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Saturday, March 24, 2007

Pulmonary Hypertension

Hypertension has definitions abnormally high blood pressure that consistently (more than 6 months) above 140/90, called the Systolic blood pressure for the top number and Diastolic blood pressure is the bottom number. A condition of elevated blood pressure that can lead to kidney disease, heart disease and stroke.

Hypertension can occur without apparent or determinable prior organic changes in the tissues, emotional tensions, possibly because of hereditary tendency, hormonal influence, or faulty nutrition. Also can be associated with demonstrable organic changes (as in nephritis, diabetes, and hyperthyroidism).

This time I will let you know about Pulmonary Hypertension.

Pulmonary Hypertension (PHT) is High blood pressure in the arteries that supply to the lungs and makes the heart work harder. Signs of pulmonary hypertension are getting short of breath with activity, having chest pain, feeling tired, Swelling or edema (ankles, legs and eventually abdomen/ascites) also fainting. Then for the symptoms usually limit a person's ability to exercise and do other activities.

Pulmonary hypertension cause by many thing, sometimes the cause is not known so the disorder is called "primary pulmonary hypertension". But if pulmonary hypertension has a known causes by breathing problems (emphysema and chronic bronchitis) or congestive heart failure, birth defects in the heart, chronic pulmonary thromboembolism and the others, called as secondary pulmonary hypertension.

Primary pulmonary hypertension (PPH) is unknown cause that results in the progressive narrowing of the blood vessels of the lungs, causing high blood pressure and eventually leading to heart failure. This is a rare disease but since 2000 According to the research case of primary pulmonary hypertension experienced the fast increase.

Therapies for pulmonary hypertension are Fluid retention, and adequate diuresis, Oxygen supplementation should be provided to hypoxemic patients, either at rest or with exertion or during sleep. Digoxin is often administered for supraventricular arrhythmias or right ventricular dilatation and other medicine belong to the pulmonary hypertension.
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Friday, March 02, 2007

Down Syndrome or Trisomy 21

Down syndrome or trisomy 21 also called mental retardation is a genetic disorder caused by the presence of an extra 21st chromosome in humans. It is described by a British doctor John Langdon Down in 1866.

Pathophysiology : The extra chromosome 21 affects almost every organ system in the body and then make results in a wide spectrum of phenotypic consequences. Down syndrome decreases prenatal viability, increases prenatal and postnatal morbidity. So far, Affected children have delayed physical growth, maturation, bone development, and dental eruption.

Down syndrome Patients have decreased buffering of physiologic reactions, resulting in hypersensitivity to pilocarpine also abnormal responses on sensory-evoked electroencephalographic tracings. Children with leukemic Down syndrome most of them have hyperreactivity to methotrexate.

Physical :
  • Growth: Short stature and obesity occurs during adolescence.

  • Behavior: Natural spontaneity, genuine warmth, cheerful, gentleness, patience, and tolerance are characteristics. A few patients exhibit anxiety and stubbornness.

  • Nose: Hypoplastic nasal bone and flat nasal bridge are typical characteristics.

  • Mouth and teeth: An open mouth with a tendency of tongue protrusion, a fissured and furrowed tongue, mouth breathing with drooling, a chapped lower lip, angular cheilitis, partial anodontia (50%), tooth agenesis, malformed teeth, delayed tooth eruption, microdontia (35-50%) in both the primary and secondary dentition, hypoplastic and hypocalcified teeth, malocclusion, taurodontism (0.54-5.6%), and increased periodontal destruction are noted.

  • Abdomen: Diastasis recti and umbilical hernia occur.

  • Medical Care :
  • Genetic counseling, If the couple has a child with trisomy 21, the risk of recurrence is about 1%. The risk does not appear to be increased in siblings of affected individuals.

  • Vaccination and medication

  • Medical care and monitoring for the adolescent with Down syndrome.
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