We mean weakness a reduction in the strength of one or more muscles. The weakness can be generalized (total bodily weakness) or localized to only one area, body side, a particular point, or muscle. It is more serious when it is localized, because it can follow a stroke, burn or injury. Weakness can be objective or subjective.
Subjective: It feels weak, but there is no measurable loss of strength;
Objective: There is a measurable loss of strength observed during a physical examination.
A subjective feeling of weakness can be associated with infectious diseases such as influenza and mononucleosis.
Causes: Measurable weakness can be derived from a variety of conditions including metabolic, neurological, primary muscular illnesses, and toxic disorders.
Low sodium or potassium levels;
Amyotrophic lateral sclerosis;
Damage to nerves;
Becker Muscular Dystrophy;
Muscular Dystrophy of Duchenne;
Poisoning from organophosphates (insecticides, nerve gases, etc.);
Paralysis due to poisoning.
THERAPY: Depending on the cause of weakness, there will be a different treatment and not comparable to another. Contact a doctor if you have:
Prolonged and inexplicable weakness;
Sudden weakness, especially when you have other conditions, such as fever;
Sudden weakness due to viral illness;
Weakness in an area of the body.
DIAGNOSIS: Your doctor will examine the physician and ask questions about your medical history and symptoms. He will also investigate the so-called aggravating factors, that is, if weakness worsens in one of these cases:
Or if one of these cases relieves the condition. A physical examination may include particular attention to the heart, lungs, and thyroid gland. If there is a particular area you feel weak, the exam will focus on muscular and nerve functions. Diagnostic tests that can be performed include:
Blood tests for autoimmune diseases;
Blood tests like a CBC and electrolytes;
The lumbar puncture;
Magnetic resonance or TAC of head and spine;
Nerve conduction studies;
Thyroid Functional Test;
Fonti: [Olney RK. Debolezza, disturbi del movimento, e squilibrio. In Kasper DL, Braunwald E, Anthony S. Fauci AS, eds. Harrison’s Internal Medicine. 16a ed. New York, NY: McGraw-Hill, 2005; http://health.nytimes.com/health/]
Delirium is a sudden and strong confusion with rapid changes in brain function that occur with physical or mental illness.
Causes: Delusion is most often caused by a usually temporary and reversible disease. Many disorders cause delirium, including conditions that deprive the brain of oxygen or other substances. Common causes include:
Infections such as those of the urinary tract or pneumonia (in people who already have cerebral damage by stroke or dementia);
Basic disorders by fluids, electrolytes or acids.
Patients with more severe brain injuries are more likely to get sick during the illness.
SYMPTOMS: Delirium involves a rapid change of mental states (for example, by lethargy to agitation, which then returns to lethargy). Symptoms include:
Changes in waking (usually you are more alert in the morning, less during the night);
Changes in sensation and perception;
Changes in the level of consciousness or awareness;
Changes in movements (for example, may be inactive or slow);
Changes in sleep;
Confusion (disorientation) on time or place;
Decrease in short term memory;
Unable to remember events since delirium began (amnesia anterograda);
Failure to remember past events (retrograde amnesia);
Inability to think or to behave properly;
Inability to stop these behaviors;
Emotional or personality changes;
Movements triggered by changes in the nervous system (psychomotor agitation).
DIAGNOSIS: The following tests may have abnormal results:
An examination of the nervous system (neurological examination);
Feelings of sensation, thought (cognitive function), and motor function.
The following tests can also be made:
Chemical test of blood;
Analysis of gas in the blood;
Analysis of cerebrospinal fluid;
Drug and alcohol levels test (toxicological test);
TAC at the head;
Magnetic resonance at the head;
Liver function tests;
Mental state test;
Calcium serum levels;
Magnesium serum levels;
Thyroid Functional Test;
Levels of thyrotoxic hormone;
THERAPY: The goal of therapy is to control or reverse the cause of the symptoms. Treatment depends on the condition that causes delirium. Diagnosis and care should take place in a pleasant, comfortable environment that physically gives the feeling of a safe environment. The person may need to stay in the hospital for a short period of time. Changing drugs that aggravate confusion, or that are not needed, can improve mental function. Drugs that can aggravate confusion include:
Alcohol and illegal drugs;
Central nervous system depressants;
Disturbances that contribute to confusion must be treated. These may include:
Decreased oxygen (hypoxia);
High levels of carbon dioxide;
Psychiatric conditions (such as depression).
Medical treatment and mental disorders often considerably improve mental function. Medications may be needed to control aggressive or agitated behavior. These are usually taken in low doses and adapted to the needs. The drugs include:
Dopamine antagonists (haloperidol, olanzapine, risperidone, clozapine);
Stabilizing mood (fluoxetine, imipramine, citalopram);
Sedative drugs (clonazepam or diazepam);
Serotoninergic (trazodone, buspirone);
Some people with delirium can benefit from hearing aids, glasses, or cataract surgery. Other treatments that may be useful:
Changing unacceptable behavior to control dangerous behaviors;
Orientation to reality to reduce disorientation.
PROGNOSIS: The acute condition that causes delirium can occur with chronic disorders that cause dementia. Acute brain syndromes can be reversible by treating the cause. Delirium often lasts only about a week, although it may take several weeks to bring mental function back to normal levels. Full recovery is possible. Any complications may be:
Loss of function capacity or self-care;
Loss of ability to interact;
Progression to coma;
Side effects from medications.
Diabetes is a chronic disease and is due to high levels of blood sugar.
Causes: Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes may be caused by insulin deficiency, insulin resistance, or both.
There are three main types of diabetes:
Type 1 diabetes is usually diagnosed during childhood. Many patients find themselves sick after 20 years. In this disease, the body produces little or no insulin, making it necessary to inject daily insulin. The exact cause is still unknown. Among the most accredited are genetic and viral problems.
Type 2 diabetes is much more common than Type 1. It is most of the case. Usually occurs in adulthood. The pancreas does not produce enough insulin to maintain normal glucose levels in the blood. Many people with type 2 diabetes do not know they have it, even if it is a serious condition. Type 2 diabetes is becoming more common due to growing obesity and lack of exercise.
The third type of diabetes is called "gestational" and it is a high level of blood glucose that develops at any time of pregnancy in a woman who does not have diabetes.
There are many risk factors for type 2 diabetes, including:
Age over 45 years;
Gestational or childbirth of a child weighing more than 4 Kg;
High cholesterol level in the blood;
Alteration in glucose tolerance;
Membership to some of the most exposed ethnic groups (especially African Americans, Native Americans, Asian Pacific Islanders, Americans and Hispanics).
SYMPTOMS: High blood glucose levels can cause several problems, including:
However, if type 2 diabetes develops slowly, some people do not detect any symptoms.
Symptoms of Type 1 Diabetes:
Weight loss despite an increase in appetite.
Patients with type 1 diabetes usually develop symptoms over a short period of time.
DIAGNOSIS: An urine analysis can be used to look for glucose and ketones. However, a urine test can not alone diagnose diabetes. The following blood glucose tests are used to diagnose diabetes: glucose fasting; Glucose tolerance; Not fasting glucose test.
THERAPY: The immediate goals are the treatment of diabetic ketoacidosis and high blood glucose levels. Since type 1 diabetes may start suddenly and has serious symptoms, people who have just been diagnosed may need to go to the hospital. Long-term goals of the treatment are to prolong life; Reduce the symptoms; Preventing diabetes to avoid related complications such as blindness, heart disease, kidney failure, and amputations of the limbs.
These objectives are achieved through:
Careful analysis of glucose levels in the blood
Meal plan and weight control
Medicines or insulin use
Early management of diabetes will help prevent the need for emergency care. These skills include:
How to recognize and treat low blood sugar levels (hypoglycaemia) and high blood sugar (hyperglycaemia)
What and when to eat
How to take insulin or medication
Record glucose levels in the blood
Testing of ketones in urine
Adjust insulin in food in case of change in dietary habits
Manage sick days
DIET: People with type 1 diabetes should eat at about the same time each day and try to be consistent with the types of foods they choose. This helps prevent blood sugar levels from becoming too high or low. People with type 2 diabetes should follow a well-balanced diet with low fat content.
PHARMACIES: Drugs for diabetes therapy include insulin and glucose lowering pills called hypoglycemic drugs. Type 1 diabetes patients need daily injections of insulin. Insulin is not available as a pill. Other people use a new type of inhaled insulin. Unlike Type 1 diabetes, type 2 diabetes can be aided in exercise with exercise, diet, and medications to be taken by mouth. There are several types of medicines used to lower blood glucose levels in type 2 diabetes.
NOTES: Regular exercise is especially important for diabetic patients. It helps control blood sugar, weight loss, and high blood pressure levels. People with diabetes who exercise regular exercise are less likely to suffer a heart attack or stroke than those who do not move. It may be necessary to modify the diet or dose of drugs to change the intensity and duration of the exercises to maintain acceptable levels of blood sugar.
Diabetics are more likely to have problems with the feet. Diabetes can damage your blood vessels and nerves and decrease your body's ability to fight infections. If you do not treat the affected feet you can also be amputated.
PREVENTION: Numerous studies have shown that rigorous blood sugar control and blood pressure levels in diabetics help to reduce the risk of kidney disease, eye disease, nervous system disorders, heart attack, and stroke.
To avoid acting too late, you should go to the emergency room if you have chevacidosis symptoms:
Increased thirst and drift
Loss of consciousness
Convulsions or loss of consciousness
Lack of coordination
Maintaining an ideal body weight and an active lifestyle can prevent type 2 diabetes. There is currently no way to prevent type 1 diabetes. There is no effective screening test for type 1 diabetes in people who are not Have symptoms. Screening for Type 2 diabetes and for those with these symptoms is not recommended for overweight children who have other risk factors for diabetes since the age of 10, overweight adults (over 25) who have other Risk factors and adults over the age of 45 if the symptoms occur every 3 years.
Source: [http://health.nytimes.com; Alemzadeh R, Wyatt DT. Diabetes Mellitus. In: Kliegman RM, ed. Kliegman: Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders; 2007; American Diabetes Association. Standards of medical care in diabetes - 2008. Diabetes Care. 2008; Eisenbarth GS, Polonsky
Anal pain, or in the anus, around the anus or rectum is a common disorder and often a cause of concern. Sometimes, it can also be accompanied by rectal bleeding, but in most cases this symptom is not caused by a serious problem like an anthrax cancer.
SYMPTOMS: Anal pain is already a symptom in itself, as well as rectal bleeding and swelling. The perianal region, being rich in nerve endings, is highly susceptible to pain, unlike the rectal mucosa and rectum where different innervation makes this area relatively unattractive.
Causes: The causes of pain in the anus can be different, including:
Coccygodynia (pain in the coccyx)
Ulcerative colitis (inflammatory bowel disease of the large intestine)
Compression of the nerve pudding
Fecal proctalgia (short-term shortness of pain due to muscle spasms)
Proctitis (inflammation of the mucous membrane surrounding the rectum)
Anise lift syndrome (muscle spasms surrounding the anus)
Lonely rectus ulcer syndrome (rectal ulcer usually associated with rectus intussusception)
Among the above mentioned causes constipation, stinging, anal abscess and hemorrhoid thrombosis are certainly the most frequent ones. The pain after defecation, for example, is typical of those who suffer from constipation. The issue of hard consistency stems, in fact, can injure the anal mucosa, causing pain. Even stinging and anal abscess cause severe pain, which tends to get worse after defecation. Hemorrhoid thrombosis, on the other hand, is the main complication of hemorrhoids with intense and sudden pain, dark red small tumors evolving towards necrosis and ulceration with low blood coagulation dark blood.
A case of anal pain during the menstrual cycle. The appearance of pelvic pain and consequently the various organs involved is not uncommon in the early stages of menstruation, especially for women suffering from dysmenorrhea. This condition is caused by the release of inflammatory substances (prostaglandins) which, once discharged, are active on all neighboring structures. The anal canal, in fact, is contiguous to the vaginal wall. Some doctors, in order to remedy pain, recommend taking an anti-inflammatory drug (eg Ibuprofen) before painful symptomatology manifests itself to counteract the effect of prostaglandins.
DIAGNOSIS: The causes of anal pain can be easily diagnosed during a proctological examination. The clinical examination includes anorectal inspection and exploration. It will then be the specialist to evaluate whether to proceed with any instrumental or bioptic findings.
CARE: Depending on the diagnosis, the most appropriate treatment will be set, to solve the problem stably. For example, in anal fissure, early-stage therapy aims to maintain soft stools and reduce hypertension of sphincters with oral drugs and topical painkillers and hot bidets. In case of anal abscess, cure is in the surgical drainage, while hemorrhoidal thrombosis therapy involves the taking of oral and topical drugs, however, surgical incision in local anesthesia, if performed early in relation to the onset of the disease, resolves Quickly and effectively the complication and its symptoms.
Painful menstrual periods are times when a woman has cramps and abdominal pains that go and come and eventually accompany her back pain. Painful menstruation affects many women. For a small number of them, discomfort makes it difficult to perform normal family, work, school or related activities for a couple of days during each menstrual cycle. Painful menstruation is the main cause of the loss of school days and work among women and adolescents around the age of twenty.
Pain may begin several days before, or even just at the beginning of the cycle. Although some pains during menstruation are normal, they are usually not excessive. The medical term indicating too painful flows is dysmenorrhoea. There are two types of dysmenorrhea:
Primary that refers to menstrual pain that occurs in normally healthy women. This type of pain is not related to specific problems with the uterus or other pelvic organs;
Secondary, if menstrual pain is attributed to some underlying disease or structural anomalies, both inside and outside the uterus.
The activity of prostaglandin hormone produced in the uterus is thought to be an important factor in primary dysmenorrhea. This hormone causes contraction of the uterus and levels tend to be much higher in women with severe menstrual pain than in women with mild pain.
CAUSES: The most common are:
Pelvic inflammatory disease;
Sexually Transmitted Diseases;
Stress and anxiety.
DIAGNOSIS: Your doctor will make a physical assessment, paying particular attention to the pelvis and abdomen. It will ask questions about the patient's medical history and current symptoms. Diagnostic tests that can be performed include:
Analysis to exclude sexually transmitted diseases such as gonorrhea, primary syphilis, chlamydia or other infections;
Your doctor may prescribe contraceptive pill to relieve menstrual pain. Many women continue to have symptoms relief, even after they have stopped taking the drug. Surgery may be needed for women who are unable to control or withstand the pain. Procedures may vary from the removal of cysts, polyps, adhesions, fibroids to hysterectomy in the event of extreme endometriosis as an alternative to drugs. For pain caused by the spiral, removal may be necessary. Antibiotics are needed for pelvic inflammatory disease.
THERAPY: The following procedure avoids prescribing drugs:
Apply a warm swab under the navel;
Lightly circular massages with the tip of your fingers around the lower abdomen;
Drink hot drinks;
Eating light but frequent meals;
Follow a diet rich in complex carbohydrates, such as whole grains, fruit and vegetables, but low in salt, sugar, alcohol and caffeine;
Hold your legs raised when you lie down, or bend your knees when you are on one side;
Practicing relaxation techniques such as meditation or yoga;
Try with anti-inflammatory or analgesic medicines, such as ibuprofen;
Try with vitamin B6, calcium, magnesium and supplements;
Make baths or hot showers;
Walk or practice regularly, even doing pelvic exercises.
If these DIY measures do not work, your doctor may prescribe medicines such as:
Birth control pill;
Strong anti-inflammatory drugs such as diclofenac (Cataflam);
Strong painkillers (including drugs, such as codeine, for short periods).
Contact a doctor immediately if:
There is an increasing or vaginal vaginal discharge;
There is fever;
Pain is unbearable;
The cycle comes with more than a week late, and there are no sexual causes;
DIY measures do not alleviate pain after 3 months;
It has a spiral for more than 3 months;
You notice blood clots or other symptoms with pain;
The pain is severe or sudden;
Pain occurs at different moments of the menstrual cycle, starts more than 5 days before the cycle, or continues after it has passed.
Sources: [French L. dysmenorrhea. Am Fam Physician. 2005; http: //health.nytimes.com/health; Harel Z. dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol. 2006]
CAUSES: Knee pain is usually the result of a poor shape during physical activity or a practiced activity without adequate heating or stretching. A simple pain often passes by itself with some rest. Being overweight may increase the risk of developing knee problems. Knee pain can be caused by:
Arthritis, including rheumatoid arthritis, osteoarthritis and gout;
Baker cysts, a fluid that fills the knee in the back and manifests with a swelling, which can accompany inflammation due to other causes, such as arthritis;
Bursitis, inflammation from repeated knee pressures, kneeling over long periods of time, excessively, or injury;
Connective tissue, such as lupus;
Dislocation of the crown;
Osteobic Band Syndrome, a disorder due to a bandwidth going from side to side of the knee;
Knee injury can cause bleeding to worsen pain;
Tendinitis, pain in the front of the knee that worsens when making stairs or walking steeply;
Meniscus pain, pain inside or outside the knee;
Tailing of ligament, leads to pain and instability of the knee;
Distortion, slight ligament injuries caused by sudden or unnatural twists.
Less common causes are:
DIAGNOSIS: Your doctor will perform a physical examination, with particular attention to your knees, hips, legs, and other joints. To help diagnose the cause of the problem, the doctor will do anamnesis with questions about pain, various symptoms, and physical habits. The following diagnostic tests can be performed:
Analysis of fluid extracted from the knee;
X-ray of the knee;
Magnetic knee resonance if a ligament or meniscus injury is suspected.
Go from a physiotherapist to learn about exercises like stretching and strengthening exercises; Or by a podologist for orthostatic prostheses, if necessary. In some cases, surgery is required. For example, if arthritis is severe, a bone replacement can be recommended. Recovery from meniscus or ligament problems is slow. Physical therapy may often be necessary. THERAPY: Many causes of knee pain, especially those related to excessive physical activity, are able to respond well to DIY care:
Rest and avoid aggravating pain, especially by not doing weight-moving activities;
Apply ice. Initially apply for 15 minutes every hour, after the first day, apply at least 4 times a day;
Keep the knee raised as far as possible to try to deflate it;
Gently compress the knee by wearing an elastic band or band. This can reduce swelling and provide support;
Take acetaminophen for pain or ibuprofen for pain and swelling;
Sleep with a pillow under or between your knees.
Your doctor may prescribe non-steroidal anti-inflammatory agents (NSAIDs), which are stronger than those available without a prescription. If these are not helpful, your doctor may inject a steroid to reduce pain and inflammation. Call your doctor if:
It is not possible to bear the weight on the knee;
There is pain, even without weight problems;
The knee cracks or stops;
The knee is deformed;
It has fever, redness or heat around the knee, or a significant swelling;
There is pain, swelling, numbness, tingling, or bluish skin below the sore knee;
You still have pain after 3 days of home therapy.
PREVENTION: The directives to avoid damage to the knee may be:
Increase level of activity slowly over time;
Always warm up before exercising, and then slowly cool. Learn correct stretching exercises without improvising;
Replace sports shoes often. Ask for advice on correct footwear for the shape of your foot and your movements.
Sources: [Labropoulos N, Shifrin DA, O. Paxinos new perspectives for the development of poplite cysts. Br J Surg. 2004; http://health.nytimes.com/health/; Fithian DC. Fracture of the injured knee frontal crest ligament. Orthop Clin North Am 2002]
Pain in the testicles
Pain in the testicles is the discomfort in one or both of the testes. Pain sometimes radiates to the lower abdomen. Testicles are found inside the scrotum and are very sensitive. Even a small injury or contact can cause pain or discomfort. A sudden and severe testicular pain, however, requires immediate medical attention. If a young person has abdominal pain, the scrotum must always be thoroughly examined. Abdominal pain may occur in certain conditions, including torsion of the testicle. It is a torsion that can block the supply of blood and cause tissue death. Testicular cancer is usually painless.
Causes: Common causes of testicular pain include:
Infection or inflammation;
Twist, more common in young people between the ages of 10 and 20.
Possible infections include:
Epididymitis: Inflammation of the tube through which the sperm leaves the testicle. This is often caused by bacteria, such as chlamydia, a sexually transmitted disease;
Orchite: Inflammation of one or both of the testes, which can be caused by bacteria or viruses such as ears. Orcite may occur at the same time as epididymitis or prostatitis (inflammation of the prostate).
Fluids in the testicles often cause painless swelling but can cause slight discomfort. There are several types of liquid collection:
Varicocele: the veins that carry the blood from the testicles are enlarged;
Spermatocele: fluid in the epididymic that forms a cyst and often contains dead sperm cells;
Idrocele: fluid in the area inside the scrotum, surrounding the testicle, common in infants.
Pain can also be caused by a hernia.
THERAPY: Some causes of testicular pain, including testicular torsion, can lead to infertility, if not treated promptly. Infections should also be examined and treated immediately. If the infection is caused by bacteria, your doctor will prescribe an antibiotic. For non-urgent causes, such as minor injuries and fluid collection, the following home care measures can reduce discomfort and swelling. These steps will help relieve the discomfort:
Provide support for the scrotum wearing a suspense;
Apply ice to the scrotum;
Have a warm bath if there are signs of inflammation;
Stay lying down, placing a towel under the scrotum;
Take analgesics or painkillers, such as acetaminophen or ibuprofen. Do not give aspirin to children.
The treatment may include:
Detection of the testicle (performed by an experienced physician);
Surgery to correct a simple testicular torsion;
Antibiotics for infections;
Surgery of drainage or removal of an abscess (rare);
Surgery for a varicocele, a hydrocele or spermatocele, especially if varicocele can contribute to infertility.
Contact a doctor or go to a emergency room if:
The pain is severe and sudden;
There was a trauma, and there was pain or swelling after an hour;
Pain is accompanied by nausea or vomiting;
You hear a nodule in the scrotum;
There is fever;
The scrotum is warm, soft to the touch, or red;
You have been in contact with someone who has the mumps.
DIAGNOSIS: Your doctor will perform a physical examination with a special focus on the groin, testicles, and abdomen. To help him diagnose the cause of the pain, the doctor will do an anamnesis with questions about the patient's symptoms and sexual habits. The following diagnostic tests can be performed:
Analysis and culture of urine;
Examination of prostate secretions.
PREVENTION: To avoid pain in the testes:
Prevent injury by wearing a suspense during physical activity, especially in contact sports;
Prevent sexually transmitted diseases by wearing condoms and other safe sex procedures;
Carry out test-monthly self-tests if you are at risk of testicular cancer;
Make sure the children receive the MMR vaccine (a combination of vaccines for mumps, measles, rubella).
If chlamydia or other sexually transmitted disease is diagnosed, all sex partners must be visited and, if infected, treated.
Sources: [Kodner C. sexually transmitted infections in men. Prim Care. 2003; http://health.nytimes.com/health/; V. Dogra acute painful scrotum. Radiol Clin North Am. 2004]
Chronic Dyshemy is a type of depression in which a person is constantly in a bad mood. However, it is not as extreme as other types of depression.
CAUSES: The exact cause of distillation is unknown. It is as with greater depressive disorder, occurs in most cases in women than men and affects up to 5% of the world's population. Dysthymia can occur alone or together with the most severe depression or mood or other psychiatric disorder.
SYMPTOMS: The main symptom of Dystymia is a sad, sad state of mind, present almost every day for at least 2 years. Symptoms are less severe than patients with severe depression, but people with this condition may still have:
Insomnia or hypersomnia;
Little energy or fatigue;
Poor or too appetite;
DIAGNOSIS: Your doctor will ask you questions about the patient's medical history, your mood and other symptoms of mental health over the last few months.
THERAPY: As with other forms of depression, there are a number of treatment options for people with disabilities:
Selective serotonin inhibitors such as fluoxetine (Prozac);
Logotherapy, such as cognitive / behavioral therapy and interpersonal therapy.
Drugs do not work for distaste as for depression. Some tests have proven that the combination of drugs and psychotherapy can lead to improvement.
PROBLEMS: Dysthymia is a chronic condition that lasts many years. Although some people heal completely, others continue to have some symptoms, including with therapy. Some people need to continue taking medicines even during therapy. Possible complications may be the side effects of antidepressant drugs such as stomach discomfort, mild insomnia, and reduced sexual desire. If not treated, distimia can become a major episode of depression. This is known as "double depression".
Sources: [Institute of Clinical Systems Improvement. Health Care Guidelines: Major Depression in Adults in Primary Care. 11 ° ed. May 2008; http://health.nytimes.com/health/; Stewart JW. Depressive care with atypical characteristics. J Clin Psychiatry. 2007]
Contact your doctor for more information. The information provided on (what the health) is of a general nature and for purely disclosure purposes can in no way replace the advice of a physician (or a legally qualified person) or, in specific cases, of other operators health.