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| Posted: 24 Dec 2010 07:09 AM PST Acne is an inflammatory disease of the skin. It is a disorder of the skin's pilosebaceous unit, which consists of an oil gland (sebaceous gland) and a canal (pore) that contains a hair called a follicle. The pore becomes blocked and causes lesions commonly known as pimples. Acne affects young people as well as adults. It can occur at anytime during the lifespan including the newborn period, but it is not until puberty that it becomes a common problem. In general, the condition is a bit more common in males than in females and is usually more severe in males than in females. It is also more common in Caucasions. The actual cause of acne is unknown. One important factor does seem to be rising levels of the hormones called androgens (male sex hormones) that are found in both boys and girls at the time of puberty. Another factor is heredity or genetics. Acne does seem to run in families. Girls or women may find their acne flares 2 to 7 days before the onset of their menstrual period. Pregnancy, coming on or off birth control pills, and stress can make acne worse. Certain drugs (androgens, lithium, and barbiturates) can cause acne. Physical trauma (squeezing, picking, rubbing, hard scrubbing or pressure from helmets, tight collars, or backpacks), greasy cosmetics, and high humidity can make acne worse. Acne lesions usually occur on the face, neck, back, shoulders and chest. The basic lesion in acne is called a comedo and is an enlarged hair follicle plugged with oil and bacteria. When the comedo stays below the skin it is called a whitehead. When it reaches the surface of the skin and opens up it is called a blackhead. Papules (small inflamed lesions that look like pink bumps on the skin), pustules (pimples), nodules (large, sore, solid lesions deep in the skin) and cysts (deep, inflamed, pus-filled lesions) are other types of acne lesions. Cysts can cause serious scaring and deformity. Diagnosis is primarily based on the appearance of the skin. No testing is usually required. Treatment is designed to prevent formation of new lesions and aid the healing of old lesions. Treatment may consist of topical creams or gels, with or without oral medications, depending on the severity of the acne. At a follow-up visit, a skin specialist called a dermatologist would re-evaluate the patient’s acne, get feedback concerning the treatment, and make any necessary adjustments in the treatment plan. Topical medications that can normalize the shedding of skin cells may contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or tretinoin, or retinoic acid. Oral antibiotics (such as tetracycline, doxycycline, minocycline, or erythromycin) may be prescribed if there are numerous inflammatory lesions. Topical antibiotics (applied to a localized area of the skin), such as clindamycin or erythromycin, are also for milder forms of inflammatory acne. Oral tetracyclines are usually not prescribed for children until after they have all their permanent teeth, because it can permanently discolor teeth that are still forming. Severe acne may benefit from a synthetic vitamin A analogue. However, this treatment requires careful consideration of potential side effects. Surgical intervention may include professional chemical skin peeling, removal of eruptions or scars through dermabrasion, or removal and/or drainage of cysts. If you have acne, clean your skin gently but thoroughly with soap and water, removing all dirt or make-up. Wash as often as needed to control oil, at least daily and after exercising. Use a clean washcloth every day to prevent bacterial infection. Shampoo hair daily when possible, using a dandruff shampoo if necessary. Comb or pull hair back to keep hair out of the face. Don’t squeeze, scratch, pick, or rub lesions because these activities can increase skin damage. Don’t rest your face on your hands. This irritates the skin of the face. Unlike other conditions, acne treatment usually requires 6 to 8 weeks before improvement is noted. Be patient! This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.
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| Posted: 24 Dec 2010 06:46 AM PST Aicardi syndrome is a rare disorder that was first identified in 1965 by a French neurologist named Dr. Jean Aicardi. Children with this disorder are either partially or completely missing the nerve fibers, called the corpus callosum, that link the two hemispheres of the brain. This symptom is usually accompanied by infantile spasms (seizures), mental retardation, and growths, called lacunae, on the retina or optic nerve. Aicardi syndrome affects only females. Researchers have identified only between 300 and 500 cases of Aicardi syndrome worldwide. The exact cause of Aicardi syndrome is not currently known. However, researchers believe it is an X-linked genetic disorder that occurs because of a random, unpredictable mutation. In simple terms, chromosomes are thread-like structures that carry genes and help to pass on genetic information. When a gene mutates, it undergoes a sudden structural change that results in a new characteristic or trait not originally found in the parent gene. The X chromosome is one of two chromosomes that determine an individual’s sex. Males have an X and a Y chromosome, while females have two X chromosomes. Defects that are X-linked appear on the X chromosome only, and not the Y. Researchers have connected Aicardi syndrome to the X chromosome because it occurs only in females. It is not a hereditary condition. Infants with Aicardi syndrome may have an apparently normal birth, but begin to develop symptoms between the ages of 3 and 5 months. At this age, important stages in normal brain development cannot occur because of the missing or incomplete corpus callosum that allows the right side of the brain to communicate with the left. Because of this, the infant begins to have infantile spasms, which is a type of seizure. Other symptoms that are definite hallmarks of Aicardi syndrome include mental retardation and growths, called lacunae, on the retina of the eye. Retinal lacunae can cause blindness. Other types of brain defects, such as microcephaly (small brain), porencephalic cysts (cerebrospinal fluid-filled cavities or gaps in the brain where there should be healthy brain tissue), and enlarged ventricles, may also be present. Females are diagnosed with Aicardi syndrome, usually between the ages of three months and five months, when infantile spasms alert the parents and healthcare provider to a disorder. A computed tomography (CT) scan or magnetic resonance imaging (MRI) of the head will show any abnormalities with the corpus callosum, cysts, or enlarged ventricles. The doctor may also order an electroencephalogram (EEG), which measures the electrical activity in the brain and helps to identify types of seizures. An eye exam will reveal any growths on the retina. The combination of female sex, seizures, abnormalities with the corpus callosum, and retinal lacunae provide a definite diagnosis of Aicardi syndrome. In some cases, the corpus callosum may look normal, but other abnormal formations in the brain are present. There is no cure or standard treatment for Aicardi syndrome. Treatment is specific to the symptoms, and usually involves medication to manage seizures and early intervention programs for developmental delays. While the prognosis for Aicardi syndrome does not appear good, continuing genetic research aims to find the cause of and a treatment for this disorder. If your child has Aicardi syndrome, you may find it helpful to seek the support of the Aicardi Syndrome Foundation, which can keep you up-to-date on the most recent findings. This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.
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| Posted: 24 Dec 2010 06:41 AM PST Mental retardation is a developmental disability that can appear from birth through the age of 18. People who are mentally retarded function at an intellectual level that is below average and have difficulties with learning and daily living skills. Approximately 2.5 to 3% of the total population are mentally retarded. In most cases, it is a lifelong condition. There is no connection between mental retardation and gender or race. In many cases, the cause of mental retardation is not found. About 5% of all cases can be linked to heredity. In these instances, the cause is a genetic defect, such as an inherited abnormal gene, gene mutation, or chromosomal defect. In very simple terms, genes are carried on thread-like structures called chromosomes, and determine our individual characteristics, such as how we look. Just one missing or faulty gene or chromosome can cause a birth defect. Two of the most common inherited causes of mental retardation are fragile X syndrome, caused by a defect in the chromosome that determines sex, and Down syndrome, caused by an extra chromosome. Gene defects such as phenylketonuria (PKU) can cause mental retardation if not found and treated early, as can hypothyroidism. Mental retardation can also occur as a result of the mother’s behaviors or illnesses during pregnancy. Behaviors that can affect the fetus’ developing brain include poor nutrition, excessive alcohol consumption, drug abuse, and cigarette smoking during pregnancy. Mental retardation due to alcohol abuse is called fetal alcohol syndrome. Pregnant women who have infections or illnesses such as rubella (German measles), cytomegalovirus, toxoplasmosis, glandular disorders, high blood pressure, or blood poisoning, or who are exposed to radiation during pregnancy, may have a mentally retarded child. Some birth defects that affect the head, brain, and central nervous system have mental retardation as a symptom. For example, neural tube defects, where the neural tube that forms the spinal cord does not close completely, can cause cerebrospinal fluid to accumulate on the brain. The pressure causes hydrocephalus, a cause of mental retardation. Difficulties in the birth process can also result in mental retardation. These include premature birth, head injury during birth, or lack of oxygen. Children can be born with normal intelligence but develop mental retardation because of childhood illnesses or injuries. Illnesses that cause mental retardation if not properly treated include chickenpox, measles, whooping cough, hyperthyroidism, or a bacterial infection called Hib disease. Meningitis and encephalitis can cause swelling in the brain that causes brain damage and mental retardation. Children who suffer a traumatic brain injury either accidentally or through abuse that includes violent blows to or shaking of the head may suffer brain damage and mental retardation. Environmental factors that affect mental development include emotional and physical neglect. Daily stimulation is essential to a child’s mental development. Infants who are neglected, as well as those who do not receive adequate nutrition, may suffer irreversible mental setbacks. Small children who live in older apartment buildings and homes painted with lead-based paint are at risk for developing lead poisoning if they put flakes of this paint into their mouths. Lead exposure can also cause mental retardation. The severity of symptoms of mental retardation and when they appear depend upon the cause. Symptoms appear during infancy if the condition is caused by a genetic disorder or an event during the pregnancy or birth process. A childhood illness or injury that causes a brain injury may suddenly make once easy tasks difficult for the child, and cause learning difficulties. In general, children who are mentally retarded fall behind when it comes to reaching developmental milestones. They may also show signs of aggression and self-injury. As they get older their scores on standardized intelligent quotient (IQ) tests are low and they have difficulties with daily life skills, called adaptive skills. Adaptive skills include basic communication, self-care, social, safety, and work skills. IQ levels are generally used to classify degrees of mental retardation. Children with mild retardation score in the range of 50 to 75. These children may not be diagnosed until they enter school because they develop social and communication skills during their first five years. However, learning difficulties become evident in a formal school setting. These children can learn up to the 6th grade level and can live independently with the support of family, community, and social services. Most children who are mentally retarded are in the mild category. About 10% of those with mental retardation are considered moderately retarded, with IQ scores in the range of 35 to 55. During early childhood, these children are able to learn to talk and communicate, but have poor social skills and awareness. Academically, they have difficulty working past the 2nd grade level. With supervision, they can learn some skills and take care of their personal needs. As these children reach adulthood, they can work well in a supervised setting, such as a group home. Children are classified as severely retarded when their IQ scores fall in the range of 20 to 40. This group accounts for only 3 to 4% of the mentally retarded population. The severely retarded have poor muscle coordination and limited communication and self-care skills during early childhood. By school age, they can learn some basic self-care and communication skills. These children benefit from living in a group home as they reach adulthood, and can perform some self-care under complete supervision. Profound retardation accounts for 1 to 2% of all mentally retarded people. With IQ scores of 20 to 25, these children have little muscle coordination during early childhood and do not reach developmental milestones, such as walking and talking. As they grow older, they may be able to perform some of the most basic self-care skills and may develop some speech skills. However, the profoundly retarded require skilled nursing care and constant supervision. Studies have shown that those with severe to profound mental retardation have a shortened life expectancy due to diseases that are often associated with these degrees of retardation. The American Association on Mental Retardation (AAMR) classifies degrees of mental retardation by the level of support the individual needs. These are intermittent support, limited support, extensive support, and pervasive (constant) support. Early diagnosis of mental retardation is important for developing an individualized plan for learning and life skills. If your doctor suspects mental retardation, he or she will take a complete medical history and perform a physical examination to determine symptoms and their possible cause. You may also need to see a child neurologist or neuropsychologist, who specializes in disorders of the nervous system. If your child is old enough, he or she may be given a standardized test of intelligence (IQ test). Commonly used tests include the Stanford-Binet Intelligence Scale, the Wechsler Intelligence Scales, the Wechsler Preschool and Primary Scale of Intelligence, and the Kaufmann Assessment Battery for Children. Physicians generally use the Bayley Scales of Infant Development to assess developmental skills in younger children. The Woodcock-Johnson Scales of IndependentBehavior and the Vineland Adaptive Behavior Scale (VABS) may also be used. Your doctor will make a diagnosis of mental retardation if your child has below average intellectual skills (an IQ below 70 – 75) and is limited in two or more adaptive skill (life skills) areas. During the 16th to 20th weeks of pregnancy, a small amount of amniotic fluid can be withdrawn from the mother’s womb and tested for a number of genetic defects. This test is called amniocentesis. A low level of alpha-fetoprotein in the amniotic fluid or in the mother’s blood during pregnancy can indicate Down syndrome in the fetus. Treatment of mental retardation involves developing an individualized plan based upon the child’s skills and needs. Early intervention programs are available in many areas to assess the needs of mentally retarded children under the age of three and provide treatment. The federal government mandates that all children between the ages of 3 and 21 who are mentally retarded receive testing and individualized education and skills training, as appropriate, within the public school system at no charge to the child’s family. The severity of retardation determines how far the child can go within the school system. The most important component of any treatment program is the love and support of the family. Most families with a mentally retarded child benefit from family therapy and support groups that help the family cope with the day-to-day demands of raising a child with special needs. Older mentally retarded children benefit from occupational therapy to help them develop life skills that will aid them in functioning independently or semi-independently as adults. While there are exceptions, most mentally retarded children will thrive in a loving home environment, rather than a residential facility. All newborns should be screened for phenylketonuria (PKU) and hyperthyroidism. Immediate treatment of these disorders can prevent retardation. If you are pregnant, you can help prevent mental retardation in your unborn child by getting good prenatal care, avoiding alcohol and cigarette smoking, following a healthy diet that is rich in green leafy vegetables, and taking prenatal vitamins, as recommended by your healthcare provider. Having your child immunized against diseases such as measles and Hib can also prevent the types of illnesses that can cause mental retardation. If you have mentally retarded child, seek the support of family and community. Your healthcare provider can put you in touch with a local agency that can help provide you with the resources you need to keep your family strong. This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice. source :http://www.hmc.psu.edu/childrens/healthinfo/m/mentalretardation.htm
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