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Diabetes mellitus, kurz auch nur als Diabetes oder Zuckerkrankheit bezeichnet, ist eine Erkrankung des Stoffwechsels, fur welche ein erhohter Blutzuckerspiegel kennzeichnend ist. Die Zuckerkrankheit (Diabetes mellitus Typ 1) beruht auf einer hormonellen Storung der Regulation des Blutzuckerspiegels. Diabetes Typ I, von dem etwa nur funf Prozent der Diabetiker betroffen sind, entsteht in der Regel dadurch, dass bestimmte Zellen der Bauchspeicheldruse zerstort werden. Bei diesen Menschen wird zur Konstanthaltung des Blutzuckerspiegels mehr Insulin benotigt als die Bauchspeicheldruse produziert.
Bei der Diabetes vom Typ II wiederum wird zwar genugend Insulin ausgeschuttet, dieses kann jedoch von den Zellen nicht richtig verarbeitet werden und der Blutzuckerspiegel steigt ebenfalls an.
Obwohl diese Form der Diabetes vor allem altere Menschen betrifft, konnen durchaus auch Kinder und Jugendliche an dieser Form der Zuckerkrankheit leiden. Diabetes mellitus ist eine Stoffwechselerkrankung, die zu einem Anstieg des Blutzuckerspiegels fuhrt. Die im Blut vorhandene Glucose wird nicht mehr zu den Leber- und Muskelzellen transportiert und demzufolge auch nicht in ihnen zur Speicherform Glykogen umgewandelt.
Wegen des Traubenzuckermangels in den Zellen wird der Energiebedarf vermehrt durch den Fett- und Eiwei?abbau gedeckt. Durch den stark erhohten Eiwei?- und Fettabbau sowie den erhohten Glucosespiegel im Blut konnen tiefgrundige Stoffwechselstorungen auftreten.
Die Zuckerkrankheit (Diabetes) au?ert sich in einem erhohten Blutzuckerspiegel sowie in einer Erhohung der Harnmenge. Um Organ- und Spatschaden zu vermeiden, ist es bei beiden Diabetesformen, Typ 1 und 2, entscheidend, dass eine Diagnose so fruh als moglich gestellt wird. Die Verdachtsdiagnose eines Pradiabetes oder manifesten Diabetes mellitus kann in der Arztpraxis oft schon anhand der Leitsymptome Polyurie und Polydipsie erfolgen.
Eine Anwesenheit von Glucose im Urin ist daher diagnostisch stets als pathologisch im Sinne eines manifesten Diabetes mellitus anzusehen.
Die Behandlung von Diabetes mellitus soll dafur sorgen, dass sich die Lebensqualitat der Betroffenen verbessert.
Die unterschiedlichen Behandlungsziele werden zwischen dem Patienten und dem Arzt gemeinsam vereinbart. Ubergewicht ist einer der gro?ten Risikofaktoren fur Diabetes - daher sollte man fettreiches Essen weitestgehend meiden und sich hauptsachlich von Obst, Gemuse und Vollkornprodukten ernahren. Jedoch kann jeder von dieser Krankheit getroffen werden; nicht selten spielen auch die Gene eine Rolle. Achtet man nicht auf einen ausgeglichenen Blutzuckerspiegel, kann Diabetes schlimmstenfalls weitere Folgeerkrankungen mit sich bringen. Diabetes ist zwar nicht heilbar, jedoch kann man mit der richtigen und konsequenten Behandlung durchaus ein beschwerdefreies Leben fuhren. Broccoli had a close relationship with cauliflower, has long been a popular food in Europe. In the case of mild diabetes, chromium may prevent the attack by the disease of diabetes management. In a scientific experiment, garlic has been found useful to lower blood sugar levels in diabetes.
Garlic milk, prepared by adding four cloves of garlic to 110 ml of milk, is one good way to take garlic. Juice of three or four bitter pumpkins and taken it every morning on an empty stomach is more effective than eating fruits.
Bitter gourd is rich in all essential vitamins and minerals, especially vitamins A, B1, B2, C and iron.
In severe type of diabetes, regular use of this combination is an effective complement to the treatment. Scientists from the University of Warwick and consumer goods manufacturer Unilever are all set to conduct a combined research that would examine the effect of nutrients in everyday fruits and vegetables in improving the cardiovascular health in people and also against protection from Type-2 diabetes.
The study will be carried out in order to better understand if the nutrients and bioactives in fruits like grapes, strawberries and olives if taken in the right combination, can improve the condition of heart and vascular health, medical Xpress reported. The study's hypothesis aims at testing if fruit nutrients can help trigger cell defense mechanisms in the tissue walls of blood vessels which not only protect them from the damage caused by the ageing process, but also help to prevent the onset of Type-2 diabetes. The researchers plan to identify which fruit and vegetables have the right nutrients to have a positive impact on people's vascular health by using the innovative screening technology developed by the University of Warwick, will be used. These findings of the three-year long research, if proven, will pave way for the development of prototype products to be tested on human blood vessels using in vitro trials, following the success of which, it will be carried out on middle-aged, overweight volunteers. For the study, the researchers will test the blood vessel function and glucose levels of the volunteers in order to demonstrate which foods directly activate and optimize protective qualities and functions within our bodies. Diarrhea Drug Overdose May Lead to Heart Problems: FDAOverdosing on the diarrhea drug Imodium to help stem opioid addiction can cause heart problems, the FDA said. Successful, permanent weight loss is possible and affordable at the Bahamas Medical Center.
Successful, permanent weight loss is possible and affordable at “Weight Loss Solutions” one of our programs at the Bahamas Medical Center. If you’re considering bariatric surgery, then welcome to our center where we compete with costs, compare with quality and safety and, we add value with a tourist experience while you are in The Bahamas. Before you decide to get your weight loss surgery elsewhere, give us a call and learn how you can benefit from our Weight Loss Solutions program and have your procedure done in The Bahamas. Bariatric surgery is performed on Obese patients who have usually failed at multiple other weight-loss attempts. Gastric banding, also known as laparoscopic adjustable banding is a procedure that positions an adjustable belt around the upper stomach. Gastric sleeve surgery (sleeve gastrectomy) which used to be the initial stage in a two-stage procedure has, as a stand-alone procedure become very popular. Gastric Plication is one of the most attractive and popular weight loss surgery options available today. Most people will lose about 10 to 20 pounds in the first month after the surgery with declining weight loss in the following months. If you are obese, and have frequently tried dieting and exercise alone and still can’t lose the weight, bariatric surgery may be an option for you. Contact the Bahamas Medical Center Weight Loss Solutions team for an evaluation and assessment of your options for bariatric surgery. Grundsatzlich werden zwei Arten dieser Erkrankung unterschieden: Diabetes vom Typ I und Diabetes Typ II. Hier sind die Ursachen in einer meist schweren Schadigung der Bauchspeicheldruse zu finden, so dass das erforderliche Insulin durch Spritzen verabreicht werden muss. Diese produzieren das lebenswichtige Hormon Insulin; dieses sorgt im Normalfall dafur, dass der uber die Nahrung aufgenommene Zucker in die Zellen gelangt und dort verarbeitet wird. Doch auch Erbfaktoren sowie Virusinfektionen konnen durchaus eine Ursache fur die Diabetes Typ I sein. Der Insulinmangel ist bei ihnen demzufolge noch starker ausgepragt und die Blutzuckerregulation wird noch problematischer. Diese Insulinresistenz ruhrt in vielen Fallen daher, dass dem Korper ein Uberschuss an Nahrung zugefuhrt wird. Dies ist vor allem auf schlechte Ernahrungsgewohnheiten zuruckzufuhren - so ist es nicht weiter verwunderlich, dass vor allem in Europa besonders viele Menschen an dieser Form der Diabetes leiden.
Infolge ungenugender oder volligem Ausfall der Insulinproduktion in der Bauchspeicheldruse ist der Glucosegehalt des Blutes standig zu hoch. Insulinmangel erhoht auch noch zusatzlich den Glykogenabbau in den Zellen und die Glucoseneubildung aus Fett und Eiwei?. Durch entsprechende Laboruntersuchungen des Blutes und des Harns kann festgestellt werden, ob eine Zuckerkrankheit vorliegt.
Dem Korper geht sehr viel Flussigkeit verloren, was sich auch in einem uberma?ig gro?es Durstgefuhl zeigt und zum standigen Trinken animiert.
Die Symptome verlaufen beim juvenilen Diabetes mellitus oft dramatischer als beim Altersdiabetes, deshalb erfolgt hier die Diagnose in der Regel fruhzeitiger. Darunter wird ein Harndrang mit vermehrtem Wasserlassen bei gleichzeitig permanent vorhandenem Durstgefuhl verstanden.
In beiden Korperflussigkeiten konnen bei Diabetes mellitus erhohte Glucosewerte nachgewiesen werden.
Um Diabetes Vorstufen zu diagnostizieren, wird der sogenannte orale Glucose-Toleranztest eingesetzt. Wahrend Typ I Patienten meist nicht ohne Insulinspritzen auskommen, haben Typ II Patienten haufig noch die Moglichkeit, das Voranschreiten der Krankheit mit einer gesunden Lebensweise aufzuhalten. Selbst wenn die Krankheit bereits weiter vorangeschritten ist, helfen oft noch Medikamente.
Herz-Kreislauf-Erkrankungen, wie Durchblutungsstorungen und im weiteren Verlauf ein Herzinfarkt oder Schlaganfalle konnen ebenso die Folge sein wie Erektionsstorungen oder Dysfunktionen der Nieren.
These vegetables are rich in potassium, which effectively replaces a large amount of potassium that lost in the urine of diabetics.
Onion also can prevent arteriosclerosis, which is a common complication of diabetes and relieve the body pain. Commonly used, therefore, toA  prevent the complications associated with diabetes, including hypertension, eye complications, neuritis and defective metabolism of carbohydrates.
This is also a health food that useful for preventing complications due to malnutrition in diabetes.
Eat a handful of peanuts every day for people with diabetes will not only prevent malnutrition, particularly lack of niacin, but also examine the development of vascular complications. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA.
The appetite of an individual would be reduced with the help of consumption of this amazing ingredient. Weight loss process would be also speeded up with the help of consumption of this essential herb. The metabolism level of an individual would be also improved by including dandelion in your diet.
Surgery is intended to be used in conjunction with diet, exercise and lifestyle changes to GET patients at or close to their target BMI (27 – 30) and to MAINTAIN the excess weight loss.
During the Roux-en-Y gastric bypass surgery the stomach is divided into a smaller, upper pouch and a larger, lower section, while the small intestine is divided and rerouted.
This band is designed to constrict the stomach and thereby limit the amount of food that the resultant upper stomach can hold. The gastric sleeve achieves weight loss by restricting the amount of food that you can ingest.
Hanna’s goal is to improve the quality of life for each of his patients, by reducing the risk factors related to obesity. Strict diet and exercise routine will increase the results and ensure long term weight loss and weight maintenance. Auch die Nahrungsaufnahme sollte zu festgelegten Zeiten passieren, damit der Energiebedarf standig gedeckt ist.
Typische Symptome, die besonders bei der Diabetes Typ I auftreten, sind uberma?iger Durst, vermehrtes Wasserlassen sowie Hei?hunger.
Aufgrund dessen gewinnen Glucagon und Adrenalin an Bedeutung und begunstigen somit die hohe Traubenzuckerbelastung unserer Korperflussigkeit. Eine weitere Folge ist ein Gewichtsverlust, bedingt durch den Abbau von Fett und Eiwei? in den Geweben.
Durch die Filtrationstatigkeit der Nieren kann Blutzucker erst ab einer Schwelle von 180 Milligramm pro Milliliter Blut in den Urin ubergehen, man spricht hier auch von der sogenannten Nierenschwelle. Au?erdem wird jeder neudiagnostizierte Diabetiker einer erweiterten Diagnostik im Hinblick auf eventuell bereits vorhandene Spatschaden zugefuhrt.
Wenn die Krankheit rechtzeitig erkannt wird, kann der gestorte Glukosestoffwechsel ohne Medikamente normalisiert werden. Naturlich muss man sich an einige Regeln halten - besonders auf die Ernahrung ist zu achten. This food is also a rich source of chromium, a mineral that is useful for lowering blood sugar. This cleansing action allows the pancreas to perform better and thus helps in the production of insulin. People with diabetes can take the equivalent of one or two cloves of garlic a day in whatever form they like, either raw or cooked in food or as capsules.


Experiments have shown that consumption of water extracted from Bengal gram increases the use of glucose in diabetics and normal people. Research has determined that this vegetable contains insulin, and designated as insulin-plant, which has been found beneficial in lowering blood and urine sugar levels.
Germinate Black Gram taken with a half cup of fresh bitter gourd juice, effective for treating mild types of diabetes. Depending on the biotypes of the above mentioned bacteria the severity of the disease varies. HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes. The mucus fat would be stripped off with the help of this wonderful herb, thus helping to clean your intestines in a much better way. Disorders related to Obesity and, conditions worsened by Obesity (co-morbidities) are controlled or cured with the excess weight loss from Bariatric surgery. Gastric plication surgery reduces the ‘effective capacity’ of the stomach by 70% with imbrication or in-folding of the greater curvature of the stomach with stitches.
Our Weight Loss Solutions program aims to keep patients at a steady 1 – 3lbs per week of excess weight loss until the target BMI is reached. Your general health and physical and emotional well-being are also measured to determine your “readiness” for a bariatric procedure.
Wahrend vom Typ I eher junge Menschen betroffen sind, kommt es bei alteren Patienten eher zu Diabetes vom Typ II. Es kommt zu Ermudungserscheinungen, zum Leistungsabfall und zu einer herabgesetzten Abwehrreaktion gegenuber Infektionserkrankungen.
Dazu gehoren beispielsweise die Analyse der Nervenleitgeschwindigkeit oder des Augenhintergrundes. Bei der Behandlung stehen zwei Arten von Insulin zur Verfugung, namlich Normalinsulin und Insulinanaloga. These minerals regulate blood sugar, thereby reducing the need for drugs and insulin for diabetes. Some authorities believe that low levels of zinc may be one factor responsible for the occurrence of diabetes.
This should be done once a day, for three to four months, with a restricted intake of carbohydrates. Since this disease is infectious it can spread by respiratory droplets or by contact with the infected person. Trends in HSV Types and Genital HerpesGenital herpes can be caused by either HSV-2 or HSV-1. Adding saline tightens the band and narrows the channel between the small upper pouch and lower stomach, delaying emptying of this pouch and producing an effect of early satiety – feeling full after ingesting a small amount of food.
However, do not make the mistake of adding sugar to the juice; else the desired results would not be achieved. The lower portion of the stomach is bypassed but not removed from the body as it is in the gastric sleeve surgery.
This combines with the reduced hunger and reduced appetite to produce weight loss over time.
Doisy and others, which appeared in Medical World News, Brewer’s yeast has lowered insulin needs of diabetes patients. Symptoms of respiratory diphtheria include fever, difficulty in breathing and swallowing and further spread of the disease can cause heart and neurological problems such as paralysis. In recent years, HSV-1 has become a significant cause in developed countries, including the United States. Gastric sleeve surgery is successful because it removes the part of the stomach that produces appetite stimulants. After the diagnosis of the infected patient, proper treatment should be taken including diphtheria antitoxin which reduces the progression of the disease and later antibiotics like penicillin and erythromycin should be applied to eradicate it completely. Vaccination and immunization of infants at the age of 2,4 ,6 months is the finest way to prevent this disease. Betroffene mussen regelma?ig zur arztlichen Kontrolle, um den Verlauf der Krankheit zu beobachten. The risk of infection is highest during outbreak periods when there are visible sores and lesions. Gastric plication may be combined with LapBand placement to optimize the success of sustained excess weight loss over time.
SymptomsWhen genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.
Herpes, Pregnancy, and Newborn InfantsHerpes can pose serious risks for a pregnant woman and her baby. The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth.
Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission. Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus. Herpes viruses include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox). The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. The usual cause of oral herpes (herpes labialis), which are commonly called cold sores or fever blisters.
HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2). Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes. It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites). In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact. To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas. The risk for infection is highest with direct contact of blisters or sores during an outbreak. But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate. The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time. However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again.
During this time, the virus can infect other people if it is passed along in body fluids or secretions. Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding). In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters. Certain triggers can wake up the virus from its dormant state and cause it to become active again. In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak.
HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years. In addition, because HSV-1 can be passed in saliva, people should also avoid sharing toothbrushes or eating utensils. Transmission of Genital Herpes Genital herpes is transmitted through sexual activity. People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner. People with active symptoms of genital herpes are at very high risk for transmitting the infection.
Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms. Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing. There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes.
While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex.
African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing. Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak. However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding). Although condoms may not provide 100% protection, they are proven to significantly reduce the risk of sexual disease transmission, including herpes. Natural condoms made from animal skin do NOT protect against HSV infection because herpes viruses can pass through them. Use a water-based lubricant.
Lubricants can help prevent friction during sex, which can irritate the skin and increase the risk for outbreaks. Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used. However, it is best not to use condoms pre-lubricated with spermicides. Do not use spermicides for protection against herpes. Nonoxynol-9 can cause irritation around the genital areas, which makes it easier for herpes and other STDs to be transmitted. Use a dental dam or condom for oral sex. If you have any symptoms of oral herpes, it is best not to perform oral sex on a partner until any visible sores or blisters have healed. Limit the number of sexual partners. The more sexual partners you have, the greater your chances of becoming infected or infecting others. It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system. The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications.
HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery. Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare. Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery.


Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery.
Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy. A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir.
It is important to treat babies quickly, before the infection spreads to the brain and other organs. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates.
Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light.
Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur. Herpes Eye ComplicationsOcular herpes is a recurrent infection that affects the eyes. Ocular herpes is usually a simple infection that clears up in a few days, but in its more serious forms, and in severe cases, it can cause blindness. It only affects the upper layer (epithelium) of the cornea and heals with scarring. Stromal Keratitis.
Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed.
Herpes Skin ComplicationsEczema Herpeticum A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system.
Untreated, this condition can be extremely serious and possibly fatal. Gingivostomatiti Oral herpes can cause multiple painful ulcers on the gums and mucus membranes of the mouth, a condition called gingivostomatitis. Children with gingivostomatitis commonly develop herpetic whitlow (herpes of the fingers). Herpetic Whitlow A herpetic whitlow is an infection of the herpes virus involving the finger, often around the fingernail. In children, this is often caused by thumb sucking or finger sucking while they have a cold sore. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent. The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms. In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes. The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters. The sores may sometimes itch, but itching decreases as they heal. About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. Women may also experience vaginal discharge. Recurrent Genital Herpes Outbreak In general, recurrences are much milder than the initial outbreak.
The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks. Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely. There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes.
HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral HerpesOral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon. Primary Oral Herpes Infection If the primary (initial) oral infection causes symptoms, they can be very painful, particularly in children. The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing. Recurrent Oral Herpes Infection A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu). The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.
The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction. Timing of Recurrences Recurrent outbreaks may occur at intervals of days, weeks, or years. For most people, outbreaks recur with more frequency during the first year after an initial attack.
The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time.
However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone.
These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes.
People diagnosed with genital herpes should also be tested for other sexually transmitted diseases. At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2.
It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations.
Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur. Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak.
PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis. PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected.
However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions.
The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies). The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2.
When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection.
If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes). Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy). Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously. Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions.
If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity. Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%.
It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year). Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences. A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day. In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms.
However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain. Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later.
Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief.
They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin. Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks.
Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products. Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women.
Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008.
Guidance on management of asymptomatic neonates born to women with active genital herpes lesions.
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.



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