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J Am Dent Assoc 1996: 127: 1202– enterovirus and clinical characteristics of 237 children 1213 lady era 100 mg line menstrual 2 days late. Clinical analysis of complication associated with herpes zoster infection of sixteen cases of lymphoepithelial carcinoma of salivary the ?fth cranial nerve generic lady era 100 mg otc pregnancy resource center. Most frequently buy cheap lady era 100 mg line womens health first, they detect infectious agents in biological specimens by disease the lower the predictive value of a positive discount lady era on line women's health nursing issues. Dis- culture, cytology, fecal examination, histopathology, ease prevalence has little effect on negative predictive immunological techniques and nucleic acid ampli?ca- values. These are the most commonly used nucleic sion, which is generally quicker than culture. Many of the ism gives the most information supporting a clinical be shipped to a diagnostic lab. If the organism in ques- infectious disease agents diagnosis of an infectious disease, but these assays tion is dif?cult to culture, can’t be cultured or takes encountered in practice colonize aren’t available nor optimal for all agents. Thus, anti- a long time to culture, such as some normal animals as well as body detection is still commonly used to diagnose viruses, Leptospira, Ehrlichia or myco- induce disease in some infectious diseases. In addition, some indicated by the appropriate faculty labs offer little external quality control. The same prob- indirect ?uorescent antibody staining in the detection of naturally lems exist with feline calicivirus. Samples that arrive proved accurate in distinguishing after noon Friday will not be Babesia spp. These age of erythrocytes that have IgM or Monday through Friday with by a pitbull terrier (B. While viral culture or serology is becoming more dif?cult adult dogs with latent infections may remain and unreliable. Antibody levels are often very low and asymptomatic for a long period of time, they sometimes undetectable. Pup- rapid and speci?c method to identify the virus in dead pies contracting the infection during the ?rst puppies or clinical samples from a symptomatic or three weeks of life are the most vulnerable. Genital, nasopharyngeal, “Turkey-egg” appearance of An entire litter may succumb to the infection within conjunctival or throat swab can be suf?cient for diag- kidneys is due to hemorrhage a 24-hour period. This anim al had been rescued it was im perative that the true identity of these tape- from a property in the upper m idwest worm eggs be determ ined. Fecal ?otation Eggs of these species are quite dif?cult to tell indicated the anim al was shedding taeniid apart based just on m orphology. Plus, this non-endem ic area does not appear to have spread this ensuring the animal wasn’t intro- parasite is not known to exist in Colorado. Test- expressed during all ing now available through the Diagnostic Laboratory, stages of active cell Stem cell as a component of the new Canine Cutaneous M ast division. Plus, it factor evaluates expres- binds to c-kit Cell Tumor Pro?le, can identify this mutation and help Mutated c-kit C-kit is guide therapeutic decisions. Mast cells M ast cell growth is driven in part by the binding Proliferation undergo limited of a growth factor (stem cell factor) to a tyrosine index, both through division kinase receptor (c-kit) expressed on the surface of m itotic index3,4 and mast cells. Spontaneous canine mast cell tumors found about 20 percent of canine mast cell tumors car- sion)— has also been demonstrated to correlate with express tandem duplications in the ried a mutation in the c-kit gene called an internal local recurrence and overall survival times, where Type proto-oncogene c-kit. The biological consequence of this duplication respectively) are associated with increased local recur- 2. Multi-center, placebo-controlled, was a change in the protein structure of c-kit, which rence and decreased survival times. Cellular proliferation in canine a decision to use Palladia over other chemotherapeutic visit the website dlab. We have detected low pathogenic avian in?u- demic H1N1 in?uenza virus (matrix gene enza viruses, primarily in wild bird samples. All swine and canine samples have tested program also provides free disease inves- negative. Both cats presented to urban poultry movement for wild bird avian in?uenza surveillance program. Tissues includ- edema or “blue-eye” in the subacute phase, at three to ing liver, spleen, kidney and lymph nodes are suitable four weeks after infection. Urine samples should be tested younger dogs, and peracute death may occur in puppies. This switched to a new ing the liquid culture for bacterial growth, notifying update will permit us to conduct of?cial laboratory information the technician of positive growth with a light. To result many times on the same day we with questions and ensure no false positives are reported, we perform a comments. If the sam ple test for liquid culture, solid culture and through this transition. Pooling can increase the (n = 27,856) cost-effectiveness of Trich testing without compromising diagnostic reliability. The piroplasmosis test-positive horse was in for the intra- and interstate movement of equids not dis- a stable with about twenty horses. If serum and be sure to include horse’s iden- they are negative, the quarantine will be released. Equine piroplasmosis is a reportable disease and As was reported in April, a horse in Col- leads to regulatory consequences. A quarantine and orado tested positive for equine piroplas- subsequent disease-control plan for any test-positive mosis. Currently, there is no vaccine or approved submitted by a Colorado private practitioner. Histologically, we observed not fully protect against subsequent intranasal vaccination of seropositive and viral challenge due to the presence seronegative calves. Current serol- in milk, urine, feces, amniotic ?uid, birth ?uids and ogy techniques lack desired sensitivity and speci?city, placenta of infected animals. The organism can sur- and seropositivity can be dif?cult to interpret as it is vive for prolonged periods in the environment and dif?cult to differentiate between acute infections and exposure to only a few organisms can result in infec- past exposure. Submissions M ost human cases results from contact with cattle, have been received from 8. Human bovine, camelid, canine, cases can also potentially result from consumption caprine and ovine species. Infection is acquired through W e receive samples for diag- inhalation or ingestion of the organism. Q fever can result of Q fever and from animals 0% in acute and chronic cases in humans. In acute cases, on premises with Q-fever 2007 2008 2009 symptoms include fever, vomiting, diarrhea, atypical positive owners.
This position is the easiest for doing Kegel exercises because the muscles then do not need to work against gravity discount lady era 100 mg without a prescription menstrual cramps but no period. Your bladder control may not improve for 3 to 6 weeks buy 100mg lady era with amex breast cancer 8 years later, although most people notice an improvement after a few weeks buy 100mg lady era amex women's health clinic kingswood. An Unexpected Natural Cure for a Humiliating Problem It’s embarrassing buy lady era 100mg fast delivery breast cancer yati bahar blogspot, it’s upsetting, and it’s secretive. Bedwetting is one of the biggest sources of embarrassment for a bedwetting child and even more so for a bedwetting teen. End Shame and Frustration If you’ve installed bedwetting alarms, restricted fluid intake and even tried hypnosis, yet still face the laundry of wet pajamas and bed linens in the morning, you’re going to be surprised, maybe even shocked, by an all-natural bedwetting curethat will end your child’s shame and frustration for good. Brain-to-Bladder Communicationsthe brain controls and regulates the bladder and every other cell, tissue, organ and system of the body. Compromise or distortion of nerve messages between the brain and the bladder can result in a loss of bladder control. Nerve Interference From Spinal Bones Nerve impulses leave the brain, travel down the spinal cord and then out between spinal bones to service the bladder. Many bedwetting children and teenagers suffer nerve interference from spinal bones in their lower back where nerves exit the spinal column. Experts Who Reduce Nerve Interferencethe symptom may be bedwetting, but the cause is nerve interference. Fortunately, there are licensed health professionals who reduce nerve interference to the bladder and the entire body who use all-natural methods. Doctors of Chiropractic have been successfully helping bedwetters for over a century! Simply put, if your child is exhibiting signs of nerve interference, a chiropractor can probably help. Chiropractors locate and reduce nerve interferences caused by spinal vertebrae that are slightly misaligned and affecting nearby nerves. But My Child Doesn’t Have a “Bad Back” True, your child may not complain of low back pain or other back-related issues. However, the sometimes-subtle spinal misalignments that chiropractors help correct are often present without pain. Find out if your child’s bedwetting is the result of these overlooked and alltoo-common spinal misalignments. Your Child’s First Visit to the Chiropractor After setting an appointment with one of the compassionate chiropractors who sponsor this site, there will be some brief paperwork. Parents often remark how impressed they are by the respect given their child, putting them at ease and giving them hope. A Thorough Head-to-Toe Examination If your child is a good candidate for chiropractic care, a complete examination will be conducted. The simple, non-invasive tests help reveal the location and extent of nervous system interferences along the spine. The All-Natural Chiropractic Adjustment After reporting the examination findings, a series of precise chiropractic adjustments will be recommended. These target the wayward bones producing the nerve interference causing the lose of bladder control. These gentle thrusts help nudge the particular vertebra back into normal alignment. Most girls stay dry through the night by the time they reach age six; some boys may still be bedwetters until they reach age seven. This should prove reassuring to parents who expect that their children will stay dry through the night at a much earlier age. Typically, bedwetting boys are no different from bedwetting girls when it comes to reasons why they wet their beds; however, boys do outnumber girls as bedwetters. Your child may be a bedwetter because: ? You were one – 75% of all childhood bedwetters have a parent who also was one. Although many parents once thought that childhood bedwetting was due to laziness, this is far from the truth. Bedwetting: Causes in Teenagers and Adults If it’s embarrassing to be a bedwetting child – how much more shame does a bedwetting teenager face? In some cases, a teenager might never have achieved any extended period of dryness (primary enuresis); in other cases, the teenager might have been dry at night for years when he or she begins wetting the bed again (secondary enuresis). This can affect their emotional health and cause them to avoid sleepovers and any type of close emotional attachments because they fear that their secret will get out. A child has a 44% chance of being a bedwetter if one parent was a bedwetter; this statistic jumps to an 80% chance if both parents were bedwetters! Bedwetting Cures Usually the parents of childhood bedwetters andteenage bedwetters try a number of differentbedwetting cures, without much success. Bedwetting diapers, a bedwetting alarm that is designed to signal when the first drop of urine hits an undergarment, or even bedwetting hypnosis are common bedwetting remedies; in most cases, these solutions are unsuccessful and the bed is still wet. With bedwetting teenagers, the answers aren’t always as simple, especially if they have never experienced any period of dryness. They are often frustrated, alone, ashamed and lonely, having been teased for years by everyone who found out about their “secret. However, they do know that there is a good chance that chiropractic can help stop bedwetting, or at least reduce the frequency of “wet” nights, if the bedwetting is related to a spinal misalignment. Several research studies have explored the effectiveness of chiropractic adjustments onbedwetters. In one such study, 25 % of children who received chiropractic adjustments experienced a 50 % or greater reduction in the number of wet nights. Listen to countless numbers of bedwetting stories, stories of the hope and help that chiropractic gave to children and teenagers who were chronic bedwetters and who are now “dry” through the night. Bedwetting Medications Medical doctors might prescribe medication as a bedwetting cure, especially for teenagers. However, unlike drug-free chiropractic care, use of these medications can produce side effects that are just as problematic as the bedwetting itself! Listed below are some of the most frequently prescribed medications for bedwetting, along with a list of possible side effects associated with each. H ome R eme di es f or B e dw etti ng Bedwetting is a very common problem associated with infants and small children. One reason behind this problem is small bladder and thus a child cannot hold his urine for all night. This is a normal phenomenon that fades with time, but as this habit can be embarrassing for parents and can even make the child feel shy, parents look for treatments. You can remove the bedwetting habit of your child with some easy and simple natural remedies. J ag g e r y Jaggery should be given to small children due to its heating effect on the body. When the body remains warm from inside, the problem of bedwetting will vanish soon. Every morning give your child a small piece of jaggery along with a cup of warm milk. After one hour give your child roasted celery seeds and roasted sesame seeds in equal amounts with a pinch of rock salt.
According to the theory of oxidative stress buy lady era 100 mg with visa menopause gas bloating, free radicals run rampant through the body reeking havoc purchase discount lady era line menstrual wheel. This is why it is so important to lower the oxidative stress with better diet lady era 100mg overnight delivery breast cancer quick facts, more exercise order discount lady era on-line menstrual belt, improved lifestyle; and to take all the antioxidant supplements known to neutralize the excess free radicals. There is still a lot to learn about the causes of diabetes, but what is known, is that our bodies may begin to malfunction five to seven years before we are ever diagnosed with diabetes. Sometimes we find that just certain foods, just certain stresses just certain times of the month make the diabetes work. Most people consume candy, french fries, potato chips, ice cream, pasta etc on a regular basis. When you consider that so many of us are overfed and so few of us get any regular exercise. The ever increasing number of overweight, out of shape, oxidatively stressed people in todayaˆ™s societies around the world, is directly proportional to the epidemic rise of diabetes. Most of these long-term complications are related to the adverse effects diabetes has on arteries and nerves. Complications related to artery damage Diabetes causes damage to both large and small arteries. This artery damage results in medical problems that are both common and serious: ? Cardiovascular disease. These deaths could be reduced by 30% with improved care to control blood pressure and blood glucose and lipid levels. Foot care programs that include regular examinations and patient education could prevent up to 85% of these amputations. Treatment to better control blood pressure and blood glucose levels could reduce diabetes-related kidney failure by about 50%. Each year, 12,000-24,000 people become blind because of diabetic eye disease, including diabetic retinopathy. Diabetes is the leading cause of new cases of blindness among adults 20-74 years old. Approximately 70% of all adult males with diabetes currently suffer or will experience sexual dysfunction or impotence. Complications related to nerve damage 60 to 70% of people with diabetes have mild to severe forms of nervous system damage. This diabetic neuropathy may result in numbness, tingling, and paresthesias in the extremities and, less often, debilitating, severe, deep-seated pain and hyperesthesias. The following are examples of diabetic neuropathy ? Peripheral neuropathythe feet and legs can develop tingling, pain, or a loss of feeling. This problem makes foot ulcers and foot infections more common, adding to the possibility that an amputation may be needed. When your body is working correctly, this adjustment includes tightening of blood vessels to prevent pooling of blood in your lower body. These signals can fail in diabetes, leaving you with low blood pressure and lightheadedness when you are standing. Each year, 10,000-30,000 people with diabetes die of complications from flu or pneumonia. They are roughly three times more likely to die of these complications than people without diabetes. About 18,000 women with preexisting diabetes deliver babies each year, and an estimated 135,000 expectant mothers are diagnosed with gestational diabetes. Many of these potential complications can significantly shorten the life of a person with diabetes, and all of them can diminish the quality of life. Diabetes complications are primarily caused by 2 factors: Excessive Glycosylation and Sorbitol Accumulation. Excessive Glycosylation ? Glycosylation is the process by which the sugar molecule binds irreversibly to a protein molecule. This process takes place in all humans, but because diabetics have higher levels of glucose in their blood and for longer durations than non diabetics, they have a much higher degree of glycosylation ocurring. This pathological process causes much of the damage in the complications of diabetes. Sorbitol Accumulation ? Sorbitol is the byproduct of glucose metabolism and is produced through the action of the enzyme aldose reductase. Since it cannot cross the cell membrane, it builds up to a toxic level inside the cells, creating an imbalance and causing a loss of electrolytes and other minerals. This accumulated sorbitol draws water in to the cell, by the process known as osmosis, and ultimately leads to the collapse of its architecture and loss of its function. This condition seems to target organs and tissues that are not dependent on insulin for their absorption of glucose. Elevations of sorbitol levels are a major problem in peripheral nerves, blood vessels, the cells of the retinal blood vessels, the lens of the eye, the pancreas, kidneys and other organs due to their lack of insulin dependence. If you have diabetes or any of the risk factors for diabetes or are just concerned about diabetes, you should start now with a natural treatment plan to reduce your risk. Diet:the single most important change any diabetic or person at risk can make is to improve their diet. This diabetic diet will reduce blood sugar, reduce insulin levels, and reduce the need for medications. It will also help to reduce weight, reduce blood pressure and support overall health and energy. Exercise: Many studies have shown that exercise is of great benefit to diabetics and can significantly reduce the risk of developing type 2 diabetes. Nutritional Supplements: There are a number of nutritional supplements that every diabetic should be taking on a daily basis. These supplements are very effective in helping to lower blood sugar and insulin levels, reduce cholesterol levels, reduce triglyceride levels, reduce blood pressure, improve energy, and reduce the risk of heart disease. These supplements can also protect your tissues (eyes, kidneys, blood vessels) from the damage diabetes often causes. They can also support your immune system, protect your heart, and improve circulation. The effectiveness of these supplements is not at all theoretical, but rather is fact. There are thousands of published studies proving the beneficial effects these supplements have on diabetics. Cinnamon Cinnamon is the brown bark of the cinnamon tree, which when dried, rolls into a tubular form known as a quill. It is available in either its whole quill form (cinnamon sticks) or as ground powder. According to cellular and molecular studies conducted at the University of California, Santa Barbara, Iowa State University and the U. Upon further examination, he isolated cinnamon as the substance in the apple pies that was preventing the diabetes. Their study included 60 Pakistani volunteers (30 men and 30 women ranging in age from 44 to 58 years) with type 2 diabetes, who were not taking insulin.
It does not require incentive purchase lady era with a mastercard menstrual diarrhea, since the insurer an already marketed medicine ongoing government must also cover the profit appropriations generic 100mg lady era with mastercard women's health center drexel. This can also force specific patients (which could be few in number or paying out-of-pocket) to continue to pay higher prices for an important medicine safe 100 mg lady era menopause 2 periods a month. The bank is already actively investing in antimicrobial R&D through its InnovFin programme purchase lady era mastercard menstrual extraction pregnancy. Our proposed model is a variation on the “megafund” idea championed by Andrew Lo and Roger Stein. Once these assets are commercialized, a portion of the revenues is ploughed back into the fund, thereby making the fund revolving and sustainable. If a small portion of this investment portfolio is dedicated to antibiotic R&D (without the expectation that these products will have high revenues, and allowing for riskier investments), this facilitates greater antibiotic R&D funded directly from the revenues of other therapeutic areas. In other words, those treatments that are enabled by antibiotics (such as oncology medicines) will start paying directly for antibiotic innovation. Alternatively, these revenues could potentially pay the European share of the market entry reward. This fund would be financed either by a one-time payment by member states or through debt raised on the capital markets. The fund would invest in a wide portfolio of biopharmaceutical and other health-related products. The fund would invest across the entire biopharmaceutical pre-launch value chain covering both R&D. The aim is to make the fund the most desirable source of external financing for biopharmaceutical activities. Greater antibiotic innovation is facilitated by allocating a percentage (10–15 per cent) of the fund to financing of antibiotic R&D aimed at unmet public health needs. This percentage is aspirational, and if there are too few high-quality antibiotic R&D projects, the funding could be used on other therapeutic areas. Antibiotic innovation investments would also be given on preferential terms, including grants for early-stage research and loans at low interest rates for development activities. Investments for non-antibiotic R&D would be in the form of either equity or royalties, thereby ensuring a financing stream back to the fund. We have heard concerns that this type of fund could increase the price of medicines overall. Recommendation:the European Commission should work with member states to gauge interest in implementing a common European market entry reward. Not all European countries will be interested in or able to contribute to a market entry reward, and those with the highest resistance levels would be better served to invest their monies in improved national infection control and stewardship programmes. The European Union’s G20 countries are France, Germany, Italy, and until 2019, the United Kingdom. It can be argued that Europe should be financially responsible for at least one-third of the cost of a global market entry reward. The European Union’s 2011 Action Plan against the Rising Threats from Antimicrobial Resistance called for research to help develop new antibiotics. It also delivered broadly accepted metrics to monitor responsible use which could be used to inform stewardship programmes, improve use of existing antibiotics and prevent inappropriate use of newly developed molecules (see section Measuring responsible clinical use). Among more immediate applications, these methods will inform health technology assessment agencies in determining the value of new antibiotics from the payer perspective (see Estimating the full value of antibiotics). The clear guidance given for implementing this evidence will provide a persuasive argument to undertake the necessary system changes at the national or supranational level. The long-term impact should be increased financing to re-ignite and maintain the necessary levels of antibiotic R&D over time while ensuring rational use. This was the strength and the originality of the project, but also represented its major challenge. This placed much pressure on participants to deliver and raised the interests at stake considerably since the project was conceived in 2013. When ReAct left we lost an important voice within the project to represent civil society. All partners were consistently included in meetings and were encouraged to comment on major documents and report drafts. In those few instances where there were no named authors (for example, policy briefs), all drafts were circulated and feedback incorporated. We also attempted to reflect diverging views when space was limited, and reflected them in detail when there was no space limitation (as is the case in this final report and many other publications). As the project developed, as well as ReAct leaving, diverging views were expressed on certain topics on which partners of this consortium have visions that are far apart. We acknowledge the procedural complexities of this public-private multi-stakeholder project and that some improvements could have been made. In terms of fostering consensus, we recognize that a more formal process could have been put in place earlier in the project. At the same time, we are unsure whether a more formal process would have been more successful in aligning people’s visions. To ensure that this report reflects the views of different stakeholders, we have clearly distinguished areas where there were different views or no consensus (e. Stephan Harbarth and Judy Hackett Towards a global definition of responsible antibiotic use: results of an international and multidisciplinary consensus procedure. Views and experiences of currently or recently hospitalized patients with regard to barriers or facilitators to responsible antibiotic use: an international qualitative descriptive study by Zanichelli V, Monnier A, Hulscher M, Huttner B 3. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics 2. The impact of antibiotics and antibiotic stewardship on transmission of resistant bacteria in hospitals • Publications in progress 1. Epidemiological differences in controlling the spread of carbapenem-resistant bacterial strains in hospitalised patients 3. A systematic review of the impact of immigrants and refugees on the spread of antibioticresistant bacteria 5. Medical tourism and the risk of infection or colonization with antibiotic-resistant organisms: A literature review 6. Estimating future trends in the spread of antibiotic resistance: the case of third-generation cephalosporinresistant E. Planned publications Itamar Megiddo, Dusan Drabik, Tim Bedford, Alec Morton, Justus Wesseler, Ramanan Laxminarayan. Investing in antibiotics to alleviate future catastrophic outcomes: what is the real option value of having an effective antibiotic to mitigate pandemic influenza? Horses for courses: how should the value attributes of novel antibiotics be considered in reimbursement decision making? Colson, Itamar Megiddo, Gerardo Alvarez-Uria, Sumanth Gandra, Tim Bedford, Alec Morton, Roger M.
Angioplasty is performed by placing a balloon into an artery under X-ray guidance and blowing it up to open the channel for better blood flow cheap lady era 100 mg overnight delivery pregnancy 5 weeks symptoms. This hormone is spilled from the kidney into the circulation and acts on another chemical purchase 100 mg lady era otc menopause weight gain solutions, which then acts on another cheap 100 mg lady era women's health center saskatoon, and in the long run the message goes to the arteries in the body to squeeze down buy lady era 100mg on-line menopause weight loss, thus raising the overall pressure in the system. This phenomenon of contracting arteries in the body is known as vasoconstriction (vaso means “blood vessel”). Imagine you lived thousands of years ago, and while you were walking through the jungle, you encountered a tiger that was inconsiderate enough to nip your leg. Your kidneys would sense this drop in filtering pressure and pour the hormone renin into your bloodstream. This would start a long chain reaction that would eventually cause your blood vessels to constrict, thus raising the pressure and keeping you alive. If your blood pressure drops too low, your brain stops working and your heart stops beating. Another consequence of renin production by the kidneys is the triggering of the production and release of other Causes of High Blood Pressure 27 hormones and chemicals from the adrenal glands,whichsiton top of the kidneys. These substances not only contribute to the constriction of the arteries, but also pass through the kidneys and cause them to reabsorb salt and water back into the circulatory system, thus helping to raise blood pressure by maintaining the fluid volume in your blood vessels. One could imagine that many things might go wrong in this complicated organ called the kidney. Tumors, infection, diabetes, autoimmune diseases (lupus, for example) or kidney stones can also cause kidney problems resulting in higher blood pressure. As mentioned above, buildup of cholesterol in the renal artery can create a partial blockage and thereby decrease blood flow into the kidney, fooling it into thinking the blood pressure in the entire system is low, triggering renin production and raising pressure. One of their jobs is to respond to signals originating in the kidney, but sometimes they act on their own. Each adrenal (ad means “on top of”; renal means “kidney”) gland looks like a little triangular hat sitting atop the kidney below it. It is made up of two parts: the middle core, known as the medulla, and the outer layer, known as the cortex (cover). The medulla makes adrenaline (whoa—what a coincidence—adrenaline being made in the adrenal gland! It also makes and stores a couple of other closely related compounds, which quickly and markedly raise blood pressure in acrisissituation. Aldosterone is a very powerful compound that travels (not very far) by way of the blood to the kidney, where it tells the kidney to reabsorb sodium (salt) before it goes out in the urine. Since everything in the body must remain in balance, water is reabsorbed along with the sodium. All of this filtering, excreting, and reabsorbing goes along for years without a hitch to make sure you get rid of toxins and things you don’t need, while saving things that you do need. But problems can occur, causing increased sodium and water reabsorption and retention, and you get bloated. In other words, your blood has more liquid in it, and that pushes against the inside of your blood vessels, raising your blood pressure. As discussed earlier, only about 5 to 10 percent of high blood pressure has a known cause (so it’s called secondary hypertension, remember? But of all the causes for hypertension, these disorders in the adrenal gland are probably the most common. And doctors are finding that a number of cases that were diagnosed as essential hypertension were really caused by overactive adrenal gland tissue. It can be sort of tricky to ferret out this problem and make the diagnosis, so physicians have missed it in some people. Other Problems We’ve seen how the kidney makes its own hormone, renin, that raises blood pressure when it senses that the blood flow lacks proper force. It’s a built-in system to prevent you from dying of too little blood pressure (also called “shock”). As stated earlier, the kidney can be fooled by a partial blockage Causes of High Blood Pressure 29 in the renal artery that feeds it, either by cholesterol or by scar tissue. It can also be affected by a myriad of hormones produced in other glands around the body. We spent some time talking about the adrenal glands, both when they function normally and when they produce too much of one substance or another that elevate blood pressure, sometimes rather wildly. Nerve signals and hormones from the brain serve as messengers to raise blood pressure often through many steps. So while most hypertension is primary, or essential— without a known cause—a few cases are secondary to other illnesses or conditions. When a doctor diagnoses high blood pressure, he or she will decide how diligently to look for the known causes, since they are only present about 5 to 10 percent of the time. Certain basic screening tests are usually ordered, and treatment recommended when necessary. But to lookforallsortsofrarecausesineverypatientisnotcosteffective, given that high blood pressure is so common and the secondary causes are so rare. Physicians will often think about these other causes when there’s something unusual, like young age, certain specific signs or symptoms, or a sudden rise in blood pressure when it was normal or under good control in the past. Keep your eyes on the adrenal glands—they’re going to turn up again when we discuss how stress affects people in many more ways than just elevating blood pressure. That means that a person could have elevated blood pressure for a long period of time and be completely unawareofit. Doctorslearnedquiteabitabouttheconsequences of hypertension by leaving it alone for years. Unfortunately, they got a very good lesson about what goes wrong when blood pressure stays high. There are a number of organs and structures that are the “targets” of chronically elevated blood pressure. The Heartthe heart is known as the most important organ in the body for obvious reasons—it pumps blood all through the body to deliver oxygen and other nutrients for proper functioning. Many things can go wrong with the heart over time, but hypertension exerts a particularly harmful influence on it. The coronary arteries are the ones that sit on the surface of the heart, sending branches down into the heart muscle to nourish it with fresh oxygen. The term coronary means “like a crown”—the arteries encircle the heart on its surface much like a crown might. Cholesterol is a big contributor to the inflammation, and it becomes part of the scar tissue in the artery wall. Hypertension also contributes to the inflammation and scar tissue formation by exerting a greater force against the inside of the artery wall. This concept is called shear force, since the column of blood coursing through the blood vessels at a higher pressure can cause small tears in the lining, resulting in damage and inflammation.
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