Health Care and Marfan Syndrome

One of the more exotic diseases known in the medical community is called Marfan Syndrome -- a genetic disorder that affects the body’s connective tissue. Connective tissue holds all the body’s cells, organs and tissue together. It also plays an important role in helping the body properly grow and develop.

Because connective tissue is found throughout the body, Marfan syndrome can affect many different parts of the body, as well. According to the Marfan Foundation, features of the disorder are most often found in the heart, blood vessels, bones, joints, and eyes. Some Marfan features – for example, aortic enlargement (expansion of the main blood vessel that carries blood away from the heart to the rest of the body) – can be life-threatening. The lungs, skin and nervous system may also be affected. Marfan syndrome does not affect intelligence.

About 1 in 5,000 people have Marfan syndrome, including men and women of all races and ethnic groups. About 3 out of 4 people with Marfan syndrome inherit it, meaning they get the genetic mutation from a parent who has it. But some people with Marfan syndrome are the first in their family to have it; when this happens it is called a spontaneous mutation. There is a 50 percent chance that a person with Marfan syndrome will pass along the genetic mutation each time they have a child. Much more detailed information is found at this site: https://www.marfan.org/about/marfan .

According to the National Institutes for  Health (NIH), individuals with Marfan syndrome are usually tall and slender, have elongated fingers and toes (arachnodactyly), and have an arm span that exceeds their body height. Other common features include a long and narrow face, crowded teeth, an abnormal curvature of the spine (Scoliosis or Kyphosis), and either a sunken chest (pectus excavatum) or a protruding chest (pectus carinatum). Some individuals develop an abnormal accumulation of air in the chest cavity that can result in the collapse of a lung (spontaneous pneumothorax).

A membrane called the dura, which surrounds the brain and spinal cord, can be abnormally enlarged (dural ectasia) in people with Marfan syndrome. Dural ectasia can cause pain in the back, abdomen, legs, or head. Most individuals with Marfan syndrome have some degree of nearsightedness (myopia). Clouding of the lens (cataract) may occur in mid-adulthood, and increased pressure within the eye (glaucoma) occurs more frequently in people with Marfan syndrome than in those without the condition.

The features of Marfan syndrome can become apparent anytime between infancy and adulthood. Depending on the onset and severity of signs and symptoms, Marfan can be fatal early in life; however, the majority of affected individuals survive into mid- to late adulthood. More information on this health care issue is located at this website: https://ghr.nlm.nih.gov/condition/marfan-syndrome .

Another related NIH site that has more detailed clinical data is located here: https://www.genome.gov/19519224/learning-about-marfan-syndrome/ .

According to KidsHealth, several different types of doctors may be involved in diagnosing and caring for someone with Marfan syndrome. They include a geneticist (a doctor who specializes in disorders of the genes), a cardiologist (heart doctor), an ophthalmologist (eye doctor), and an orthopedist (bone doctor).

Symptoms of Marfan syndrome may be apparent when a child is very young, while some people don't have noticeable symptoms until their teen years or even adulthood. But some people go through life never knowing they have the disease, and that can be dangerous. Getting diagnosed early means doctors can do a lot to help keep someone healthy.

Teens with Marfan syndrome must be followed closely by a team of doctors. Because teens' bodies grow and change so quickly, most teens will need echocardiograms at least once a year, plus frequent eye and bone exams. This helps doctors stay on top of any new problems. Many of the complications of Marfan syndrome can be managed with medications and, if necessary, surgery.

Doctors may prescribe special medicines called beta blockers and ARBs (angiotensin-receptor blockers), which work to lower blood pressure and reduce wear and tear on the blood vessels. This can often delay the progression of aortic dilation. If the aorta does eventually widen to a potentially dangerous size, or if valve leakage becomes a problem, a doctor may recommend surgery to repair or replace the damaged parts of the heart.

Marfan syndrome affects people differently, so life is not the same for all teens who have it. Some have severe cases of Marfan syndrome and many symptoms that require lots of medical care. Others have such a mild form that they simply need to have a checkup once a year. There are lots of things people with Marfan syndrome can do to help keep themselves healthy. The most important is to avoid putting extra stress on the heart.

That means avoiding any sport where there's a lot of running, physical contact, muscle straining, or the chance of getting hit in the chest — things like basketball, football, baseball, gymnastics, weightlifting, and track. One thing people who have Marfan syndrome should never do is smoke or use tobacco products. More information is available at this website: http://kidshealth.org/en/teens/marfan.html .

According to the March of Dimes, here’s what you need to know about Marfan syndrome:

·         Marfan syndrome usually is inherited. This means it’s passed from parents to children through genes.

·         If you or a family member has Marfan syndrome, talk to a genetic counselor to learn about the chances of your baby having it.

·         People with Marfan syndrome can have a range of health problems and may need special medical care.

·         With the right treatment, people with Marfan syndrome can live as long as people without the condition.

Marfan syndrome is a birth defect. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. More details are located at this website: http://www.marchofdimes.org/complications/marfan-syndrome.aspx .

Marfan syndrome should be diagnosed as early as possible if you suspect that your child may be symptomatic, especially if one parent is already suffering from this disease. Early diagnosis is key to preventing a serious medical situation later in the child’s physical development. Consult your doctor or a medical professional if you feel that testing should be done.

Until next time.

Health Care and Fleas

Sometimes a dog just has to scratch. But people shouldn’t be doing the same, especially if your dog has fleas, or if your home all of a sudden has an infestation of those pesky little bugs. They seem to be everywhere once they show up, and it feels like they multiply like…. Well, like fleas!

Fleas are small flightless insects that form the order Siphonaptera. As external parasites of mammals and birds, they live by consuming the blood of their hosts. Adults are up to about 3 mm long and usually brown. Covered with microscopic hair and are compressed to allow for easy movement through animal fur.

According to Orkin, the pest control company, adult fleas are parasites that draw blood from a host. Larvae feed on organic debris, particularly the feces of adult fleas, which contain undigested blood. Fleas commonly prefer to feed on hairy animals such as dogs, cats, rabbits, squirrels, rats, mice and other domesticated or wild animals. Fleas do not have wings, although they are capable of jumping long distances. Eggs are not attached to the host. Eggs will hatch on the ground, in rugs, carpet, bedding, upholstery or cracks in the floor. Most hatch within two days.

Fleas depend on a blood meal from a host to survive, so most fleas are introduced into the home via pets or other mammal hosts. Orkin reports that on some occasions, fleas may become an inside problem when the host they previously fed on is no longer around. Then fleas focus their feeding activity on other hosts that reside inside the home. An example of such a situation is when a mouse inside the home is trapped and removed, the fleas that previously fed on the mouse are then forced to feed on pets or people. Much more detail on this issue can be found at this site: http://www.orkin.com/other/fleas/ .

According to this website, https://www.doyourownpestcontrol.com/fleas.htm , most of the time, fleas prefer nonhuman source for feeding, but if infestations are heavy, or when other hosts are not available, fleas will feed on humans. Fleas usually require warm and humid conditions to develop. A flea can jump 7 to 8 inches vertically and 14 to 16 inches horizontally with their long and powerful legs. A skin reaction to a flea bite appears as a slightly raised and red itchy spot. Sometimes these sores bleed.

Due to the flea life cycle (complete metamorphosis) and feeding habits, many people don't realize they have a flea problem until they are away from their house for an extended period. The flea problem is discovered, because the fleas get hungry while the hosts (you and your pets) are away. When you return, they become highly active because they are looking for food.

People tend to think putting the pet outside will solve the flea problem, but that typically makes the fleas turn to human hosts instead. There are several types of fleas, but the most common is the cat flea, which also feeds on dogs and humans. Fleas are attracted to body heat, movement, and exhaled carbon dioxide. The best time to start a flea control program is in the late spring, prior to an infestation, since adult fleas comprise only 5% of the total flea population. To contain an active flea infestation, fleas must be controlled at every stage.

When pet owners are asked what they dread most about the summer months, the topic that invariably comes up most is fleas! Fleas on dogs and cats! These small dark brown insects prefer temperatures of 65-80 degrees and humidity levels of 75-85 percent -- so for some areas of the country they are more than just a "summer" problem.

How do you know if fleas are causing all that itching – formally known as pruritus? Generally, unlike the burrowing, microscopic Demodex or Scabies Mites, fleas can be seen scurrying along the surface of the skin. Dark copper colored and about the size of the head of a pin, fleas dislike light so looking for them within furry areas and on the pet's belly and inner thighs will provide your best chances of spotting them. A lot of additional information about fleas and how to treat them is found at this website: http://www.petmd.com/dog/care/evr_dg_fleas_on_dogs_and_what_you_can_do_about_them .

Fleas are tiny, irritating insects, according to HealthLine. Their bites are itchy and sometimes painful, and getting rid of them is hard. Sometimes professional pest control treatment may be required. Fleas reproduce quickly, especially if you have pets in the household. But even if you don’t have pets, your yard can potentially play host to fleas, and you may end up with a bunch of mysterious bites. For more details, visit this website: http://www.healthline.com/health-slideshow/flea-bites .

According to the University of Kentucky School of Entomology, if you neglect to treat the pet's environment (the premises), you will miss more than 90% of the developing flea population -- the eggs, larvae and pupae. If the pet spends time indoors, the interior of the home should also be treated. Before treatment, the pet owner should:

·         Remove all toys, clothing, and stored items from floors, under beds, and in closets. This step is essential so that all areas will be accessible for treatment.

·         Remove pet food and water dishes, cover fish tanks, and disconnect their aerators.

·         Wash, dry-clean or destroy all pet bedding.

·         Vacuum! -- vacuuming removes many of the eggs, larvae and pupae developing within the home. Vacuuming also stimulates pre-adult fleas to emerge sooner from their insecticide-resistant cocoons, thus hastening their contact with insecticide residues in the carpet. By raising the nap of the carpet, vacuuming improves the insecticide's penetration down to the base of the carpet fibers where the developing fleas live. Vacuum thoroughly, especially in areas where pets rest or sleep. Don't forget to vacuum along edges of rooms and beneath furniture, cushions, beds, and throw rugs. After vacuuming, seal the vacuum bag in a garbage bag and discard it in an outdoor trash container. 

It is important that the pet be treated in conjunction with the premises, preferably on the same day. Adult fleas spend virtually their entire life on the animal -- not in the carpet. Untreated pets will continue to be bothered by fleas. They may also transport fleas in from outdoors, eventually overcoming the effectiveness of the insecticide applied inside the home. Much more detailed info on this subject is located here: https://entomology.ca.uky.edu/ef602 .

Both indoor and outdoor areas can be sprayed with insecticides to eliminate fleas, if necessary. According to this website, http://www.petsandparasites.org/dog-owners/fleas/, treatment of your home or yard is best performed by a trained pest control expert. Consult with your veterinarian as to which flea products will break the flea life cycle in the environment. Most flea problems can be managed by treating and preventing fleas on your pet. It is important to keep in mind that flea problems may be different from pet to pet or between households, and each problem may require a special method of control.

See your veterinarian for advice on your specific situation. Your veterinarian can recommend safe and effective products for controlling fleas and can determine exactly what you need. Your veterinarian can also determine whether you should consult with a pest control specialist about treating your home and yard.

There are both chemical and natural ways to treat fleas, and for those who are more inclined to treat flea infestation naturally, fleas in the home can be easily and effectively eradicated without the use of poisons. The age-old scourge of fleas, usually associated with pet dogs or cats, can affect any home. And while chemical-based flea treatments can be effective, they may pose health hazards to occupants as well as pets. Natural and non-toxic flea control methods, such as Diatomaceous Earth, and electric flea traps, are safer options.

Surveys show that as many as 50% of American families report using some kind of flea and tick control product on pets, exposing millions of children to toxic chemicals on a daily basis. Initial research also shows that thousands of pets may be sickened or die each year as a result of chronic low-dose exposure to organophosphate-based insecticides through their flea and tick collars.

But while there are countless stories of pets, and even people, who have suffered the ill effects of flea treatments, finding alternatives can be a problem for most people. For a significant amount of information about natural applications to treat an infestation of fleas, visit this website: http://eartheasy.com/live_natural_flea_control.html .

Fleas are a common problem if you have pets. Getting ahead of the problem with preventive measures to kill and control fleas is the best way to avoid a much bigger issue for both your pets and your family and home. Use quality products and have regular veterinarian visits to make sure your pets and family are well and remain free from this itchy, and sometimes dangerous,  situation.

Until next time.

Health Care and Diptheria

Diphtheria once was a major cause of illness and death among children, according to the Centers for Disease Control (CDC). The United States recorded 206,000 cases of diphtheria in 1921 and 15,520 deaths. Before there was treatment for diphtheria, up to half of the people who got the disease died from it.

Starting in the 1920s, diphtheria rates dropped quickly in the United States and other countries with the widespread use of vaccines. In the past decade, there were less than five cases of diphtheria in the United States reported to CDC. However, the disease continues to cause illness globally. In 2014, 7,321 cases of diphtheria were reported to the World Health Organization, but there are likely many more cases.

Diphtheria is an infection caused by the Corynebacterium diphtheriae bacterium, according to the CDC. Diphtheria is spread (transmitted) from person to person, usually through respiratory droplets, like from coughing or sneezing. Rarely, people can get sick from touching open sores (skin lesions) or clothes that touched open sores of someone sick with diphtheria.

A person also can get diphtheria by coming in contact with an object, like a toy, that has the bacteria that cause diphtheria on it. For more details, visit this website: https://www.cdc.gov/diphtheria/about/index.html .

Diphtheria typically causes a sore throat, fever, swollen glands and weakness, according to the Mayo Clinic. But the hallmark sign is a sheet of thick, gray material covering the back of your throat, which can block your airway, causing you to struggle for breath. Diphtheria is extremely rare in the United States and other developed countries, thanks to widespread vaccination against the disease.

Medications are available to treat diphtheria. However, in advanced stages, diphtheria can damage your heart, kidneys and nervous system. Even with treatment, diphtheria can be deadly — up to 3 percent of people who get diphtheria die of it. The rate is higher for children under 15. More information on this disease is also available at this site: http://www.mayoclinic.org/diseases-conditions/diphtheria/home/ovc-20300505 .

According to HealthLine, in some cases, these toxins can also damage other organs, including the heart, brain and kidneys. This can lead to potentially life-threatening complications, such as myocarditis, paralysis or kidney failure. Children in the United States and Europe are routinely vaccinated against diphtheria, so the condition is rare in these countries. However, diphtheria is still fairly common in developing countries where immunization rates are low.

In these countries, children under age 5 and people over age 60 are particularly at risk of getting diphtheria. People are also at an increased risk of contracting diphtheria if they:

·         Aren’t up to date on their vaccinations.

·         Visit a country that doesn’t provide immunizations.

·         Have an immune system disorder, such as AIDS.

·         Live in unclean or crowded conditions.

You may also develop cutaneous diphtheria, or diphtheria of the skin, if you have poor hygiene or live in a tropical area. Diphtheria of the skin usually causes ulcers and redness in the affected area. More info on diptheria is located at this website: http://www.healthline.com/health/diphtheria#Overview1 .

Preventing diphtheria, according to KidsHealth, depends almost completely on giving the diphtheria/tetanus/pertussis vaccine to children (DTaP) and non-immunized adolescents and adults (Tdap). After a single dose of Tdap, adolescents and adults should receive a booster shot with the diphtheria/tetanus vaccine (Td) every 10 years.

Most cases of diphtheria occur in people who haven't received the vaccine at all or haven't received the entire course.The Tdap vaccine is also recommended for all pregnant women during the second half of each pregnancy, regardless of whether or not they had the vaccine before, or when it was last given.

The immunization schedule calls for:

·         DTaP vaccines at 2, 4, and 6 months of age

·         Booster dose given at 12 to 18 months

·         Booster dose given again at 4 to 6 years

·         Tdap vaccine given at 11-12 years

·         Booster shots of Td given every 10 years after that to maintain protection

·         Tdap vaccine during the second half of each pregnant woman's pregnancy

Although most children tolerate it well, the vaccine sometimes causes mild side effects such as redness or tenderness at the injection site, a low-grade fever, or general fussiness or crankiness. Severe complications, such as an allergic reaction, are rare. Much more information on this subject is found at this site: http://kidshealth.org/en/parents/diphtheria.html .

Additional online sources are these sites: http://www.immunize.org/diphtheria/ ,  https://www.vaccines.gov/diseases/diphtheria/ , and this website http://www.vaccineinformation.org/diphtheria/  .

Usually the matter is settled, one way or the other, in 7 to 10 days. Sometimes there are lasting complications such as arthritis, paralysis, or brain damage, according to this website: https://www.drgreene.com/articles/diphtheria/ . Cutaneous diphtheria is not as serious as other forms, but it usually takes up to 3 months to recover – and sometimes a year or more.

Antitoxin and diphtheria antibiotics should be given immediately. Skin lesions need to be thoroughly and carefully cleaned. Other treatment will depend on the clinical status of the victim. It may be minimal or critical care may be required. Most need tube feedings and frequent suctioning. Some need a tracheostomy, according to DrGreene.com. Strict bed rest is recommended for all those with diphtheria for at least 2 or 3 weeks, with heart monitoring at least several times a week for a month or more to detect any damage to the heart. Most people who recover from diphtheria do not develop immunity! They need to be immunized soon after recovery.

Diptheria is deadly, and can be spread easily in many situations. If you or your children have not been immunized against it, visit your doctor or a health care facility as soon as possible to be vaccinated. Preventive care is the first line of defense against this terrible disease.

Until next time.