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Treatment Adive for a Fractious Baby

Treatment Adive for a Fractious Baby


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How to get pregnant faster: Tips and facts to increase fertility

We've spoken to the experts to come up with 10 tips for how to get pregnant quickly and safely.

  • Tip 1: Track period
  • Tip 2: Monitor ovulation
  • Tip 3: Find 'fertile window'
  • Tip 4: Strive for healthy weight
  • Tip 5: Take a prenatal vitamin
  • Tip 6: Eat healthy foods
  • Tip 7: Find balance in workouts
  • Tip 8: Know the impact of age
  • Tip 9: Kick smoking
  • Tip 10: Know when to seek help
  • How to get pregnant if you have PCOS
  • What if you have endometriosis?
  • Other questions

You may have many questions about how to get pregnant, particularly if you have an underlying condition. Taking care of your body is a good first step to optimize your fertility. But what else can you do to improve their odds of having a baby?

The most important advice for a woman who wants to get pregnant is to get to know her body, specifically her menstrual cycle, said Dr. Mary Ellen Pavone, a reproductive endocrinologist and infertility specialist, and medical director of the in-vitro fertilization program at Northwestern Medicine's Reproductive Endocrinology and Infertility division in Chicago.

"It's important to know how far apart her cycles are so she can more accurately time intercourse to try to get pregnant," Pavone said.

We've highlighted the top 10 tips that may help increase your chances of becoming pregnant. As always with this type of information make sure to speak to a medical professional as this advice is broad and you may require specialist attention. You should still find this article and accompanying video on how to get pregnant useful.


Symptoms

The symptoms of NAS depend on:

  • The type of drug the mother used
  • How the body breaks down and clears the drug (influenced by genetic factors)
  • How much of the drug she was taking
  • How long she used the drug
  • Whether the baby was born full-term or early (premature)

Symptoms often begin within 1 to 3 days after birth, but may take up to a week to appear. Because of this, the baby will most often need to stay in the hospital for observation and monitoring for up to a week.

  • Blotchy skin coloring (mottling)
  • Diarrhea or high-pitched crying
  • Excessive sucking
  • Fever
  • Hyperactive reflexes
  • Increased muscle tone
  • Irritability
  • Poor feeding
  • Rapid breathing
  • Seizures
  • Sleep problems
  • Slow weight gain
  • Stuffy nose, sneezing
  • Sweating
  • Trembling (tremors)
  • Vomiting

What tests will I need?

As above, the timing of when you would be referred to a specialist for tests may depend on where you live. In the UK, this is usually only if you have had three miscarriages in a row, although in some cases it may be earlier, particularly if you are over the age of 35. In some other places, you may have tests after two miscarriages, and even if you have had a normal pregnancy in between the two miscarriages. Ideally you would be referred to a specialised recurrent miscarriage clinic.

The tests done may vary depending on your particular situation, your medical and family history and where you live, but can include:

    to look for abnormalities of the womb (uterus) such as fibroids or an unusual shape. Further investigation may be required if the scan picks up any abnormality. In pregnancy an ultrasound scan may be helpful early on to check the neck of the womb for cervical insufficiency if you have had miscarriages late in previous pregnancies.
  • A blood test for antiphospholipid antibodies. Antibodies are proteins produced by the immune system that fight infection. In APS, abnormal antibodies are produced which attack a normal substance called phospholipid. If a blood test picks up these abnormal antibodies, you may or may not have APS, but you will need repeat tests, and tests for other abnormal (autoimmune) antibodies. Some people who do not have APS have the antibodies harmlessly for a short time. So a single positive test may not be relevant to recurrent miscarriage. See the separate leaflet called Antiphospholipid Syndrome for more information about the blood tests involved.
  • Blood tests for inherited abnormalities of the blood clotting system.
  • Blood tests for other medical conditions. You would normally have blood tests to check for thyroid conditions and diabetes. If you have symptoms or signs of other medical conditions which may be relevant then other specific hormone tests may be appropriate, although these would not be routinely done in all women.
  • Blood tests to look at the chromosomes of both parents.
  • Testing the chromosomes of a miscarried fetus in some cases, where this is possible.

Treating hearing problems

Children with a cleft palate are more likely to develop a condition called glue ear, where fluid builds up in the ear.

This is because the muscles in the palate are connected to the middle ear. If the muscles are not working properly because of the cleft, sticky secretions may build up within the middle ear and may reduce hearing.

Your child will have regular hearing tests to check for any issues.

Hearing problems may improve after cleft palate repair and, if necessary, can be treated by inserting tiny plastic tubes called grommets into the eardrums. These allow the fluid to drain from the ear.

Sometimes, hearing aids may be recommended.


Macrolides erythromycin, clarithromycin, and azithromycin are preferred for the treatment of pertussis in persons 1 month of age and older. For infants younger than 1 month of age, macrolides should be used with caution as an association between orally administered erythromycin and azithromycin with infantile hypertrophic pyloric stenosis (IHPS) has been reported. However, azithromycin remains the drug of choice for treatment or prophylaxis of pertussis in very young infants because the risk of developing severe pertussis and life-threatening complications outweigh the potential risk of IHPS. Clinicians should monitor infants younger than 1 month of age who receive a macrolide for the development of IHPS and for other serious adverse events. For persons 2 months of age and older, an alternative to macrolides is trimethoprim-sulfamethoxazole.

View photos of an infant getting treatment for pertussis in the hospital.

Footnote

On March 12, 2013, the Food and Drug Administration (FDA) issued a warning external icon that azithromycin can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm in some patients. Azithromycin remains one of the recommended drugs for treatment and chemoprophylaxis of pertussis, but consider using an alternative drug in those who have known cardiovascular disease, including:

  • Patients with known prolongation of the QT interval, a history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, or uncompensated heart failure
  • Patients on drugs known to prolong the QT interval
  • Patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents.

Elderly patients and patients with cardiac disease may be more susceptible to the effects of arrhythmogenic drugs on the QT interval.


The Double Standard of Forced Treatment

Forced treatment for people with mental illness has had a long and abusive history, both here in the United States and throughout the world. No other medical specialty has the rights psychiatry and psychology do to take away a person&rsquos freedom in order to help &ldquotreat&rdquo that person.

Historically, the profession has suffered from abusing this right &mdash so much so that reform laws in the 1970s and 1980s took the profession&rsquos right away from them to confine people against their will. Such forced treatment now requires a judge&rsquos signature.

But over time, that judicial oversight &mdash which is supposed to be the check in our checks-and-balance system &mdash has largely become a rubber stamp to whatever the doctor thinks is best. The patient&rsquos voice once again threatens to become silenced, now under the guise of &ldquoassisted outpatient treatment&rdquo (just a modern, different term for forced treatment).

This double standard needs to end. If we don&rsquot require forced treatment for cancer patients who could be cured by chemotherapy, there&rsquos little justification for keeping it around for mental illness.

Charles H. Kellner, MD unintentionally provides a perfect example of this double-standard in this article about why he believes electroconvulsive therapy (ECT, also known as shock therapy) shouldn&rsquot be held to the same standards as FDA-approved drugs or other medical devices:

Yes, ECT has adverse effects, including memory loss for some recent events, but all medical procedures for life-threatening diseases have adverse effects and risks. Severe depression is every bit as lethal as cancer or heart disease. It is inappropriate to allow public opinion to determine medical practice for a psychiatric illness this would never happen for an equally serious nonpsychiatric illness.

And yet, strangely enough, if someone were dying from cancer or heart disease, they have an absolute right to refuse medical treatment for their ailment. So why is it that people with mental disorders can have that similar right taken away from them?

People who&rsquove just been told they have cancer are often not in their &ldquoright&rdquo minds. Many people never recover from that information. Some rally, undergo treatment, and live a long and happy life. Others feel like they&rsquove been given a death sentence, resign themselves to the disease, and refuse medical treatment.

As long as they do it in the quiet of their home, nobody seems to much care.

Not so with mental disorders. No matter what the concern &mdash depression, schizophrenia, bipolar disorder, heck, even ADHD &mdash you could be forced into treatment against your will if a doctor thinks it may help you. Technically, he or she must also be concerned about your willingness to live, but isn&rsquot an oncologist also concerned about their patient&rsquos will to live?

I&rsquove wrestled with this double standard all my professional life. Early in my career, I believed professionals had the right to force a person to undergo treatment. I rationalized this position &mdash as most psychiatrists and psychologists do &mdash arguing to myself that since many mental disorders can cloud our judgment, it seems like something that may be appropriate from time to time.

I was never fully comfortable with this idea, though, because it seemed completely antithetical to the basic human right of freedom. Shouldn&rsquot freedom override the right to treat someone, especially against their will?

After talking with hundreds of people over the years &mdash patients, clients, survivors, people in recovery, advocates, and even colleagues who voluntarily underwent psychiatric treatment procedures such as ECT &mdash I&rsquove come to a different point of view. (Luckily, it appears ECT treatment is in decline and may someday go the way of the dodo bird.)

Forced treatment is wrong. Just as no doctor would ever force someone to undergo cancer treatment against their will, I can no longer back the rationalizations that justify forcing a fellow human being to undergo treatment for their mental health concern without their consent.

As a society, we&rsquove shown time and time again that we cannot devise a system that won&rsquot be abused or used in ways that it was never intended. Judges simply don&rsquot work as check for forced treatment, because they don&rsquot have any reasonable basis on which to actually rest their judgment in the short time they&rsquore given to make a determination.

The power to force treatment &mdash whether through the old-style commitment laws or the new-style &ldquoassisted outpatient treatment&rdquo laws &mdash cannot be trusted to others to wield compassionately or as an option of last resort.

What should be good enough for the rest of medicine should be good enough for mental health concerns. If an oncologist can&rsquot force a cancer patient to undergo life-saving chemotherapy, there&rsquos little that can justify our use of this type of power in psychiatry and mental health.

It&rsquos a double-standard in medicine that has gone on long enough, and in modern times, has outlived its purpose &mdash if it ever even had one.


Fact Sheet: Guidelines for Patients Receiving Radioiodine I-131 Treatment

Radioiodine (sodium I-131) is a form of radiation therapy that has been used for many years to treat thyroid conditions. It is safe and effective but requires you to observe certain precautions to decrease the small amount of radiation that other people may receive from your body and bodily fluids.

How long does the radioiodine stay in your body?

Radioiodine stays in your body for only a short time. Most of the radioiodine that does not go to thyroid tissue will be eliminated from your body during the first few days after treatment. Radioiodine leaves your body primarily through your urine, but very small amounts can be found in your saliva, sweat and bowel movements.

Ask your doctor for more information. You also may get more information from the Society of Nuclear Medicine and Molecular Imaging at www.snmmi.org.

How can you reduce radiation exposure to others?

Radiation exposure to other people can be reduced by keeping a reasonable distance between yourself and others and keeping the time you are close to others to a minimum. Your doctor should review the following instructions with you and answer all of your questions. It is important to let your doctor know if you will not be able to follow all of these instructions.

These instructions apply if you are returning to your own home after treatment using private transportation. You should ask your doctor for additional instructions if you are planning to use public transportation or stay in a hotel or other non-private lodging.

First 8 hours:

  • Drink one glass of water each hour and use the bathroom as soon as possible when you need to empty your bladder. Men should sit on the toilet while urinating to decrease splashing. Use a tissue to wipe up any urine on the toilet bowl and flush twice. Wash your hands and rinse the sink.
  • Maintain a distance of at least 3 feet from all people. If possible, you should drive home alone. If it is not possible to drive alone, you should choose the seat that keeps as much distance as possible between you and the other passengers. You should not use public transportation.

First two days:

  • Do not share cups, glasses, plates or eating utensils. Wash items promptly after using. Other people may use items after they are washed.
  • Do not share towels or washcloths.
  • Flush the toilet twice and rinse the sink and tub after use.
  • Wash your towels, bed linens, underwear, and any clothing stained with urine or sweat.

First week:

  • Arrangements should be made for others to provide childcare for infants and very young children.
  • Sleep alone for 7 days unless otherwise instructed by your doctor.
  • Avoid kissing and physical contact with others, and maintain a distance of at least 3 feet from women who are pregnant and children under 18 years old.
  • Avoid activities where you may be close to others for more than 5 minutes, for example, movie theaters, sporting events and public transportation.

Additional instructions for women who are breastfeeding

You must stop breastfeeding before you can be treated with radioiodine. If possible, you should stop breastfeeding for 6 weeks prior to treatment. You should not resume breastfeeding after treatment for your current child, but you may safely breastfeed babies you may have in the future. Failure to follow this guidance may result in permanent damage to the thyroid gland of the nursing infant or child.

Pregnancy

Radioiodine treatment should not be given during pregnancy. Tell your doctor if you are pregnant or could be pregnant. If you are planning to become pregnant, you should wait at least 6 months after treatment to ensure your thyroid hormone level is normal and that you do not need additional treatment. Consult your doctor.

Other things you should know during the first week after treatment:

Small amounts of radiation from your body may trigger radiation monitors at airports, border crossings, government buildings, hospitals, and waste disposal sites for up to 3 months after treatment. Ask your doctor for advice if you will be in these areas. Your doctor can provide you with a letter describing your medical treatment if you cannot avoid these areas.

Discarded items that are heavily stained with urine, saliva, nasal secretions, sweat or blood may trigger alarms at waste disposal sites. Ask your doctor for advice on how to safely dispose of these items.


Your Digestive System & How It Works

The digestive system is made up of the gastrointestinal (GI) tract—also called the digestive tract—and the liver, pancreas, and the gallbladder. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.


What are the complications of rib injuries?

Most rib injuries heal well with no problems. Complications can occur if internal organs are damaged by the sharp end of a broken rib.

Pneumothorax

Pneumothorax occurs if the membrane around the lung is damaged. Air enters and forms a pocket of trapped air around the lung, which squashes the lung. The word pneumothorax means air in the thorax. Symptoms include shortness of breath or pain on breathing - sometimes pain near the shoulder. A pneumothorax can show on a chest X-ray. It may need treatment to remove the trapped air, under local anaesthetic.

A pneumothorax is usually noticed soon after the injury. However, it can occur later, even several days afterwards. So be alert for symptoms such as shortness of breath, increasing chest pain, or pain that is not near the break (fracture). Obtain urgent medical advice if you have any of these symptoms.

Rarely, a dangerous pneumothorax can occur where air is trapped under pressure. It compresses the lungs and causes increasing difficulty breathing. This is called a tension pneumothorax and is a medical emergency. Note: anyone who has difficulty breathing or who feels more breathless than usual needs immediate medical help.

Surgical emphysema

A sharp fractured rib can let air from the lung get in underneath the skin. This causes a swollen or bubbly area which may crackle when pressed. It is called surgical emphysema. It will clear up gradually. Surgical emphysema can sometimes be linked to a pneumothorax (see above) and the pneumothorax may need treatment.

Haemothorax

This is similar to a pneumothorax except that there is blood, not air, trapped around the lung. The blood collects at the base of the lung, so may cause shortness of breath or pain in the lower part of the chest. It is treated by draining off the trapped blood.

Tummy (abdominal) injuries

The lower ribs are near the liver, spleen and kidneys. Rib fractures can cause internal damage to these organs. Symptoms are pain in the tummy or back (rarely, pain may travel to the shoulder). If there is internal bleeding then you will feel faint or very unwell. Urgent surgery is needed.

Chest infections

Rib fractures which are painful make it difficult to breathe deeply or cough properly. This can make it difficult to clear mucus in the chest, leading to chest infections. Good pain relief helps to prevent chest infections. (See 'What is the treatment for rib injuries?', above.)

Even with good painkillers, some people may develop a chest infection following a rib injury. If you have symptoms such as cough, high temperature (fever), chest pain, shortness of breath or increasing phlegm (sputum), see a doctor urgently.

Complications are more likely if the injury involved a large force and if the injured person is frail or has other medical problems. If you suspect a complication, obtain urgent advice.

Further reading and references

Nirula R, Diaz JJ Jr, Trunkey DD, et al Rib fracture repair: indications, technical issues, and future directions. World J Surg. 2009 Jan33(1):14-22. doi: 10.1007/s00268-008-9770-y.

Nirula R, Mayberry JC Rib fracture fixation: controversies and technical challenges. Am Surg. 2010 Aug76(8):793-802.



Comments:

  1. Bennett

    Bravo, seems to me, is a remarkable phrase

  2. Rickman

    Thanks for the tip, how can I thank you?

  3. Pascual

    It is a pity that I cannot speak now - there is no free time. I will be released - I will definitely express my opinion on this issue.



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