Degos Disease...Extremely Rare Vasculopathy !!

Degos disease (also called malignant atrophic papulosis) is an extremely rare vasculopathy that affects the lining of the medium and small veins and arteries, resulting in occlusion (blockage of the vessel) and tissue infarction.

The disease is named for Robert Degos who recognized it as a clinical entity in 1942, after it was first described by Kohlmeier in 1941.

What is Degos ?

Degos Disease seems to be a disease of the blood vessels - a thrombotic vasculopathy.

Cells in the linings of the walls of the medium and small veins and arteries under the skin swell when they become inflamed.

This causes the blood flow to be restricted.

Scars left after healing. Lesions on foot had coalesced, broken down and ulcerated. Cellulitis developed with MRSA, and treated with Vancomycin. Ulcers eventually healed after 5 months with daily applications of Manuka honey and then neat Vitamin E (D-Alpha-tocopherol). Scars are sensitive and severe neurological pain has occurred at intervals, treated with Ketamine.

Scars left after healing. Lesions on foot had coalesced, broken down and ulcerated. Cellulitis developed with MRSA, and treated with Vancomycin. Ulcers eventually healed after 5 months with daily applications of Manuka honey and then neat Vitamin E (D-Alpha-tocopherol). Scars are sensitive and severe neurological pain has occurred at intervals, treated with Ketamine.

Smaller groups of lesions, now about 8 years old - all scars and no sensitivity at all.

Lesions about 8 years old. Many have coalesced. Some still become inflamed but most are now scars. The white atrophic centres are flaky.

Lesions about 8 years old. Many have coalesced. Some still become inflamed but most are now scars. The white atrophic centres are flaky.

Where this happens ?

spots (lesions) appear on the skin. They are small and red, slightly raised.

As they develop, the centre becomes dry and white (atrophic). Sometimes the spots itch.

The blood vessels affected include those supplying the skin, gastrointestinal tract, and central nervous system. This can result in bowel ischemia (mesenteric ischemia or ischemic colitis), chronic skin lesions, ocular lesions, strokes, spinal lesions, mononeuritis multiplex, epilepsy, headaches or cognitive disorders. Pleural or pericardial effusions are also reported.

The outcome of this disease can be fatal with a median survival of 2 to 3 years, although some appear to have a benign form (Degos acanthoma) which affects only the skin. There are fewer than fifty living patients at present known worldwide, and less than 200 reported in the medical literature. Treatment options are limited, consist mainly of Antiplatelet drugs or anticoagulants or immunosuppressants, and effect of treatment is limited to case reports.

Sometimes the disease affects blood vessels in other parts of the body. Most commonly, the gut, the central nervous system or the eyes are involved.

Most case histories in the medical literature are of ‘worst case’ scenarios.

Don't get panic?

You will read statistics and numbers which might scare you - but they are often based on projections and on published case reports. There are lots of Degos patients whose cases haven’t been written up and who are alive and well.

There are also lots of confident assertions which just aren’t true! For example: “This disease affects mainly young men” - not in our experience! Or “The lesions don’t appear on the soles of the feet” - wrong again! Percentages and actual numbers can’t be right, as no-one has compared living patients until now. Take it all with a pinch of salt and add your experience to our site and to the data being collected in Dessau,Germany.

Other names for Degos disease are:

• Malignant atrophic papulosis
• Köhlmeier - Degos disease
• Köhlmeier disease
• Degos - Köhlmeier disease
• Degos disease
• Degos syndrome
• Erythrokeratoderma en cocardes
• Thromboangiitis obliterans

World's Most Hungriest Girl In Just 5... OMG !!

Suman Khatun, a five year-old obese Indian girl who suffers from a suspected hormonal imbalance, is so insatiably hungry she is eating herself to death, doctors fear

In just one week, she devours over 10 kilograms of rice, 24 eggs, six litres of milk and five kilos of potatoes.

Her hunger even leads her to sneak out and pester her neighbours for food in the village of Metiala in the Indian state of West Bengal

Earning just £6 a week, her parents have reached their wits' end with their daughter who weighs in at almost 12 stone, despite being only three and half feet tall

"When she is not fed she cries, shouts, screams and has even thrown rocks at us" says Suman's mother Belly Bibi, 33

Crippled by their daughter's appetite, Suman's family has been unable to afford to travel to Calcutta for expert medical treatment.

Suman struggles to walk as she suffers from severe respiratory problems.

At 2, Suman weighed seven stone and her weight has increased by up to 15 kilos per year

"I believe that it is a clear case of a malfunctioning pituitary gland...but without diagnostic tools I can only treat the symptoms".

Worst Pandemic Wave Of H1N1 - Everything You Need To Know !!

The H1N1 viral strain implicated in the 2009 flu pandemic among humans often is called "swine flu" because initial testing showed many of the genes in the virus were similar to influenza viruses normally occurring in North American swine.But further research has shown that the outbreak is due to a new strain of H1N1 not previously reported in pigs.

Swine influenza (also called H1N1 flu, swine flu, hog flu, and pig flu) is an infection by any one of several types of swine influenza virus. Swine influenza virus (SIV) is any strain of the influenza family of viruses that is endemic in pigs.As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3.

Swine influenza virus is common throughout pig populations worldwide. Transmission of the virus from pigs to humans is not common and does not always lead to human influenza, often resulting only in the production of antibodies in the blood. If transmission does cause human influenza, it is called zoonotic swine flu. People with regular exposure to pigs are at increased risk of swine flu infection. The meat of an infected animal poses no risk of infection when properly cooked.

Chief Medical Officer Sir Liam Donaldson has said swine flu cases may be peaking for now

The estimated new cases of swine flu last week was just 30,000 compared to 110,000 the week before, showing that the first wave of the swine flu pandemic has now past its peak in England, Sir Liam Donaldson, the chief medical officer said.

The number of deaths has increased from 27 to 36 but these have not occured in the last week, rather the invesigations into whether they are related to swine flu have now been completed.

Overall two thirds of the deaths are in people with serious underlying health conditions with 12 per cent in otherwise healthy people.

A fifth of the deaths occurred in young people, aged up to 15-years and almost one in three of the deaths was in the 16 to 44 year age group.

Sir Liam said there had been slight shift in the pattern with the proportion in older people and those with more severe underlying conditions increasing slightly, but overall the numbers are small and this does not suggest the disease is changing in any way.

The number of people in hospital with swine flu has also dropped from 746 on July 29 to 530 on August 5th.

Transmission to humans :-

People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and reassortment can co-occur.Vaccination of these workers against influenza and surveillance for new influenza strains among this population may therefore be an important public health measure.Transmission of influenza from swine to humans who work with swine was documented in a small surveillance study performed in 2004 at the University of Iowa.This study among others forms the basis of a recommendation that people whose jobs involve handling poultry and swine be the focus of increased public health surveillance.Other professions at particular risk of infection are veterinarians and meat processing workers, although the risk of infection for both of these groups is lower than that of farm workers.

Signs and symptoms (In Human) :-

According to the Centers for Disease Control and Prevention (CDC), in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting.The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

Prevention :-

Prevention of pig to human transmission

Swine can be infected by both avian and human influenza strains of influenza, and therefore are hosts where the antigenic shifts can occur that create new influenza strains.

The transmission from swine to human is believed to occur mainly in swine farms where farmers are in close contact with live pigs. Although strains of swine influenza are usually not able to infect humans this may occasionally happen, so farmers and veterinarians are encouraged to use a face mask when dealing with infected animals. The use of vaccines on swine to prevent their infection is a major method of limiting swine to human transmission. Risk factors that may contribute to swine-to-human transmission include smoking and not wearing gloves when working with sick animals.

Prevention Of Human To Human Transmission

Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth.Swine flu cannot be spread by pork products, since the virus is not transmitted through food.The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Diagnosis can be made by sending a specimen, collected during the first five days for analysis.

Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public.Chance of transmission is also reduced by disinfecting household surfaces, which can be done effectively with a diluted chlorine bleach solution.Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain,vaccines against the new strain are being developed and could be ready as early as June 2009.

Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor for advice.

Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.

Treatment :-

In humans

If a person becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). Beside antivirals, supportive care at home or in hospital, focuses on controlling fevers, relieving pain and maintaining fluid balance, as well as identifying and treating any secondary infections or other medical problems. The U.S. Centers for Disease Control and Prevention recommends the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs. The virus isolates in the 2009 outbreak have been found resistant to amantadine and rimantadine.

In the U.S., on April 27, 2009, the Food and Drug Administration (FDA) issued Emergency Use Authorizations to make available Relenza and Tamiflu antiviral drugs to treat the swine influenza virus in cases for which they are currently unapproved. The agency issued these EUAs to allow treatment of patients younger than the current approval allows and to allow the widespread distribution of the drugs, including by non-licensed volunteers.



sources: en.wikipedia.org / telegraph.co.uk

Wide Angle - Top 10 Animals That Carry Flu

Health organizations worldwide are struggling to contain a swine flu outbreak that has killed at least 149 people in Mexico and sickened many more throughout the world, including in the United States, Europe and New Zealand. U.S. cases have now been reported across the country, with victims in California, Kansas, New York, Ohio and Texas.
Flu was first found among pigs in 1930. Over subsequent decades, health experts have identified influenza viruses in several other species as well. But which animals can pass such viruses on to people? You might be surprised by our top 10 list.

1. Chicken

Avian flu may not be the headline-maker now, but it has caused hundreds of human deaths over just the past decade, with chickens being the most common source of contagion.

"Many birds are susceptible to influenza strains that may transmit to humans, but butchering, handling and other forms of close contact heighten the risk," April Johnson told Discovery News. Johnson is an assistant professor of epidemiology and public health in the Purdue University School of Veterinary Medicine's Department of Comparative Pathobiology. "The H5N1 avian virus continues to be of concern because 60 percent of all humans who have contracted this illness died after becoming infected."

2. Pig

Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, has long warned that "pigs play a role in transmitting influenza virus to humans." Earlier reported cases, however, mostly involved agricultural workers, or others who were in close direct contact with pigs. A child on a communal farm in Canada, for example, came down with the swine flu in 2006.

The Centers for Disease Control and Prevention (CDC) has been monitoring swine flu for some time as well, since pigs can be infected with human and avian viruses, in addition to their own pig-specific germs.

If an infection of more than one virus occurs simultaneously, "recombination may occur," Jean-Pierre Vaillancourt, a professor of veterinary medicine at the University of Montreal, told Discovery News. He explained that the latest strain appears to consist of "a virus that's 80 percent swine, with the rest being a mixture of avian and human viruses."

Although world leaders, such as President Barack Obama, are urging "concern" and not alarm over the outbreak, the potential for pandemic exists, experts have informed Discovery News, since the disease is now spreading from person to person.

3. Duck

Ducks are often raised for their meat, especially in Asia. Health experts, therefore, often monitor duck illnesses in China, Hong Kong, Thailand, Vietnam and other Asian countries that have experienced avian flu outbreaks.

"Ducks are more considered as carriers, however, than as direct threats," said Johnson, who explained that ducks seem less likely to spread influenza to humans, but that they can infect other animals. Researchers in Mexico have not ruled out the possibility that a bird, such as a chicken or duck, was the original source of the latest outbreak, which could have jumped to pigs and then humans.

4. Goose

Both wild and domestic geese have been known to contract the infamous H5N1 virus.

The birds' broad ranges can pose a problem: "These birds can fly 1,000 miles a day at maximum," explained Yi Guan, of the University of Hong Kong, China. If geese raised for poultry come into contact with infected wild geese, the risk of influenza spreading to humans increases. Most cases involving geese began with poultry workers in Asian countries who had direct contact with sick or dead birds.

5. Turkey

While not all birds can catch the flu, most are susceptible to Type A influenza that may spread to humans. Turkeys are no exception. Earlier this year, in fact, an H5 avian influenza virus surfaced on a turkey farm in southern British Columbia. It was quickly contained. Nevertheless, tens of thousands of turkeys have been slaughtered in Canada and elsewhere when such infections have been identified.

In 2004, for example, British Columbia's Fraser River Valley experienced an outbreak that affected 40 commercial farms and led to the culling of 17 million birds, according to the Center for Infectious Disease Research and Policy.

Suppliers maintain rigid guidelines to ensure public safety. "We often criticize factory farms, but in this case modern production has helped to reduce direct contact with animals, thus staving off infections," Vaillancourt told Discovery News. "In Asia and Mexico, many families live with their poultry and other animals raised for food, so they remain in close proximity to them."

6. Horse

According to the CDC, horses too can become infected with Type A influenza viruses.

"People with horses must handle them a lot, particularly around the facial area," said Marie Gramer, an assistant clinical professor of veterinary population medicine at the University of Minnesota's College of Veterinary Medicine. "When horses suffer from an influenza virus, they can cough, sneeze and have a runny nose just like we do."

"What's coughed out," she added, is of less risk to humans than avian germs, "because most pathogens that infect horses become more species-specific."

7. Dog

In 2004, cases of an unknown respiratory illness in dogs, initially racing greyhounds, were reported to the CDC. An investigation showed that this respiratory illness was caused by the equine influenza A H3N8 virus.

Scientists believe that this virus jumped from horses to dogs, and can now spread from dog to dog, leading to the canine-specific H3N8 virus. Experts consider the strain to be "a newly emerging pathogen in the dog population."

If it jumped from horses to dogs, could it move from dogs to humans?

"It's possible, but it would need a perfect storm," Gramer said. "The moment of transfer would have to involve the right person, the right place, the right animal and the right time."

8. Cat

Cats, like dogs, enjoy close contact with people. While most experts believe that simple hand-washing can eliminate the risk of obtaining diseases from pets, there is a possibility that both dogs and cats could spread a recombined form of avian influenza to humans.

"Cases of tigers and domesticated cats coming down with avian flu have been reported overseas," Johnson told Discovery News. "In most, if not all, cases, I believe, the animals had consumed dead infected chickens or other birds." The easiest way to stave off such risks would be to monitor pets so they don't eat birds or any other wild, potentially infected prey.

9. Seal

While no "seal flu" has been known to spread to humans, the marine mammals can become infected with Type A influenza viruses. And Vaillancourt said other diseases have crossed the human-seal species line.

"Some populations consisting of people who eat raw seal meat have been diagnosed with toxic parasitic illnesses," he said. "We've done studies that show cooking reduces nearly all of this problem."

10. Whale

Could a whale flu be in our future? Whales can suffer from influenza, probably by catching germs spread by bird waste. In theory, people could be exposed to and infected by the virus if they came in close contact with infected whales or poorly cooked whale meat. But the risk of that happening, not surprisingly, is low.

"It's really unlikely, because the ocean tends to dilute things," Gramer said. "Again, such a scenario would need a perfect storm since, as it stands, wild waterfowl, like seagulls, poop out the virus, which then has a slim chance of infecting whales."

Poisonous Bite Of A Dangerous Rattlesnake

A man was bitten by a Northern Pacific rattlesnake (the snake was originally identified as a Western Diamondback rattlesnake, but that species is not found near Yosemite) just after his 13th birthday.

He was located on a trail in a hiking area near Yosemite National Park, California. The bite occurred when he was sitting on a small boulder at a distance of 4.5 miles from the trailhead with his cabin group at camp. He had his arms dangling at his side, and a 5 foot long rattlesnake bit him in the middle of his left palm.

From this point, an amazing rescue took place, taking 4 hours to transport him the 4.5 miles to the trailhead. The camp director had previously called the hospital, and a helicopter was waiting at the trailhead. During the 30 minute helicopter ride he was going in and out of consciousness, having trouble keeping his eyes open. They arrived at the Modesto, CA hospital, where the doctor in the emergency room decided that his case was too severe to treat at that medical center. He told him this, which was the last thing he heard before going unconscious.

Although he was unconscious for approximately the next 24 hours, he have heard about the following events from his parents.

He  was taken from the Modesto hospital to the UC Davis Medical Center in Sacramento, the trauma center for Northern California. His snake bite was determined to be too severe for Modesto to deal with. At the UC Davis hospital he underwent a fasciotomy, which involved the doctors cutting open his arm from the palm up to about the middle of his biceps. This was to relieve the extreme pressure that had built up in his arm from the rattlesnake venom, making his arm as hard as a rock until the fasciotomy.

He  spent the next 35 days in the UC Davis hospital, had 8 surgeries performed for cleaning out the dead tissue from his arm, and finally had a skin graft from his leg to close up his arm, which had remained open for 30 days after the fasciotomy until the skin graft surgery. That is 10 surgeries in total at UC Davis.

He  was released from the hospital, had 4 months of intense physical therapy, and flew to Duke University Medical Center in North Carolina for a follow-up surgery. This was a vascular flap surgery, during which they took a chunk of skin and muscle from his  back, attached its blood vessels to the ones in his  arm using microsurgery, and then stitched it to his  arm. Although 2 emergency surgeries were required within 24 hours on account of blood loss, the vascular flap was a success, and after 6 more months of physical therapy, his  hand had had a significant improvement in mobility from when he left UC Davis and could move each finger only 2-3 millimeters.

His  hand now has fully mobility and is about 80% as strong as it was before, thanks to his Dad and he resuming their rock climbing after a 1 year break due to the lack of strength in his left hand. He use it for about 90% of the things he used to do with his left hand (he was  right handed). 13 surgeries, $700,000 worth of helicopter flights, surgeries, and hospital stays, and 20 months later, he was very happy with the outcome of this experience and his good fortune of getting through all this without any significant loss.

 
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