ACL injury

 ACL injury

An ACL injury is the tearing of the anterior cruciate (KROO-she-ate) ligament, or ACL, inside your knee joint. An ACL injury most commonly occurs during sports that involve sudden stops and changes in direction — such as basketball, soccer, tennis and volleyball.

Immediately after an ACL injury, your knee may swell, feel unstable and become too painful to bear weight. Many people hear a "pop" in their knee when an ACL injury occurs.

Depending on the severity of your ACL injury, treatment may include surgery to replace the torn ligament followed by rehabilitation exercises to help you regain strength and stability. If your favorite sport involves pivoting or jumping, a proper training program can help you to reduce your chances of an ACL injury.

CAUSES:

Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone (femur) to your shinbone (tibia) and helps stabilize your knee joint.

Most ACL injuries happen during sports and fitness activities. The ligament may tear when you slow down suddenly to change direction or pivot with your foot firmly planted, twisting or overextending your knee.

Landing awkwardly from a jump can also injure your ACL, as can falls during downhill skiing. A football tackle or motor vehicle accident also can cause an ACL injury. However, most ACL injuries occur without such contact.

Treatments and drugs:

 

Initial treatment for an ACL injury aims to reduce pain and swelling in your knee, regain normal joint movement and strengthen the muscles around your knee.
You and your doctor will then decide if you need surgery plus rehabilitation, or rehabilitation alone. The choice depends on several factors, including the extent of damage to your knee and your willingness to modify your activities.
Athletes who wish to return to sports involving cutting, pivoting or jumping usually pursue surgical reconstruction to prevent episodes of instability. More-sedentary individuals usually can maintain knee stability with rehabilitation alone.
Therapy
Rehabilitation therapy will be needed, whether or not you have surgery on your knee. Therapy will include:

• The use of crutches and, possibly, a knee brace
• Range-of-motion exercises to regain your full knee motion
• Muscle-strengthening and stability exercises

Surgical and other procedures

• Arthrocentesis. An ACL injury tends to cause bleeding inside the knee, which can lead to significant swelling. This swelling can be reduced by arthrocentesis, a procedure in which a needle is inserted into the knee joint to draw off the excess fluid.
• Surgical reconstruction. A torn ACL can't be successfully sewn back together, so the ligament is replaced with a piece of tendon from another part of your leg. This surgery is usually performed arthroscopically through small incisions around your knee joint. A camera is used to guide the placement of the ACL graft.

 

Addison's disease

Addison's disease

Addison's disease is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison's disease, your adrenal glands produce too little cortisol and often insufficient levels of aldosterone as well.

Also called adrenal insufficiency or hypocortisolism, Addison's disease occurs in all age groups and affects both sexes. Addison's disease can be life-threatening.

Treatment for Addison's disease involves taking hormones to replace the insufficient amounts being made by your adrenal glands, in order to mimic the beneficial effects those naturally made hormones would normally produce.

CAUSES:

Addison's disease results when your adrenal glands are damaged, producing insufficient amounts of the hormone cortisol and often aldosterone as well. These glands are located just above your kidneys. As part of your endocrine system, they produce hormones that give instructions to virtually every organ and tissue in your body.

Your adrenal glands are composed of two sections. The interior (medulla) produces adrenaline-like hormones. The outer layer (cortex) produces a group of hormones called corticosteroids, which include glucocorticoids, mineralocorticoids and male sex hormones (androgens).

Some of the hormones the cortex produces are essential for life — the glucocorticoids and the mineralocorticoids.

Glucocorticoids. These hormones, which include cortisol, influence your body's ability to convert food fuels into energy, play a role in your immune system's inflammatory response and help your body respond to stress.
Mineralocorticoids. These hormones, which include aldosterone, maintain your body's balance of sodium and potassium to keep your blood pressure normal.
Androgens. These male sex hormones are produced in small amounts by the adrenal glands in both men and women. They cause sexual development in men and influence muscle mass, libido and a sense of well-being in men and women.

Primary adrenal insufficiency
Addison's disease occurs when the cortex is damaged and doesn't produce its hormones in adequate quantities. Doctors refer to the condition involving damage to the adrenal glands as primary adrenal insufficiency.

The failure of your adrenal glands to produce adrenocortical hormones is most commonly the result of the body attacking itself (autoimmune disease). For unknown reasons, your immune system views the adrenal cortex as foreign, something to attack and destroy.

Other causes of adrenal gland failure may include:

Tuberculosis
Other infections of the adrenal glands
Spread of cancer to the adrenal glands
Bleeding into the adrenal glands

Secondary adrenal insufficiency
Adrenal insufficiency can also occur if your pituitary gland is diseased. The pituitary gland makes a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its hormones. Inadequate production of ACTH can lead to insufficient production of hormones normally produced by your adrenal glands, even though your adrenal glands aren't damaged. Doctors call this condition secondary adrenal insufficiency.

Another more common cause of secondary adrenal insufficiency occurs when people who take corticosteroids for treatment of chronic conditions, such as asthma or arthritis, abruptly stop taking the corticosteroids.

Addisonian crisis

If you have untreated Addison's disease, an addisonian crisis may be provoked by physical stress, such as an injury, infection or illness.

Treatments and drugs:

All treatment for Addison's disease involves hormone replacement therapy to correct the levels of steroid hormones your body isn't producing. Some options for treatment include:

Oral corticosteroids. Your doctor may prescribe fludrocortisones (Florinef) to replaces aldosterone. Hydrocortisone (Cortef), prednisone or cortisone acetate may be used to replace cortisol.
Corticosteroid injections. If you're ill with vomiting and can't retain oral medications, injections are an option.
Androgen replacement therapy. To treat androgen deficiency in women, dehydroepiandrosterone can be prescribed. Some studies suggest that this therapy may improve overall sense of well-being, libido and sexual satisfaction.

An ample intake of sodium is recommended, especially during heavy exercise, when the weather is hot, or if you have gastrointestinal upsets, such as diarrhea. Your doctor will also suggest a temporary increase in your dosage if you're facing a stressful situation, such as an operation, an infection or a minor illness.

Addisonian crisis
An addisonian crisis is a life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium. This situation requires immediate medical care. Treatment typically includes intravenous injections of:

Hydrocortisone
Saline solution
Sugar (dextrose)

Attention-deficit/hyperactivity disorder (ADHD) in children

Attention-deficit/hyperactivity disorder (ADHD) in children

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often persists into adulthood. ADHD includes some combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior. Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school.

While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions.

A diagnosis of ADHD can be scary, and symptoms can be a challenge for parents and children alike. However, treatment can make a big difference, and most children with ADHD grow up to be normal adul

CAUSES:

Parents may blame themselves when a child is diagnosed with ADHD, but the causes likely have more to do with inherited traits than parenting choices. At the same time, certain environmental factors may contribute to or worsen a child's behavior. Although there's still a lot that isn't known about ADHD, several factors may cause it:

Altered brain function and anatomy. While the exact cause of ADHD remains a mystery, brain scans have revealed important differences in the structure and brain activity of people with ADHD. For example, there appears to be less activity in the areas of the brain that control activity levels and attention.
Heredity. ADHD tends to run in families. Several genes that may be associated with ADHD are currently being studied.
Maternal smoking, drug use and exposure to toxins. Pregnant women who smoke are at increased risk of having children with ADHD. Alcohol or drug abuse during pregnancy may reduce activity of the nerve cells (neurons) that produce neurotransmitters. Pregnant women who are exposed to environmental poisons also may be more likely to have children with symptoms of ADHD.
Childhood exposure to environmental toxins. Preschool children exposed to certain toxins are at increased risk of developmental and behavioral problems. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span.
Food additives. Substances added to food, such as artificial coloring or food preservatives, may contribute to hyperactive behavior. Although sugar is a popular suspect in causing hyperactivity, there's no reliable proof of this.

Alternative medicine:

There's little research that indicates that alternative medicine treatments can significantly reduce ADHD symptoms. Some alternative medicine treatments that have been tried include:

Yoga and meditation. While it might seem to make sense that two calming activities, such as yoga and meditation, would help reduce symptoms of ADHD, there's no conclusive evidence that either therapy does so.
Special diets. Most diets for ADHD involve eliminating foods thought to increase hyperactivity, such as sugar and caffeine, and common allergens such as wheat, milk and eggs. Some diets recommend eliminating artificial food colorings and additives. So far, studies haven't found a consistent link between diet and improved symptoms of ADHD, though a limited number of studies suggest diet changes might make a difference. Limiting sugar, however, doesn't seem to help.
Vitamin or mineral supplements. While certain vitamins and minerals are necessary for good health, there's no evidence that supplemental vitamins or minerals can reduce symptoms of ADHD. "Megadoses" of vitamins — doses that far exceed the Recommended Dietary Allowance (RDA) — can be harmful.
Herbal supplements. There is no evidence to suggest that herbal remedies, such as St. John's wort, help with ADHD.
Essential fatty acids. These fats, which include omega-3 oils, are necessary for the brain to function properly. Researchers are still investigating whether these may improve ADHD symptoms.
Neurofeedback training. Also called electroencephalographic biofeedback, this treatment involves regular sessions in which a child focuses on certain tasks while using a machine that shows brain wave patterns. Theoretically, a child can learn to keep brain wave patterns active in the front of the brain — improving symptoms of ADHD. While this treatment looks promising, more research is needed to see whether this treatment works.

Actinic keratosis

Actinic keratosis

An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on your skin that develops from years of exposure to the sun. It's most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck — areas of skin typically exposed to the sun.

An actinic keratosis, also known as solar keratosis, enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin. An actinic keratosis takes years to develop, usually first appearing in older adults. Many doctors consider an actinic keratosis to be precancerous because it can develop into skin cancer.

You can reduce your risk of actinic keratosis by minimizing your sun exposure and protecting your skin from ultraviolet (UV) rays.

CAUSES:

Frequent or intense exposure to UV rays, typically from the sun, causes an actinic keratosis.

An actinic keratosis begins in your skin's top layer — the epidermis. The epidermis is as thin as a pencil line, and it provides a protective layer of skin cells that your body continually sheds.

Normally, skin cells within the epidermis develop in a controlled and orderly way. In general, healthy new cells push older cells toward the skin's surface, where they die and eventually are sloughed off. When skin cells are damaged through UV radiation, changes occur in the skin's texture and color, causing blotchiness and bumps or lesions.

Most of the damage to skin cells results from exposure to UV radiation from sunlight and commercial tanning lamps and beds. The damage adds up over time, so the more time you spend in the sun or in a tanning booth, the greater your chance of developing skin cancer. Your risk increases even more if most of your outdoor exposure occurs at times of the day or in locations where the sunlight is most intense

Treatments and drugs:

It's impossible to tell exactly which patches or lesions will develop into skin cancer. Therefore, actinic keratoses are usually removed as a precaution. Your doctor can discuss with you which treatment is appropriate for you. With most of these procedures, the treated area takes a few days to several weeks to heal.

Actinic keratosis treatment options may include:

Freezing (cryotherapy). An extremely cold substance, such as liquid nitrogen, is applied to skin lesions. The substance freezes the skin surface, causing blistering or peeling. As your skin heals, the lesions slough off, allowing new skin to appear. This is the most common treatment, takes only a few minutes and can be performed in your doctor's office. Side effects may include blisters, scarring, changes to skin texture, infection and darkening of the skin at the site of treatment.
Scraping (curettage). In this procedure, your surgeon uses a device called a curet to scrape off damaged cells. Scraping may be followed by electrosurgery, in which a pencil-shaped instrument is used to cut and destroy the affected tissue with an electric current. This procedure requires a local anesthetic. Side effects may include infection, scarring and changes in skin coloration at the site of treatment.
Creams or ointments. Some topical medications contain fluorouracil (Carac, Fluoroplex, Efudex), a chemotherapy drug. The medication destroys actinic keratosis cells by blocking essential cellular functions within them. Another treatment option is imiquimod (Aldara), a topical cream that modifies the skin's immune system to stimulate your body's own rejection of precancerous cells. Diclofenac gel (Voltaren, Solaraze), a nonsteroidal anti-inflammatory topical drug, may help, too. Side effects may include skin irritation such as pain, itching, stinging or burning sensation, crusting, and sensitivity to sun exposure at the site of treatment.
Chemical peeling. This involves applying one or more chemical solutions — trichloroacetic acid (Tri-Chlor), for example — to the lesions. The chemicals cause your skin to blister and eventually peel, allowing new skin to form. Skin peeling usually lasts for five to seven days. Other side effects may include stinging or burning sensation, redness, crusting, changes in skin coloration, infections and, rarely, scarring. This procedure may not be covered by insurance, as it's often considered cosmetic.
Photodynamic therapy. With this procedure, an agent that makes your damaged skin cells sensitive to light (photosensitizing agent) is either injected or applied topically. Your skin is then exposed to intense laser light to destroy the damaged skin cells. Side effects may include redness, swelling and a burning sensation during therapy.
Laser therapy. A special laser is used to precisely remove the actinic keratoses and the affected skin underneath. Local anesthesia is often used to make the procedure more comfortable. Some pigment loss and scarring may result from laser therapy.
Dermabrasion. In this procedure, the affected skin is removed using a rapidly moving brush. Local anesthetic is used to make the procedure more tolerable. The procedure leaves skin red and raw-looking. It takes several months for the skin to heal, but the new skin generally appears smoother.

Talk to your doctor about your treatment options. The procedures have various advantages and disadvantages, including side effects, risk of scarring, and the number of treatment sessions required. Afterward you'll likely have regular follow-up visits to check for new patches or lesions.

Acromegaly

Acromegaly

Acromegaly (ak-roh-MEG-uh-lee) is a rare hormonal disorder that develops when your pituitary gland produces too much growth hormone, nearly always as a result of a noncancerous (benign) tumor. The excess hormone causes swelling, skin thickening, tissue growth and bone enlargement, especially in your face, hands and feet.

Acromegaly occurs in adulthood, usually during middle age. In children who are still growing, too much growth hormone can cause a condition called gigantism that leads to an abnormal increase in height as well as excess bone growth.

Because acromegaly is uncommon and physical changes occur gradually, it often isn't recognized right away. Although untreated acromegaly can lead to serious illness and premature death, available treatments can reduce your risk of complications and significantly improve your symptoms.

Causes:

Acromegaly occurs when your body produces too much growth hormone. The source of the excess hormone is almost always your pituitary gland, a small bean-shaped structure at the base of your brain behind your nose. Growth hormone is one of several hormones your pituitary gland produces.

Growth hormone plays an important role in growth and regeneration of your bones and other tissues by stimulating your liver to produce another hormone called insulin-like growth factor-I (IGF-I).

In adults, a tumor is the most common cause of excess growth hormone:

Pituitary tumors. Most cases of acromegaly are caused by a noncancerous (benign) tumor, or adenoma, of the pituitary gland. In addition to producing excess growth hormone, these tumors can press on nearby tissues as they grow. This pressure can cause some of the symptoms of acromegaly, such as headaches and impaired vision.
Nonpituitary tumors. In a few people, acromegaly is caused by benign or cancerous tumors in other parts of the body, such as the lungs, pancreas or adrenal glands. Some of these tumors actually secrete growth hormone. In other cases, they produce a hormone called growth hormone-releasing hormone (GH-RH), which stimulates the pituitary gland to make more growth hormone.

Treatments and drugs:

Doctors treat acromegaly caused by benign tumors of the pituitary gland with surgery, medications and radiation. Your initial care plan will depend on your age, the size and location of your tumor, and other medical conditions you may have. Over time, you may need more than one type of treatment. The goal of therapy is to return your growth hormone and IGF-1 levels as close to normal as possible to avoid serious complications and eliminate the risk of premature death. With successful treatment, swelling and enlargement of your soft tissues may gradually subside. Treatment can't reverse excess bone growth, but it can prevent more growth from occurring.

If your acromegaly is caused by a tumor outside your pituitary gland, your doctor will develop an individualized treatment plan based on the tumor's location and whether it is benign or cancerous.

Surgery
Doctors can remove many pituitary tumors using transsphenoidal surgery. In this procedure, named for the sphenoid sinus — air pocket behind the nose — your surgeon extracts your tumor through a small incision through the back wall of your nose.

Because transsphenoidal surgery is complex, it's important to choose a surgeon experienced in performing this procedure. Research has shown that more-experienced surgeons who perform greater numbers of procedures generally have more successful outcomes.

Removing the tumor surgically can quickly and effectively return growth hormone levels to normal and relieve pressure on the tissues around your pituitary gland. But even the most experienced surgeon may not be able to completely remove tumors that have grown large or extended into nearby blood vessels or other structures. Incomplete tumor removal may result in growth hormone levels that stay high after surgery, requiring further treatment with medication or radiation.

Medications
Doctors may choose to manage your acromegaly with medication if your pituitary tumor is inaccessible to surgery, or you're at high risk of surgical complications. You may also need drugs if your growth hormone levels stay high following surgery. Your need for medications may continue for the rest of your life. Drugs used to lower the production of growth hormone or block its action on target tissues include:

Somatostatin analogues (SSAs). The drugs octreotide (Sandostatin, Sandostatin LAR) and lanreotide (Somatuline Depot) are synthetic versions of the brain hormone somatostatin — growth hormone release-inhibiting hormone. They can decrease growth hormone levels by blocking the pituitary gland's excess production. They can also shrink tumors over time. When starting octreotide treatment, you initially inject yourself with a short-acting preparation under your skin (subcutaneously) every eight hours to determine if you have any side effects from the medication and if it's effective. Then, if it's tolerated and effective, you can take a long-acting form that requires an injection into the muscles of your buttocks (gluteal muscles) by a health care professional, administered once a month. Lanreotide is given as a long-acting subcutaneous injection once a month. Your health care professional may give the injection or teach you or a family member how to do it. Common side effects of SSAs include pain at the injection site, intestinal cramping and diarrhea, and gallbladder problems.
Growth hormone receptor antagonists (GHRAs). The medication pegvisomant (Somavert) blocks the effect of growth hormone on body tissues. You administer pegvisomant yourself daily by subcutaneous injection. This medication can normalize IGF-I levels and relieve symptoms in most people with acromegaly, but doesn't lower growth hormone levels or reduce the tumor size. Common side effects include headache, fatigue, nausea and diarrhea.
Dopamine agonists. Cabergoline (Dostinex) and bromocriptine (Parlodel) offer another strategy to reduce growth hormone production and shrink tumors. Both drugs can be taken as pills, but are effective for significantly fewer people than are somatostatin analogues or growth hormone receptor antagonists. Doctors sometimes prescribe treatment combining dopamine agonists with somatostatin analogues. Common side effects of dopamine agonists include nausea, intestinal cramps and headache.

Radiation
Your doctor may recommend radiation treatment if tumor cells remain after surgery and medication is ineffective in reducing your growth hormone levels. Radiation therapy can quickly stop lingering tumor cells from growing and slowly reduce growth hormone levels. It may take years for this treatment to noticeably improve acromegaly symptoms, and you may continue to need medication while you and your doctor wait for your growth hormone levels to fall.

You receive radiation treatment in one of two ways:

Conventional radiation therapy. This type of radiation is usually given every weekday over four to six weeks. It may take five to 10 years or more for your growth hormone levels to return to normal.

Stereotactic radiosurgery. Radiation can also be given stereotactically, with precisely focused, intense beams aimed at a tumor from multiple directions. This strategy can deliver a high dose of radiation to tumor cells while limiting the amount of radiation to nearby normal tissues.

Current stereotactic technologies deliver radiation with a gamma knife, a linear accelerator or a proton beam. These treatments may be given in a single session or multiple sessions. Emerging evidence suggests that stereotactic approaches may bring growth hormone levels back to normal within three to five years.

Stereotactic radiosurgery is available at a limited number of U.S. medical centers. Pituitary tumors that are too close to the point where the eye (optic) nerves cross are not eligible for stereotactic surgery. Your doctor will determine which type of radiation therapy is right for you.

After your treatment for acromegaly, you'll require monitoring by your doctor to make sure that your pituitary gland is functioning properly and that your symptoms are getting better. This follow-up care may last the rest of your life. Because acromegaly is linked to a risk of precancerous colon polyps, you should have a screening colonoscopy close to the time of your diagnosis and at recommended intervals afterwards.

Acne

Acne

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Acne most commonly appears on your face, neck, chest, back and shoulders. Acne can be distressing and annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up.

Depending on its severity, acne can cause emotional distress and lead to scarring of the skin. The good news is that effective treatments are available — and the earlier treatment is started, the lower your risk of lasting physical and emotional damage.

Causes:

Three factors contribute to the formation of acne:

Overproduction of oil (sebum)
Irregular shedding of dead skin cells resulting in irritation of the hair follicles of your skin
Buildup of bacteria

Acne occurs when the hair follicles become plugged with oil and dead skin cells. Hair follicles are connected to sebaceous glands. These glands secrete an oily substance known as sebum to lubricate your hair and skin. Sebum normally travels up along the hair shafts and then out through the openings of the hair follicles onto the surface of your skin. When your body produces an excess amount of sebum and dead skin cells, the two can build up in the hair follicles and form together as a soft plug, creating an environment where bacteria can thrive.

This plug may cause the follicle wall to bulge and produce a whitehead. Or, the plug may be open to the surface and may darken, causing a blackhead. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside hair follicles produce lumps beneath the surface of your skin called cysts. Other pores in your skin, which are the openings of the sweat glands onto your skin, aren't normally involved in acne.

Factors that may worsen acne
These factors can trigger or aggravate an existing case of acne:

Hormones. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives can also affect sebum production.
Certain medications. Drugs containing corticosteroids, androgens or lithium are known to cause acne.
Diet. Studies indicate that certain dietary factors, including dairy products and carbohydrate-rich foods — such as bread, bagels and chips, which increase blood sugar — may trigger acne.

Acne myths
Contrary to what some people think, these factors have little effect on acne:

Greasy foods and chocolate have proved to have little to no effect on the development or course of acne.
Dirty skin. Acne isn't caused by dirt. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse. Simple cleansing of the skin to remove excess oil and dead skin cells is all that's required.

Alternative medicine:

Some studies suggest that taking the following supplements may help treat acne:

Tea tree oil. Gels containing 5 percent tea tree oil may be as effective as are lotions containing 5 percent benzoyl peroxide, although tea tree oil might work more slowly. Tea tree oil may cause a skin reaction known as contact dermatitis. There's also some concern that topical products containing tea tree oil might cause breast development in young boys. Don't use tea tree oil if you have acne rosacea because it can worsen symptoms.
Alpha hydroxy acids. These natural acids — found in foods such as citrus fruits, sugar cane, apples and grapes — help remove dead skin cells and unclog pores when applied topically. Alpha hydroxy acids may also improve the appearance of acne scars. Adverse reactions to alpha hydroxy acids include redness, mild stinging and skin irritation.
Azelaic acid. This naturally occurring acid is found in whole-grain cereals and animal products and has antibacterial properties. A 20 percent azelaic acid cream seems to be as effective as many other conventional acne treatments, including 5 percent benzoyl peroxide and oral tetracycline.
Zinc supplements. The mineral zinc plays a role in wound healing and reduces inflammation, which could help improve acne. Taking a zinc supplement with food may reduce side effects, including a bad taste in your mouth and nausea. Zinc can also be added to lotions or creams and may reduce acne breakouts.
Brewer's yeast. A specific strain of brewer's yeast, called CBS 5926, seems to help decrease acne. Brewer's yeast may cause migraines in susceptible people and may cause intestinal upset.

More research is needed to understand the potential role of these and other dietary supplements in the treatment of acne.

Always talk with your doctor before trying a natural remedy. Dietary supplements can cause side effects and may alter the safety and effectiveness of certain medications.

Abdominal aortic aneurysm

Abdominal aortic aneurysm

An abdominal aortic aneurysm is a weakened and bulging area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta, about the thickness of a garden hose, runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. Although you may never have symptoms, finding out you have an abdominal aortic aneurysm can be frightening.

Most small and slow-growing abdominal aortic aneurysms don't rupture, but large, fast-growing abdominal aortic aneurysms may. Depending on the size and rate at which the aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Once an abdominal aortic aneurysm is found, doctors will closely monitor it so that surgery can be planned if it's necessary. Emergency surgery for a ruptured abdominal aneurysm can be risky.

Causes:

Most aortic aneurysms occur in the part of your aorta that's in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including:

Tobacco use. Cigarette smoking and other forms of tobacco use appear to increase your risk of aortic aneurysms. In addition to the damaging effects that smoking causes directly to the arteries, smoking contributes to the buildup of fatty plaques in your arteries (atherosclerosis) and high blood pressure. Smoking can also cause your aneurysm to grow faster by further damaging your aorta.
High blood pressure. High blood pressure, especially if poorly controlled, increases the risk of developing an aortic aneurysm. This is because high blood pressure can damage and weaken your arteries.
Infection in the aorta (vasculitis). In rare cases, aortic aneurysm may be caused by an infection or inflammation that weakens a section of the aortic wall.

Aneurysms can develop anywhere along the aorta, but when they occur in the upper part of the aorta, they are called thoracic aortic aneurysms. More commonly, aneurysms form in the lower part of your aorta, and are called abdominal aortic aneurysms. Rarely, an aneurysm can occur in between the upper and lower parts of your aorta. This type of aneurysm is called a thoracoabdominal aneurysm.

Treatments and drugs:

Here are the general guidelines for treating abdominal aortic aneurysms:

Small aneurysm. If you have a small aortic abdominal aneurysm — about 1.6 inches, or 4 centimeters (cm), in diameter or smaller — and you have no symptoms, your doctor may suggest a watch-and-wait (observation) approach, rather than surgery. In general, surgery isn't needed for small aneurysms because the risk of surgery outweighs the risk of rupture.

If you choose this approach, your doctor will monitor your aneurysm with periodic ultrasounds, usually every six to 12 months and encourage you to report immediately if you start having abdominal tenderness or back pain - potential signs of a dissection or rupture.
Medium aneurysm. A medium aneurysm measures between 1.6 and 2.2 inches (4 and 5.6 cm). It's less clear how the risks of surgery versus waiting stack up in the case of a medium-size aortic abdominal aneurysm. You'll need to discuss the benefits and risks of waiting versus surgery and make a decision with your doctor.
Large, fast-growing or leaking aneurysm. If you have an aneurysm that is large (larger than 2.2 inches, or 5.6 cm) or growing rapidly (more than 0.5 cm over six months), you'll probably need surgery. In addition, a leaking, tender or painful aneurysm requires treatment. There are two types of surgery for abdominal aortic aneurysms.

Open-abdominal surgery to repair an abdominal aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place, through an open-abdominal approach. With this type of surgery, it will likely take you several months to fully recover.

Endovascular surgery is a less invasive procedure sometimes used to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded up into your aorta. The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm and fastened in place with small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.

Recovery time for people who have endovascular surgery is shorter than for people who have open-abdominal surgery — about one or two weeks compared with six weeks for open surgery.

The options for treatment of your aneurysm will depend on a variety of factors, including location of the aneurysm, your age, kidney function and other conditions that may increase your risk for surgery or endovascular repair.

Glaucoma

 GLAUCOMA

What is glaucoma ?
Damage of optic nerve is generally known as glaucoma. This destruction eventual  guide to loss of vision (Blindness)when extra fluid builds up in the eye this can happen , such as when the eye makes too much fluid . Any eye wound or surgery lapse may also cause glaucoma.There are many  types of glaucoma such as: Open Angle Glaucoma,Congenital Glaucoma and Close Angle Glaucoma  . This disease generally attack human when they reach age 40 . An optician cannot diagnose the disease and only an ophthalmologist or an optometrist can diagnose and treat glaucoma.