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Takayasu Disease (Takayasu’s Arteritis)

Published January 25, 2015 by teacher dahl

TAK pix

Takayasu’s arteritis, also called TAK, is a rare disease involving inflammation in the walls of the largest arteries in the body: the aorta and its main branches. The disease results from an attack by the body’s own immune system, causing inflammation in the walls of arteries. The inflammation leads to narrowing of the arteries, and this can reduce blood flow to many parts of the body.

TAK can result in a weak pulse or loss of pulse in arms, legs and organs. For this reason, people used to refer to the illness as “pulseless disease.”

FAST FACTS

  • TAK is much more common in women than men.
  • The disease most often starts in young adults, but children and middle-aged people may get it, too.
  • Doctors find TAK on angiograms. Angiograms are types of X-ray tests that look at arteries. In TAK, angiograms show narrowing of large arteries.
  • Narrowed or blocked arteries cause problems that range from mild to serious.
  • Treatment of TAK almost always includes glucocorticoids (prednisone and others), which help reduce the inflammation.
  • Patients also may be prescribed other medications that suppress the immune system.

    WHAT IS TAKAYASU’S ARTERITIS?
    This disease is one of many types of vasculitis. Vasculitis refers to inflammation of blood vessels, and arteries are a type of blood vessel. In TAK, this inflammation occurs in the walls of large arteries: the aorta and its main branches. These blood vessels supply blood to the head, arms, legs and internal organs, such as the kidneys. Inflammation may cause the vessels’ walls to thicken. With time, this thickening results in a narrowing inside the artery, called a “stenosis.” If severe enough, such narrowing can reduce blood flow and result in less oxygen sent to the body parts or organs that the artery supplies.

Stenosis can cause symptoms (what you feel) and problems ranging from annoying to dangerous:

  • Pain with use of an arm or leg (called “claudication”)
  • Dizziness, headaches or fainting
  • Weakness and fatigue
  • High blood pressure
  • Chest pain
  • Heart attack
  • Stroke
    Stenosis occurs slowly with time, and smaller vessels may grow and expand to carry blood around the blockage. These new vessels are called “collateral vessels.” Collateral vessels may help prevent major organ damage.

Sometimes inflammation in the artery weakens the vessel wall, causing vessel expansion rather than narrowing (stenosis). This expansion is called an aneurysm (a bulge in the artery). The aorta as it emerges from the heart is one of the more common areas where an aneurysm can form. An aneurysm in the aorta might lead to heart valve dysfunction or rupture (bursting) of the aorta.

WHAT CAUSES TAKAYASU’S ARTERITIS?
As with most types of vasculitis, the cause of TAK is not known. It is rare to see more than one case in a family and the role of genetics is unclear. A link between TAK and an infection has also not been proven.

TAK is thought to be an autoimmune disease, which means that the body comes under attack by its own immune system. In TAK, the immune system is attacking the blood vessels.

juvenile arthritis pix

WHO GETS TAKAYASU’S ARTERITIS?
TAK is rare, affecting perhaps one in 200,000 people. It most often occurs in people ages 15–40 years, but sometimes affects younger children or middle-aged adults. Nine of 10 patients are female. TAK seems to be more common in East Asia, India and, perhaps, Latin America, than in other regions. Yet, it is rare even in these regions and occurs in a wide range of ethnic groups.

HOW IS TAKAYASU’S ARTERITIS DIAGNOSED?
Doctors most often find TAK on an angiogram, a test that shows how well blood flows in arteries. A doctor often orders an angiogram when a patient has symptoms and abnormal results of the physical exam. These include loss of pulse or low blood pressure in an arm, or abnormal sounds (“bruits”) heard over large arteries with a stethoscope.

There are various types of angiograms, including standard ones that involve injection of dye directly into an artery while X-ray test are taken. Less invasive types of angiography use another imaging technique such as computed tomography, and this is CT angiography or CTA. When MRI—magnetic resonance imaging— is used, it is called magnetic resonance angiography or MRA.

Angiograms may show narrowing of one or more large arteries. It is important for the doctor to try to distinguish between narrowing due to vasculitis (inflammation of arteries) and narrowing due to atherosclerosis (“hardening” of the arteries). At times, this can be challenging. There are other causes of arterial narrowing as well, including fibromuscular dysplasia, another rare disease that mainly affects women.

Large arteries can also become inflamed in a few other diseases. Examples include other types of vasculitis: giant cell arteritis (a disease of older adults), relapsing polychondritis, Cogan’s syndrome and Behçet’s disease. Some infections can also cause inflammation in large arteries.

Blood tests for inflammation include measurements of the erythrocyte sedimentation rate (sometimes referred to as the “sed rate” or ESR) and C-reactive protein (often called CRP). Results of these tests are often, but not always, high in patients with TAK. However, these tests are also abnormal in a large number of other inflammatory diseases. Patients with TAK may also have anemia due to chronic (long-term) inflammation. Anemia is also tested for with a blood test. None of these blood tests can tell you for sure if you have TAK, and these blood tests may be abnormal in many other diseases.

Patients with TAK may have no symptoms, and the disease is so rare that doctors may not easily recognize it. Thus, there is often a delay in detecting it, sometimes several years.

HOW IS TAKAYASU’S ARTERITIS TREATED?
TAK most often needs treatment to prevent further narrowing of affected arteries. Yet, the narrowing that has already occurred often does not improve, even with drug treatment.

  • Glucocorticoids (prednisone, prednisolone or others), often referred to as “steroids,” are an important part of treatment. The dose and length of treatment depend on how bad the disease is and how long the patient has had it. However, these drugs can have long-term side effects.
  • Doctors sometimes prescribe immune-suppressing drugs because their side effects may be less serious than those of glucocorticoids. This is called “steroid-sparing” treatment. These medicines include methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide and drugs that block tumor necrosis factor (such as etanercept, adalimumab or infliximab). Doctors frequently prescribe these drugs to treat other rheumatic diseases, but they also use them to treat TAK. There is not enough proof that these drugs are definitely effective in treating TAK. Research studies are ongoing to find new drugs to treat TAK.
  • Some experts advise routine use of low-dose aspirin. The thought is that it will help prevent blood clots from forming in damaged arteries.

Therapy for TAK also includes screening for high blood pressure and high cholesterol, and treatment if these problems are present.

Lasting damage to arteries sometimes needs a vascular procedure or surgical treatment. This may involve angioplasty (widening a narrowed or blocked blood vessel), with or without placement of a stent, to prop open the vessel. Another treatment option is bypass grafting, a surgery to redirect blood flow around a blockage in a blood vessel.

WHAT IS THE BROADER HEALTH IMPACT OF TAKAYASU’S ARTERITIS?
Because TAK can cause heart problems, high blood pressure and stroke, patients with TAK should talk to their doctor about ways to lower the risk of these serious problems.

LIVING WITH TAKAYASU’S ARTERITIS
TAK is a chronic disease and may need long-term treatment. Some patients have no symptoms or only mild symptoms, but others are disabled or need surgery more than once. Side effects from medicines, mainly glucocorticoids, can be troubling. Patients taking immunosuppressants are at risk of infections.

Blood pressure measurement is often not correct (falsely low due to blocked arteries) in the arm. So, your health care provider may need to measure your blood pressure in a leg.

The disease can recur after treatment or can silently get worse. It is often very hard to know whether TAK is active again. Thus, most patients need frequent doctor visits and angiograms.

POINTS TO REMEMBER

  • TAK is a rare inflammatory disease of large arteries.
  • These patients often need treatment with glucocorticoids and immunosuppressive drugs.
  • Symptoms of TAK reflect poor blood flow to tissues and organs.
    Detection of TAK most often requires testing by use of angiograms.
  • THE RHEUMATOLOGIST’S ROLE IN TREATING TAKAYASU’S ARTERITIS
    Rheumatologists are usually the experts with the most overall knowledge about TAK. Thus, they direct the care of these patients, particularly those patients needing immunosuppressive drugs. Other doctors that patients may need to see include a cardiologist (heart doctor) and a vascular surgeon. A team approach can offer the best care to patients with this disease.

Source :rheumatology .org

Seven (7) Foods That Can Trigger Acne

Published September 2, 2014 by teacher dahl

bread

Bread
If you’re prone to acne, baguettes, croissants, and all that other good stuff may make the situation worse. “Wheat causes inflammation,” Lipman says. “And to get rid of acne, you want to reduce inflammation in your body.” Yap Tan points out that many commercially produced breads also have sugar, soybean oil, and dairy: “You could eat an English muffin and unknowingly consume three big triggers: dairy, soy, and sugar.”

 

sugar

Sugar

As if we needed another reason to give up the white stuff. “Sugar can absolutely cause breakouts, because it’s pro-inflammatory,” Lipman confirms. “Acne is considered an inflammatory condition, and someone with acne-prone skin should follow an anti-inflammatory diet.”

That doesn’t mean you have to give up sweetness for good, though. Lipman recommends eating fruit (not fruit juice) and, if you must have sweetener, choose small amounts of stevia, raw honey, or maple syrup.

 

coffeeCoffee
A cup of joe can wake you up, but it can worsen a breakout, too. “There’s an organic acid inside coffee beans that raises cortisol levels,” Yap Tan says. Cortisol, also known as the stress hormone, can act like an androgen, simultaneously stimulating sebaceous glands and inflammation. Switching to decaf won’t do anything, since caffeine isn’t the trigger; your best bet, says Yap Tan, is to replace coffee with tea or yerba mate.

dairy

Dairy
Bad news, dairy queens: milk actually doesn’t do a complexion good. Because of recent research on diet and acne, the American Academy of Dermatology now says there may be a link between milk consumption and breakouts.

Blame the hormones in dairy, says Dr. Frank Lipman,  an integrative and functional medicine physician and the founder of Eleven Eleven Wellness Center in New York City. “Dairy causes spikes in certain pimple-producing hormones,” he explains. “I encourage patients to have almond milk, rice milk, coconut milk, or hemp milk instead of cow’s milk.”

soyaSoy
If you break out around the mouth and along your jawline, tofu and other soy foods could be to blame. And it’s all due to the natural plant estrogens found in soybeans. “Phytoestrogens mimic natural estrogen levels, and that throws off our hormones,” says esthetician Kimberly Yap Tan, founder of Skin Salvation, an acne clinic in San Francisco. Soy derivatives show up in everything from veggie burgers to energy bars, so read labels carefully.

peanutsPeanuts
Peanuts contain an androgen, which can make acne worse by increasing sebum production. “Peanuts will generally make people more oily,” Yap Tan notes. “I’ve had clients with white pustules around the nose, and it turned out they were eating more peanut butter than usual.” Acne-safe alternatives to peanuts include other nuts such as almonds and cashews, which don’t affect androgen levels.

coco oilCoconut oil
“A lot of people are shocked to hear about this one,” Yap Tan says of this comedogenic oil. “But not only does coconut oil clog pores around the mouth, it also creates a stubborn kind of inflammation—usually on the cheeks and along the jawline.” That goes for coconut oil that’s applied topically or ingested with food, so check your pantry along with your medicine cabinet.

So, what should you eat?

what should be eaten


Both Yap Tan and Lipman advocate swapping processed foods for natural ones. “Sticking to fresh, whole foods like protein, vegetables, healthy fats, and gluten-free grains is the way to go,” Lipman says. And in time, even certain acne-triggering foods may find their way back into your diet—without sending you to breakout town.

“Each person is different, and everyone has a different threshold with these foods,” Yap Tan says. “We don’t want to tell people they can’t eat these foods for the rest of their lives, but without eliminating them, we can’t find out what’s triggering the acne.”

source : Yahoo-She

Coping With Exam Stress

Published August 23, 2014 by teacher dahl

eyes

As the examination period approaches, you may feel the pressure of the exams getting to you. This is not surprising — in fact it is quite normal to feel some anxiety about exams. Most people find that a bit of pressure spurs us on and enables us to get down and do some serious work.

General Exam Stress-Busting Tips:

  • Believe in yourself
    You wouldn’t have been given a place on the course if you didn’t have the ability to do it. Therefore, if you prepare for the exams properly you should do fine, meaning that there is no need to worry excessively.
  • Don’t try to be perfect
    It’s great to succeed and reach for the stars. But keep things in balance. If you think that “anything less than A+ means I’ve failed” then you are creating mountains of unnecessary stress for yourself. Aim to do your best but recognise that none of us can be perfect all of the time.
  • Take steps to overcome problems
    If you find you don’t understand some of your course material, getting stressed out won’t help. Instead, take action to address the problem directly by seeing your course tutor or getting help from your class mates.
  • Don’t keep things bottled up
    Confiding in someone you trust and who will be supportive is a great way of alleviating stress and worry.
  • Keep things in perspective
    The exams might seem like the most crucial thing right now, but in the grander scheme of your whole life they are only a small part.

lying examinee

 

Overcoming test anxiety:  General preparation

  • Building confidence

Review your personal situation and skills
Academic counselors can help you in these areas, or refer to our Guides on the topic:

  • Developing good study habits and strategies (a link to our directory)
  • Managing time
    (dealing with procrastination, distractions, laziness)
  • Organizing material to be studied and learned
  • Take a step by step approach to build a strategy and not get overwhelmed
    Outside pressures  success/failure consequences (grades, graduation), peer pressure, competitiveness, etc.
  • Reviewing your past performance on tests  to improve and learn from experience

Test preparation to reduce anxiety:  Approach the exam with confidence

  • Use whatever strategies you can to personalize success: visualization, logic, talking to your self, practice, team work, journaling, etc.
  • View the exam as an opportunity to show how much you’ve studied and to receive a reward for the studying you’ve done
  • Be prepared!
  • Learn your material thoroughly and organize what materials you will need for the test. Use a checklist
  • Choose a comfortable location for taking the test with good lighting and minimal distractions
  • Allow yourself plenty of time, especially to do things you need to do before the test and still get there a little early
  • Avoid thinking you need to cram just before
  • Strive for a relaxed state of concentration
  • Avoid speaking with any fellow students who have not prepared, who express negativity, who will distract your preparation
  • A program of exercise is said to sharpen the mind

Get a good night’s sleep the night before the exam

good sleep

Don’t go to the exam with an empty stomach

  • fresh fruits and vegetables are often recommended to reduce stress.
  • Stressful foods can include processed foods, artificial sweeteners, carbonated soft drinks, chocolate, eggs, fried foods, junk foods, pork, red meat, sugar, white flour products, chips and similar snack foods, foods containing preservatives or heavy spices

food

  • Take a small snack, or some other nourishment
  • to help take your mind off of your anxiety.
  • Avoid high sugar content (candy) which may aggravate your condition

exam stress pix

During the test:

  • Read the directions carefully
  • Budget your test taking time
  • Change positions to help you relax
  • If you go blank, skip the question and go on
  • If you’re taking an essay test
  • and you go blank on the whole test, pick a question and start writing. It may trigger the answer in your mind

Don’t panic    when students start handing in their papers. There’s no reward for finishing first

Use relaxation techniques
If you find yourself tensing and getting anxious during the test:

  • Relax; you are in control.
  • Take slow, deep breaths
  • Don’t think about the fear
  • Pause: think about the next step and keep on task, step by step
  • Use positive reinforcement for yourself:
  • Acknowledge that you have done, and are doing, your best

Expect some anxiety

  • It’s a reminder that you want to do your best and can provide energy
  • Just keep it manageable
  • Realize that anxiety can be a “habit”
  • and that it takes practice to use it as a tool to succeed

After the test, review how you did

  • List what worked, and hold onto these strategies
  • It does not matter how small the items are: they are building blocks to success
  • List what did not work for improvement
  • Celebrate that you are on the road to overcoming this obstacle

Source: studygs.net./humanities.manchester.uk

 

How You Can Easily Make Your Crush Fall in Love with You

Published February 22, 2013 by teacher dahl

fall in love together

Can I Make My Crush Fall in Love With Me? Here is How You Can Easily Make Your Crush Fall in Love with you.

Generally, men/women never fall for those who are too aggressive. Though men/women like to be chased, they still want to feel challenged and make their own move to win the heart of that special person. General rules apply for men and women when it comes to attraction. Choose what will work best through these following suggestions:

Love yourself for your crush to love you in return 
This is a universal rule in attraction. Always show that confidence and never show any signs of dependency or weakness. Men like women who are never afraid of what and who they are and vice versa.

Be patient; take it one step a time 
Assuming that he is still not attracted or caught by the love bug, give him/her time to think about it by reciprocating the interest showed to him. Spend more time with him and make every moment count.

Trying too hard will not make things better
Don’t exert too much to catch his attention. It is also suggested to keep calm and never force the issue. He will notice every single step made and he will learn about it at the right time. Make him fall in love without pre-empting his feelings. Love is best enjoyed when there is a mutual agreement of the situation.

Confidence will never fail you
Always be cool and never show any act of desperation. Men dig women who know what they want and believe in what they do and vice versa. Talk smart, speak eloquently and be sensible in any conversation.

Add a dash of mystery and guessing game

Make him/her become more interested by playing that guessing game. As much as men are thrilled when women don’t show too much about themselves, women also enjoy this set-up. Both genders want challenges and they want to win a boy/girl with their own efforts.

Learn more about him to show that he is desired
Sometimes men like the attention. They are flattered when a woman knows about their favorite food, favorite activities and anything that is important about them.

source:
ezinearticles.com

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