Bladder: Facts, Function & Diseases


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Bladder: Facts, Function & Diseases

Bladder: Facts, Function & Diseases

Two long tubes called ureters connect the bladder, which stores urine, to the kidneys, which produce urine.

Credit: Nerthuz | Shutterstock

The bladder is a round, bag-like organ that stores urine. It is located in the pelvic area, just below the kidneys and right behind the pelvic bone. While it is basically a fleshy storage tank, it is very complex in its design.

The bladder is typically the size of a large grapefruit, according to the Weill Cornell Medical College. It can stretch much larger when needed, though, and shrinks back when it is empty. In fact, it can hold around 16 ounces (almost half a liter) of urine at one time for two to five hours comfortably, according to the U.S. National Library of Medicine (NLM).

It is normal to urinate around six to eight times in a 24-hour period, according to the Cleveland Clinic. More frequent trips to the bathroom may indicate a problem with the bladder, though it is common to urinate more as one ages.

The bladder is connected to the kidneys by two long tubes called ureters. When urine is produced by the kidneys, it travels down the ureters to the bladder, where it is stored. The bladder has four layers.

From the inside out, the epithelium is the first layer on the inside of the bladder. It acts as a lining for the bladder. The lamina propria is the next layer. It consists of connective tissue, muscle and blood vessels. Wrapped around the lamina propria is the layer called the muscularis propria or detrusor muscle. According to John Hopkins Pathology, this layer consists of thick, smooth muscle bundles. The final, outer layer is the perivesical soft tissue, which is made up of fat, fibrous tissue and blood vessels.

The other parts of the bladder are located at the bottom of the sack. An opening at the bottom of the bladder is connected to the urethra. A circular, muscular sphincter pinches tight to keep the opening and the urethra from leaking urine.

When a person urinates, the detrusor muscles contract to squeeze the urine out of the bladder while the sphincter relaxes to open the opening of the bladder and urethra. The opening at the bottom of the bladder empties urine into the urethra, where it then empties from the body.

Many diseases and conditions can originate in the bladder. “The most common bladder problems I see in my practice in women are frequent urges to urinate and leakage of urine,” said S. Adam Ramin, urologic surgeon and founder of Urology Cancer Specialists in Los Angeles, California. Leakage and frequent urges often are caused by the decreased capacity of the bladder and overactivity of the bladder. An overactive bladder can be caused by a wide range of conditions, including constipation and excess caffeine in the system, according to the Mayo Clinic. Leakage of urine, or incontinence,can also be caused by bladder spasms or stress. A bladder sling is sometimes used to treat stress urinary incontinence.

“The most common bladder problems in men are frequent urination at nights and incomplete bladder emptying. This is usually due to an enlarged prostate causing obstruction of bladder emptying,” Ramin told Live Science.

Bladder infections may be another cause of frequent urination. Bladder infections, also called cystitis, are among the most common bacterial infections, according to Harvard Health. Around one-third of all females get a bladder infection at least once. Some of the symptoms include burning or pain during urination, needing to urinate a lot though only a small amount of urine is passed each time, sudden needs to urinate, lower abdomen pain and cloudy or bloody urine.

Another problem that can originate in the bladder is bladder cancer. About 577,400 people in the United States live with bladder cancer, according to the National Cancer Institute. It typically affects older people, though younger people have been known to develop bladder cancer, according to the Mayo Clinic. Some symptoms of bladder cancer include blood in the urine, frequent or painful urination and back or pelvic pain.

An anterior prolapse, also called a prolapsed bladder or cystocele, is a bladder problem specific to females. It happens when the tissue between a woman’s bladder and vaginal wall weakens due to a strain. The weakening allows the tissue to stretch and the bladder bulges into the vagina, according to the Mayo Clinic.

Bladder stones are caused by concentrated urine that crystalizes in the bladder. Typically, people who have problems emptying their bladder have problems with bladder stones, according to the Mayo Clinic. Though many bladder stones are so small they can barely be seen with the human eye, one man was found to have an egg-shaped bladder stone that weighed 1.7 lbs. (770 grams) and measured 4.7 inches by 3.7 inches by 3 inches (12 by 9.5 by 7.5 centimeters). This isn’t the largest bladder stone on record, though. The largest bladder stone was 7 inches long, 5 inches thick and 3.7 inches tall (17.9 by 12.7 by 9.5 cm), and weighed 4.2 lbs. (1.9 kg), according to Guinness World Records. [Related: This Man’s Bladder Stone Was Almost as Big as an Ostrich Egg]

Sometimes, there is no choice but to hold urine, but it may not be good for the bladder. “Holding your urine for a short period of time, usually up to one hour, is typically okay,” Ramin said. “However, protracted and repeated holding of urine may cause over-expansion of bladder capacity, transmission of excess pressure into the kidneys, and the inability to completely empty the bladder. These problems in turn may lead to UTI [urinary tract infection], cystitis and deterioration of kidney function.”

Drinking plenty of water throughout the day can also help prevent bladder stones by preventing the concentration of minerals that cause the stones. The Mayo Clinic suggests asking a medical profession about how much water the body needs according to age, size and activity level.

Editor’s Note: If you’d like more information on this topic, we recommend the following book:

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How Do You Die from Hepatitis A?


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How Do You Die from Hepatitis A?

How Do You Die from Hepatitis A?

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A woman in Australia died after eating frozen pomegranate seeds that were linked to an outbreak of hepatitis A, health officials announced this week.

The 64-year-old woman’s death is the first in the hepatitis A outbreak tied to pomegranate seeds that has sickened 24 people in Australia, according to SA Health, the public health system in South Australia. Although the product tied to the outbreak — packets of Creative Gourmet’s frozen pomegranate arils — was recalled two months ago, it can take up to seven weeks for people to show symptoms of the viral illness after they’ve been infected, SA Health said in a June 5 statement.

But how do you die from a hepatitis A infection?

Hepatitis A is a contagious liver infection caused by the hepatitis A virus, according to the U.S. Centers for Disease Control and Prevention (CDC). The virus attacks and destroys liver cells, said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, who was not involved in the Australia case. The vast majority of people with hepatitis A have only mild symptoms and recover completely from the infection without incurring lasting damage to their liver, he said. [27 Devastating Infectious Diseases]

But a small proportion of people, about 1 in every 250 people with hepatitis A (0.4 percent), develop life-threatening complications from the infection, such as liver failure, according to the United Kingdom’s National Health Service (NHS).

People who die from a hepatitis A infection usually have an underlying liver disease, such as an infection with the virus hepatitis B or C, or alcoholic liver disease, that already caused damage to their liver.

“If you have hepatitis C and are infected with hepatitis A on top of that, that could lead to a fatal infection,” Adalja told Live Science. It’s unclear, however, if the woman in Australia had an underlying liver disease.

Several recent U.S. outbreaks of hepatitis A, which have affected primarily the homeless population and illicit-drug users, have had relatively high death rates. For example, an outbreak in Michigan has been linked with 838 cases of illness and 27 deaths since August 2018, meaning the death rate is 3.2 percent, according to the Michigan Department of Health and Human Services. This higher death rate may be because this population has higher rates of both hepatitis C and alcoholic liver disease, Adalja said.

Liver damage can be fatal because the liver is “one of the most vital organs that you have,” Adalja said. It’s responsible for many functions, including clearing toxins from the body and making compounds that help blood clot.

Because people with underlying liver disease are at higher risk for complications from hepatitis A, it’s very important that they be vaccinated against hepatitis A virus, Adalja said.

Symptoms of hepatitis A infection usually don’t appear until two to six weeks after a person has been infected, and include fever, fatigue, nausea, vomiting, dark-yellow urine, joint pain and jaundice (a yellowing of the skin and eyes), according to the CDC.

Original article on Live Science.

Carpal Tunnel Syndrome: Symptoms and Treatment


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Carpal Tunnel Syndrome: Symptoms and Treatment

Carpal tunnel syndrome generally starts with nighttime numbness or tingling, and pain in the hand.

Credit: Image Point Fr | Shutterstock

Carpal tunnel syndrome is a nerve-related condition that causes pain and numbness in the wrists and hands. It affects three times as many women as men, according to the National Institute of Neurological Disorders and Stroke (NINDS). It’s primarily seen in adults, especially those who perform assembly-line-type work. Such workers are three times more likely to get carpal tunnel syndrome (CTS) than those who perform desk work, according to the NINDS.

Recently, research have found that using devices such as phones, gaming consoles, computers and tablets, can cause CTS in students, as well. Young adults who spent an average of nine hours a day using electronic devices reported more pain in their wrists and hands than their peers who spent less time each day using such devices, according to findings published online in the journal Muscle & Nerve. This puts them at more risk of developing CTS. [Related: Too Much Tech Tied to Carpal Tunnel Syndrome]

The carpal tunnel is a passageway in the wrist that protects the median nerve, the main nerve to the hand; the flexor tendons that bend the fingers and thumb; and other soft tissues, such as ligaments and blood vessels. According to the American Academy of Orthopedic Surgeons(AAOS), carpal tunnel syndrome occurs when the tissues surrounding the flexor tendons swell and put pressure on the median nerve. This pressure can then pinch the nerve, causing the pain associated with CTS.

Carpal tunnel syndrome can have many causes. The most likely cause, according to the AAOS, is heredity. Some people simply have smaller carpal tunnels, and this trait runs in families. Other contributing factors, according to NINDS, include:

  • Trauma or injury to the wrist that causes swelling, such as sprain or fracture
  • Overactivity of the pituitary gland
  • Hypothyroidism
  • Rheumatoid arthritis
  • Work stress
  • Repeated use of vibrating hand tools
  • Fluid retention during pregnancy or menopause
  • Development of a cyst or tumor in the canal

NINDS says there is little clinical data to prove that repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Repeated motions performed at work or in sports have been associated with other disorders, such as bursitis and tendonitis. Repetitive activity may also bring on writer’s cramp, or spasms in the muscles of the hand that make holding a pen or pencil difficult.

Symptoms of carpal tunnel syndrome generally start with nighttime numbness or tingling, along with hand pain, according to Dr. Shari Liberman, a hand and upper extremity orthopedic surgeon at Houston Methodist Hospital. “Usually, the patient will wake up at night with those symptoms and has to shake out their hands to relieve the pain. The symptoms can progress to daytime numbness or tingling and pain.” Those affected with these symptoms should see a physician, Liberman told Live Science.

These sensations may appear when the individual holds an object, such as a book. As the condition worsens, pain may extend beyond the wrist all the way up to the shoulder, or into the hand. “When the carpal tunnel compression is severe, the patient will begin to experience weakness in the affected hand,” Liberman said. Sometimes pain may be misinterpreted as CTS. Sprains, arthritis and other problems may be the actual cause of the pain, which makes it important to get a diagnosis from a professional.

Carpal tunnel syndrome is fairly common and affects 4 to 10 million Americans, according to the American College of Rheumatology.

To diagnose carpal tunnel syndrome, a physician will first perform a physical exam. After checking the feeling and strength in the hand, the doctor may also want to perform additional tests to rule out any other conditions. These exams can include an EMG or nerve conduction velocity test, according to John Hopkins University.

An EMG is also called a myogram or an electromyography. This test measures the electrical output of muscles. The doctor places a tiny needle into particular muscles, and this needle detects the electrical activity of the muscles.

A nerve conduction velocity study tests the speed of electrical impulses in the nerves. Two electrodes are placed on the surface of the skin, and a shock is sent to the nerve. The speed is determined by how long it takes the impulses to travel between electrodes. This test is also called an electroneurography or EneG.

For mild cases of carpal tunnel syndrome, surgery is usually not necessary. CTS will get worse without some form of treatment, according to the AAOS, but it can be stopped if caught in the early stages.

Over-the-counter medications, such as nonsteroidal anti-inflammatory drugs or NSAIDs (aspirin, ibuprofen and diclofenac, for example), can alleviate pain related to inflammation. Physicians may also inject a corticosteroid such as prednisone into the carpal tunnel for pain relief.

If an underlying condition causes the carpal tunnel syndrome, treatment of that condition can often reduce carpal tunnel symptoms.

Severe cases may require surgery, but patients can try other treatments first. “There are minimally invasive treatments, such as needle-thread ultrasound-guided release, that have a down time of only one evening,” Dr. Nathan Wei, director of the Arthritis Treatment Center in Frederick, Maryland, told Live Science. Surgery has a high success rate, over 90 percent, according to the Cleveland Clinic.

Surgery options include endoscopic and open surgery, according to the Mayo Clinic. Endoscopic surgery involves making two small incisions on the ligament that is pressing on the nerve. Open surgery involves opening up the area with a large incision to cut the ligament.

By itself, exercising the affected area is not likely to relieve the pain and should not replace other treatments, said Dr. Peter C. Amadio, of the Mayo Clinic. Liberman agreed, adding that exercises can even exacerbate the symptoms. “Specifically, biking and weightlifting put pressure on the carpal tunnel and can make the symptoms worse,” she said. “I recommend a nighttime splint to keep the wrist in a neutral position to allow the pressure on the carpal tunnel to decrease.”

Other forms of treatment, such as yoga, occupational therapy and ultrasound therapy, can be integrated into a regular health plan to help patients deal with the symptoms of carpal tunnel syndrome, according to the Mayo Clinic.

There are several ways to reduce the risk of developing carpal tunnel syndrome. Here are some tips from the University of Maryland Medical Center:

  • Take breaks from activities that strain the wrist, and bend the wrist every so often.
  • Adjust the work area to prevent strain on joints. Individuals who type as part of their profession should keep the keyboard at elbow height or lower so the wrist is relaxed during work.
  • Watch your posture at work. Keep the shoulders back to avoid straining neck and shoulder muscles, which can eventually cause problems in the wrists and hands.
  • Exercise the joints, which can build muscle that will protect the carpal tunnel areas from damage.
  • Use the appropriate force when performing tasks such as writing or typing. In other words, don’t grip the pen tightly or bang the keys on the keyboard. This puts unnecessary stress on the wrist and hand.
  • Use ergonomic tools that can put less pressure on your joints.

This article is for informational purposes only, and is not meant to offer medical advice.

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Suicide Rates Increase in Nearly All States


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Suicide Rates Increase in Nearly All States

Suicide Rates Increase in Nearly All States

A map showing increases in suicide rates in U.S. states from 1999 to 2016.

Credit: CDC

In a concerning trend, deaths from suicide have increased in nearly every U.S. state in recent years, according to a new report from the Centers for Disease Control and Prevention.

The report found that from 1999 to 2016, suicide rates increased in 49 states, with 25 states experiencing increases of more than 30 percent. Overall, nearly 45,000 people died by suicide in 2016, which is more than twice the number of deaths from homicide, the CDC said.

Suicide is “a tragedy for families and communities across the country,” Dr. Anne Schuchat, the principal deputy director of the CDC, said in a statement. “From individuals and communities, to employers and health care professionals, everyone can play a role in efforts to help save lives and reverse this troubling rise in suicide.” [5 Myths About Suicide, Debunked]

Although suicide is often attributed solely to mental health conditions, it is rarely caused by a single factor, the researchers said. Indeed, the report found that more than half of people who died by suicide did not have a diagnosed mental health condition at the time of their death. Other problems often contribute to suicide risk, such as relationship problems, substance use, or financial or job stress.

Still, Schuchat stressed that better recognition of mental health conditions and improved access to mental health care remain important in preventing suicides.

But “if we only look at this as a mental health issue, we won’t make the progress that we need,” Schuchat said in news conference today (June 7). People can help prevent suicide by recognizing the warning signs, as well as the circumstances that often lead up to suicide, and take this as an opportunity to reach out to the person and help them get the help they need, Schuchat said.

According to #BeThe1To, a public health campaign by the National Suicide Prevention Lifeline, warning signs for suicide can include talking about feeling hopeless, trapped or like a burden to others; talking about wanting to die; increasing drug and alcohol use; acting anxiously or behaving recklessly; withdrawing from people; and experiencing extreme mood swings.

If you or someone you know needs help, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Suicide is the 10th leading cause of death in the United States, and just one of three leading causes of death that’s on the rise, according to the CDC.

The new report also found that, among U.S. states and the District of Columbia, suicide rates varied fourfold in 2014-2016, from about 7 per 100,000 residents per year in Washington, D.C., to 29 per 100,000 residents per year in Montana.

During the study period, suicide rates increased in nearly all states, with increases ranging from about 6 percent in Delaware to 57 percent in North Dakota. In Nevada, the only state that saw a decrease, the rate fell by 1 percent. (But Nevada still had a relatively high suicide rate during the study period.)

Preventing suicide requires help from all sectors of society, the researchers said. For example, states can help by expanding options for temporary assistance for those struggling with financial or housing stress; health care systems can help by offering treatment options by phone or online in places where services are not widely available; and communities can help by offering programs and events that bring people together so they feel connected. Everyone can help by learning the warning signs for suicide and how to respond.

Original article on Live Science.

Diwali: Hindu Festival of Lights


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Diwali: Hindu Festival of Lights

 

Homes are decorated with patterns made with colored rice, lentils and powder during Diwali.

Credit: Aisyaqilumaranas/Shutterstock

 

Diwali, also known as Deepawali, is the Hindu festival of lights. It is celebrated for five days across India and other parts of southern Asia, as well as in many other places around the world. It is the biggest Hindu festival and most important Hindu holiday of the year. During Diwali, people perform cleansing rituals, decorate their homes, gather for special feasts, exchange gifts and light fireworks.

Though the exact dates change depending on local custom, the festival is typically celebrated in the Hindu month of Kartik, which falls in October or November. In 2018, the festival will start on Nov. 5 and end on Nov. 9, according to the Indian Express.

Diwali is “the most awaited and the most celebrated festival of India,” according to the Society for the Confluence of Festivals of India (SCFI), an association that promotes awareness of the festival. It is like rolling “a bit of Christmas, New Year’s Eve and the Fourth of July all into one,” according to Hinduism Today.

Diwali celebrates the light overcoming the dark, according to the SCFI’s website, DiwaliFestival.org. The light symbolizes knowledge and wisdom, while darkness is a symbol for all negative forces, such as wickedness, destruction, violence, lust, envy, injustice, greed, oppression and suffering.

Hindu children held earthen lamps called diyas to celebrate Diwali.

Hindu children held earthen lamps called diyas to celebrate Diwali.

Credit: Asianet-Pakistan/Shutterstock

 

Households light dozens of little clay oil lamps, called diyas, to symbolize the triumph of light over darkness, good over evil, and knowledge over ignorance. The word “Diwali,” or “Deepawali” in Sanskrit, means “a row of lamps” in Sanskrit.

The festival’s roots lie in Hindu scriptures and legends, according to the SCFI, and there are many stories associated with the celebration. For example, Diwali commemorates the triumph of Rama, the lord of virtue, over the demon Ravana, as well as the return of Rama to his kingdom after 14 years of exile.

Hindus also commemorate the victory of the god Krishna over Narakasura, a king who had aligned himself with a demon, causing him to turn evil. Also, Lakshmi, the goddess of wealth — including the wealth of money, pleasure, power, strength, knowledge, peace and children — is said to walk the Earth and bless people. Other legends are celebrated according to different local customs. Sikhs, Jains and Buddhists also celebrate Diwali but mark different events and stories. However, they all symbolize the victory of light over darkness.

Street vendors sell colorful clay idols of the goddess Lakshmi for Diwali.

Street vendors sell colorful clay idols of the goddess Lakshmi for Diwali.

Credit: CRS PHOTO/Shutterstock

The names of the five days of Diwali vary by region. Each day has its own set of traditions and rituals. “The uniqueness of this festival is its harmony of five varied philosophies, with each day to a special thought or ideal,” according to the SCFI.

Dhanteras

On the first day of Diwali, called Dhanteras (or Dhanvantari Triodasi, Dhantrayodashi or Dhan Theras), Hindus celebrate the day that Dhanvantari, the god of good health and medicine, emerged from the ocean with the gift of Ayurveda (the knowledge of life) to humanity, according to the SCFI. They also celebrate the day that Lakshmi also came out of the ocean with a pot of gold, according to the Indian Express. “Dhanteras” translates to mean wealth and prosperity.

Leading up to this day, houses and businesses are cleaned and decorated. Floors are decorated with bright, geometric patterns called rangoli, which serve as symbols of good luck and welcome guests and Lakshmi.

The diyas are lighted in every room of the home all night long so that the dark cannot enter. Sweet snacks, called prasad, are offered to Lakshmi and Yama Raj, the god of death, with prayers (puja) for protection from an untimely death.

This is also a major shopping day, especially for new clothes and for gold ornaments and silver utensils, in order to bring luck and prosperity, according to the Indian Express.

Narak Chaturdasi (Choti Diwali)

On the second day of Diwali, known as Choti Diwali orNarak Chaturdasi, Hindus remember Krishna’s victory over Narakasura. Others, especially in northern India, celebrate Rama and his victory against Ravana, while those in Bengal worship Kali, the goddess of death. Jains also celebrate Mahaveera, the 24th tirthankara (spiritual teacher) of Jainism and his reaching nirvana, or perfection.

On this day, fewer diyas are lit, and fewer fireworks are set off. Many people take a ritual bath before sunrise, rubbing massage oil and uptan (a paste of garam flour and fragrant powders) onto their bodies to relieve tension. They rest to prepare for fully celebrating Diwali.

Lakshmi Puja

The third day, Lakshmi Puja, is the main day of Diwali festivities. It falls on the night of the new moon. Celebrators clean their houses and themselves, dress in their best clothes and pray to Lakshmi and Ganesha, the god of wisdom and remover of obstacles, according to the Indian Express. The prayer rituals can take hours to perform. Lakshmi is believed to roam the land at night and visit the cleanest house first. Diyas are placed in all the house’s windows to welcome the goddess. The night ends with huge feasts and fireworks.

Padwa

The fourth day of Diwali is known as Padwa or Govardhan Puja. Celebrators prepare and offer up a large mountain of vegetarian food to express their gratitude to the gods, according to the SCFI. The day commemorates when Krishna lifted Govardhan Hill to protect villagers from torrential rains and flooding. The mountain of food represents the hill. After the festival, the food is shared by all.

A ritual performed on this day involves building a mound out of mud or cow dung to represent Govardhan Hill, according to the Times of India. The mini-mountain is then adorned with food and flowers and prayers are made to Krishna.

Bhai Duj

The fifth day of Diwali, known as Bhai Duj (also spelled Bhai Dooj)or Bhai Tika (also spelled Bhai Teeka), is dedicated to sisters. According to legend, Yama Raj, the god of death, visited his sister on this day. He gave his sister a vardhan (a blessing), which would be distributed to all those who visited her on that day, freeing them from their sins and allowing them to achieve moksha (final emancipation). Brothers visit their sisters’ homes on this last day of Diwali to pray for long life and prosperity.

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