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Dr. Leonardo is a registered trademark ® of Dr. Leonardo Interactive Webservices, LLC

We'll Do It For You

Information Pricing

No Time? No Problem.
Like the DIY idea of Dr. Leonardo websites, but just don’t want to Do-It-Yourself?
We understand! Fussing over website details isn’t for everyone. But we do love building websites with our builder and we’re kind of obsessive about how we do things. Plus, we can build them lickety-split – typically in 48 hours or less.
So, if it’s easier, we’ll do it for you! And we promise – you’ll love the finished site as much as we loved building it.
Call us today at 516-586-1300

We’ll Build Your Website for Just $250
Review Your Current Website and Migrate Basic Information
Add Your Accepted Insurance Plans
Link Your Patient Portal
Add Standard Patient Education Relative to Your Specialty
Add Standard Office Policies Information and Edit as Necessary
Add Up to 3 Provider or Staff Profiles
Update Your DNS Records and Launch Your Website
Confirm That Your Website Is Live and Operating Properly
Call us today at 516-586-1300

We Need Only 15-20 Minutes of Your Time.

Call us today at 516-586-1300

The Power of Dr. Leonardo Content

Natural Language Processing & The Power of Content
Why is Dr. Leonardo clinical content so important? Aside from saving you a ton of time when building out your website, its biggest value is a result of Natural Language Processing and modern search trends.
Search has adapted to Natural Language Processing — everyday language, as though a visitor is asking a question of someone (think of Apple Siri^® or Amazon Alexa^®). Yet, a search engine’s primary function is still to match a visitor’s search query to the most relevant website that is likely to answer the question.

Does North Central Ophthalmology Treat Cataracts?. . .

See How it influences the first page of search results.

Dr. Leonardo connects your practice name with the patient education associated with your healthcare specialty. This gives your website an incredible level of authority with Google, Yahoo! and Bing, especially when your name is paired together with a health condition, insurance plan or hospital network.
Get Started Yourself Or We’ll Do It For You

Patient Education Content

8,800+ Unique Topics to Choose From – All Completely Editable
Patients come to your website with questions about their care. Educate them with quality information. The Dr. Leonardo Library of healthcare content will help you fill your website with information your patients will enjoy reading.
With more than 8,800 topics featured in the Dr. Leonardo Library, you can quickly and easily create patient education webpages for your site. All content is editable and you can add additional information too. Information on the conditions you treat and the services you provide establishes authority with search engines and credibility to your patients.
Get Started Yourself Or We’ll Do It For You

Online Appointment Scheduling

Communicate with Patients Safely
Dr. Leonardo Appointments Button Your patients will love the ease and simplicity of scheduling appointments themselves at your website.
Patient Information is sent securely to your dashboard using our HIPAA-Compliant SecureForms™ messaging system feature SSL encryption.
Third-Party Scheduling & EHR Patient Portals
Dr. Leonardo also supports various third-party scheduling products:

EHR Products
EHR products generally route appointment scheduling through their Patient Portals. Dr. Leonardo supports integration with most patient portal products including Greenway Health and Amazing Charts, our two preferred partners.
Get Started Yourself Or We’ll Do It For You

HIPAA-Compliant

Your Website is Protected Within a Secure Network
Healthcare practices are required to provide HIPAA-compliant security when communicating electronically with their patients and other providers. Dr. Leonardo websites reside on the same HIPAA-compliant cloud-hosting network that is used by many EHR systems to secure sensitive patient data.
With Dr. Leonardo, you can feel confident knowing that your website, its content, and any patient communications are fully protected and secure.
Get Started Yourself Or We’ll Do It For You

Website Performance Analytics

Dr. Leonardo Tracks Patient Visits & Behavior
Dr. Leonardo features analytic reporting on visits to your website, which pages were viewed, and how your site is indexed throughout the web:
○ New & Returning Visitors
○ Page Views
○ Appointment Requests
○ Daily Visits – Weekly & Since Publication
○ Visitor Behavior – Weekly
Website Performance Reports are emailed automatically at the end of each week, and are also available dynamically on the Dr. Leonardo Console Dashboard.
Get Started Yourself Or We’ll Do It For You

Patient Reviews & Ratings

Ratings & Connectivity to Facebook, LinkedIn, etc
Feature patient reviews and five-star ratings on your website from third-party partners such as Doctor.com and others.
Use the Social Media Widget to add social media icons to the sidebar of your website. Give your patients easy access to view your Facebook, Twitter, Google+, YouTube & LinkedIn Accounts.
Get Started Yourself Or We’ll Do It For You

Patient Portal Integration

Embed Your Portal Into Your Website
Put your patient portal where it can’t be missed – on your website!
Now that your practice has made the switch to electronic medical records, your website is more important than ever. Meaningful-Use regulations require your patients have online access to view their records so your practice may qualify for financial reimbursement. Providing access to your patient portal has never been easier, and your patients will appreciate the seamless experience as they access their portal directly from your website.
Get Started Yourself Or We’ll Do It For You

Integrated Search Engine Optimization

Adjust Your SEO Settings For Better Visibility
All Dr. Leonardo websites have built-in automated SEO functionality so patients will be able to find you by individual name and by practice name on Google, Yahoo!, and Bing.
You can further customize your search engine settings for individual pages by editing page titles and descriptions, H-tags, image-tags, keywords and all written content including patient education pages.
Dr. Leonardo automatically generates XML Site Maps, and SEO can be adjusted on a site-wide basis for title tag taxonomy, footers, Google and Bing Webmaster Tools, Google Analytics and Forms and AdWords/Bing Conversion Tracking.
Get Started Yourself Or We’ll Do It For You

Report: Nearly 60 percent of searches now from mobile devices

“A recent report from Hitwise (registration required) argues that in the US mobile search is roughly 58 percent of overall search query volume. That’s based on an average of 11 key categories and associated queries analyzed by Hitwise in its ‘Mobile Search: Topics and Themes’ report. The company ‘examined hundreds of millions of online search queries’ across PCs, smartphones and tablets between April 10 and May 7, 2016.”
Note: the category with the second highest percentage of mobile search volume was ‘Health’ with 68 percent.
CONTINUE TO THE ARTICLE >>

Frequently Asked Questions

Is Dr. Leonardo a Web Builder or a Website Design Company?
Dr. Leonardo is an Internet Presence Management Platform. Our design engine is intended as a Do-It-Yourself (DIY) builder developed exclusively for the healthcare industry with more than 1,000 uniquely different design themes for dental, medical and veterinary specialties. Additionally, the Dr. Leonardo platform includes patient education content on more than 8,800 health conditions.
You can use the web builder to create your website yourself, or you can have us create it for you if its easier. Either way, you get a fully-customized website that you easily manage yourself for thousands of dollars less than most website design firms.
I Want a Custom-Looking Website. Can I Modify My Design?
Yes. Dr. Leonardo PRACTICE-Sites feature dozens of high-resolution photographs for use as animated images on your Home Page. There are more than 6,000 dental, medical and veterinary photos and clinical illustrations to use to customize the interior pages of your website. Plus, you can upload your own images too.
Can an Outside Agency Perform Search Engine Optimization (SEO) Services?
Yes. Dr. Leonardo has partnerships with various companies including outside digital marketing agencies, but you can also provide access to your own agency if you prefer.
What Happens When I Want a New Website Design? Will I Have to Rebuild My Site?
There’s no need or cost to restyle your website since you can change your design at any time with a simple click of a button. New advances in technology, such as responsive mobile designs, are available to you without having to rebuild your entire website.
Do I Have to Sign a Long-Term Contract?
Dr. Leonardo does not require a contract. Our subscription terms are month-to-month, so you may cancel at any time

Why Do I Need a PROVIDER-Site if Information About Me is Already on Directories?
Provider-directories actively encourage their visitors to compare you against as many as nine (9) other providers in the same specialty and who may be located nearby. Your patients can easily become distracted by visiting these other provider profiles and schedule appointments with competing providers. Provider-directories also limit the information that can be edited and presented, so you typically cannot change colors, background photos or edit any of the healthcare content within a directory profile. You have complete control of your Dr. Leonardo PROVIDER-Site’s appearance and content.
How Does a PROVIDER-Site Rank at the Top of Search Engine Results for My Name?
Dr. Leonardo PROVIDER-Sites associate your name directly with the health content on your Profile-Site. This enables search engines to pair queries of your name and professional title with the clinical conditions you treat, the insurance plans you accept, etc. Your PROVIDER-Site has tremendous relevant authority and will typically rank above other websites when patients search for you by name.
Who Owns My Domain Name?
You do! When you purchase a domain registration through Dr. Leonardo, you have complete control over the information for the Registrant and Administrative Contacts.
Do I Have to Sign a Long-Term Contract?
Dr. Leonardo does not require a contract. You may cancel your subscription at any time.

How Does Dr. Leonardo's Find & Claim Function Work?

Find Your Site & Claim Your Domain
Our Find & Claim function searches various databases for your name and then instantly builds your PROVIDER-Site from public information relating to your professional license as a healthcare provider.
At the same time, Dr. Leonardo also queries the ICAAN domain registry for your name as a .COM domain. If your name is currently available, Dr. Leonardo allows you to reserve your domain while you edit your PROVIDER-Site.
You can, of course, always edit your information and professional credentials. However, Dr. Leonardo‘s automated process gives you a tremendous head-start in completing most of your PROVIDER-Site for you.

Schedule an Appointment with: John Smith, MD

John Smith, MD

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Day of the Week – Month Day, Year

First Name *

Last Name *

Phone Number *

Mobile Number

Email *

Preferred Contact Method

Phone

New Patient? *

Yes

Reason for Visit *

Self-Scheduling Set to Explode in Healthcare

“Driven by patient demands for greater convenience and more control, US health systems are adopting digital patient self-scheduling tools to differentiate themselves competitively, improve efficiencies and enhance patient engagement and satisfaction. A recent Accenture survey shows 77 percent of patients think that the ability to book, change or cancel appointments online is important. A rapid explosion in use of digital solutions for DIY appointment making will radically alter the US health system marketplace over the next five years.
Accenture predicts that by the end of 2019, 66 percent of US health systems will offer digital self-scheduling and 64 percent of patients will book appointments using digital tools. Nearly 38 percent of appointments will be self-scheduled—almost 986 million appointments—creating $3.2 billion in value.”
CONTINUE TO THE ARTICLE >>

Achilles Tendonitis

Achilles tendonitis (also tendinitis) is an inflammation of the Achilles tendon, the strong band of tissue that connects the calf muscle to the heel. This condition occurs when excessive stress is put on the tendon. Achilles tendonitis is usually a painful but short-lived condition. It not treated, however, Achilles tendonitis can increase the risk of Achilles tendon rupture, a serious injury requiring immediate medical attention. Most cases of Achilles tendonitis can be prevented by beginning an exercise regimen slowly, with preparation, and by increasing an exercise program gradually and with care.
Causes of Achilles Tendonitis
Achilles tendonitis is usually caused by excessive or repetitive strain on the tendon. It is frequently found in athletes who suddenly increase their activity level, or in middle-aged individuals who exercise intensely but irregularly. Older individuals are at increased risk of injuring the tendon because tendons weaken during normal aging. Movements that may put strain on the Achilles tendon include walking, running, jumping or pushing up onto the toes.
Risk Factors for Achilles Tendonitis
Apart from age and improper preparation for exercise, other risk factors for Achilles tendonitis include:
○ Being male
○ Being obese
○ Having flat feet or tight calf muscles
○ Wearing non-supportive footwear
○ Exercising in very cold weather or on hilly terrain
○ Having diabetes or hypertension
Taking certain antibiotics, known as fluoroquinolones, such as Cipro and Levaquin, also puts individuals at greater risk of developing Achilles tendonitis.
Symptoms of Achilles Tendonitis
Typically, the pain of Achilles tendonitis initially manifests after engaging in a sports activity as a mild ache in the calf or above the heel. Other symptoms may include:
○ Increased pain after running or climbing stairs
○ Pain when walking
○ General tenderness and swelling at the site
○ Stiffness or tenderness upon awakening
○ Lessening of pain with mild activity
If a patient experiences severe pain or disability in the region of the Achilles tendon, a ruptured tendon should be suspected and medical attention should be sought immediately.
Diagnosis of Achilles Tendonitis
Achilles tendonitis is usually diagnosed through a combination of physical examination, including an assessment of flexibility, range of motion, reflexes, inflammation and alignment at the injury site, and one or more of the following imaging tests:
○ X-rays
○ MRI Scan
○ Ultrasound
The chief purpose of these imaging tests is to rule out the possibility of a tendon rupture, a more serious injury that requires surgical intervention.
Treatment of Achilles Tendonitis
As with most injuries, conservative methods of treatment are normally tried first, but the initial treatment will depend, to some extent, on the patient's level of pain and dysfunction.
Home Care
Tendonitis usually responds well to self-care measures, including rest, ice application, and elevation of the affected area, in combination with over-the-counter pain and anti-inflammatory medication.
Assistive Devices and Orthotics
In order to relieve pain and accelerate healing by taking weight off the injured area, assistive devices, such as, walking boots, crutches or canes may be recommended and prescribed. Orthotics, or shoe inserts, may also be suggested to provide a cushion that diminishes pressure exerted on the Achilles tendon.
Prescribed Medications
When over-the-counter medications are insufficient, the doctor may prescribe stronger analgesics or anti-inflammatories.
Physical therapy
Physical therapy may be advised as an alternative method of treatment. Physical therapists are trained to instruct and assist in exercises the patient can use to stretch, strengthen and heal not only the Achilles tendon, but the adjacent, supportive region. They may also use laser, ultrasound and electrical stimulation as part of the rehabilitative process.
Surgery
If diagnostic tests have shown that the Achilles tendon is torn or ruptured, or if the patient doesn't show marked improvement after several months of conservative treatment, surgical repair of the Achilles tendon may be necessary.
If surgical intervention is necessary, most patients will require physical therapy after the operation to regain maximum strength and flexibility.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Achalasia

Achalasia is a rare esophageal disorder in which the esophagus has trouble transporting food to the stomach. Since sluggish digestive motion is involved in achalasia, it is known as a motility disorder of the gastrointestinal tract. The lower esophageal sphincter, which is a ring around the site where the esophagus and stomach join, is supposed to relax when swallowing, but In patients with achalasia it does not function properly.
Causes of Achalasia
Achalasia is typically caused by damage to the esophageal nerves. Sometimes, it may be an hereditary condition. Achalasia occurs most frequently in middle-aged or older adults.
Symptoms of Achalasia
The symptoms of achalasia are very uncomfortable and interfere with everyday life. They may include:
○ Unintentional weight loss
○ Regurgitation
○ Chest pain, particularly after eating, which may extend to the back, neck, and arms
○ Cough
○ Difficulty swallowing
○ Heartburn
○ Anemia
Diagnosis of Achalasia
In addition to a thorough physical examination, the doctor may perform the following diagnostic tests for achalasia:
○ Blood tests
○ Upper endoscopy
○ X-rays of the upper GI tract
○ Esophageal manometry
Treatment of Achalasia
Treatment of achalasia is designed to reduce the pressure at the lower esophageal sphincter. It may involve:
Injection of BOTOX
One treatment for achalasia is the injection of BOTOX, or botulinum toxin, into the esophageal sphincter during endoscopic surgery. BOTOX will weaken the sphincter muscles sufficiently to enable food to once again move from the esophagus to the stomach without a problem. Although this treatment is usually successful, it is not long-lasting and must be repeated periodically — from every few weeks to every few months. BOTOX injections are most frequently used in elderly patients or patients at high risk for post-surgical complications.
Medications
Calcium channel blockers or long-acting nitrates may also be used as a treatment for achalasia since they relax the lower esophagus sphincter. They are often especially effective when symptoms first appear. For most patients, however, medications are only likely to provide short-term relief and for many patients medications may have troubling side effects.
Surgery
Two types of surgery may be considered to remedy achalasia: cutting the muscle of the sphincter, also known as esophagomyotomy or Heller myotomy, or dilatation of the esophagus where it is most narrow during an endoscopy, known as esophagogastroduodenoscopy.
Risks of Achalasia
The treatments for achalasia are quite safe, but when surgical procedures are undertaken there are always risks. In general, the risks of surgery may include:
○ Excessive bleeding
○ Blood clots
○ Adverse reactions to anesthesia or medications
○ Post-surgical infection
○ Damage to adjacent organs
○ Breathing problems
○ Hernia at the incision site
The surgical procedures used to treat achalasia may further include the following complications:
○ Regurgitation of acid or food, known as reflux
○ Aspiration pneumonia caused by breathing food into the lungs
○ Perforation or tearing of the esophagus
Recovery from Achalasia
Recovery from the surgical procedure performed to treat achalasia varies depending on whether the surgery is performed as open surgery or laparoscopically. Since the laparoscopic procedures are minimally invasive and require smaller incisions, they result in less pain and a more rapid recovery.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Acupuncture

Practiced by Chinese healers for more than 5,000 years, acupuncture is a type of holistic medicine designed to facilitate the proper flow of Qi (ch’i), the life-giving energy that travels through the body’s pathways (meridians). By helping Qi to move unimpeded through the meridians, acupuncture provides nourishment to all of the body’s cells, muscles, organs, glands and tissues. During an acupuncture session, fine needles are inserted into the body at specific points along the meridians to break up blockages and restore a full, healthy flow of Qi.
Reasons for Acupuncture
Acupuncture focuses on improving the body as a whole, rather than simply treating a particular symptom. It is often used to provide pain relief for certain medical conditions or issues, including the following:
○ Asthma
○ Postoperative pain
○ Depression
○ Chronic pain
○ Allergies
○ Irritable-bowel syndrome (IBS)
○ Chronic headaches or migraines
○ Common colds
○ Carpal tunnel syndrome
○ Fibromyalgia
○ Tennis elbow
○ Menstrual cramps
○ Lower-back pain
○ Myofascial pain (caused by muscle spasms)
○ Osteoarthritis
○ Nausea
○ Sinusitis
○ Neck pain
○ Gastritis
○ Vomiting
○ Dental pain
Acupuncture is sometimes also used to help stroke victims overcome paralysis, and problems with swallowing and speech.
The Acupuncture Procedure
Before starting the session, the acupuncturist usually examines the parts of a patient's body that are painful, and ask questions about current symptoms and existing health conditions. This evaluation, which is designed to ensure that the patient has the best-possible treatment outcome, can take up to an hour to complete.
During acupuncture treatment, needles are inserted, depending on the patient’s symptoms, into the skin at targeted areas and depths. Only sterile, single-use needles (usually between five to 20 per session) are used to avoid potential infection and ensure the patient's safety. Once the needles have been placed, the practitioner gently moves or twirls them; needles may also be heated by electrical impulses. Needles are kept in place for five to 20 minutes, with patients typically undergoing a total of 12 treatments on a weekly or biweekly basis.
Risks of Acupuncture
Acupuncture is considered safe in the hands of an experienced professional, which is why it is important for a patient to research the background of the acupuncturist before undergoing treatment. A patient who is pregnant, or has a pacemaker or bleeding disorder, has a greater risk of experiencing complications from acupuncture, and may not be a good candidate.
Although rare, risks and possible complications of acupuncture include the following:
○ Organ injury (especially if needles are pushed in too deeply)
○ Mild discomfort
○ Soreness
○ Bleeding
○ Bruising at the needle sites
○ Infection (especially if needles are reused)
Results of acupuncture largely depend on the individual patient, and it is often combined with more conventional treatments, such as prescription drugs, to maximize results. If symptoms do not improve within a few weeks of receiving acupuncture, further treatments may be necessary.
The device checks the patient’s blood pressure every 15 to 30 minutes throughout the day in order to thoroughly monitor blood pressure while the patient goes through a normal day’s activities. Patients will be asked to keep a diary of their day so that the doctor can fully analyze any changes in blood pressure. The device will be removed the next day at the doctor’s office, and the monitoring information will be transferred to a computer. Any treatment modifications can be made after the results are reviewed by the doctor and patient.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Abdominoplasty

Abdominoplasty (tummy tuck) helps flatten the abdomen by removing excess fat and skin, and tightening muscles. The best candidates for abdominoplasty are in good physical condition, with pockets of fat or loose skin that have not responded well to diet and exercise. Abdominoplasty can also be appropriate for slightly obese people whose skin has lost some of its elasticity, and for women with skin and muscles stretched from pregnancy. Anyone planning on losing a significant amount of weight, and women planning on having (more) children, should wait before undergoing abdominoplasty.
The Abdominoplasty Procedure
Abdominoplasty takes approximately 2 to 5 hours to perform; the patient is placed under general anesthesia. Two incisions are made: one from hipbone to hipbone close to the pubic area, and another around the navel. Skin is separated from the abdominal muscles, which are then pulled together and stitched into place for a firmer abdomen and narrower waist. The skin flap is then stretched down over the newly tightened muscles, excess skin is removed, and the navel is reattached where it looks natural. The incisions are then closed, and sterile surgical dressings are applied over the sutured areas.
Recovery After Abdominoplasty
After surgery, a temporary tube may be inserted to drain excess fluid from the surgical site. An overnight hospital stay may be necessary. Recovery time ranges from 2 weeks to 2 months. Abdominoplasty leaves a scar spanning the lower abdomen from hip to hip, although it is low enough to be concealed by a bikini. Maintaining weight with a balanced diet and regular exercise provides long-lasting results.
Risks of Abdominoplasty
In addition to the usual risks associated with surgery and anesthesia, risks associated with abdominoplasty include the following:
○ Asymmetry
○ Poor aesthetic result
○ Unsightly scarring
○ Loose skin
○ Numbness in skin sensation
○ Need for revisional surgery
Patients who have had previous abdominal surgery may find that their old scars look more raised, have stretched or are more noticeable in general. Undergoing a scar revision may minimize their prominence.br class=”poppbreak”>Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Abnormal Pap Smears

A Pap test, or Pap smear, is part of a woman’s annual wellness exam. The Pap test involves extracting a small sample of cells from the cervix. These cells are examined, in a lab, for abnormal cell changes. The Pap test is used in diagnosing cervical cancer and human papilloma virus, or HPV.
An abnormal Pap smear doesn’t necessarily indicate a condition like HPV or cervical cancer. Pap smears detect any changes within the cervical cells, not just cervical cancer. Abnormal Pap smear results may indicate other conditions such as inflammation or infection. False positives are also possible from Pap smears, however further testing is recommended to protect your health whenever the Pap smear is abnormal.
Types of Pap Smear Results
There are three categories of results: normal, unclear and abnormal.
Negative Result
A negative, or normal, result occurs when no changes to the cells of the cervix have been detected. This is a healthy diagnosis, however, the patient should continue to receive regular Pap smear tests.
Unclear Result
Unclear results are not uncommon, and they simply refer to an inconclusive finding that the cervical cells may or may not be abnormal. This may mean that too few cells were collected during the test. It can also indicate a disease or infection as well as changes caused by hormones or inflammation. The results may be influenced by other factors too, such as having had sexual intercourse, using a douche or applying vaginal cream in the two days prior to the Pap smear testing.
Abnormal Result
Abnormal, or positive, results typically indicate changes to the cervical cells, which may be caused by a number of conditions. They range from mild changes, which may be the result of an infection, to moderate or severe changes, which are a sign of potentially serious pre-cancerous or cancerous tissues.
Follow-Up for Abnormal Pap Smears
The doctor will make recommendations for additional testing or treatment based upon the patient's age and type of dysplasia, or abnormal cells which are found in the cervix.
Repeated Pap Smear
Some patients may require a repeat Pap smear every three months for follow-up,until the Pap smear results return to normal. This is a standard approach when the changes that were detected in the cervical cells are considered minor, and they will often resolve with no treatment. However, these follow-up appointments are essential to ensure that the initial results were an anomaly.
Colposcopy
The doctor may recommend a colposcopy test if the Pap smear is abnormal. During the colposcopy, a microscope is used to examine the cervix more closely and a biopsy is taken from the cervix. The exam itself is similar to a Pap smear in that a speculum is inserted into the vagina so that the cervix is visible. After the biopsy results are received, the doctor will recommend any treatment indicated to prevent cervical cancer.
Loop Electrosurgical Excision Procedure
Some patients will need a mini-surgery called loop electrosurgical excision procedure, also known as LEEP, to remove precancerous cells from the cervix. During the procedure, the abnormal cells are removed to prevent the development of cervical cancer. Wire loops attached to an electrosurgical generator cut away the affected tissue, causing the cells to heat and burst. The tissue removed is sent to a lab for further evaluation and to ensure that the abnormal area has been fully removed.
False positive results of Pap smears may sometimes occur. Recent research and new technology has led to more accurate tests, however these are more costly and are not always covered by insurance. If a false positive result occurs, the doctor may recommend the use of a different test to confirm the results. The possibility for false negative results also exists. It is recommended to regularly receive a Pap smear as a part of a woman's annual wellness exam. The patient should discuss all testing results and treatment options with the doctor.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Addiction

An addiction is an uncontrollable dependence on a certain substance or activity. People become addicted to different things for different reasons, but can be affected both physically and psychologically. With addiction, the activity or substance often becomes the major focus of a person’s life, leading to the exclusion of other activities, impairing work, social, and family responsibilities, and affecting the individual's health, mood, and self-respect. Addicted individuals may suffer from anxiety, low self-esteem or depression and often feel as if they have no control over their lives or behavior.
Types of Addictions
Both physical and psychological addictions affect the part of the brain that produces endorphins, or pleasure inducing substances. These chemicals make the person feel “high” or euphoric when indulging in their addiction.
Physical Addictions
Physical addictions are usually a result of the use of a particular substance. After excessive use, people build up a tolerance and need a larger and larger dose to feel the same effects of the substance. If they do not use the substance, they may suffer from symptoms of withdrawal. Common types of physical addictions may include:
○ Alcohol
○ Drugs
○ Caffeine
○ Nicotine/Smoking
Behavioral or Psychological Addictions
Psychological or behavioral addictions occur when there is an uncontrollable urge to perform an activity. Behavioral addictions are not substance-related, and include a strong and recurring compulsion to engage in a certain activity despite the harmful consequences to either the individual or others. Behavioral addictions may include:
○ Sex
○ Interne
○ Exercise
○ Dieting
○ Overeating
○ Gambling
○ Shopping
○ Cell phone use
Causes of Addictions
There is no specific cause for a person to develop an addiction, however, an addiction may be influenced by a person’s genetic makeup and social or environmental factors. Many people believe that genetics may cause a risk of addiction and environmental factors such as family life, upbringing and peer influences may also play a role in causing an addiction. Children who grow up in homes where a parent abuses drugs or alcohol or participates in other addictive behaviors may be at a greater risk for developing an addiction, for both genetic and environmental reasons.
Treatment for Addiction
Addiction is a treatable condition. The first step in the successful treatment of an addiction often begins when the individual admits that they have a problem and need help. Physical addictions to substances such as drugs or alcohol may be treated with medication. Behavioral therapy and counseling are also an important part of treatment. Behavioral therapy is often used to help patients identify, avoid, and cope with situations in which they are most likely to partake in addictive activities. Family or group therapy may also help the patient maintain a supportive environment and improve family relationships.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Learn How Patients Search For Physicians

“Overwhelmingly, patients search for individual providers (e.g. doctors, dentists) over hospitals or other healthcare facilities. In fact, 76.3%* of individuals reported going online to find an individual provider, versus only 29.9%* that searched for a facility. This is an important wake-up call for hospitals and health systems. While listing facilities online is a great starting point, failing to list physicians and other individual providers will cause you to miss out on three out of four potential patients.
We also discovered that more than half* of all patients choose healthcare providers based on information found outside of the provider’s website. This means prospective patients are using search engines and other healthcare directory and review sites to search for and choose providers.”
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Asbestosis

Asbestosis is a chronic respiratory disorder caused by inhaling asbestos fibers. Asbestos is a material that was commonly used in construction, particularly in insulation and floor tiles, until the mid-1970s. Inhalation of its dust can cause scar tissue to form in the lungs, resulting in respiratory distress. Symptoms of asbestosis range from mild to severe, and usually do not appear until there has been prolonged exposure. The majority of patients with the disease acquired it on the job before federal regulations on its use were put into effect. Asbestosis cannot be cured, but it can be treated.
Causes of Asbestosis
Inhalation of high levels of asbestos dust over a long period causes fibers to become imbedded in the alveoli, the air sacs of the lungs. These fibers are an irritant to lung tissue, causing it to scar and stiffen. The more the disease progresses, the stiffer the lung tissue becomes, preventing it from contracting and expanding in the usual way, and interfering with normal breathing. In individuals who smoke, asbestosis progresses more quickly.
Symptoms of Asbestosis
Typically, it takes between 20 and 30 years after initial exposure for the symptoms of asbestosis to appear. Symptoms include the following:
○ Shortness of breath
○ Chest tightness or pain
○ Persistent, dry cough
○ Loss of appetite and weight loss
○ Chronic fatigue
○ Pleural effusion (fluid accumulation in the pleural cavity)
In advanced stages of asbestosis, patients may develop clubbed fingertips and toes that appear wider than normal, and abnormalities of the nails.
Diagnosis of Asbestosis
When a patient suffering from respiratory symptoms has a history of exposure to asbestos, the possibility of asbestosis must be investigated. In order to diagnose it, the doctor performs a thorough physical examination, and may perform the following tests:
○ Pulmonary-function tests
○ Chest X-ray
○ Pulmonary CT scan
During diagnosis, asbestosis must be distinguished from mesothelioma. Though they share many of the same symptoms, mesothelioma is form of cancer, and has a worse prognosis. Patients with asbestosis have a higher risk of developing mesothelioma than those who do not.
Treatment of Asbestosis
While there is no cure for asbestosis, measures can be taken to relieve symptoms and slow its progression. In some cases, the initial treatment is to assist the patient in giving up smoking, which exacerbates the condition and contributes to the development of lung cancer. Other possible treatments may, depending on the severity of the individual case, include one or more of the following:
○ Drainage of the pleural cavity
○ Oxygen therapy
○ Medication to lower blood pressure
○ Lung transplant
Patients with asbestosis require follow-up examinations. The frequency of such examinations is determined by the stage of the disease. Because of increased susceptibility, it is extremely important that asbestosis patients take steps to prevent respiratory infections by getting necessary vaccinations for flu and pneumonia, and avoiding people who are ill.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Clitorodynia

Volvodynia is a condition that involves chronic pain and discomfort of the vulva and vaginal area. Clitorodynia is a form of vulvodynia in which the pain is concentrated in and around the clitoris. The area may feel sore and uncomfortable much of the time or may be intensified while exercising, wearing tight clothing or having sexual intercourse. In some patients, sitting for long periods of time and dealing with stress can worsen the symptoms.
Symptoms of Clitorodynia
Symptoms of clitorodynia mainly affect the clitoris and may include:
○ Pain
○ Burning
○ Stinging
○ Swelling
○ Soreness
Causes of Clitorodynia
In many cases, the exact cause of clitorodynia is not known. In some cases it may be the result of:
○ Infection
○ Sexually transmitted disease
○ Trauma to the clitoral area
○ Sexual abuse
○ Allergic reaction
○ Hormonal changes
Treatment of Clitorodynia
Lifestyle changes such as wearing loose-fitting clothing, physical therapy and over-the-counter pain medication may help some patients. For those with severe or persistent symptoms, prescription medication, topical pain relievers and nerve block injections can be effective treatment methods for reducing pain.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Ankylosing Spondylitis

Ankylosing spondylitis is a form of chronic inflammatory arthritis that significantly affects the joints of the spine. This autoimmune condition causes swelling between the vertebrae, and often affects one or both sacroiliac joints, the joints that attach the spine to the pelvis. In severe cases, the extreme swelling may cause the bones of the spine to fuse. Pain, swelling, and stiffness in the lower back are the typical symptoms of ankylosing spondylitis, but inflammation may occur in other parts of the body, including the eyes. Men are more likely than women to develop ankylosing spondylitis and it most commonly occurs in late adolescence or early adulthood.
Causes of Ankylosing Spondylitis
The exact cause of ankylosing spondylitis is unknown, though the disorder is believed to have a genetic link. Research indicates that individuals who carry a gene known as HLA-B27 are at a greater risk of developing the condition, although most people who carry the gene never develop it. Having a family history of ankylosing spondylitis is also a risk factor for the disorder.
Symptoms of Ankylosing Spondylitis
Early symptoms of ankylosing spondylitis are most commonly evident in young adult males and often include pain in the lower back and hips. Pain may also be experienced in parts of the body where tendons and ligaments attach to the bones. Over time, these symptoms may worsen or may only occur intermittently. Symptoms of ankylosing spondylitis may include:
○ Pain in the sacroiliac joints
○ Pain in the shoulders, knees, feet, breastbone or ribs
○ History of gastrointestinal infections, Crohn’s disease or ulcerative colitis
○ Fatigue because of chronic inflammation
○ Eye inflammation or sensitivity (iritis or uveitis)
Complications of ankylosing spondylitis may, in severe but rare cases, affect circulation and respiration. Over time, the disorder may cause the bones of the vertebrae to fuse and parts of the spine and ribcage to become inflexible. As a result, lung capacity may become restricted, causing breathing difficulty. It is also possible for ankylosing spondylitis to affect the heart, impairing heart function by distorting the shape of the aortic valve.
Diagnosis of Ankylosing Spondylitis
To diagnose ankylosing spondylitis, the doctor must take a complete medical history and perform a full physical examination. During the exam, the patient’s spinal mobility and chest expansion capability are evaluated. Blood tests may be performed to detect for inflammation or infection, including a genetic test to discover the telltale HLA-B27 gene. Diagnostic imaging tests may also be administered for more accurate, detailed visualization of bone and soft tissue. These may include X-rays and MRI scans.
Treatment of Ankylosing Spondylitis
There is no cure currently available for ankylosing spondylitis. A range of medications, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) and prescribed corticosteroids, may be administered. In more problematic cases, anti-rheumatic drugs (DMARDS) may be prescribed. These can be very effective in reducing swelling and pain. Physical therapy and exercise are also very beneficial for many patients. In the most severe cases, treatment may include surgery to replace joints in the hip or knee, or to straighten the spine.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Acoustic Neuroma

An acoustic neuroma is a benign tumor found on the vestibular cochlear nerve, the nerve that connects the ear to the brain. This nerve is behind the ear, right under the brain.
A type of auditory tumor, an acoustic neuroma is also known as a vestibular schwannoma. This type of tumor is usually slow-growing and, although it does not affect brain tissue as cancerous tumors do, it may press against the nerves controlling hearing and balance as it grows. An acoustic neuroma is an uncommon cause of hearing loss. Many patients do not experience any problems from this type of tumor because it may remain very small, but if enlarges enough to exert serious pressure on the brain, it may become life-threatening.
Causes of an Acoustic Neuroma
Most of the time, the cause of an acoustic neuroma is unknown. If acoustic neuromas develop in both auditory nerves, the underlying cause may be a heredity disorder known as neurofibromatosis type 2, but this genetic defect accounts for only a very small percentage of cases. The great majority of acoustic neuromas are known as sporadic form, of no known origin. The one clear risk factor for this disorder is exposure to high doses of radiation.
Symptoms of an Acoustic Neuroma
As long as an acoustic neuroma remains small, the patient is usually asymptomatic. As it grows, however, and presses against the hearing and balance nerves, the patient will begin to show symptoms, which may become more severe as the tumor increases in size. These symptoms include the following:
○ Loss of hearing in one ear
○ Balance problems
○ Dizziness
○ Vertigo
○ Ringing in the ears, also known as tinnitus
○ Taste changes
Less commonly, patients with an acoustic neuroma may experience pain in one ear or on the face, or weakness of facial muscles. In extreme cases, if left untreated, an acoustic neuroma can eventually cause pressure on the brain, producing much more serious symptoms including confusion, numbness, facial paralysis and permanent hearing loss.
Diagnosis of an Acoustic Neuroma
A physical examination as well as the following diagnostic tests may be administered to detect the presence of an acoustic neuroma:
○ Hearing test
○ Auditory brain stem response (ABR)
○ Electronystagmography (ENG)
○ Head MRI scan
○ Head CT scan
An ENG checks the effectiveness of the eyes, brain and middle ears and how these systems function while patients participate in various exercises to test their balance and move into different positions.
Treatment of an Acoustic Neuroma
When an acoustic neuroma remains small, the patient may only need regular heckups and evaluations of the tumor's growth. If the tumor has increased in size to the point that it interferes with normal functioning, radiosurgery may be required. In radiosurgery, radiation is focused on the site of the tumor to stop its growth. Radiosurgery allows the tumor to be removed without incision, protecting against damage to adjacent brain tissue. When acoustic neuromas are large, regular surgery may be used to prevent them from causing permanent damage.
There are risks associated with both radiosurgery and regular surgery for treatment of an acoustic tumor. With radiosurgery, risks may include partial or total hearing loss in the affected ear, permanent dizziness, facial paralysis or brain swelling. As with other forms of radiation, there is a chance that a malignancy may reoccur.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Acute Renal Failure

Acute renal failure (ARF) occurs when the kidneys suddenly stop filtering waste products from the blood. This sudden loss of function can result from injury, trauma or infection, or from complications during surgery. It usually affects people who have additional health-related conditions.
Causes of Acute Renal Failure
Acute renal failure can be caused by a loss of blood flow to the kidneys, or when blocked or damaged kidneys prevent urine from flowing. Although ARF can affect anyone, it is more common in older people, and those who suffer from underlying conditions that include the following:
○ Kidney disease
○ Liver disease
○ Diabetes
○ High blood pressure
Acute renal failure is also more common in people who are obese.
Symptoms of Acute Renal Failure
Unlike chronic renal failure, in which symptoms develop slowly and over time, acute renal failure causes sudden symptoms that include the following:
○ Swelling
○ Seizures
○ Confusion
○ Fluid retention
○ Internal bleeding
If a person lapses unexpectedly into a coma, ARF may be the reason.
Diagnosis of Acute Renal Failure
Acute renal failure is diagnosed through a complete review of symptoms and a physical examination by a doctor. Additional tests include the following:
○ Urinalysis
○ Blood tests
○ X-rays or other imaging tests
A kidney biopsy may also be performed to further determine the cause of ARF.
Treatment of Acute Renal Failure
Treatment for ARF aims to restore kidney function, and prevent waste from building up in the body. Treating the underlying cause or illness can help the kidneys to regain function. Other methods of treatment include dialysis, which is often administered for a few days or weeks before the kidneys again function on their own, or medication. In severe cases, a kidney transplant may be necessary.
After treatment, patients need to make dietary adjustments, and may also be prescribed antibiotics to prevent or treat infection. Left untreated, acute renal failure can be fatal.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Acquired Platelet Function Defect

Acquired platelet function defects are conditions that cause the platelets responsible for blood clotting, to malfunction. When working properly, the platelets within the blood work with proteins known as clotting factors, to help the body stop bleeding after an injury. Certain factors may cause the platelets to stop working properly, causing symptoms of uncontrolled bleeding. Acquired platelet function defects may be caused by certain disorders or medications that effect the normal blood clotting process.
Causes of Acquired Platelet Function Defect
Acquired platelet function defect may be caused by a variety of conditions, including:
○ Polycythemia vera
○ Myelofibrosis
○ Chronic myelogenous leukemia
○ Primary thrombocythemia
○ Kidney failure
○ Multiple myeloma
Acquired platelet function defects may also develop after long-term use of medications such as penicillin, anti-inflammatory drugs, antihistamines, anti-depressants or steroids.
Symptoms of Acquired Platelet Function Defect
Symptoms of acquired platelet function defect may vary and range from mild to severe. Symptoms may include:
○ Heavy menstrual periods
○ Abnormal vaginal bleeding between periods
○ Blood in the urine or bowel movements
○ Unexplained bruising
○ Blood in vomit
○ Skin rashes
○ Nosebleeds
Internal or gastrointestinal bleeding may also occur, resulting in dark black or tar-like bowel movements.
Diagnosis of Acquired Platelet Function Defect
Acquired platelet function defects are diagnosed through a physical examination and a review of symptoms. Blood samples are taken and the following tests are performed on the blood:
○ Platelet count
○ Bleeding time
○ Prothrombin time tests (clotting time)
○ Platelet aggregation test (platelet stickiness)
Blood urea nitrogen and creatinine tests may also be performed to evaluate kidney function.
Treatment of Acquired Platelet Function Defect
Treatment for acquired platelet function defect varies, and focuses on any underlying conditions that have caused this defect. Medication known as desmopressin may be prescribed to increase the blood's ability to clot. Additional treatment methods may include:
○ Dialysis for platelet defects caused by kidney failure
○ Platelet transfusions
○ Discontinuing medications that contribute to the condition
In most cases, treating the underlying cause of acquired platelet function defects can correct the problem. Left untreated, acquired platelet function defect can cause severe anemia or prolonged bleeding.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Amputation

Amputation is the removal of a limb or extremity: arm, leg, hand, foot, finger or toe. A treatment of last resort, it is performed only after all other forms of treatment have failed. It is used to treat severe infection, disease progression, removal of a tumor on a bone or muscle, or persistent pain. Before undergoing an amputation, a thorough physical examination is performed to verify that amputation is the only feasible option. The most common type of amputation is removal, either above or below the knee, of the leg.
Reasons for an Amputation
The primary reason for amputation is a lack of circulation, which can result from a variety of causes, in the affected limb or extremity. When blood vessels are damaged and do not permit normal blood flow to the extremities, tissue can die and infection set in. When infection cannot be controlled through antibiotics or debridement, which is the scraping away of diseased tissue, amputation may be unavoidable. Reasons an amputation are performed include the following:
○ Prolonged constriction of the affected limb
○ Traumatic accident
○ Battlefield wound
○ Spread of a disease process (such as malignancy or gangrene)
○ Diabetes
○ Atherosclerosis
○ Peripheral artery disease (PAD)
○ Frostbite
○ Neuroma (nerve tumor)
Although patients with PAD are usually treated successfully in other ways, it is patients with this disorder, particularly those who also have diabetes, who have the great majority of amputations.
The Amputation Procedure
Amputation is a serious surgical procedure that usually requires either general or spinal anesthesia. Because of the trauma to the patient, general anesthesia may be preferred, particularly when a limb, rather than a digit, is removed. After amputation, the incision is either closed immediately or kept open for a few days until infection is no longer an issue.
Risks of an Amputation
As with any serious surgery, amputation has risks. Because amputations are, to a greater or lesser extent, psychologically as well as physically traumatic, the patient’s mental state must also be addressed. Possible complications from amputation include the following:
○Contracture (permanent muscle/joint shortening)
○ Infection
○ Hematoma
○ Phantom-limb pain
○ Psychological distress
○ Deep vein thrombosis
○ Pulmonary embolism
○ Joint deformity
○ Infection
○ Opening of the wound
○ Necrosis (death of skin tissue)
Excessive bleeding is also a possible complication of amputation.
Recovery from Amputation
Although the hospital stay for an amputation may be relatively short, the recuperative period is longer, involving as it does both physical and psychological rehabilitation, and adjustment to altered mobility or dexterity. In most cases, amputation also requires postsurgical adjustment to a prosthetic device. At times, due to the trauma of having a body part removed, the patient has a severe psychological reaction. Because emotional issues can interfere with healing and overall health, psychotherapy or psychotropic medication may be necessary.
A hospital stay of 1 to 2 weeks is usually required after an amputation. During this time, the site is monitored to verify that proper healing is taking place. Prescription painkillers are administered as necessary during the recovery period. As soon as sufficient healing has taken place, the patient begins physical therapy to learn how to perform the day-to-day tasks that involved the amputated body part. In many cases, the patient, when sufficiently healed, is fitted with a prosthesis, a device that replaces the amputated body part, and then given therapeutic instruction on how to use it.
In rare instances, it may be possible for an amputee to have a limb transplanted from a donor's body. This involves extremely complex surgery and rehabilitation, but can be successful. If a limb is successfully transplanted, anti-rejection medications must be taken for the remainder of the recipient’s life. There are also unusual cases in which a patient’s own digits are transplanted to another part of the body where they will be more useful.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

3-D Imaging

In medicine, 3-D imaging is the process used to create images of the human body and its internal organs. This type of procedure requires a patient to lie still while a machine circles the patient to record the images. Different techniques are used depending on the part of the body being examined and what variety of image is needed. If nuclear medicine is being used, a contrast dye is administered to help with visibility of the specified areas.
Three-dimensional imaging is performed by a medical doctor called a radiologist and radiology technicians. It can be used for many reasons, such as to assess an injury or to locate a tumor.
After the 3-D scanning is complete, the images are compiled into a maneuverable, three-dimensional image of the area, allowing the radiologist to analyze it. The referring physician can then use the results to diagnose the problem and determine a course of treatment — all before any surgery begins.
Types of 3-D Imaging
There are many types of 3-D imaging, including:
○ Ultrasonography
○ Computed tomography
○ Echocardiography
○ Magnetic resonance imaging
○ Nuclear medicine
Benefits of 3-D Imaging
Three-dimensional imaging offers advantages to physicians in almost every area of medicine. For example, neurosurgeons no longer need to drill into the skull to look at the brain. Cardiologists don't have to spread the ribcage to study the heart. It is not necessary for radiologists to biopsy large samples of tissue to find a tumor.
In short, doctors are able to collect more information than ever about a problem before attempting surgery, and patients benefit from minimally invasive procedures because the problem area has been precisely located.
There are also uses for three-dimensional imaging during surgery. In computer-assisted, or robotic, surgery, a surgeon is able to operate using a highly precise robotic arm equipped with a tiny camera. The surgeon controls its every movement while watching a screen that displays video images of what is happening inside the patient. This gives the surgeon the precise view traditional open surgery would provide, but with the benefit of a steady “arm” and small incisions.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Abdominal Aortic Aneurysm

An aneurysm is a localized, balloon-like expansion in a blood vessel caused by weak vessel walls. The aorta is the artery that carries oxygen-rich blood from the heart to the legs. When a bulge occurs in the abdominal section of the aorta, between the diaphragm and the legs, it is called an “abdominal aortic aneurysm.” Most aortic aneurysms occur in the abdomen, and most abdominal aortic aneurysms occur beneath the kidneys, and may continue into the iliac (leg) arteries.
Causes of Abdominal Aortic Aneurysm
Atherosclerosis, the narrowing of arteries due to fatty-tissue accumulation, weakens vessel walls, and is responsible for about 80 percent of aortic aneurysms. Other causes include the following:
○ Congenital deformity
○ Blood vessel injury
○ Hypertension
○ Inflammation due to disease
○ Advanced syphilis
○ Fungal infection
Men are more likely than women to develop abdominal aortic aneurysms. Being over the age of 60 also increases one's chances of developing abdominal aortic aneurysms.
Symptoms of Abdominal Aortic Aneurysm
Abdominal aortic aneurysms can occur without warning. Possible symptoms include the following:
○ Deep abdominal or lower-back pain
○ Pulsing sensation in the abdomen
○ Pallor, rapid pulse, and dry skin or mouth
○ Excessive thirst
○ Anxiety
○ Nausea and vomiting
○ Lightheadedness, or fainting with upright posture
○ Sweating, clammy skin
○ Fatigue
○ Palpitations or tachycardia
○ Impaired concentration and shock
An abdominal aortic aneurysm can be detected by manual examination by a physician, and by X-rays, ultrasound, CT and MRI scans, and aortography.
Treatment of Abdominal Aortic Aneurysm
Surgery is recommended for arteries at great risk for rupture: those more than six centimeters wide, and those four to six centimeters wide in patients otherwise in good health. Surgery is performed immediately on arteries that threaten imminent rupture or have already ruptured, although success is far less likely once the vessel has burst.
While an abdominal aortic aneurysm presents a grave danger, when it is repaired before rupture the prognosis is quite good. Recovery from the surgery, however, may take several months.
Traditional surgery involves making an incision to open the abdomen, then removing the aneurysm and replacing the excised vessel piece with a synthetic tube. Minimally invasive laparoscopic techniques require only small incisions, typically made in the femoral artery in the thigh, through which a thin tube with a camera is inserted so the surgeon can see inside the patient’s body without the need for open surgery.
Risks of Abdominal Aortic Aneurysm
The weakened, bulging vessel walls are susceptible to rupture, a catastrophic event that causes severe bleeding and pain, and is often fatal. Half of all untreated abdominal aortic aneurysms end in rupture and death within 5 years. Leakage rather than rupture can occur, causing blood to flow through the inner lining into the vessel wall (aortic dissection). Blood clots can also form in the aneurysm and travel to other arteries, where they may block blood flow. Other complications are infection and blockage of the aorta.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Accessory Navicular Bone Syndrome

An ambulatory blood pressure monitor is a small device worn on a belt, with a blood pressure cuff wrapped around the arm under the clothes for a 24-hour period in order to regularly check blood pressure levels.
Reasons for Accessory Navicular Bone Syndrome
Accessory navicular bone syndrome typically develops when the abnormal bone, or the posterior tibial tendon to which it attaches, are irritated. This may be the result of:
○ Traumatic injury to the foot or ankle
○ Constant rubbing of footwear against the bone
○ Excessive exercise or overuse
Many patients with accessory navicular syndrome also have flat feet which, because a flat foot puts more stress on the posterior tibial tendon, exacerbates the condition.
Nonsurgical Treatment of Accessory Navicular Bone Syndrome
There are several treatment options for accessory navicular bone syndrome. These may include some or all of the following:
○ Immobilization with a cast or walking boot
○ Applications of ice packs
○ Non-steroidal anti-inflammatory drugs (NSAIDs)
○ Injected steroids
○ Physical therapy
○ Orthotics
They first four methods listed are designed to reduce swelling and alleviate pain. The goal of the remaining two is to strengthen muscle, reposition the foot correctly, and prevent recurrence of injury.
Surgical Treatment of Accessory Navicular Bone Syndrome
The Kidner procedure is the most common surgical treatment for accessory navicular bone syndrome. This procedure involves detaching the bone from the posterior tibial tendon and then removing it entirely from the foot. The tibial tendon is then reattached and the incision is closed with stitches. Patients will likely wear a light cast and use crutches after surgery. They will require some physical rehabilitation focused on stretching the affected tendon and should be able to resume normal physical activity after about 6 weeks.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Acanthamoeba Keratitis

Acanthamoeba keratitis is a rare eye infection that can lead to a permanent loss of vision. The condition is caused by Acanthamoeba, a tiny organism commonly found in water sources such as lakes, oceans and tap water, as well as in the soil and air conditioning and sewage systems. If a person swims in a body of water contaminated by Acanthamoeba, for example, the microbe may come into contact with the cornea of the eye and initiate an infection.
Acanthamoeba keratitis usually occurs in otherwise healthy individuals. Contact lens wearers, however, are often at a higher risk of infection because the microbes can settle on the surface of a lens.
Symptoms of Acanthamoeba Keratitis
The typical symptoms of Acanthamoeba keratitis may initially be mistaken for those of several other, less serious eye conditions, as many types of infections produce similar reactions. Therefore, it is important to visit an eye doctor for a thorough examination and diagnosis. The symptoms of Acanthamoeba keratitis can last for several days or persist for weeks, and if left untreated may result in permanent damage.
Common symptoms of the condition include:
○ Eye pain
○ Blurred vision
○ Blepharospasm, or excessive eye blinking and spasms of the eye muscles
○ Eye redness
○ Photophobia, or a sensitivity to bright light
○ Excessive tearing
○ Sensation of a foreign substance in the eye
○ Severe headaches
Risks for Acanthamoeba Keratitis
Anyone can develop Acanthamoeba keratitis, but it most frequently occurs in people who regularly wear contact lenses. Some common risk factors for Acanthamoeba keratitis may include:
○ Improper storage and handling of contact lenses
○ Hot tub use, swimming or showering while wearing contact lenses
○ A history of trauma to the cornea
○ Exposure to contaminated water
○ Improper disinfection of contact lenses
Diagnosis of Acanthamoeba Keratitis
Acanthamoeba keratitis progresses rapidly, so early diagnosis is essential for preventing damage from occurring. The infection can usually be diagnosed based on the patient’s symptoms, although for confirmation the doctor will typically also perform a confocal microscopy. This is an optical imaging technique that is used to magnify the area and provide a better view of the amoeba. Once the diagnosis is established, the doctor will determine an individualized treatment plan based on the patient’s specific needs.
Treatment of Acanthamoeba Keratitis
Acanthamoeba keratitis is usually treated with prescription medications. These medications can alleviate symptoms and cure the infection, and typically begin to provide effective relief within a few weeks of use. However, once a patient has suffered from Acanthamoeba keratitis, there remains a greater risk for experiencing a recurrence of the condition in the future.
If the condition continues to progress or recurs despite the use of prescription medications, corneal surgery may be necessary. Surgery is generally only required when Acanthamoeba keratitis has been diagnosed at a later stage and only in those cases in which corneal scarring has occurred and vision is affected. One surgical option is a corneal transplantation, which involves the replacement of a damaged cornea, either partially or completely, with donated corneal tissue. Another surgical treatment method is phototherapeutic keratectomy, or PTK, during which a laser is used to remove damaged tissue from the cornea.
Prevention of Acanthamoeba Keratitis
Due to the complexities of Acanthamoeba keratitis and how quickly it can progress, preventative measures can significantly reduce a patient's risk for infection and corneal damage. Common methods of preventing this condition include visiting an eye care provider on a regular basis for examinations, removing contact lenses before entering a hot tub or going swimming, washing hands with soap and water before handling contact lenses and always properly cleaning and storing the lenses.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Age Spots

Age spots, also known as brown spots, liver spots and solar lentigines, are a common sign of aging. Flat, oval areas of pigmentation, age spots tend to appear on parts of the body, such as the face, hands, arms, shoulders and feet, that are exposed to the sun. Most common in people older than 40, they can be freckle-sized or more than a half-inch in length, and range in color from light brown to black. When age spots are grouped together, they appear even larger.
Causes of Age Spots
Although age spots are usually caused by accumulated exposure to the sun’s ultraviolet (UV) light, they may also be the result of using tanning beds/lamps; trauma or injury; or genetic predisposition. People with light skin are more likely to develop age spots, as are those with a history of frequent sunburn or sun exposure.
Diagnosis of Age Spots
True age spots are harmless and do not require treatment. If what is thought to be an age spot appears irregular, however, a biopsy may be performed to ensure that it is not malignant. Spots with the following characteristics should be evaluated by a physician:
○ Dark pigmentation
○ Unusual combination of colors
○ Rapidly increasing in size
In addition, spots that are itchy, red or sensitive, or that bleed, should be checked for malignancy.
Treatment Options for Age Spots
Although age spots are not medically dangerous, many people who develop them find them aesthetically unappealing. Treatments to remove age spots or make them less prominent include the following:
○ Liquid nitrogen (cryotherapy)
○ Bleaching creams
○ Microdermabrasion
○ Laser skin resurfacing
○ Chemical Peels
Treatment of age spots is considered strictly cosmetic, so insurance companies typically do not cover procedures to remove them.
Prevention of Age Spots
To prevent age spots or keep them from worsening, avoiding prolonged sun exposure and regularly using a broad-spectrum (UVA and UVB) sunscreen is recommended. Wearing UV-blocking clothing and a broad-brimmed hat will provide additional protection.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Acromegaly

Acromegaly is a rare endocrinological disorder in which an excessive amount of growth hormone is produced by the pituitary gland after normal growth has been completed. In almost all cases, acromegaly results from a noncancerous tumor on the pituitary gland. In rare instances, acromegaly is caused by a tumor elsewhere in the body.
Patients with acromegaly develop pronounced enlargement of the hands, feet, brows, jaws and ears. Because the condition develops gradually, it sometimes takes years to diagnose, but it is a serious condition, requiring medical attention to relieve symptoms and prevent life-threatening complications.
Symptoms of Acromegaly
Acromegaly most often occurs in middle-aged adults, but symptoms can appear at any age. When children who are still growing develop a similar hormone disorder, it is called gigantism. Apart from abnormal growth, patients with acromegaly may be troubled by a variety of symptoms, including:
○ Sleep apnea
○ Coarse skin, enlarged pores
○ Enlarged tongue
○ Fatigue
○ Excessive perspiration and body odor
○ Muscle weakness
○ Headaches or back pain
○ Hoarseness
○ Enlarged, painful joints
○ Enlarged organs
○ Visual problems
○ Excessive growth of hair in women
○ Unexplained weight gain
Women with acromegaly may experience menstrual irregularities and men may experience erectile dysfunction.
Diagnosis of Acromegaly
Although it may take a long time for patients and their doctors to become aware of the symptoms of acromegaly because of their gradual appearance, once the condition is suspected there are several diagnostic tests available. In addition to a comprehensive physical examination, blood tests and imaging tests are often performed. Diagnostic tests for acromegaly may include:
○ Blood tests to measure hormone levels
○ Glucose tolerance test
○ Spinal X-rays
○ MRI scan of the pituitary gland
○ Echocardiogram
If acromegaly is suspected, imaging tests may be used to pinpoint the location of the pituitary tumor and assess its size.
Treatment of Acromegaly
In most cases, acromegaly is a treatable condition. Treatment options include surgical removal of the tumor, medication, and radiation therapy of the pituitary gland. The most common treatment of acromegaly is surgical removal of the tumor which in many cases leads to a rapid recovery. Some patients, however, may not be good candidates for surgery. If this is the case, prescription medications and radiation therapy may be administered. While nonsurgical treatments cannot completely remove tumors, they can provide relief from symptoms.
Risks of Acromegaly
Left untreated, acromegaly can result in serious illness and even death. Complications of untreated acromegaly can include:
○ Severe headaches
○ Hypertension
○ Diabetes
○ Cardiomyopathy
○ Kidney failure
○ Colonic polyps or colorectal cancer
○ Osteoarthritis
○ Sleep apnea
○ Hypopituitarism
○ Uterine fibroids
○ Spinal cord compression
○ Vision loss
Even when surgery is successful, patients who have suffered from acromegaly have to be monitored for a possible recurrence. While hormone levels usually improve post-surgery, they may not fully return to normal and additional treatment may be needed.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Abscess

An abscess is a tender mass on a specific area of the body caused by bacterial infection. It presents as a painful swelling, pink to red in color, warm or hot to the touch. Abscesses often appear on the head and neck, limbs, torso, and are especially common in moist sites on the body such as the armpits or groin. They may also develop internally at the site of a recent operation, or, occasionally, for no apparent reason. Most often, surgical abscess drainage is necessary for successful treatment.
Types of Abscesses
Although common in parts of the body where moisture accumulates, abscesses can appear on any area of the skin or within the body. Some common types of abscesses are:
○ Dental
○ Bartholin gland, in the anus or vagina
○ Pilonoidal, at the base of the spine
○ Boil, or furuncle, around a hair follicle
○ Postsurgical abscess
Abscesses are also common in the armpits or groin.
Causes of an Abscess
An abscess may develop as a primary bacterial infection or as a complication following surgery. During an immune response, the body sends white blood cells to the area of infection. As the white blood cells attack the bacteria, the resulting inflammation and the death of nearby tissue lead to the formation of a cavity. An abscess is formed when the cavity fills with pus, a combination of dead tissue, white blood cells, and bacteria.
An abscess may also be caused by an obstruction of a sebaceous, or sweat, gland, an inflammation of a hair follicle, or a puncture or minor tear of the skin. Once germs penetrate the skin, the body’s immune system attacks these germs and inflammation results. As these substances accumulate, pressure and swelling in the area result in pain.
Risk Factors for an Abscess
While abscesses may occur in any individual, they occur more frequently in individuals with poor hygiene, those who inhabit dirty environments, and those with chronic skin conditions or poor circulation. They also occur more easily in patients with weakened immune systems. Weakened immune systems may result from:
○ Underlying diseases, such as diabetes, chronic digestive disorders or cancers
○ Chronic steroid therapy
○ Chemotherapy
○ Traumatic injury
○ Substance abuse
Even in otherwise healthy, hygienic patients, some individuals are more prone to abscess development than others, either because of anatomical anomalies, a tendency to ingrown hairs, or other unknown factors.
Treatment of an Abscess
There are some situations in which an abscess will come to a head, rupture and drain without surgical intervention. In most cases, however, an abscess, unlike other infections, does not respond to antibiotic treatment alone. It usually requires an incision and drainage through needle aspiration. Frequently, the drainage procedure is performed under ultrasound or with the assistance of CT guidance. This ensures precise and effective treatment.
If an abscess is in the mouth or on the skin's surface, a local anesthetic is normally administered and a surgical incision is made at the site in order for the abscess to drain and be thoroughly cleansed of infected material. If the abscess is internal, however, an imaging test, such as an ultrasound, CT or MRI scan, may be used to locate it and define its borders. Once located, the abscess is typically drained with an aspiration needle, but, since it is likely to refill, surgery is usually necessary as well. This operation is usually performed under general anesthesia.
Fluid aspirated during the drainage procedure is sent for laboratory analysis to pinpoint the type of bacteria involved so the appropriate antibiotic can be prescribed.
Possible Complications of an Abscess
Most abscesses worsen if left untreated. The encapsulated infection can spread to surrounding tissues under the skin and eventually into the bloodstream. If the patient develops sepsis, a systemic infection that spreads through the blood, the situation becomes life-threatening. When any patient with an abscess develops a fever or becomes very ill, the situation must be treated as an emergency.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Abnormal Perineal Descent

Abnormal perineal descent is associated with difficulty defecating. In patients with this condition, the perineum, the skin and tissue located between the vaginal opening or scrotum and the rectal opening, descends below its normal position. This prolapse can be caused by a tearing or stretching of the ligaments that support the area, and is often accompanied by pelvic organ prolapse.
Causes of Abnormal Perineal Descent
It appears that excessive straining during bowel movements may be a factor in the development of this condition. Other causes may include a weakening of the pelvic floor muscles (pelvic floor dysfunction). Such muscle weakness may be due to a genetic abnormality, related to degeneration associated with the aging process, or may be the result of traumatic injury during pregnancy, labor or forced sexual activity.
Symptoms of Abnormal Perineal Descent
While abnormal perineal descent, which is more common in women than men, may be asymptomatic, it may cause one or more of the following symptoms:
○ Perineal pain
○ Constipation or obstructed defecation
○ Some degree of fecal incontinence
○ Cystocele, prolapse of the bladder into the vagina
○ Rectocele, prolapse of the rectum into the vagina
○ Pain during sexual intercourse
○ Urinary pain, urgency or incontinence
There is controversy about whether some of these symptoms are actually the result of abnormal perineal descent or are caused by other factors.
Diagnosis of Abnormal Perineal Descent
Abnormal perineal descent is diagnosed by digital rectal examination and through the use of a tool called a perineocaliper that measures how far the perineum has descended. Other tests used to detect the condition include ultrasound scans and defecography. The latter is an X-ray examination of the pelvic organs that measures whether, or how far, they descend during defecation.
Treatment of Abnormal Perineal Descent
Physical therapy may be successful in alleviating the symptoms of perineal descent, although surgery is often required to repair the weakened or torn ligaments that support the perineum.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Activator Technique

The Activator Technique of chiropractic treatment makes use of a device known as a mechanical force, manual assisted instrument (MFMA) as an alternative to manual manipulation of the spine or joints. Considered a gentler form of chiropractic treatment, the activator technique involves using the MFMA, a handheld spring-loaded instrument, to deliver enough kinetic energy to the spine to move the vertebrae slightly, correcting misalignment. This treatment method is commonly employed to relieve back pain, neck pain, and various types of headaches. Some studies indicate that the Activator Technique may be as effective as manual adjustment in relieving back pain.
The Activator Technique, like some other chiropractic treatments, involves analysis of leg length in order to determine misalignment. Presuming that leg length inequality, unless congenital or the result of an injury or disease, indicates a spinal subluxation, the practitioner examines the patient in order to identify such inequality and test certain neurological responses. The chiropractor can then restore spinal balance using the MFMA device. Besides the Diversified Technique, the Activator Technique is the treatment most commonly used by American chiropractors. More than half of the chiropractors practicing in the United States use this method of treatment with at least some of their patients.
The Activator Technique Procedure
With the patient lying prone, the chiropractor evaluates any discrepancy in leg length. Such inequality is usually the result of the patient’s posture, which puts more weight on one hip than the other. Once the doctor determines that there is a leg length inequality, the MFMA device is used to move the vertebrae into alignment. The practitioner normally moves the instrument progressively up the spine from the lumbar to the cervical region The goal of the Activator Technique is to relieve pain and restore motion to the subluxated vertebra or joint.
Benefits of the Activator Technique
The chief benefit of the Activator Technique is that the thrust to the patient delivered by the MFMA is of high velocity and low amplitude. Because the thrust of the MFMA is so quickly applied, the patient’s muscles don’t have time to resist. The MFMA instrument can pinpoint the location of the problem precisely and administer pressure more exactly. This Activator Technique is considered especially helpful in adjusting children, who may have trouble lying still, and older patients, who may be more susceptible to pain or injury because of arthritis or osteoporosis.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

24 Hour Blood Pressure Monitor

An ambulatory blood pressure monitor is a small device worn on a belt, with a blood pressure cuff wrapped around the arm under the clothes for a 24-hour period in order to regularly check blood pressure levels.
Reasons for a 24-Hour Blood Pressure Monitor
Patients who have uncontrollable high blood pressure may be required to use the monitor. Patients may be asked to wear the monitor if they are:
○ Taking a new medication
○ Pregnant and have high blood pressure
○ Suffering from fainting spells
○ Taking other medications that affect blood pressure
The device checks the patient’s blood pressure every 15 to 30 minutes throughout the day in order to thoroughly monitor blood pressure while the patient goes through a normal day’s activities. Patients will be asked to keep a diary of their day so that the doctor can fully analyze any changes in blood pressure. The device will be removed the next day at the doctor’s office, and the monitoring information will be transferred to a computer. Any treatment modifications can be made after the results are reviewed by the doctor and patient.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Back Lift

While losing weight is a positive event and dramatic weight loss results in numerous benefits to a person’s health, after weight reduction surgery, or any substantial amount of weight loss, many parts of the body may have unsightly sagging skin. After extensive weight loss, the skin and tissues of the back often lack the elasticity to conform to the reduced body size, and therefore the skin may sag or appear as “rolls”. A surgical procedure known as a back lift, or upper body lift, can address the issue of excess skin and fat on the back. A back lift is a surgical procedure that focuses on recontouring and tightening up the back by removing excess skin and fat.
The Back Lift Procedure
A back lift is performed while the patient is sedated under general anesthesia. A back lift procedure concentrates on the mid to upper back area and sides of the upper abdomen beneath the arms. This is a particularly difficult spot for women as these rolls of skin tend to surface above and below the bra line. An incision is made across the back and excess tissue is removed. Liposuction may also be used to remove any excess fat from the area. The remaining skin is then sutured closed, resulting in a smooth and toned appearance. Bandages are applied to the incisions following the procedure and small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect. Most back lifts are outpatient procedures and are completed in about one to two hours.
Recovery from a Back Lift
There may be some swelling and discomfort after a back lift, but most discomfort can be managed with medication. After back lift surgery patients are advised to avoid exercise and lifting any heavy objects as this type of activity can cause the stitches to tear. As with any surgery, some scarring will be present and the incision may form a thin scar. The visibility of scarring will vary by patient, and most women can easily conceal any scars under a bra or bathing suit strap.
Risks of a Back Lift
While a back lift is considered a safe procedure, there are risks which may include:
○ Reaction to anesthesia
○ Infection
○ Blood clots
○ Bleeding
○ Accumulation of fluids
Some patients may experience numbness in the upper and lower back after a back lift. In most cases, this numbness disappears over time and sensations gradually return to normal.
Back lift surgeries are an effective form of cosmetic treatment for both men and women, especially after a significant weight loss, and are often combined with other body contouring procedures to help patients achieve their aesthetic goals all at once.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Allergies of the Ear, Nose and Throat FAQs

What are allergies?
Allergies are abnormal responses of the immune system to normally harmless substances. These substance are known as allergens. Some of the most common allergens affecting the ear, nose and throat are pollen, dust, mold and animal dander. When the body is exposed to an allergen, it releases a variety of chemicals, including histamine. Histamine is the precipitating cause of the allergic reaction.
What causes ear, nose and throat (ENT) allergies?
The precise cause of allergies remains unknown, but a hereditary factor is involved. If one parent has allergies, his or her child is much more likely than the general population to have allergies. If both parents suffer from allergies, a child has a greatly increased risk of developing an allergy. The specific allergen affecting the child may be different from the one affecting the parent. Allergies may develop over time once a threshold of exposure has been reached.
What are the symptoms of ENT allergies?
Most allergic reactions involving the ear, nose and throat are relatively mild, but may still interfere with everyday activities. Their symptoms include nasal rhinitis, which causes sneezing, runny nose, congestion and post-nasal drip. Patients with ear, nose and throat allergies may also suffer from headaches, itching, and soreness in the throat or ears. When plant and tree pollens cause these symptoms, the condition is commonly referred to as hay fever. More severe reactions, including anaphylaxis, are rare, but may be life-threatening. Because allergies of the ear, nose and throat are reactions to airborne allergens, sufferers may also experience allergic reactions in the eyes, skin, lungs or gastrointestinal tract.
How are allergies diagnosed?
Diagnosing allergies is done by evaluating symptoms and performing a full physical exam. A skin or blood test may also be done. The skin test is done by placing different potential allergens on the skin, and pricking the skin so the substance can enter the body. If a reaction occurs on the skin, an allergy is diagnosed.
How can allergies be treated?
The most effective way to treat allergies is simply to avoid exposure to allergens but, of course, this is not always possible. For outdoor allergies, remaining indoors as much as possible during certain seasons may relieve symptoms. Because allergens often enter the body through the eyes, wraparound sunglasses may also prove helpful. Other treatments include antihistamines, decongestants, nasal sprays and eye drops. Allergy shots, a type of immunotherapy, may also be used as treatment. To increase a body's tolerance, an allergen is injected at increasingly larger amounts over time.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Bloat and Torsion

Bloat and torsion, also known as gastric dilation and volvulus, or GDV, is a life-threatening condition involving distension and abnormal rotation of the stomach. It occurs most often in large animals like horses and in certain large breeds of dogs, but can also occur in smaller dogs and in cats. Bloat and torsion usually manifests in healthy animals in their prime, frequently when they have engaged in vigorous exercise immediately after eating.
Bloat occurs when the stomach fills with gas, putting pressure on other organs and often restricting breathing. When distended, the stomach can easily rotate on its axis and cut off blood flow, causing rapid necrosis of cells and organ failure. Bloat and torsion can occur independently or together, but in either case emergency surgery is almost always required to save the animal’s life.
Causes of Bloat and Torsion
The causes of bloat and torsion in dogs and cats are largely unknown, but genetics and anatomy are believed to play roles in the development of this disorder, since particular large breeds of dogs, such as great Danes, standard poodles and German shepherds are at greater risk, as are dogs with an immediate relative who has had the disorder. Dachshunds are possible victims of this disorder because of their anatomical construction. Excitable temperament and a history of gastrointestinal problems also appear to put animals at greater risk.
Environmental factors also seem to be possible causes of bloat and torsion. These include:
○ Ingestion of too much food
○ Drinking too much water, especially just after eating
○ Delaying bowel movements
○ Being too active immediately after eating
Symptoms of Bloat and Torsion
Symptoms of bloat and torsion are not unique to the disorder, but since GDV is often fatal, should never be ignored. These symptoms include:
○ Anxious behavior like pacing
○ Abdomen distension
○ Retching
○ Abdominal distention
○ Excessive salivation
○ Tachycardia (rapid heart beat)
○ Dyspnea (labored breathing)
○ Weak pulse
○ General weakness
○ Pale mucus membranes
○ Collapse
Diagnosis of Bloat and Torsion
It is possible that symptoms similar to those indicating bloat and torsion may be caused by a bacterial infection, gastroenteritis, or simple overeating, so it is important that the condition be accurately diagnosed before treatment is administered. A physical examination by a veterinarian is necessary and may provide clues to the condition, but bloat and torsion is usually conclusively diagnosed through imaging techniques, such as abdominal X-rays, CT scans or MRIs. Other diagnostic tests for the disorder may include urinalysis and testing for lactate levels in the blood.
Treatment of Bloat and Torsion
Treatment for this emergency condition typically includes releasing gas from the stomach through a tube or large needle in order to stabilize the animal. After stabilization, surgery is usually performed to repair any damage caused by the condition. Sometimes an operation to affix the stomach to the abdominal wall, called a gastropexy, is performed to prevent the problem from reoccurring.
Even after treatment, many animals die from this condition. Depending on how long the condition has existed, there may be a mortality rate of over 50 percent. This is why it’s crucial to get veterinary treatment as promptly as possible. The risk of developing bloat and torsion can be decreased by monitoring animals’ diet and exercise habits as carefully as possible.
Additional Resources
○ Medline Plus
○ Medline Plus
○ American Veterinary Medical Association
○ American Veterinary Society of Animal Behavior
○ United States Department of Agriculture
○ PetMD

Arthritis in Dogs and Cats

Arthritis is as common in animals as it is in humans. Also known as degenerative joint disease, arthritis involves the loss of the cartilage that coats and protects the end of the bones in movable joints. When the uncoated nerve ends on the bones touch, the result is pain and inflammation. This most often occurs as a result of wear and tear, but the animal may have an underlying hereditary predisposition to the problem.
Causes of Arthritis in Animals
Arthritis in dogs is most often an inherited condition known as degenerative osteoarthritis which may manifest in several ways, such as hip dysplasia or patella luxation. Osteoarthritis may be more frequently found in particular breeds, especially large ones, and is more common in obese animals.
Arthritis in dogs and cats may also be caused by injury, by infection of the joint (septic arthritis) or by an immune-mediated inflammation (rheumatoid arthritis). The latter, caused by an invasion of white cells from the immune system into the joints, may occur as a result of disorders such as polyarthritis or Lyme disease, or may be the result of chronic bacterial or fungal infection or cancer.
Symptoms of Arthritis
Symptoms of arthritis vary depending on which joints are affected, the age of the animal and the severity of the disease, but pain is almost always present. Since dogs and cats are non-verbal, the humans tending them may have to detect their animals' pain by observation of altered behavior patterns. The animal may growl or hiss upon contact, for example, indicating pain. Some other common symptoms of arthritis include:
○ Swollen joints
○ Muscle atrophy
○ Cracking sound during joint movement
○ Difficulty sitting down, standing up or jumping
○ Decrease in appetite
○ Fatigue from minimal exercise
○ Changes in stride, such as limping
○ Behavioral changes, especially unexpected aggression
Diagnosis of Arthritis
There are several methods of diagnosing arthritis in dogs and cats. Once a medical history and thorough physical examination have been done, some or all of the following may be administered to make a definitive diagnosis:
○ Blood tests
○ Joint taps (tests of joint fluid)
○ X-rays
○ CT scans or MRIs
Treatments for Arthritis
Treatments of arthritis in animals are, for the most part, similar to those administered to humans. Since arthritis is not curable, these treatments focus on decreasing pain and increasing mobility. These treatments may include:
○ Keeping the animal to a healthy weight
○ Non-steroidal anti-inflammatory drugs (NSAIDS) for pain relief
○ Chondrotin or glucosamine supplements to promote joint cartilage repair
○ Antibiotic administration for Lyme disease or Rocky Mountain spotted fever
○ Physical therapy or acupuncture
○ Corticosteroid treatment
○ Stem cell therapy
○ Joint replacement surgery
Such treatments may vary, depending on the cause of the condition, and, in most instances, several may be administered concurrently.
When surgery is necessary, only the hip can be replaced in dogs and cats, whereas in larger animals, knee and elbow replacements may be possible as well.
Additional Resources
○ Medline Plus
○ American Veterinary Medical Association
○ American Veterinary Society of Animal Behavior
○ United States Department of Agriculture
○ PetMD

Bird Health Examination

Birds, like all pets, should be taken for regular, usually annual, veterinarian checkups. Owners of birds should be careful to seek out a board-certified avian veterinarian since most vets who treat dogs and cats are not sufficiently familiar with avian health care. This is important because birds, unlike some other pets, frequently evidence only very subtle symptoms of disease. The annual examination is also a good time to discuss any concerns about the bird’s health or behavior with the doctor.
Newly acquired birds should be examined within the first week of adoption to detect any possible illness and to make sure the owner is well-informed about how the new pet should be taken care of. The new bird should be kept isolated from other birds for 3 to 4 weeks following adoption. The avian vet will take care to make this possible at the first examination. Hopefully, the new bird will check out as perfectly healthy, but, even so, some baseline assessments must be made to ensure future health.
Medical History
The avian vet will take a full history of the bird, including its age, diet, activity level, and previous environment. Any contact the bird has had with other birds, direct or indirect, is pertinent. Indirect contact includes visiting bird shows or aviaries or eating food purchased from pet shops with open containers.
Physical Examination
The avian veterinarian can tell a great deal from the bird’s appearance, including its feathers, skin, beak, eyes, ears, nose and throat. The bird’s posture and attitude are also noted. The vet will check the bird’s respiration, bones, abdomen, muscles and vent (rear opening) to make sure all its parts are in good working order. Even its droppings will be examined for normalcy of color and composition.
The bird is always weighed during a physical examination, in grams rather than ounces for accuracy. This is important for the doctor to have as a baseline, since, once the bird is full-grown, its weight should remain constant.
Diagnostic Testing
The veterinarian may decide, based on the bird’s age, physical condition, species, or history, to administer other diagnostic tests to detect or rule out disease or imbalance. These tests may include:
○ Blood count
○ Chemical blood work
○ Examination of blood for parasites
○ Cell cultures to check for bacteria or yeast infection
○ Screening for certain viral infections
○ X-rays
Tests for viruses are particularly important for birds in households with several birds, birds who live in aviaries and birds that are to be used for breeding. Screening tests for psittacosis, commonly known as parrot fever, are often performed because this pathogen can be transmitted to humans.
If X-rays are necessary to examine the bird for foreign bodies, fractures, tumors, foreign objects or lung conditions, the bird may be briefly anesthetized for this portion of the examination.
Additional Resources
○ Medline Plus
○ American Veterinary Medical Association
○ American Veterinary Society of Animal Behavior
○ United States Department of Agriculture
○ PetMD

BioHorizons Dental Implants®

BioHorizons dental implants restore the health, appearance and functionality of patients' teeth with reliable, long-lasting results.
Using dental implants for dental reconstruction ensures that healthy teeth are not compromised. Dental implantology has become the standard of care for tooth replacement. BioHorizons implants offer patients the tightest, most secure restorations available for oral complications related to:
○ Missing or diseased teeth
○ Gum disease
○ Infection or trauma
BioHorizons implants are strong, lightweight, biocompatible. They are constructed from from titanium, a commonly used material in implant dentistry. Some of the dental products offered by BioHorizons are:
○ Dental implants with crowns
○ Traditional crowns and bridges
○ Individual dental implants
○ Permanently secured dentures
BioHorizons dental implants carry a lifetime warranty, and have a track record clinically proven by some of the most thorough and in-depth research in the industry.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ National Institute of Dental and Craniofacial Research
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Bruxism

Bruxism is a disorder, usually manifesting itself at night, in which a person grinds, gnashes or clenches her or his teeth. Occasional grinding of teeth is not harmful, but when it occurs often, teeth can be damaged and other oral complications occur. People with bruxism are more likely to suffer from other sleep-related disorders, including snoring or sleep apnea. Sleep partners may notice bruxism in one another, and dentists can often diagnose it during routine examinations based on damage to teeth or crowns.
Risk Factors for Bruxism
There is no known cause for bruxism, and, for unknown reasons, it is common in young children, often disappearing in adolescence. People more at risk for bruxism include those who have the following:
○ Certain abnormalities of the jaw
○ Stress and/or anxiety
○ Other sleep disorders
○ Missing, crooked or misaligned teeth
Also more at risk for bruxism are people who drink excessive amounts of alcohol, smoke cigarettes, drink caffeinated beverages, take illegal stimulants, and have competitive and/or aggressive personalities.
Because the above factors increase the risk for bruxism, making lifestyle changes, and performing relaxation exercises, especially those involving the jaw and mouth, may be helpful.
Symptoms of Bruxism
Over time, bruxism can wear down enamel, and chip, fracture and loosen teeth. Bruxism can also cause damage to the inner cheek or tongue. During a dental examination, early signs of bruxism may be detected, which is one of the reasons that regular dental checkups are vital. Apart from a sleep partner’s reporting the sound of teeth grinding or clenching, a person may become aware of the condition when experiencing one or more of the following symptoms:
○ Facial or jaw pain
○ Tight or fatigued jaw muscles
○ Earache
○ Headache at the temples
○ Difficulty sleeping through the night
○ Increased tooth sensitivity
○ Feeling that the jaw will not open or close completely
A clicking sound as the jaw is opened or closed, typical of patients with temporomandibular disorders (TMD), is often indicative of bruxism.
Treatment of Bruxism
In addition to lifestyle changes, treatment options include using a custom mouth guard at night to protect teeth from grinding. In some cases, a muscle relaxant is prescribed to relax the jaw muscles. In severe cases in which bruxism has not responded to treatment, orthodontic adjustment or surgery may be considered.
In cases in which bruxism has damaged teeth, a dentist should be consulted about restoring them. When bruxism is noticed in a young child, it should be reported to a dentist promptly. Although bruxism in children usually resolves on its own, it should be carefully monitored to avoid complications.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ National Institute of Dental and Craniofacial Research
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Air-Abrasion Dentistry

Air abrasion is a dental technique that may be used as an alternative to traditional dental drilling to remove tooth decay and assist in other dental procedures. The air-abrasion system is mainly used to treat small cavities, and remove plaque and decay without the use of a local anesthetic.
Air abrasion removes decay from teeth through a blast or stream of pellets consisting of a mixture of air, silica and aluminum oxide. The particles of decay on a tooth’s surface are removed as it is hit by the stream of pellets and air. The decay is then suctioned away through a thin tube.
Benefits of Air Abrasion Dentistry
Air abrasion has many benefits over traditional drilling methods, including:
○ Little or no need for anesthesia
○ No heat, sound, pressure or vibration
○ Less risk of chipping or fracturing teeth
○ More healthy tissue remaining after the procedure
○ Dry work surface allows optimal placement of fillings
The air-abrasion technique is commonly used to treat small cavities that are close to the surface of the teeth. It is not recommended for use on deeper cavities that are closer to the pulp of the tooth. The air-abrasion technique can also be used to help repair old tooth restorations by accessing difficult areas such as those between the teeth.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ National Institute of Dental and Craniofacial Research
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

Dental Abscess

A dental abscess is an infection in a tooth or the surrounding gums. When cavities and gum-related issues are left untreated, teeth can decay and bacteria can spread to surrounding areas of the mouth and jaw, causing deeper infection. Dental abscesses can have serious medical ramifications, so it is important that they be treated promptly.
Causes of Dental Abscess
A dental abscess is usually caused by poor oral hygiene and a lack of proper dental care, though serious dental infections can sometimes result from underlying medical conditions that affect the immune system such as diabetes or chemotherapy. Dental abscesses can also be triggered by minor oral trauma, like an injury that causes a chipped or loosened tooth.
Symptoms of Dental Abscess
There are many possible symptoms of a dental abscess, but the primary one is severe toothache in which the pain is described as "throbbing" or "shooting." Other common symptoms of a dental abscess may include:
○ Pain when chewing
○ Foul-smelling breath
○ Bitter taste in the mouth
○ Extreme sensitivity to heat or cold
○ Red and swollen gums
○ Swollen neck glands
○ Open, draining sore on the gum
If the dental abscess is allowed to progress without treatment, the patient may experience fever, chills and general feelings of disease. In rare and extreme cases, the condition can become systemic and life-threatening.
Patients should be aware that pain may stop while a dental abscess is still active. This happens if the pulp in the root of the tooth dies. It is therefore essential to see a dentist when there has been severe dental pain, even if that pain abates.
Diagnosis of Tooth Abscess
The dentist is usually able to diagnose a tooth abscess during a dental examination since the patient typically feels pain when the affected tooth is tapped or probed. Patients normally feel an increase in pain level when they bite down or close their mouths tightly. The dentist may also notice red and swollen gums in a patient with a dental abscess. In order to confirm the diagnosis and to check for possible bone erosion, the doctor is likely to have dental X-rays taken as well.
Treatment of Dental Abscess
There are a number of methods used to treat a dental abscess, depending on how far the condition has advanced. The first goal is always to eradicate the infection and prevent complications; the second is to preserve the tooth wherever possible.
Treatments of a dental abscess, depending on severity of the condition, may include one or more of the following:
○ Drilling out a cavity and filling it
○ Regional drainage of the abscess through the gum
○ Performing a root canal
○ Crowning the affected tooth
○ Extraction of the affected tooth
○ Administration of antibiotics
It is also possible for the inflammation and pain of an abscess to be treated with a low-level laser, also known as phototherapy. Whichever type of therapy is used, a patient with a dental abscess typically takes nonsteroidal anti-inflammatory drugs (NSAIDs) or prescribed medication to alleviate pain.
Complications of Dental Abscess
Left untreated, dental infections can be extremely serious, and in rare cases deadly. If bacteria from the tooth infection enter the patient's bloodstream through the gums, they can affect any number of tissues, causing:
○ Sepsis, infection of the blood
○ Cellulitis, infection of the soft tissue
○ Osteomyelitis of the jaw
○ Endocarditis, affecting the heart
○ Pneumonia, affecting the lungs
Although these complications rarely occur, they present real dangers, so any patient with a dental abscess should seek prompt medical attention.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ National Institute of Dental and Craniofacial Research
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

At-Home Orthodontic Care

For patients who wear braces, oral hygiene is extremely important. Food and plaque can become stuck not only between the teeth, but between the small spaces where braces and wires attach. To maintain healthy teeth, and keep braces clean and breath fresh, the mouth should be cleaned thoroughly and regularly, preferably after every meal. Dental hygiene at bedtime is essential.
Eating With Braces
Patients with braces can eat nourishing and enjoyable foods, but sweets, soda and other sugary foods should be avoided as much as possible. Particularly damaging are sticky and chewy foods, such as taffy, dried fruits and caramel, because they can adhere to braces, and be difficult to remove.
To keep braces from loosening or breaking, patients should avoid hard candies, nuts, popcorn and other inflexible foods. Crunchy fruits and vegetables should be cut into small pieces before eating, and ice should not be chewed.
Dental Hygiene With Braces
Removing food particles is particularly important for patients with braces. To avoid tooth decay and enamel stains, as well as the permanent light spots that can result from the reaction of bacteria with metal, teeth should be carefully brushed on all surfaces.
Special orthodontic floss should also be used at least once a day to clean the spaces between wires and braces. The patient should stand in front of a mirror to ensure that all areas have been flossed. Using anti-bacterial mouthwash is also helpful.
When performing a full cleaning after eating is impossible, rinsing the mouth vigorously with water is recommended.
Preventing Dental Injuries
Although everyone should make an effort to protect the teeth during potentially dangerous activities, it is especially necessary for those who wear braces. There is no reason to avoid participating in sports, but there is every reason to wear teeth-protecting mouth guards when doing so.
Additional Resources
○ Medline Plus
○ National Institutes of Health
○ National Institute of Dental and Craniofacial Research
○ Centers for Disease Control and Prevention
○ Eunice Kennedy Shriver National Institute of Child Health and Human Development
○ U.S. Department of Health & Human Services
○ U.S. National Library of Medicine
○ WebMD

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