Subarachnoid hemorrhage

Subarachnoid hemorrhage clinical manifestations:

(1) before unruptured saccular aneurysms are usually asymptomatic, but larger aneurysms can cause headaches or focal signs: partial paralysis of eye movements associated with dilated pupils often posterior communicating artery and carotid artery junction aneurysm in cavernous also oppressed section ⅲ, ⅳ, ⅵ cranial nerve V or the eye pieces.

(2) The vast majority (over 90%) sudden onset, slow onset minority. The disease mainly headache is common and first symptom, manifested as sudden severe headache whole, or headache is located in the first part, and soon spread to the whole head, often accompanied by nausea, vomiting; headache on one side who ruptured blood vessels in the side. However, due to different circumstances age, lesions, ruptured blood vessel size, the number of times the incidence, clinical manifestations vary greatly; light can no obvious symptoms and signs, severe sudden coma and stillbirths in the short term, 20% of have seizures. Older, less bleeding, pain tolerance strong or severe coma can no obvious meningeal irritation. Sometimes lower back pain more prominent position than the headache. Approximately 25% of patients may appear before the retina or vitreous hemorrhage, which is clinically useful characteristic signs. Most young age of onset, but also children and elderly onset. Most before the onset of obvious incentives, such as strenuous exercise, fatigue, cough or defecation, drinking, emotional and other dynamic at onset, a small number of patients in a quiet disease, including sleep. More than a third of patients, the disease a few days before the headache, stiff neck, nausea, vomiting, fainting or vision impairment, often due to the small amount of bleeding caused by an aneurysm. Subarachnoid hemorrhage in the early stages up to 25% misdiagnosis can lead to delays in treatment, and increased mortality.

(3) small number of patients side hemiparesis, sensory disturbances, aphasia, etc., were mostly due to the early stage of hemorrhage broken into the brain parenchyma and cerebral edema, often late Department of delayed vasospasm. Fundus examination shows 25% of vitreous film showings massive bleeding, such bleeding can occur within hours of the onset of l. This is the basis for diagnosis of SAH is quite strong, excessive bleeding, blood can invade the body cause glass visual impairment. 10% to 20% visible papilledema.

Clinical features (4) of the disease in old age is not typical, familiar with the characteristics of the elderly subarachnoid hemorrhage, timely and correct diagnosis and treatment is the key to reducing mortality. 40 to 70 years more. Sudden onset, may have emotional force, defecation, coughing and other incentives. The most common symptoms are sudden severe headache, nausea, vomiting, paleness, cold sweat. Half of the patients may have varying degrees of consciousness, to a transient unconsciousness as much, severe coma. 20% may have a seizure. Psychiatric symptoms or even the only symptom of some elderly patients. Delirium, agitation, hallucinations and delusions, disorientation, personality changes.

(6) children subarachnoid hemorrhage

① minor bleeding: can be asymptomatic and signs, or only mild irritability, muscle tension slightly under BCSF often recover within a week, more common in premature children, accounting for 75% of SAH in newborns;.

② bleeding more: full-term children more common, often convulsions within 48 hours after birth, but generally in good condition;

③ heavy bleeding: acute progressive disease, rapid death. The first two cases the prognosis is good, but can cause hemorrhagic hydrocephalus.

(7) complications

1) re-bleeding: the emergence of projections severe headache, vomiting, disturbance of consciousness, meningeal irritation, retinal fresh hemorrhage and other relevant neurological symptoms and signs his condition stabilized or improved once again, re-bleeding occurred in one after the first bleeding for the month, especially two weeks, its mechanism for the first 7 to 14 days after the bleeding plasmin activity increased, prompting clot primary vessel rupture due to dissolution; the causes for the patient irritability, excitement will Fen, defecation and high blood pressure.

2) cerebral vasospasm: clinically seen mainly delayed spasm, manifested as a gradual emergence of a stable or improving condition after disturbance of consciousness, paralysis or partial absence of neurological signs, but no sign of bleeding Ran said. Delayed cerebral vasospasm usually occurs in 4 to 14 days after the hemorrhage, the mechanism may be related to the cerebrospinal fluid oxyhemoglobin, 5-HT, TXA2 levels increased about.

3) hydrocephalus: non-traffic and normal pressure hydrocephalus.

Non-communicating hydrocephalus: clinical manifestations of the gradual emergence of increased intracranial pressure symptoms, such as apathy, unresponsive, headache intensified, deepened consciousness, neck stiffness worse. According to the time of onset can be divided into acute and chronic: Acute means the disease within seven days of hydrocephalus caused by ventricular dilatation, more than this time are known as chronic hydrocephalus acute hydrocephalus and more as the third ventricle, cerebral aqueduct, fourth ventricle or basal accumulation of blood pool. Cerebrospinal fluid circulation obstruction caused by chronic preserved more due to the aqueduct and basal cell adhesions.

Normal pressure hydrocephalus: ① The main symptoms of mental disorders, the light show is forgetful, unresponsive, severe dementia. ② abnormal gait, initially only walk weak legs, dragging step, after the development of spastic gait. ③ urinary incontinence: more mental disorders and abnormal gait appear after, occurred in 4 to 6 weeks after subarachnoid hemorrhage. ④ Other signs include: horizontal nystagmus, extrapyramidal signs.

4) Water and electrolyte imbalance: after SAH 5% ~ 30% of patients with hyponatremia can occur within blood vessels and reduce blood volume, may aggravate cerebral edema, mainly caused by inappropriate secretion of antidiuretic hormone.

5) neurogenic cardiopulmonary disorders: severe SAH with fluctuations in the level of catecholamines and sympathetic tone, which in turn causes neurogenic cardiac dysfunction, neurogenic pulmonary edema, or both simultaneously.

Four Principles of summer health

First, spleen and dehumidification. Dampness is a big evil summer, with summer spleen dysfunction, people often feel poor appetite, easy to diarrhea, greasy tongue and other symptoms appear, it should be dressed in uniforms dampness thing. More generally choose spleen aromatic dampness and light penetration dampness of the goods, such as rugosa, lotus seeds, Perrin and the like.

Second, the heat summer heat. High summer temperatures, heat Xie Sheng, human Firelight more prosperous, so commonly used these drugs with detoxification pure heart and fire effects, such as chrysanthemum, mint, honeysuckle, forsythia, the leaves like Qushu.

Third, nourishing lung and kidney. Chinese medicine believes that law by the five elements, summer heart Huo and lungs, kidney water virtual failure to pay attention to nourishing the lung and kidney yin. Can be used wolfberry fruit, habitat, lily, mulberries and sour and lung drugs, such as Schisandra, can prevent sweating too, Hao Shang-chun gas.

Fourth Winter Disease. The so-called Winter Disease, the human body and the outside world in the summer Sheng yang to treat some good winter hair disease with acupuncture substandard governance method of internal medicine. As with fresh sesame flowers often rub easy to frostbite Department, winter can prevent frostbite; ointment posted on acupuncture points to treat winter asthma and rhinitis.

Treatment of obesity

Summary of treatment of obesity:

Obesity emphasis on behavior, diet, exercise as the main comprehensive treatment, supplemented by drugs or surgery if necessary. Control the total food intake, low calorie, low fat diet. Select weight loss drugs should be cautious. Application of drug treatment must adhere to weight loss diet and exercise therapy, or after stopping weight can rebound.



Detailed treatment of obesity:

Treatment:

(A) treatment principle

Treatment principles for reducing caloric intake and increase calorie consumption. Emphasis on behavior, diet, exercise as the main comprehensive treatment, supplemented by drugs or surgery if necessary.

(Ii) specific treatment method

1. Behavior Therapy

Through publicity and education so that patients and their families to have a correct understanding of the dangers of obesity and thus cooperate with treatment. Adopt a healthy lifestyle, changing diet and exercise habits, consciously adhere to long-term, it is the most important step in the treatment of obesity. While supporting the social, rational emotional therapy is also important.

2. diet therapy

Control the total food intake, low calorie, low fat diet. For obese patients daily energy intake should be less than the physiological requirements, to a certain extent the negative balance. Patients with low heat difficult to adhere to, and can cause weakness, hair loss, depression, or even arrhythmia, there is a certain risk. Diet is divided into low-calorie diet and very low calorie diet. Most daily diet means low heat 62 ~ 83kJ / kg body weight per day means a very low calorie diet <62kj 15="" 200g="" 20="" 25="" 500g="" 60="" 65="" a="" absorbing="" amount="" and="" appropriate="" avoid="" balanced="" calories="" carbohydrates="" chocolate="" complex="" convenience="" d="" diet="" dietary="" eat="" energy="" enough="" fast="" fat="" fiber="" fluid="" font="" food="" foods="" fresh="" fried="" fruit="" grain="" high="" in="" increase="" kg.="" less="" meet="" micronutrients.="" mixed="" non-food="" non-heat="" of="" protein="" provide="" quality="" ratio="" reasonable="" requires="" respectively="" right="" salt.="" satiety.="" snacks="" structure="" sweets="" the="" to="" total="" use="" vegetables="" vitamins="" with="">

3. exercise therapy

And the combination of dietary treatment, and long-term adherence, can make the prevention of obesity or weight loss in obese patients. About activity or exercise should vary, incremental approach. Activity or movement should be simple, combined with personal preferences. Exercise designed according to the following steps: calculation of daily life withered check → day → energy consumption to 10% of the total as a daily exercise → into concrete movement type and time → efficacy and reflect the adjustment.

4. The long-term weight loss drug treatment drug treatment may produce adverse drug reactions and drug resistance, and thus the choice of drug therapy indications must be very careful. Weight loss drugs are the following categories.

(1) Weight Loss Drugs: ① Sibutramine: central role of weight-loss drugs, the recommended dose is 10 ~ 30mg / d, usually every 5mg, 3 times a day, orally, for 3 to 6 months. Adverse reactions are nausea, insomnia, dry mouth, rhinitis, constipation, increased blood pressure and heart rate and so on. ② Orlistat: fat absorption inhibitor dosage is 120mg, 3 times a day, orally, taking early mild digestive side effects such as bloating, stool frequency increased, the fat will be like. Note that the application would not affect the absorption of fat-soluble vitamins.

(2) assist weight loss medication: metformin, α-glucosidase inhibitors (acarbose, Basen, etc.), metformin 1.5 ~ 2g / d, divided 2 to 3 times a day orally, acarbose each 50mg, meal when taking a meal should be carbohydrate-based.

(3) Other drugs: such as leptin, cholecystokinin, intestinal somatostatin, corticotropin releasing hormone, growth hormone, growth factors and opiate antagonist.

5. Surgical treatment

Indications of surgical treatment of obesity: ① patients were morbidly obese, BMI Chaoguo 40 kg / m2; ②BMI is 36 ~ 40 kg / m2, while severe obesity-related diseases; ③ severe obesity existence for at least five years for non-surgical those who can not make weight loss treatment; ④ no significant history of mental illness and alcoholism.

(C) the treatment Precautions

1. Select the weight loss drugs should be careful, pregnancy, lactation, unstable angina, uncontrolled hypertension, unstable systemic disease, psychosis and fear of food, should not use diet pills. Monoamine oxidase inhibitor Taboo diet pills Ng, not with the treatment of migraine, angle-closure glaucoma drugs, and - ring antidepressants and with the use of general anesthetic. Younger than 18 years old and more than 65 years of age should use caution.

2. The application of drug treatment must adhere to weight loss diet and exercise therapy, or after stopping weight can rebound.

3. found serious drug-related adverse events should be closely observed, promptly disabled.

Nipple pain turned out to be Raynaud's disease!

Nipple pain is a reaction of breast disease, these patients are generally still breast-feeding period mother. They nursed him will reflect his own pain, Raynaud's disease which is performance. Your understanding of the disease do? Today Xiaobian to detail.
What is Raynaud's disease?
Raynaud's phenomenon is a disease refers to small blood vessels of the body. Because the contraction blood flow, the site of occurrence will be the first white, then purple due to tissue hypoxia, and finally restored after the circulation due to vascular congestion, and turned red. Raynaud's disease occurs most often in the position of the finger, but also other parts of the body can happen, of course, is no exception nipple.
Why nipples Raynaud's disease occur?
Raynaud's disease is the most basic causes blood vessels is due to dominate the nerves, resulting in overly sensitive due to receive stimuli. Common predisposing factors are cold, stress, emotional, infection and so on.
Also, nipple pain because winter people come seeking treatment, a lot more than in the summer. However, according to the doctor's experience, Raynaud's disease of the nipple is often not simply caused by the cold weather, usually also associated with other multiple factors.
In addition to weather, nipple Raynaud's disease the most common causes of the merger is bad milk and nipple infections. Poor baby milk, or eat due to illness increased frequency appease milk, can cause excessive stimulation of the nipple, causing abnormal blood vessel contraction. Nipple candidiasis infection or infection into fine, repeated no cure, will then lead to Raynaud's disease.
Raynaud's disease treated?

In addition to weather, nipple Raynaud's disease the most common causes of the merger is bad milk and nipple infections. Poor baby milk, or eat due to illness increased frequency appease milk, can cause excessive stimulation of the nipple, causing abnormal blood vessel contraction. Nipple candidiasis infection or infection into fine, repeated no cure, will then lead to Raynaud's disease.
In drugs, the general effect of Raynaud's disease using painkillers are usually poor, but you want to use to vasodilators situation is not uncommon. The most important thing is to keep warm, maintaining a good mood, while milk and other actively solve problems or infections, so over-sensitive nerves returned to normal, the situation is slowly improving pain before.

What easily threatened abortion?

First: the cause of threatened abortion are more likely embryonic factors, possible reasons for the mother, low progesterone, infection, that may arise from the activities threatened abortion phenomenon. Bed rest, have sex and keep the stool, do check the blood HCG and progesterone, in order to further miscarriage treatment.
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Second: threatened abortion may have many causes, such as: pregnant women, poor physical fitness, cold side of the uterus or did manual labor, or lead to marital intercourse, it may be of poor quality sperm and egg itself.
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Third: General abortion more than three times the women, to be vigilant, in the short term, the more the number of abortions, against big, female endocrine disorder, affecting the normal function of the endocrine system, female genital injuries caused by gynecological diseases, causing severe habitual abortion.

Precautions
After some pregnant women found that threatened abortion, fear of drugs affect the fetus quality, just give miscarriage, this is actually unscientific, pregnant women found to have signs of threatened abortion due approaching the hospital for examination, and not free to choose their own miscarriage drug.

What causes ectopic pregnancy

The main reason for ectopic pregnancy tubal inflammation, which will directly induce the formation of ectopic pregnancy. What causes ectopic pregnancy? Female friends appeared ectopic pregnancy, it is best treated as soon as possible, the disease directly affects their fertility. For there is no birth of a female friend, the emergence of ectopic pregnancy, which would directly by the blow, so patients do not have to worry too much, as modern medicine continues to progress, we are better able to treat the disease, we have the following to specifically look at the cause of ectopic pregnancy.
Which women will be prone to ectopic pregnancy
Which women will easily lead to ectopic pregnancy happen? What causes ectopic pregnancy? Tubal ectopic pregnancy occurs mostly among the emergence of inflammation. Tubal surgery or tubal dysplasia and taking emergency contraception, etc. These reasons will directly induce the formation of ectopic pregnancy. Female friends must pay attention had annex inflammation or pelvic inflammatory disease, or in patients who appear tubal surgery patients, and patients with infertility, these female friends must pay attention, to avoid the formation of ectopic pregnancy.
Women ectopic pregnancy prevention

Female friends must be positive to the formation of ectopic pregnancy prevention, planning to become pregnant female friends in life we ​​must develop good habits and dietary laws often do not smoke or drink, prevent ectopic pregnancy must do before pregnancy preparatory work should be timely to check to exclude the presence of a variety of gynecological diseases, if the normal pregnancy is very difficult, at this time we must choose ovulation drugs, it is best to follow the doctor's instructions, can be vigilant, had suffered an ectopic pregnancy If you choose women pregnant again, this time it must exclude the probability of occurrence of ectopic pregnancy.

Is there any way to treat heart beats

The heart is the central part of the human body, is also critical of several parts, if the heart problem is very dangerous, as this is not a serious heart beats mild symptoms do not need treatment, let's look for treatment Is there any way the heart beats.
Is there any way to treat heart beats 1
First: the heart beats, can be simply understood as the heart beating at a normal law, suddenly early abnormal beating. According to the research, it said about 70 percent of people have appeared premature heart of the phenomenon, but the symptoms are not obvious, it is difficult to attract attention. Not a premature heart disease, abnormal heart rhythms but the phenomenon is not terrible, but it may indicate the occurrence of some kind of heart disease, so the key is to learn self-examination, timely treatment. Under normal circumstances, there are premature heart-related symptoms or signs, early detection and timely treatment.
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Second: In general, premature heart does not require special treatment, usually premature therapeutic purposes only relieve symptoms and reduce the incidence of complications, so for patients with mild and require no treatment or only psychological or placebo, in peacetime good cardiac care can be. For patients with frequent premature heart, you can take medication to relieve symptoms and radiofrequency ablation.
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Third: For the treatment of premature heart, we must first find out the reason and eliminate premature, premature heart of the phenomenon will gradually be eliminated. If you can not find the cause of premature heart, should go to hospital for examination, the doctor will determine the need for treatment and the treatment of premature heart according to the test results.

Precautions
This leads to premature heart for many reasons, this disease can not be nervous, do not need some of what treatment, as long as identify the cause of the disease, and to eliminate the reasons for premature heart symptoms will gradually have improved, most good recovery.

What beverages should not drink when having fever?

A beverage: bogey tea: drinking tea will keep the excited state of the brain, enhance blood circulation and accelerate heartbeat role opposite also cause high blood pressure, thereby enabling the patient body temperature, irritability and fever patients themselves heartbeat and blood pressure is much higher than usual, and if the tea, then temperature will rise faster. At the same time, tea also affect the decomposition of drug absorption, is capable of a very serious reduce the efficacy of the drug.
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Drink Two: bogey drink cold: Because we need to know what caused the fever, if it is not clean because of food-borne infectious disease caused by fever, gastrointestinal function will then drop, cold drink will cause the body's defenses are weakened, or even make the condition worsen even endanger life.
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Drink three: bogey drink honey water: when the fever should be heat-based, not for nourishing. Honey belong supplements, if more than taking the honey, then the patient will not get a good clean-up heat, eliminate, but also easily lead to other diseases, once it is best not to drink honey water.

Precautions
After the fever must add more water, and pay attention to eat more fresh fruits and vegetables, and to keep warm, the body as much as possible out of a sweat, and pay attention to take medicine on time, so that can be a little bit of activity in the blood circulation.

Five Principles of liver disease Diet Care

Liver disease refers to occur in liver disease, including hepatitis B, hepatitis, fatty liver, and so on. Liver disease is a great danger, in daily life should be active based care, especially in patients with liver disease diet must be reasonable to follow the five principles.
1. To ensure the right amount of energy available. General from 2000 to 2500 kcal per day more appropriate, the right amount of protein can save energy consumption, enhance physical strength, promote liver cell regeneration and repair, but the energy is too high will cause weight gain, leading to fatty liver.
2. To provide adequate protein. To promote repair and regeneration of liver cells, it should increase the protein supply, should generally be accounted for 15% of total daily energy. Alternatively eat milk and eggs. Lean meat, tofu and other foods. But it is worth noting that, in patients with cirrhosis should not eat lots of short-term high-protein food to prevent a sharp rise in blood ammonia concentration, resulting in hepatic coma.

3. the water. Daily water intake is maintained at more than 2000 ml. Because more water can replenish body fluids, enhance blood circulation, promote metabolism, drink plenty of water is also beneficial to digestion and absorption and eliminate waste, reducing metabolites and toxins to the liver damage.
4. vitamin supplements. Vitamins are essential nutrients the body, is very rich in the liver, the liver is closely related, directly involved in the metabolic activity of the liver. Once suffering from liver disease, it will hinder the absorption of vitamins occur, causing a variety of vitamin deficiency, and therefore appropriate to increase vitamin intake, eat more foods rich in vitamins.
5. Keep fat intake. Patients with liver disease more commonly have tired of the oil and loss of appetite and other symptoms, usually, less than the amount of fat in patients with daily intake, and therefore to maintain a sufficient amount of fat intake. But it is worth noting that fasting animal fats, use vegetable oil.