Information on Macroglossia

Macroglossia is the abnormal enlargement of the tongue. Macroglossia may arise secondary to a main disorder that may be either congenital or acquired. Macroglossia may reason major morbidity. Macroglossia slightly than because of an external growth like a tumor. Symptoms and physical findings related with macroglossia may comprise noisy, high-pitched breathing (stridor), snoring, swallowing, sleeping, and/or feeding difficulties. Macroglossia is common in primary and myeloma-related amyloidosis. Amyloidosis is an accumulation of insoluble proteins in tissues that impedes normal function. Macroglossia is also a medical attribute in congenital hypothyroidism, rare inherited syndromes such as Beckwith-Wiedemann syndrome and immunodeficiency, centromere instability and facial anomalies syndrome, acromegaly and Hurler syndrome. Other symptoms comprise speech impediment, swallowing difficulties, airway obstruction, drooling, and failure to flourish. The successful administration of macroglossia needs a multidisciplinary approach. Medical management may be adequate if the enlargement of the tongue is due to systemic illness, but surgical reduction offers the best practical and cosmetic results and minimises morbidity. Airway obstruction demands inflame intervention; tracheostomy is occasionally essential. Early management assists rehabilitation and decreases the risk of permanent maxillofacial abnormalities and abnormalities of speech. Conservative methods of treating macroglossia are of limited worth. Corticosteroids can be life saving in acute airway obstruction and are constructive postoperatively to diminish oedema. Reduction glossectomy has been the main surgical treatment for patients with symptomatic macroglossia. Patients with macroglossia face appreciable physical and psychological problems requiring support and rehabilitation. Secondary orthodontic care and speech therapy may have significant roles in this. Excision should be traditional whenever possible, particularly with benign illness, to allow the tongue to fit happily in the oral cavity and renovate normal occlusion. Surgical aims are to decrease the tongue size and produce improved function. Surgical techniques offer a choice of a V shaped wedge resection, circumferential wedge resection, or a combined transoral and transcervical approach for grossly enlarged lesions. Neoplasms certainly may be control by chemoradiation, depending on their type and susceptibility.

Many girls find that yeast infections tend to show up right before they get their periods because of the hormonal changes that come with the menstrual cycle. Clothing (especially underwear) that is too tight or made of materials like nylon that trap heat and moisture might lead to yeast infections because yeast can thrive in this type of environment. And douching and using scented sanitary products can upset the healthy balance of bacteria in the vagina and make yeast infections more likely.

Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida. These infections enter into the bloodstream through breakdowns or cuts in the skin or mucous membranes. Candidal organisms may build up in an area because of frequent use of strong antibiotics, which kill the bacteria that normally keep it under control.

If you can get away with it, avoid wearing underwear at all. Another suggestion is to wear a loose gown or something that doesnt bind in the crotch area with no underwear.

Parasites are almost always found where there is candida overgrowth and may have played a significant role in causing the candida overgrowth. Many excrete ammonia and toxins that kill friendly bacteria such as acidophilus just like candida does. Anything that kills friendly bacteris, like antibiotics, will help the candida to overgrow, as the friendly flora in your intestinal tract are supposed to keep candida and harmful bacteria in check. Some types of parasites will suppress the immune system response in the intestines which would enable yeast to overgrow.

Yeast can be found in the vagina, rectum, digestive system and mouth. Excessive amounts of yeast causes itching and a burning sensation. The most common and pesky yeast infection occurs in the vaginal tract. This is called Candidiasis and may be identified by a thick, white discharge. It looks like cottage cheese and smells like bread (which uses yeast to rise).

Treatment first aims to improve the underlying condition that predisposes the patient to candidiasis, such as controlling diabetes or discontinuing antibiotic therapy and catheterization, if possible.

If you use a cream or suppository to treat the infection, don’t depend on a condom or diaphragm for birth control. The oil in some medicines weakens latex, the material often used to make these devices.

Sarah Rhodes suffered from chronic yeast infections for many years before finally discovering a natural, permanent cure that works. Read about Sarah and the secret that permanently cured her yeast infections at: yeastinfectionsnomore.com

Getting rid of candida is very tough. If you have been suffering from candida yeast infections for years, fighting it without much success using diet or drugs or herbal products, you know how hard it is to eliminate. Maybe you had recurring vaginal yeast infections, oral thrush, migraine headaches, sinus ear or eye infections, toenail or skin fungus, brain fog, depression, fatigue so bad you cant even hold a job - completely wiping out your life, or any of the other manifestations of candida overgrowth.

Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida. These infections enter into the bloodstream through breakdowns or cuts in the skin or mucous membranes. Candidal organisms may build up in an area because of frequent use of strong antibiotics, which kill the bacteria that normally keep it under control.

In women, signs and symptoms of a vaginal yeast infection are a white cheesy discharge that typically itches and irritates the vagina and surrounding outer tissues. On occasion there may be pain with sexual intercourse or burning with urination.

Corticosteroids and oral contraceptives should be avoided because they may upset the normal, healthy balance of the body. The most healing diet for this condition is one that is fruit-free, sugar-free and yeast-free. Eating yogurt or other food items containing acidophilus can help treat and prevent yeast infection. Women with diabetes often find that yeast infections are less common when blood sugar levels are controlled.

If the mouth is infected, the lining of the mouth is often red and sore. Sometimes the yeast causes white spots and patches on the tongue and cheek lining. This is called “thrush.” The yeast can cause creamy-yellow, raised sores on the mouth.

Having a yeast condition can increase your susceptibility to contracting HIV, since vaginal irritation may allow easier passage of the virus into the bloodstream. For years women’s health advocates worked to demonstrate that the common perception of HIV and AIDS was based on men’s experiences, and it is now recognized that nearly-constant yeast overgrowth can be a marker of HIV infection in women. The immune system suppression from HIV can cause an imbalance in the vagina’s chemistry, resulting in persistent yeast overgrowth.

Yogurt which contains live cultures of L. Acidophilus (not pasteurized) can help prevent yeast infections. L. Acidophilus is also available in pill form and can be purchased at health food store and larger grocery stores.

Sarah Rhodes suffered from chronic yeast infections for many years before finally discovering a natural, permanent cure that works. Read about Sarah and the secret that permanently cured her yeast infections at: yeastinfectionsnomore.com

Definition: Chronic Vomiting
- Acute vomiting that fails to respond to appropriate symptomatic therapy
- Untreated vomiting that persists longer than two weeks
– Consistent
– Intermittent or episodic

Approach to Vomiting
- Primary GI
– Gastric
– Small intestinal
– Colonic
- Secondary GI
– Systemic illness that affects GI function

Secondary GI Causes of Vomiting
SYSTEM
- Kidneys
- Liver
- Exocrine pancreas
- Endocrine pancreas
- Adrenals
- Peritoneum
- CNS

- Thyroid
- Uterus
- Systemic infection

Disease:
- Renal failure
- Hepatic disease
- Pancreatitis
- DKA
- Addison’s
- Peritonitis
- Cerebral or vestibular disease
- Hyperthyroidism
- Pyometra
- Sepsis

Overview:
Gastric Causes of Chronic Vomiting
- Chronic gastritis
– Lymphocytic/plasmacytic
– Eosinophilic
– Associated with GHLOs
– Parasitic
– Reflux gastritis
- Gastric foreign body
- Gastric ulceration
- Gastric motility disorders
- Gastric neoplasia

Overview:
Intestinal Causes of Chronic Vomiting
- Inflammatory bowel disease (IBD)
- Intestinal neoplasia
- Duodenal ulcers
- Fungal enteritis
- Chronic intussusception
- Foreign bodies
- Colitis

Chronic Vomiting: History
- Characterize vomiting
– Onset
– Duration
– Frequency
– Progression
– Relationship to eating
– Specific features (blood, foreign material, undigested food, projectile, etc.)
– Response to changes in diet or feeding schedule, medication, other changes

Associated clinical signs-
– Appetite changes
– Weight loss
– Diarrhea
– Changes in attitude (lethargy)
– PU/PD
– Cough, tachypnea, dyspnea
– Other

- Potential exposures prior to onset:
– Medications
– Plants
– Toxins
– Garbage
– Potential foreign bodies
– Other sick animals

- Dietary history
- Deworming history
- Vaccination status
- Past medical history
- Past surgical history

Approach to Vomiting:
- Primary GI
– Gastric
– Small intestinal
– Colonic
- Secondary GI
– Systemic illness that affects GI function

Chronic Vomiting:
Diagnostic Steps
- CBC, biochemistry profile, UA
- Fecal
- Survey abdominal radiographs
- Cats:
– T4 if over 6 yrs, FeLV, FIV
– occult heartworm test
- Elimination diet
- Endoscopy
- Abdominal ultrasound
- Barium series
- Laparatomy

Approach to Chronic Vomiting
CBC, biochemistry profile, UA, fecal
Survey abdominal radiographs
Cats: T4 if over 6 yrs, FeLV, FIV (occult heartworm test)

Mild Signs:
- Elimination diet

Significant Clinical Signs:
- Endoscopy
- Abdominal ultrasound
- Barium series
- Laparotomy

Overview:
Gastric Causes of Chronic Vomiting
- Chronic gastritis
– Lymphocytic/plasmacytic
– Eosinophilic
– Associated with GHLOs
– Parasitic
– Reflux gastritis

- Gastric foreign body
- Gastric ulceration
- Gastric motility disorders
- Gastric neoplasia

Chronic Gastritis
Classified by etiology, breed, and/or histopathology
Types of Chronic Gastritis

– Lymphocytic/plasmacytic gastritis (Chronic non-specific gastritis, IBD)
– Eosinophilic gastritis
– Granulomatous gastritis
– Atrophic gastritis
– Gastritis associated with GHLOs
– Parasitic gastritis
– Reflux gastritis

Etiopathogenesis of Chronic Lymphocytic/Plasmacytic Gastritis

- Non-specific reaction to many insults
- Either wall defects allow antigen absorption from stomach stimulating immune response OR breakdown in immune tolerance (auto-immune gastritis)
- Mucosal damage allows back-diffusion of acid
- Gastric inflammation compromises motility, secretions and plasma proteins lost into lumen

Chronic Lymphocytic/Plasmacytic Gastritis: Clinical Features
- Persistent intermittent vomiting exacerbated by eating
- Diarrhea occurs if animal has concurrent IBD of intestines
- PE, CBC, chemistries, UA, fecal, and survey radiographs – typically NAF

Chronic Lymphocytic/Plasmacytic Gastritis: Diagnosis
- Obtain endoscopic biopsies or full-thickness biopsies by laparotomy
- Infiltration of the gastric mucosa predominantly with lymphocytes and plasma cells
- Mucosa may be normal thickness (simple gastritis), increased (hypertrophic), or decreased (atrophic) Note: Mucosal hypertrophy can cause outflow obstruction

Chronic Lymphocytic/Plasmacytic Gastritis: Treatment
PRIMARY THERAPY
- +/- NPO or “no food” for 24-48 hours
- Multiple small daily meals
– Easily digested diet (i/d)
– Novel protein diet (e.g. venison and rice)
– Hydrolyzed protein diet (z/d, HA)
- Gastric protectant (Sucralfate)
- Treat for ulceration if indicated

SECONDARY THERAPY
- Prednisolone 1-2 mg/kg PO q12 hr, tapered
- Usually reserve antiemetics for acute exacerbations

Eosinophilic Gastritis
- Clinical signs like L/P gastritis
- Inflammatory infiltrate dominated by eosinophils
- May have peripheral eosinophilia
- May be associated with:
– Generalized eosinophilic gastroenteritis (dogs and cats)
– Eosinophilic granulomas (dogs)
– Hypereosinophilic syndrome (cats)

Eosinophilic Gastritis
- Suspected etiologies
– Parasites
– Dietary hypersensitivity
– Hypereosinophilic syndrome (cats) – neoplastic-

Eosinophilic Gastritis: Treatment
- Therapeutic deworming
- Treat as for L/P gastritis except use prednisolone as part of primary therapy
- Cats usually require higher doses of steroids for control (2-3 mg/kg q12 hr)
- If refractory, add azathioprine
- Resect granulomatous masses

Eosinophilic Gastritis: Prognosis
- Eosinophilic gastritis +/- enteritis: Good prognosis for control of clinical signs
- Hypereosinophilic syndrome in cats: Very guarded prognosis

Dr. D.S. Merchant is a Gold Medalist in (Anatomy %26 Histology), Resident AKUH, Pakistan. For more information on Gastroenterology or visit www.update.pk is a popular website that offers information on Endoscopy, Pulmonary Disease and VHF Medications.

Getting rid of candida is very tough. If you have been suffering from candida yeast infections for years, fighting it without much success using diet or drugs or herbal products, you know how hard it is to eliminate. Maybe you had recurring vaginal yeast infections, oral thrush, migraine headaches, sinus ear or eye infections, toenail or skin fungus, brain fog, depression, fatigue so bad you cant even hold a job - completely wiping out your life, or any of the other manifestations of candida overgrowth.

Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida. These infections enter into the bloodstream through breakdowns or cuts in the skin or mucous membranes. Candidal organisms may build up in an area because of frequent use of strong antibiotics, which kill the bacteria that normally keep it under control.

In women, signs and symptoms of a vaginal yeast infection are a white cheesy discharge that typically itches and irritates the vagina and surrounding outer tissues. On occasion there may be pain with sexual intercourse or burning with urination.

Corticosteroids and oral contraceptives should be avoided because they may upset the normal, healthy balance of the body. The most healing diet for this condition is one that is fruit-free, sugar-free and yeast-free. Eating yogurt or other food items containing acidophilus can help treat and prevent yeast infection. Women with diabetes often find that yeast infections are less common when blood sugar levels are controlled.

If the mouth is infected, the lining of the mouth is often red and sore. Sometimes the yeast causes white spots and patches on the tongue and cheek lining. This is called “thrush.” The yeast can cause creamy-yellow, raised sores on the mouth.

Having a yeast condition can increase your susceptibility to contracting HIV, since vaginal irritation may allow easier passage of the virus into the bloodstream. For years women’s health advocates worked to demonstrate that the common perception of HIV and AIDS was based on men’s experiences, and it is now recognized that nearly-constant yeast overgrowth can be a marker of HIV infection in women. The immune system suppression from HIV can cause an imbalance in the vagina’s chemistry, resulting in persistent yeast overgrowth.

Yogurt which contains live cultures of L. Acidophilus (not pasteurized) can help prevent yeast infections. L. Acidophilus is also available in pill form and can be purchased at health food store and larger grocery stores.

Sarah Rhodes suffered from chronic yeast infections for many years before finally discovering a natural, permanent cure that works. Read about Sarah and the secret that permanently cured her yeast infections at: yeastinfectionsnomore.com

A fine head of hair is a joy to behold and probably one of our most important social and secondary sexual characteristics. Everybody wants to have a good head of hair and the upset and trauma when problems arise with the hair and hair growth are simply enormous. Loss of hair or hair condition is viewed by most people as far more serious than even the worst imaginable systemic illness because it is clearly visible, and part of our persona, our style, the way we want people to see us has been changed or permanently lost.

This book sets out the deciding factors; it contains all you need to know to improve your hair growth and to improve your hair condition. It is a do-it-yourself guide for good hair growth. Detailed explanations and pictures of some of the many dreadful hair and scalp ailments have been avoided. These require specialist treatment from a Dermatologist or Trichologist.

Here we try to “accentuate the positive” to show that it is possible for people with average or poor hair growth or condition to improve their position to get to the optimum hair growth. Everything you ever wanted to know about your hair, and were afraid to ask is set out here. This book will ensure that you always have a good hair day.

Everybody will experience some degree of trouble with his or her hair or scalp at some time. However, if you are experiencing hair loss or an irritating scalp problem you do not need to just tolerate it. You can take an active step today and seek help from The Hair Centre.

Gary Heron is one of Europe’s leading trichologists for the past 20 years dealing directly with every type of hair loss and scalp disorder for both men and women of all ages and ethnic backgrounds. Gary has had over twenty years’ experience in dealing with every type of hair or scalp problem. For example, he helps people suffering with scalp disorders such as psoriasis, seborrhoeic dermatitis, folliculitis or from hair loss and thinning caused by genetic baldness, alopecia or through chemical or physical damage.http://www.thewestminsterpractice.com

Gary says,” Everybody will experience some degree of trouble with his or her hair or scalp at some time. However, if you are experiencing hair loss or an irritating scalp problem you do not need to just tolerate it. You can take an active step today and seek help from The Hair Centre”. All treatments products supplied are formulated especially for The Hair Centre by leading trichologists and chemists. They have undergone exhaustive clinical trials and testing to ensure we can target disorders of the hair and scalp effectively.

If you’re a girl who’s had her period, you may have heard frightening stories about toxic shock syndrome (TSS), a serious illness originally linked to the use of tampons. But TSS isn’t strictly related to tampons. The contraceptive sponge and the diaphragm, two types of birth control methods, have been linked to TSS. And, sometimes, the infection has occurred as a result of wounds or surgery, where the skin has been broken, allowing bacteria to enter.

Toxic shock syndrome can happen to anyone %26mdash; men, women, and children. Although it can be serious, it’s a very rare illness. If you’re concerned about toxic shock syndrome, the smartest thing you can do is to read and learn about it, then take some precautions.

What Is Toxic Shock Syndrome?

TSS is a systemic illness, which means that it affects the whole body. It can be caused by one of two different types of bacteria, Staphylococcus aureus and Streptococcus pyogenes %26mdash; although toxic shock that is caused by the Streptococcus bacteria is rarer. These bacteria can produce document.write(deftoxins60)toxins. In some people whose bodies can’t fight these toxins, the immune system reacts. This reaction causes the symptoms associated with TSS.

When people think of TSS, they often think of tampon use. That’s because the earliest cases of the illness, back in the late 1970s, were related to superabsorbent tampons. Research led to better tampons and better habits for using them %26mdash; such as changing tampons more often. The number of TSS cases dropped dramatically. Today about half of all TSS cases are linked to menstruation.

Aside from tampon use, TSS has been linked to skin infections that are typically minor and can be associated with the chickenpox rash. TSS has also been reported following surgical procedures, giving birth, and prolonged use of nasal packing for nosebleeds %26mdash; although all of these are rare.

What Are the Signs and Symptoms?

Symptoms of TSS occur suddenly. Because it’s an illness that is caused by a toxin, many of the body’s organ systems are affected. The signs and symptoms of TSS include:

high fever (greater than 102° Fahrenheit [38.8° Celsius])

rapid drop in blood pressure (with lightheadedness or fainting)

sunburn-like rash on the entire body

vomiting and diarrhea

severe muscle aches or weakness

bright red coloring of the eyes, throat, and vagina

headache, confusion, disorientation, or seizures

kidney and other organ failure

The average time before symptoms appear for TSS is 2 to 3 days after an infection with Staphylococcus or Streptococcus, although this can vary depending on the cause of the infection.

Can I Prevent TSS?

The risk of getting TSS is already low. But you can reduce it still further by simply following some common-sense precautions:

Clean and bandage any skin wounds.

Change bandages regularly, rather than keeping them on for several days.

Check wounds for signs of infection. If a wound gets red, swollen, painful, or tender, or if you develop a fever, call your doctor right away.

If you’re a girl whose period has started, the best way to avoid TSS is to use sanitary napkins instead of tampons.

For girls who prefer to use tampons, select the ones with the lowest absorbency that can handle your menstrual flow and change them frequently. You can also alternate the use of tampons with sanitary napkins.

If you’ve already had an episode of TSS or have been infected with S. aureus, don’t use tampons or contraceptive devices that have been associated with TSS (such as diaphragms and contraceptive sponges).

What Do Doctors Do?

TSS is a medical emergency. If you think you or someone you know may have TSS, call a doctor right away. Depending on the symptoms, a doctor may see you in the office or refer you to a hospital emergency department for immediate evaluation and testing.

If doctors suspect TSS, they will probably start intravenous (IV) fluids and antibiotics as soon as possible. They may take a sample from the suspected site of the infection, such as the skin, nose, or vagina, to check it for TSS. They may also take a blood sample. Other blood tests can help monitor how various organs like the kidneys are working and check for other diseases that may be causing the symptoms.

Medical staff will remove tampons, contraceptive devices, or wound packing; clean any wounds; and, if there is a pocket of infection (called an abscess), a doctor may need to drain pus from the infected area.

People with TSS typically need to stay in the hospital, often in the intensive care unit, for several days to closely monitor blood pressure, respiratory status, and to look for signs of other problems, such as organ damage.

TSS is a very rare illness that’s usually not fatal if recognized and treated promptly.

Reviewed by: Larissa Hirsch, MD
Date reviewed: January 2007
Originally reviewed by: Joel Klein, MD Printer-friendly versionEmail this article to a friendSend email to us