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Diagnonistic Test

Echocardiogram

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Definition
An echocardiogram uses sound waves to produce images of your heart. This common test allows your doctor to see how your heart is beating and pumping blood. Your doctor can use the images from an echocardiogram to identify various abnormalities in the heart muscle and valves.

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It determines the size of your heart, and assess how well it is functioning. The test can estimate how forcefully your heart is pumping blood, and can spot areas of the heart wall that have been injured by a previous heart attack or some other cause.

Depending on what information your doctor needs, you may have one of several types of echocardiograms. Each type of echocardiogram has very few risks involved.

Why it’s done
Your doctor may suggest an echocardiogram if he or she suspects problems with the valves or chambers of your heart or your heart’s ability to pump. An echocardiogram can also be used to detect congenital heart defects in unborn babies.

Depending on what information your doctor needs, you may have one of the following kinds of echocardiograms:

*Transthoracic echocardiogram. This is a standard, noninvasive echocardiogram. A technician (sonographer) spreads gel on your chest and then presses a device known as a transducer firmly against your skin, aiming an ultrasound beam through your chest to your heart. The transducer records the sound wave echoes your heart produces. A computer converts the echoes into moving images on a monitor. If your lungs or ribs obscure the view, a small amount of intravenous dye may be used to improve the images.

*Transesophageal echocardiogram. If it’s difficult to get a clear picture of your heart with a standard echocardiogram, your doctor may recommend a transesophageal echocardiogram. In this procedure, a flexible tube containing a transducer is guided down your throat and into your esophagus, which connects your mouth to your stomach. From there, the transducer can obtain more detailed images of your heart.

*Doppler echocardiogram. When sound waves bounce off blood cells moving through your heart and blood vessels, they change pitch. These changes (Doppler signals) can help your doctor measure the speed and direction of the blood flow in your heart. Doppler techniques are used in most transthoracic and transesophageal echocardiograms.

*Stress echocardiogram. Some heart problems — particularly those involving the coronary arteries that feed your heart muscle — occur only during physical activity. For a stress echocardiogram, ultrasound images of your heart are taken before and immediately after walking on a treadmill or riding a stationary bike. If you’re unable to exercise, you may get an injection of a medication to make your heart work as hard as if you were exercising.

Risk Factors:
There are minimal risks associated with a standard transthoracic echocardiogram. You may feel some discomfort similar to pulling off an adhesive bandage when the technician removes the electrodes placed on your chest during the procedure.

If you have a transesophageal echocardiogram, your throat may be sore for a few hours afterward. Rarely, the tube may scrape the inside of your throat. Your oxygen level will be monitored during the exam to check for any breathing problems caused by the sedation medication.

During a stress echocardiogram, exercise or medication — not the echocardiogram itself — may temporarily cause an irregular heartbeat. Serious complications, such as a heart attack, are rare.

How do you prepare for the test?
No special preparations are necessary for a standard transthoracic echocardiogram. Your doctor will ask you not to eat for a few hours beforehand if you’re having a transesophageal or stress echocardiogram. If you’ll be walking on a treadmill during a stress echocardiogram, wear comfortable shoes. If you’re having a transesophageal echocardiogram, you won’t be able to drive afterward because of the sedating medication you’ll receive. Be sure to make arrangements to get home before you have your test.

What happens when the test is performed?

During the procedure
An echocardiogram can be done in the doctor’s office or a hospital. After undressing from the waist up, you’ll lie on an examining table or bed. The technician will attach sticky patches (electrodes) to your body to help detect and conduct the electrical currents of your heart.

If you’ll have a transesophageal echocardiogram, your throat will be numbed with a numbing spray or gel. You’ll likely be given a sedative to help you relax.

During the echocardiogram, the technician will dim the lights to better view the image on the monitor. You may hear a pulsing “whoosh” sound, which is the machine recording the blood flowing through your heart.

Most echocardiograms take less than an hour, but the timing may vary depending on your condition. During a transthoracic echocardiogram, you may be asked to breathe in a certain way or to roll onto your left side. Sometimes the transducer must be held very firmly against your chest. This can be uncomfortable – but it helps the technician produce the best images of your heart.

After the procedure
If your echocardiogram is normal, no further testing may be needed. If the results are concerning, you may be referred to a heart specialist (cardiologist) for further assessment. Treatment depends on what’s found during the exam and your specific signs and symptoms. You may need a repeat echocardiogram in several months or other diagnostic tests, such as a cardiac computerized tomography (CT) scan or coronary angiogram.

How long is it before the result of the test is known?
If a doctor does the test, you might get some results immediately. If a technician performs the test, he or she records the echocardiogram on a videotape for a cardiologist to review later on. In this case, you’ll probably receive results in several days.

Results:
Your doctor will look for healthy heart valves and chambers, as well as normal heartbeats. Information from the echocardiogram can reveal many aspects of your heart health, including:

*Heart size. Weakened or damaged heart valves, high blood pressure or other diseases can cause the chambers of your heart to enlarge. Your doctor can use an echocardiogram to evaluate the need for treatment or monitor treatment effectiveness.

*Pumping strength. An echocardiogram can help your doctor determine your heart’s pumping strength. Specific measurements may include the percentage of blood that’s pumped out of a filled ventricle with each heartbeat (ejection fraction) or the volume of blood pumped by the heart in one minute (cardiac output). If your heart isn’t pumping enough blood to meet your body’s needs, heart failure may be a concern.

*Damage to the heart muscle. During an echocardiogram, your doctor can determine whether all parts of the heart wall are contributing equally to your heart’s pumping activity. Parts that move weakly may have been damaged during a heart attack or be receiving too little oxygen. This may indicate coronary artery disease or various other conditions.

*Valve problems. An echocardiogram shows how your heart valves move as your heart beats. Your doctor can determine if the valves open wide enough for adequate blood flow or close fully to prevent blood leakage. Abnormal blood flow patterns and conditions such as aortic valve stenosis — when the heart’s aortic valve is narrowed — can be detected as well.

*Heart defects. Many heart defects can be detected with an echocardiogram, including problems with the heart chambers, abnormal connections between the heart and major blood vessels, and complex heart defects that are present at birth. Echocardiograms can even be used to monitor a baby’s heart development before birth.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/echocardiogram.shtml
http://www.mayoclinic.com/health/echocardiogram/MY00095

http://www.sads.org.uk/cardiac_tests.htm

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Diagnonistic Test Health Problems & Solutions

Cardiac Catheterization

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Alternative Name: Catheterization – cardiac; Heart catheterization

Definition:
Cardiac catheterization with coronary angiogram takes pictures of the blood vessels in your heart, to evaluate the health of your heart and detect any narrowing of the blood vessels or other problems. The catheterization is performed by a cardiologist (or sometimes a radiologist) who is a specialist in doing this type of test.
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This process involves passing a catheter (a thin flexible tube) into the right or left side of the heart. In general, this procedure is performed to obtain diagnostic information about the heart or its blood vessels or to provide treatment in certain types of heart conditions.

Cardiac catheterization can be used to determine pressure and blood flow in the heart’s chambers, collect blood samples from the heart, and examine the arteries of the heart with an x-ray technique called fluoroscopy. Fluoroscopy provides immediate (“real-time”) visualization of the x-ray images on a screen and provides a permanent record of the procedure.
Why the Test is Performed ?
Cardiac catheterization is usually performed to evaluate heart valves, heart function and blood supply, or heart abnormalities in newborns. It may also be used to determine the need for heart surgery.

Therapeutic catheterization may be used to repair certain types of heart defects, open a stenotic heart valve, and open blocked arteries or grafts in the heart.
How the Test is Performed:
You lie on your back as a medical technician connects you to a heart monitor. An intravenous (IV) line is inserted into one of the blood vessels in your arm, neck, or groin after the site has been cleansed and numbed with a local anesthetic.. You may be given a sedative through the IV so that you are relaxed during the test.

First, the doctor injects a local anesthetic into the skin. This might sting momentarily. After the skin is numb, the cardiologist inserts a catheter (a thin, hollow plastic tube) into a large artery-usually in your groin but possibly in your arm or wrist.

Using live x-rays displayed on a video monitor as a guide, your doctor moves the catheter along the artery until it reaches your aorta (the large blood vessel that carries blood from your heart to the rest of your body). The tip of the catheter is pushed up the aorta until it reaches the heart and then gently pushed into the coronary arteries that supply blood directly to your heart muscle.When the tip of the catheter reaches one of the coronary arteries, the doctor injects contrast dye through the catheter. The dye illuminates the artery, allowing the doctor to see if it is blocked or narrowed. The procedure is repeated to visualize the other coronary arteries.

X-ray pictures are taken while the dye travels down the arteries. The arteries look like thick lines on the x-ray; a narrowing or blockage in an artery appears as a thinner line (see Figure 1). Your doctor might also inject some contrast medium into the left ventricle of your heart to show how forcefully your heart is pumping. The entire procedure usually takes from one to several hours.

How you Prepare for the Test:
Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in the hospital and you will be asked to wear a hospital gown. Sometimes, admission the night before the test is required. Otherwise, you will be admitted as an outpatient or an inpatient the morning of the procedure.

Your health care provider should explain the procedure and its risks. A witnessed, signed consent for the procedure is required.

Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.

During this procedure, local anesthetics (numbing agents) are used to minimize pain. Tell the cardiologist if you have ever had an allergic reaction to a local anesthetic or to contrast dyes. Also let your doctor know if you could be pregnant, since the x-rays used during this procedure can damage a fetus.

. Tell the cardiologist if you’re taking a nonsteroidal anti-inflammatory drug (NSAID) or other medicines that affect blood clotting and could increase the chance of bleeding from the procedure. You should also tell your doctor if you take insulin shots or blood sugar-lowering pills so that you can take steps to avoid dangerously low blood sugar, or hypoglycemia.

How the Test Will Feel?
The study is carried out in a laboratory by a trained cardiologist or radiologist and technicians or nurses.

You will be awake and able to follow instructions during the catheterization. A mild sedative is usually given 30 minutes before the procedure to help you relax. The procedure may last from 1 to several hours.

You may feel some discomfort at the site where the IV is placed. Local anesthesia will be used to numb the site, so the only sensation should be one of pressure at the site. You may experience some discomfort from having to remain still for a long time.

After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the IV is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.

Risk Factors:
There are several potential risks. First, the catheter can irritate the heart, in rare cases causing a disturbance in the heart rhythm. Should this happen, the doctor can immediately use devices and medicines to restore a normal heart rhythm. The catheter occasionally can cause the coronary artery to go into spasm, temporarily reducing the blood flow and causing chest pain. For this reason, alert the doctors and nurses if you develop any chest discomfort, trouble breathing, or any other problem during the test.

In addition, the contrast medium can sometimes impair kidney function. This effect is almost always temporary, but some people have permanent damage. Another possible complication is bleeding at the place where the catheter was inserted. If blood collects under the skin, it can form a large painful bruise called a hematoma. This usually resolves on its own, without requiring additional treatment. Occasionally, people are allergic to the contrast dye and develop a rash, hives, or difficulty breathing after the dye is injected. If this should occur, the medical staff in the catheterization laboratory have medicines available to treat the allergic reaction.

The amount of radiation from this test is too small to be likely to cause harm.
Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally, the risk of serious complications ranges from 1 in 1,000 to 1 in 500. The risks include the following:
*Cardiac arrhythmias
*Cardiac tamponade
*Trauma to the artery caused by hematoma
*Low blood pressure
*Reaction to contrast medium
*Hemorrhage
*Stroke
*Heart attack
Must you do anything special after the test is over?
You should lie flat for a few hours after this procedure. Often, a small plug or stitch is used to prevent bleeding from the artery that was entered to perform the catheterization. If you received a sedative, you might feel sleepy and shouldn’t drive or drink alcohol for one day after the catheterization.

What Abnormal Results Mean

The procedure can identify heart defects or disease, such as coronary artery disease, valve problems, ventricular aneurysms, or heart enlargement.

The procedure also may be performed for the following:
*Primary pulmonary hypertension
*Pulmonary valve stenosis
*Pulmonary embolism
*Tetralogy of Fallot
*Transposition of the great vessels
*Tricuspid regurgitation
*Ventricular septal defect

How long is it before the result of the test is known?
Your doctor will have your results as soon as the test is completed. In particular, the doctor can tell you if you have any blockages in the coronary arteries, how many and how severe they are, and the best way to treat them. In some cases, your doctor is even able to remove any blockages immediately by performing an intervention known as a coronary angioplasty, a procedure that uses a tiny inflatable balloon to reopen the artery.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/cardiac-catheterization.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/003419.htm

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News on Health & Science

Should Statins be Available for Everyone?

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They lower cholesterol and heart attack risk and may hold promise against other diseases, including cancer. Doctors consider broadening their use.
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Should statin drugs be put in the water, or what? ¶ More than 13 million Americans are taking these medications to lower their cholesterol and hopefully stave off heart disease — a job the drugs appear to excel at. Statins can lower “bad” LDL cholesterol by 20% to 60%. Over time, this can lower the risk of having a heart attack by about the same amount. ¶ For many years, it was believed that statins worked solely by reducing blood cholesterol, which can build up in sticky plaques in the arteries that supply blood to the heart, potentially blocking blood flow and causing heart attacks. But evidence is mounting that the drugs reduce heart disease risk through more than just their cholesterol-lowering effects. New research suggests they may be beneficial even for people with cholesterol in the normal range. ¶ This has doctors and medical researchers debating whether many more people should be on statins than currently fall under treatment guidelines. Some drug companies and doctors have even argued that low doses of the drugs should be available over the counter, as they are in the United Kingdom.

At the same time, other studies are reporting that statins might help prevent or treat a number of noncardiovascular conditions — including multiple sclerosis, cancer and Alzheimer’s disease. With all this news, many may be wondering, “Should I take a statin, just in case?”

Experts, for the most part, will say only, “Maybe.”

Most of the people at high risk of cardiovascular disease “are going to be safer and live longer if they’re on a statin than if they’re not,” says Nathan Wong, director of the UC Irvine Heart Disease Prevention Program. But that doesn’t hold for people whose risk for heart attacks is very low to begin with, he adds. “I’m not saying that everyone is going to be better on a statin. They need to be used with discretion.”

All six statins available today — atorvastatin (Lipitor), rosuvastatin (Crestor), simvastatin (Zocor), lovastatin (Mevacor), pravastatin (Pravachol) and fluvastatin (Lescol) — work by blocking an enzyme called HMG-CoA reductase.

In the liver, blocking this enzyme shuts down cholesterol production and increases the amount of cholesterol the liver takes out of the bloodstream.

But statins also block HMG-CoA reductase in the cells lining blood vessels, where, among other things, they can reduce inflammation.

Dramatic results
The anti-inflammatory effect of statins has been on many heart experts’ minds since the Nov. 9 announcement of the results of a clinical trial called JUPITER. The trial showed that statin treatment can reduce the risk of heart disease in people with normal cholesterol levels but high levels of inflammation as measured by blood levels of a marker called C-reactive protein (CRP).

A team led by Dr. Paul Ridker of Brigham and Women’s Hospital in Boston and Harvard Medical School found that in 8,901 people with high blood CRP levels, rosuvastatin (Crestor) reduced the risk of a heart attack by 54% and the need for bypass surgery or angioplasty by 46% compared with an equal number of people taking a placebo.

There were 68 heart attacks and 131 bypass surgeries/angioplasties in the placebo group, but only 31 and 71, respectively, in the group taking the statin. There were 48% fewer strokes — 64 versus 33. These effects were so dramatic that regulators stopped the trial, slated to go for four years, after less than two. AstraZeneca, the company that makes Crestor, funded the JUPITER trial.

The results raise an obvious question: Are the cholesterol-lowering effects or the inflammation-reducing effects of statins more important?

Dr. Christopher Cannon, a cardiologist at Brigham and Women’s, says they both play a part: “You have to have some cholesterol get into the arteries [and cause damage]. And if you have inflammation that damages the lining of the arteries, the cholesterol gets in more easily.”

Inflammation can also encourage plaques to rupture, causing clots that block blood flow. “Both [cholesterol buildup and inflammation] are happening simultaneously, and both are inhibited simultaneously with statins,” Cannon says.

Currently, more than 13 million people take statin drugs for elevated LDL cholesterol, and at least 47 million more have cholesterol levels high enough to make them eligible by current National Heart, Lung, and Blood Institute cholesterol guidelines.

Ridker estimates an additional 4 million to 6 million people would be added to the mix if everyone who would have qualified for the JUPITER trial (men over 50, women over 60, LDL cholesterol below 130 mg/dL and CRP above 2 mg/L) started taking a statin.

Anti-inflammatory:

Statins may be good for more than just fighting heart disease.

Very preliminary studies suggest that the anti-inflammatory effects of statins could help treat autoimmune diseases. A small, nine-month study of 36 patients with multiple sclerosis published in April in the journal PLoS One showed that statin treatment, either alone or combined with standard MS treatment, reduced the number of brain lesions characteristic of the disease by 24% and reduced their size by about 12%.

Another pilot study of just seven people, published in September 2007 in the Journal of the American Academy of Dermatology, showed that a statin reduced the severity of the skin disease psoriasis

A combined analysis of 19 studies, published in August in the International Journal of Cancer, found that statin use reduced the risk of advanced prostate cancer by 23%.

And a study published in November in the Journal of the National Cancer Institute showed that men prescribed statins had a 4.1% decline in their blood levels of prostate-specific antigen (PSA), a marker of prostate cancer.

There is some evidence that statins can lower the risk of developing Alzheimer’s disease. An October study of almost 7,000 people in Rotterdam, Netherlands, found that people taking a statin had about a 50% lower risk of Alzheimer’s compared with those who had never used cholesterol-lowering medication. Other studies, however, have failed to find an effect of statins on the risk for dementia or Alzheimer’s disease.

As the benefits of these drugs are experienced by more people, the risks will be too. Though statins are generally considered safe, they do have side effects.

Drugs’ side effects:-
The most commonly reported adverse event associated with statins is muscle pain. A 2006 analysis of seven clinical trials published in Medscape General Medicine found that 2.5% to 6% of patients taking statins reported aches and pains related to their drugs.

Rhabdomyolysis, a breakdown of skeletal muscle that can lead to kidney failure and sometimes death, has also been linked to statins. According to the 2006 Medscape report, less than 0.1% of patients taking statins reported rhabdomyolysis. There was only 0.15 death from rhabdomyolysis per 1 million prescriptions.

Liver effects are also seen in some patients taking statins. In less than 1% of patients taking moderate doses of statins, and in about 2% to 3% of those taking high doses, liver enzyme levels are abnormally high. But the enzyme changes usually subside after discontinuing statin use or switching to a different statin, says Dr. Antonio Gotto, dean of Weill Cornell Medical College in New York.

In 2007, the Food and Drug Administration conducted an investigation into whether statins increase the risk of the fatal neurodegenerative disease amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, when the agency received a higher than expected number of reports of the disease in people taking statins. Although an analysis of 41 long-term controlled clinical trials reported in September detected no such link, the FDA has said it plans to continue studying the issue.

Dr. Scott Grundy, a professor of internal medicine and director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center at Dallas, says he thinks the drugs, on balance, are safe. But he adds that caution is still warranted, especially when it comes to considering a broad expansion of their use or prescribing them earlier in people’s lives.

Statins have been in use only since the late 1980s, he notes, and so there hasn’t been enough time yet to learn what might happen if someone were to be on the drugs for 30 or 40 years. “It is possible that some of these rare side effects might turn out to be quite important if [statins are] started early in life and continued for years and years,” he says.

Whether statin use is substantially expanded may depend on how the results of the JUPITER trial and other recent research are incorporated into new cholesterol guidelines slated to be released next year by the National Heart, Lung and Blood Institute.

If CRP testing becomes part of the standard battery of tests that guide risk assessment and statin treatment decisions, millions more Americans could find themselves filling a prescription.

Currently, most doctors use CRP testing as a sort of tie-breaker when they are on the fence as to whether a patient is at high enough risk of heart disease to warrant statin therapy. Patients might, for example, have intermediate cholesterol levels but a family history of heart attacks or some other risk factor.

Dr. Mary Malloy, co-director of the adult lipid clinic and director of the pediatric lipid clinic at the UCSF Medical Center, does not think this should change, even though she characterizes the JUPITER results as “very impressive.”

“I am personally not ready to corral everyone over 35 and do CRP testing,” she says.

Wong says it’s important that people take into account a person’s absolute risk when judging whether or not a patient needs a statin.

Of the JUPITER trial, he says, “There was a 44% reduction in cardiovascular events. This sounds very dramatic, and it is.” But the risk of heart attack in those patients was pretty tiny to begin with — 2.8%. The 44% drop took it down to 1.6%.

The bottom line is that monetary cost as well as potential side effects of statins must be weighed against the potential benefits.

Wong’s biggest concern is that people will get the idea that statins are a cure-all — and they’ll stop bothering about habits that could affect their heart health just as much.

“People think statins are magic pills,” he says. “You can’t forget about other risk factors like smoking, diabetes and blood pressure. . . . you have to make sure all these things are adequately controlled.”

Sources: Los Angles Times

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Ailmemts & Remedies

Autism

Prominent characteristics of the syndrome incl...
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Definition:
Autism is a brain development disorder that is characterized by impaired social interaction and communication, and restricted and repetitive behavior, all starting before a child is three years old. This set of signs distinguishes autism from milder autism spectrum disorders (ASD) such as pervasive developmental disorder not otherwise specified (PDD-NOS).

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Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by multigene interactions or by rare mutations. In rare cases, autism is strongly associated with agents that cause birth defects. Other proposed causes, such as childhood vaccines, are controversial; the vaccine hypotheses lack convincing scientific evidence. Most recent reviews estimate a prevalence of one to two cases per 1,000 people for autism, and about six per 1,000 for ASD, with ASD averaging a 4.3:1 male-to-female ratio. The number of people known to have autism has increased dramatically since the 1980s, at least partly as a result of changes in diagnostic practice; the question of whether actual prevalence has increased is unresolved.

Autism causes children to experience the world differently from the way most other children do. It’s hard for people with autism to talk with other people and express themselves using words. Some people who have autism keep to themselves and many can’t communicate without special help.

They also may react to what’s going on around them in unusual ways. Normal sounds may really bother someone with autism — so much so that the person covers his or her ears. Being touched, even in a gentle way, may feel uncomfortable.

Children with autism often can’t make connections that other kids make easily. For example, when someone smiles, you
know the smiling person is happy or being friendly. But a child with autism may have trouble connecting that smile with the person’s happy feelings.

A child who has autism also has trouble linking words with their meanings. Imagine trying to understand what someone is saying if you didn’t know what their words really meant. It is doubly frustrating then if a child can’t come up with the right words to express his or her own thoughts.

Autism causes children to act in unusual ways. They might flap their hands, say certain words over and over, have temper tantrums, or play only with one particular toy. Most kids with autism don’t like changes in routines. They like to stay on a schedule that is always the same. They also may insist that their toys or other objects be arranged a certain way and get upset if these items are moved or disturbed.

If someone has autism, his or her brain has trouble with an important job: making sense of the world. Every day, your brain interprets the sights, sounds, smells, and other sensations that you experience. If your brain couldn’t help you understand these things, you would have trouble functioning, talking, going to work or school, and doing other everyday things. People can be mildly affected by autism, so that they only have a little trouble in life, or they can be very affected, so that they need a lot of help.

Causes:
It has long been presumed that there is a common cause at the genetic, cognitive, and neural levels for autism’s characteristic triad of symptoms. However, there is increasing suspicion that autism is instead a complex disorder whose core aspects have distinct causes that often co-occur.

Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by multigene interactions or by rare mutations with major effects. Complexity arises due to interactions among multiple genes, the environment, and epigenetic factors which do not change DNA but are heritable and influence gene expression. Early studies of twins estimated heritability explains more than 90% of the risk of autism, assuming a shared environment and no other genetic or medical syndromes. However, most of the mutations that increase autism risk have not been identified. Typically, autism cannot be traced to a Mendelian (single-gene) mutation or to a single chromosome abnormality like Angelman syndrome or fragile X syndrome, and none of the genetic syndromes associated with ASDs has been shown to selectively cause ASD. Numerous candidate genes have been located, with only small effects attributable to any particular gene. The large number of autistic individuals with unaffected family members may result from copy number variations—spontaneous deletions or duplications in genetic material during meiosis. Hence, a substantial fraction of autism cases may be traceable to genetic causes that are highly heritable but not inherited: that is, the mutation that causes the autism is not present in the parental genome.

Gene replacement studies in mice suggest that autistic symptoms are closely related to later developmental steps that depend on activity in synapses and on activity-dependent changes, and that the symptoms may be reversed or reduced by replacing or modulating gene function after birth. All known teratogens (agents that cause birth defects) related to the risk of autism appear to act during the first eight weeks from conception, and though this does not exclude the possibility that autism can be initiated or affected later, it is strong evidence that autism arises very early in development. Although evidence for other environmental causes is anecdotal and has not been confirmed by reliable studies, extensive searches are underway. Environmental factors that have been claimed to contribute to or exacerbate autism, or may be important in future research, include certain foods, infectious disease, heavy metals, solvents, diesel exhaust, PCBs, phthalates and phenols used in plastic products, pesticides, brominated flame retardants, alcohol, smoking, illicit drugs, vaccines, and prenatal stress. Although parents may first become aware of autistic symptoms in their child around the time of a routine vaccination (and parental concern about vaccines has led to a decreasing uptake of childhood immunizations and an increasing likelihood of measles outbreaks), there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella vaccine and autism, and no scientific evidence that the vaccine preservative thiomersal helps cause autism.

Despite extensive investigation, how autism occurs is not well understood. Its mechanism can be divided into two areas: the pathophysiology of brain structures and processes associated with autism, and the neuropsychological linkages between brain structures and behaviors. The behaviors appear to have multiple pathophysiologies.

Autism affects about 1 in every 150 people, but no one knows what causes it. Some scientists think that some children might be more likely to get autism because it or similar disorders run in their families. Knowing the exact cause of autism is hard because the human brain is very complicated.

The brain contains over 100 billion nerve cells called neurons. Each neuron may have hundreds or thousands of connections to other nerve cells in the brain and body. The connections (which are made by releasing neurotransmitters) let different neurons in different areas of the brain — areas that help you see, feel, move, remember, and much more — work together.

For some reason, some of the cells and connections in the brain of a child with autism — especially those that affect communication, emotions, and senses — don’t develop properly or get damaged. Scientists are still trying to understand how and why this happens.

Symptoms:
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Core symptoms:
The severity of symptoms varies greatly between individuals, but all people with autism have some core symptoms in the areas of:

Social interactions and relationships. Symptoms may include:
*Significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial expressions, and body posture.

*Failure to establish friendships with children the same age.

*Lack of interest in sharing enjoyment, interests, or achievements with other people.

*Lack of empathy. People with autism may have difficulty understanding another person’s feelings, such as pain or sorrow.

Verbal and nonverbal communication. Symptoms may include:

*Delay in, or lack of, learning to talk. As many as 40% of people with autism never speak.1

*Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun.

*Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia).

*Difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.

Limited interests in activities or play. Symptoms may include:
*An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy.

*Preoccupation with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.

*A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.

*Stereotyped behaviors. These may include body rocking and hand flapping.

Symptoms during childhood
Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child’s first 3 years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games, such as peekaboo; and does not begin to talk. Sometimes, a child will start to talk at the same time as other children the same age, then lose his or her language skills. They also may be confused about their child’s hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or she may appear to hear a distant background noise, such as the whistle of a train.

With early and intensive treatment, most children improve their ability to relate to others, communicate, and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or “live in a world of their own.”

Symptoms during teen years:
During the teen years, the patterns of behavior often change. Many teens gain skills but still lag behind in their ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for teens who have autism than for others this age. Teens are at an increased risk for developing problems related to depression, anxiety, and epilepsy.

Symptoms in adulthood:
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at least partial independence.2

Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak. Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average to above-average intelligence.

Other symptoms:
Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these symptoms, especially problems with social relationships, are more severe for people with autism. For more information, see the topic Attention Deficit Hyperactivity Disorder.

About 10% of people with autism have some form of savant skills-special limited gifts such as memorizing lists, calculating calendar dates, drawing, or musical ability.1

Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with autism have strong food likes and dislikes and unusual preoccupations.

Sleep problems occur in about 40% to 70% of people with autism.

Other conditions:
Autism is one of several types of pervasive developmental disorders (PDDs), also called autism spectrum disorders (ASD). It is not unusual for autism to be confused with other PDDs, such as Asperger’s disorder or syndrome, or to have overlapping symptoms. A similar condition is called pervasive developmental disorder-NOS (not otherwise specified). PDD-NOS occurs when children display similar behaviors but do not meet the criteria for autism. It is commonly called just PDD. In addition, other conditions with similar symptoms may also have similarities to or occur with autism.

Diagnosis:
Diagnosis is based on behavior, not cause or mechanism. Autism is defined in the DSM-IV-TR as exhibiting at least six symptoms total, including at least two symptoms of qualitative impairment in social interaction, at least one symptom of qualitative impairment in communication, and at least one symptom of restricted and repetitive behavior. Sample symptoms include lack of social or emotional reciprocity, stereotyped and repetitive use of language or idiosyncratic language, and persistent preoccupation with parts of objects. Onset must be prior to age three years, with delays or abnormal functioning in either social interaction, language as used in social communication, or symbolic or imaginative play. The disturbance must not be better accounted for by Rett syndrome or childhood disintegrative disorder. ICD-10 uses essentially the same definition.

Several diagnostic instruments are available. Two are commonly used in autism research: the Autism Diagnostic Interview-Revised (ADI-R) is a semistructured parent interview, and the Autism Diagnostic Observation Schedule (ADOS) uses observation and interaction with the child. The Childhood Autism Rating Scale (CARS) is used widely in clinical environments to assess severity of autism based on observation of children.

A pediatrician commonly performs a preliminary investigation by taking developmental history and physically examining the child. If warranted, diagnosis and evaluations are conducted with help from ASD specialists, observing and assessing cognitive, communication, family, and other factors using standardized tools, and taking into account any associated medical conditions. A pediatric neuropsychologist is often asked to assess behavior and cognitive skills, both to aid diagnosis and to help recommend educational interventions. A differential diagnosis for ASD at this stage might also consider mental retardation, hearing impairment, and a specific language impairment such as Landau-Kleffner syndrome.

Clinical genetics evaluations are often done once ASD is diagnosed, particularly when other symptoms already suggest a genetic cause. Although genetic technology allows clinical geneticists to link an estimated 40% of cases to genetic causes, consensus guidelines in the U.S. and UK are limited to high-resolution chromosome and fragile X testing. A genotype-first model of diagnosis has been proposed, which would routinely assess the genome’s copy number variations. As new genetic tests are developed several ethical, legal, and social issues will emerge. Commercial availability of tests may precede adequate understanding of how to use test results, given the complexity of autism’s genetics. Metabolic and neuroimaging tests are sometimes helpful, but are not routine.

ASD can sometimes be diagnosed by age 14 months, although diagnosis becomes increasingly stable over the first three years of life: for example, a one-year-old who meets diagnostic criteria for ASD is less likely than a three-year-old to continue to do so a few years later. In the UK the National Autism Plan for Children recommends at most 30 weeks from first concern to completed diagnosis and assessment, though few cases are handled that quickly in practice. A 2006 U.S. study found the average age of first evaluation by a qualified professional was 48 months and of formal ASD diagnosis was 61 months, reflecting an average 13-month delay, all far above recommendations.[102] Although the symptoms of autism and ASD begin early in childhood, they are sometimes missed; adults may seek diagnoses to help them or their friends and family understand themselves, to help their employers make adjustments, or in some locations to claim disability living allowances or other benefits.

Underdiagnosis and overdiagnosis are problems in marginal cases, and much of the recent increase in the number of reported ASD cases is likely due to changes in diagnostic practices. The increasing popularity of drug treatment options and the expansion of benefits has given providers incentives to diagnose ASD, resulting in some overdiagnosis of children with uncertain symptoms. Conversely, the cost of screening and diagnosis and the challenge of obtaining payment can inhibit or delay diagnosis. It is particularly hard to diagnose autism among the visually impaired, partly because some of its diagnostic criteria depend on vision, and partly because autistic symptoms overlap with those of common blindness syndromes.

Treatment:
There is no cure for autism, but doctors, therapists, and special teachers can help people with autism overcome or adjust to many difficulties. The earlier a child starts treatment for autism, the better.

The main goals of treatment are to lessen associated deficits and family distress, and to increase quality of life and functional independence. No single treatment is best and treatment is typically tailored to the child’s needs. Intensive, sustained special education programs and behavior therapy early in life can help children acquire self-care, social, and job skills, and often improve functioning and decrease symptom severity and maladaptive behaviors; claims that intervention by age two to three years is crucial are not substantiated. Available approaches include applied behavior analysis (ABA), developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy.Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children and is well-established for improving intellectual performance of young children.[106] Neuropsychological reports are often poorly communicated to educators, resulting in a gap between what a report recommends and what education is provided. The limited research on the effectiveness of adult residential programs shows mixed results.

Many medications are used to treat ASD symptoms that interfere with integrating a child into home or school when behavioral treatment fails. More than half of U.S. children diagnosed with ASD are prescribed psychoactive drugs or anticonvulsants, with the most common drug classes being antidepressants, stimulants, and antipsychotics. Aside from antipsychotics, there is scant reliable research about the effectiveness or safety of drug treatments for adolescents and adults with ASD. A person with ASD may respond atypically to medications, the medications can have adverse effects, and no known medication relieves autism’s core symptoms of social and communication impairments.

Although many alternative therapies and interventions are available, few are supported by scientific studies.Treatment approaches have little empirical support in quality-of-life contexts, and many programs focus on success measures that lack predictive validity and real-world relevance. Scientific evidence appears to matter less to service providers than program marketing, training availability, and parent requests. Though most alternative treatments, such as melatonin, have only mild adverse effects some may place the child at risk. A 2008 study found that compared to their peers, autistic boys have significantly thinner bones if on casein-free diets; in 2005, botched chelation therapy killed a five-year-old child with autism.

Treatment is expensive; indirect costs are more so. A U.S. study estimated an average cost of $3.2 million in 2003 U.S. dollars for someone born in 2000, with about 10% medical care, 30% extra education and other care, and 60% lost economic productivity. Publicly supported programs are often inadequate or inappropriate for a given child, and unreimbursed out-of-pocket medical or therapy expenses are associated with likelihood of family financial problems; one 2008 U.S. study found a 14% average loss of annual income in families of children with ASD, and a related study found that ASD is associated with higher probability that child care problems will greatly affect parental employment. After childhood, key treatment issues include residential care, job training and placement, sexuality, social skills, and estate planning.

Different children need different kinds of help, but learning how to communicate is always an important first step. Spoken language can be hard for kids with autism to learn. Most understand words better by seeing them, so therapists teach them how to communicate by pointing or using pictures or sign language. That makes learning other things easier, and eventually, many children with autism learn to talk fluently.

Therapists also help children learn social skills, such as how to greet people, wait for a turn, and follow directions. Some children need special help with living skills (like brushing teeth or making a bed). Others have trouble sitting still or controlling their tempers and need therapy to help them control their behavior. Some children take medications to help their moods and behaviour, but there’s no medicine for autism.

Students with mild autism sometimes can go to mainstream school. But many children with autism need calmer, more orderly surroundings. They also need teachers trained to understand the problems they have with communicating and learning. They may learn at home or in classes at special or private schools.

Click to see:->
Gut and Psychology Syndrome: Natural Treatment for Autism
Natural Treatment for Autism with Enzymes

Autism – Natural Remedies formulated by a Clinical Psychologist

Natural & Herbal Remedies for Autism

Chelation of Mercury for the Treatment of Autism

Native Remedies of Autism

Natural Therapy of Autism

Other conditions
Autism is one of several types of pervasive developmental disorders (PDDs), also called autism spectrum disorders (ASD). It is not unusual for autism to be confused with other PDDs, such as Asperger’s disorder or syndrome, or to have overlapping symptoms. A similar condition is called pervasive developmental disorder-NOS (not otherwise specified). PDD-NOS occurs when children display similar behaviors but do not meet the criteria for autism. It is commonly called just PDD. In addition, other conditions with similar symptoms may also have similarities to or occur with autism.

Prognosis:
There is no known cure. Children recover occasionally, sometimes after intensive treatment and sometimes not; it is not known how often this happens. Most children with autism lack social support, meaningful relationships, future employment opportunities or self-determination. Although core difficulties remain, symptoms often become less severe in later childhood. Few high-quality studies address long-term prognosis. Some adults show modest improvement in communication skills, but a few decline; no study has focused on autism after midlife. Acquiring language before age six, having an IQ above 50, and having a marketable skill all predict better outcomes; independent living is unlikely with severe autism. A 2004 British study of 68 adults who were diagnosed before 1980 as autistic children with IQ above 50 found that 12% achieved a high level of independence as adults, 10% had some friends and were generally in work but required some support, 19% had some independence but were generally living at home and needed considerable support and supervision in daily living, 46% needed specialist residential provision from facilities specializing in ASD with a high level of support and very limited autonomy, and 12% needed high-level hospital care. A 2005 Swedish study of 78 adults that did not exclude low IQ found worse prognosis; for example, only 4% achieved independence. A 2008 Canadian study of 48 young adults diagnosed with ASD as preschoolers found outcomes ranging through poor (46%), fair (32%), good (17%), and very good (4%); 56% of these young adults had been employed at some point during their lives, mostly in volunteer, sheltered or part time work. Changes in diagnostic practice and increased availability of effective early intervention make it unclear whether these findings can be generalized to recently diagnosed children.

Living With Autism:
Some children with mild autism will grow up and be able to live on their own. Those with more serious problems will always need some kind of help. But all children with autism have brighter futures when they have the support and understanding of doctors, teachers, caregivers, parents, brothers, sisters, and friends.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.charliebrewersworld.com/page4.htm
http://en.wikipedia.org/wiki/Autism
http://www.webmd.com/brain/autism/autism-symptoms

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Categories
Health Quaries

Some Health Quaries & Answers

Towering disturbance:-…....CLICK & SEE

Q: I own a flat on the third (top) floor of a building. The residents’ association has leased out the terrace to a cell phone company which has erected a tower there. I have a pacemaker and am worried about the impact of the signals from the tower on my heart. What should I do?

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A: Signals from microwaves and cell phones do affect pacemakers. Irregularities in the heart rate have been noticed when a phone is held even 15cm away from the pacemaker. When you are living just under a phone tower, the signal is likely to be strong and powerful. The first symptoms of the pacemaker being affected are a feeling of faintness and irregularity in your pulse rate. You can be fitted with a 24-hour monitoring device by your cardiologist. This will document any irregularity, so you know it is real and not psychological.

If there are any changes, it may make sense to move. Your building association is unlikely to cancel a financially lucrative enterprise and get the tower relocated.

Circumcise to protect:-

Q: I read that circumcision offers protection against AIDS. I wonder if I should get my one-year-old son circumcised.

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A: Circumcision is a surgical procedure that involves removal of the skin and mucosal tissue that covers the glans, the tip of the penis. Circumcision is unconditionally practised by Jews and Muslims. It is a part of their religious culture. In others it is usually performed if the foreskin gets stuck (phimosis) or infected. It does help in the prevention of AIDS and other sexually transmitted diseases. But it does not give 100 per cent protection.

All operations can have complications. Problems like infection or bleeding, though rare, can arise after the surgery. Unless your son’s paediatrician has advised circumcision for a particular reason, it does not make sense to put him through elective surgery. When he is older, teaching him about responsibility, sexual norms and safe sex may be a better option.

Yellow vs white:-

Q: There are natural and “artificial” eggs available in the market. The colour of the yolk in the two differs. Is there a difference in their nutritive values? Is eating eggs healthy?

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A: Eggs contain easily digestible proteins, fats, vitamins and antioxidants. They are a complete food in themselves. The recommended intake is one egg a day for those with a normal lipid profile (cholesterol and triglycerides). If the lipids are raised, cutting down on yolks to a maximum of two per week would be fine. Egg whites do not add to the cholesterol level, and you can eat as many of these as you like.

The colour of the yolk only depends on the type of feed the hen has received. It does not affect the egg’s nutritive value. By natural eggs, I think you mean those laid by hens that roam free, and by “artificial” the ones that are laid in hatcheries. Nutrition-wise, both are the same.

Music mania:-

Q: My daughter listens to music the whole day. I don’t like it, but do not want to put a stop to it unless it is harmful.

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A: If your daughter is listening to music instead of doing her homework or studying, perhaps you need to interfere. But do check her academic performance first. Listening to music does have many positive effects. It soothes, pacifies and relieves tension in children and in adults. Music during exercise provides a cognitive boost, in addition to the other benefits of regular activity. Loud music, on the other hand, can damage hearing, increase the heart rate and produce paradoxical excitement.

Unequal feet:

Q: My shoes never fit both the feet perfectly. One is always a little loose or tight.

A: A person’s feet may not be identical in shape and size. One is usually marginally larger than the other. If this difference is marked, footwear will never fit properly. It is better to buy a bigger size and wear two socks on the foot that is smaller. Otherwise, you have to buy two pairs of shoes.

Cauliflower ear:

Q: I pierced my ear in the upper part, in addition to the ear lobe. It has become red, swollen and painful. My ear now looks ugly and deformed. What should I do?

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A: The condition you are describing is called “cauliflower ear”. It occurs when a blood clot develops in the cartilage of the ear as a result of injury. The accumulated blood becomes infected and this destroys the cartilage, making it shrunken and shrivelled.

As soon as there is pain and swelling owing to an injury (even piercing), it should be treated with ice packs and antibiotics. Once it becomes misshapen, cosmetic reconstruction by a plastic surgeon is the only option.

Sources: The Telegraph (Kolkata, India)

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