular exercise program, calcium and vitamin D supplements.

4. Smoking cessation, and medications may help prevent additional compression fractures.

5. Muscle relaxants, external back-braces, and physical therapy modalities also may help.

6. Nonsteroidal anti-inflammatory drugs have been shown to significantly increase gastrointestinal bleeding.

Segmental Stiffness Of The lower Back

Most of us start off with a beautifully mobile and smooth running back and rarely are we stiff backed unless there is a reason for it. The back is well evolved to do the job it has to do and does this mostly very well. Spinal bones are separated from the vertebrae by discs which are thicker in areas of greater mobility and greater load, allowing more movement. Facet joints at the back of the spine limit and control spinal motion, stopping inappropriate spinal displacement in response to the loads placed on the spine. Muscles are strong, in balance and working in harmony to achieve the movement and stability required.

Inhibition of the stabilising musculature occurs with an episode of acute spinal pain and this can persist beyond the resolution of the pain to generate a long-lasting instability which puts the segment at increased risk of re-injury over time. Longer term effects include the occurrence of degenerative alterations in the spinal structures such as joints and discs, causing segmental levels to develop stiffness and eventually chronic back pain. The discs have fluid forced out of them by gravitational compression forces and must counteract them by generating a fluid absorption force.

As compression forces tend to be more powerful as time goes on, dehydration of the disc occurs to some extent as it narrows and stiffens. This can be imaged on x-ray but the disc is likely to show changes and painful problems long before the results can be seen on x-ray. A segment is defined as two adjacent vertebrae and the intervening intervertebral disc, an altered disc contributing to an abnormal segment which moves abnormally and pushes abnormal loads onto tissues where they are not designed to take them. Physiotherapists can feel the restrictions in spinal movements which occur when a stiff segment limits segmental excursion.

After an acute back pain injury the surrounding musculature tends to go into muscle spasms to splint and protect the injured segment until inflammation reduction and healing have had a chance to begin. Steady reduction in pain and progress in healing is usually accompanied by lessening of the back spasms and a restoration of normal spinal movement. However, this does not always occur as muscles may remain contracted and overprotective, causing a shortened tissue area which keeps the local joints and other tissues in a permanently shortened position.

Sitting for extended periods can increase the likelihood of suffering from increased compression of the lumbar discs with consequent fluid loss. Repeated flexion maintains the regular cycle of fluid uptake and avoidance of this movement interferes with this important process for disc health. The maintenance of abnormal posture and lack of strength in the abdominal muscles are also important factors.

Having a series of acute episodes of lumbago can predispose to developing a segmental stiffness problem, often with the stiff or abnormally moving segments of the spine having been present for a long period before they start to give pain symptoms. Actions which make this syndrome worse will tend to hold the spine in flexion for long periods or at end ranges, such as sitting for extended times and bending forwards repeatedly, actions which push joints further than their limits of comfort. The spinal facet joints develop an extension dysfunction and the spinal segment can become adaptively shortened, compromising its movement ability. My own lumbar spine has some of these back problems and limits my ability to do repeated lifting or bent over work.

However, I have been significantly improved by following Sarah Key’s method of back care, popularised in her book Sarah Key’s Back Sufferers Bible. While it is hard to agree with all the assertions she states in her book (as she herself admits), there is no doubt she has some very good ideas on how to practically manage low back pain. She describes the chronically stiff segmental back along with several other back pain syndromes and prescribes an exercise and management regime for treating them. The regime is not difficult but has very good results, particularly in my case where I felt I was stuck with my lower back pain and now realise this may not be the case.