|
|
Bladder Infections and Urinary Tract Infection Cure
What is a urinary tract infection (UTI)? A UTI is an infection anywhere in the urinary tract.* Your urinary tract includes the organs that collect and store urine and release it from your body. They are the kidneys ureters bladder urethra Kidney....
Diabetic Gains From Nutritious Whole Grains
My mother was a diabetic and when she was diagnosed, it was called adult onset diabetes. Do you know why they changed the name to type 2? I’m afraid the sad truth is it can no longer be called “adult,” because the deadly type 2 diabetes is now...
Erectile Dysfunction - Discover More About Its Causes and The Various Ways To Cure Impotence Problem
What is Erectile Dysfunction?
Impotence, or commonly known as erectile dysfunction, is the inability to achieve and sustain an erection hard enough or long enough for sexual intercourse. This disorder is also commonly known as erectile dysfunction....
Evening Primrose Oil Benefits
The evening primrose oil which we use is extracted from the seeds of Oenthera biennis, a plant native to North America. The evening primrose plant resembles a primrose but is related to the willow herb group. This oil is called evening primrose...
Obesity and Weight Loss - Muscle and the importance of low body fat!
Today you have a good chance of getting diabetes or becoming obese or both. And if you do, then chances are you will be in for a long life filled with pain, discomfort and little quality in your life. However, it does not have to come to that. Hi,...
|
|
|
|
|
|
|
|
Medical question #2. Ovarian cysts. Part2
Polycystic ovarian syndrome is a little bit different animal actually. Here is some genetic predisposition.
Classically: an overweight young female presents with oligomenorrhea or amenorrhea, anovulation, acne, hirsutism, and or infertility.
What is what? Poly = many. Many, many, many men. So PCOS means bunch of those bubbles in the ovaries. The follicles did not rupture on time, as they should. Oligo means a little. Meno is derived from menses. Rrhea means flow in Latin
So olygomenorrhea = flowing a little bit (less than it should). A- is a prefix that means "No". So, amenorrhea = no flow at all. Hirsutism. I don't remember where it came from, but means hairy or hairiness. Actually excessive hairiness.
Causes of PCOD or PCOS (disease or syndrome) are obesity, genetic predisposition and some other causes of Luteinizing hormone (LH) excess.
There is a self-amplifying cycle:
LH stimulates theca lutein cells. Theca means sort of capsule. Doesn't really matter, just an anatomical term. Those cells are special. They produce androstendione and testosterone. Androstendione and testosterone are actually male hormones. You know, bodybuilders use these hormones to get muscle bulk. You probably heard about those hormones. Sport doping uses testosterone. So, athletes build their muscles and trash their liver.
Rumors say that a famous Hollywood actor used the hormones. Later he got liver transplant. Though he always denied the use.
Anyway, female body converts androstendione into estrone (a weak estrogen). Fat cells do this. Estrone is a female hormone already.
Basically any body produces androgens (andros = man) and estrogens (female hormones). Just the proportion of those hormones makes us male or female.
The cycle happens in normal person as well.
The estrone stimulates pituitary secretion of LH. Pituitary is a small gland in you brain. Pea Size. It's small, but it sooooo powerful.
Pituitary has another name - hypophysis. Hypo means down, phys means growth, so this gland is growing from below the rest of the brain. Pituitary gets bunch of connections from hypothalamus. Hypothalamus means “below thalamus”. These two areas of brain regulate almost all the hormone production in organism.
Higher levels in brain hierarchy regulate them.
Hypophysis gets a command. Then it produces some intermediate messengers and hormones. The hormones go into blood and control whole body.
Hormones are like orders, like messages to the rest of the body.
Brain may give quick orders: Signals go through the nerves. It is like a phone order or cablegram.
Brain also regulates organism through the hormones. This is like a mail order. Sort of if the brain sends letters by regular mail. The hypophysis is the Post Office in this case.
PCOS kicks in when a woman is obese. There are more fat cells to convert androstendione to estrone. Estrone has such effect that it stimulates pituitary secretion of LH. LH in its turn goes back to those theca lutein cells we discussed and turns them on again, to produce more androstendione, which is again converted into estrone.
Self-amplifying cycle
In addition, that increased level of testosterone causes the hirsutism (she becomes hairy like a male) and acne in female. In a normal person this cycle is probably designed to support the development of fetus. Estrogen helps placenta to grow. Placenta supports fetal growth.
However, in a person with PCOD the cycle is going out of normal control. In this case LH causes growth of the cysts in the ovaries.
Why?
Because the corpus luteum cyst is partially made by overgrowth of those theca lutein cells. LH stimulates theca lutein cells. Also, women with PCOS have intolerance to glucose (sugar) and resistance to insulin. It means there is a lot of insulin (hormone that helps to utilize glucose mainly).
However excessive insulin does not work. Either receptors to insulin do not work or something else, but the glucose is not utilized. Hence, energy inside the cells drops. Hence, a big pile of other problems mounts. As if it is Diabetes Mellitus. Diabetes is a different topic of discussion. For us, it is worthwhile to mention that people with diabetes are very much prone to any infection.
PCOS causes acanthosis nigricans also. Acantocytes are special skin cells. Nigricans means
black in Latin. That thing looks like thickened pigmented skin. When you touch it, it feels like velvet. Usually it happens in axilla, neck, below breast, in inner thigh and vulva. So, mostly all those places where skin folds.
The treatment for PCOS includes different medications: oral contraceptives, progesterone, glucocorticoids, ketoconazole, spironolactone, cyproterone, flutamide, cimetidine, finasteride, ovarian wedge resection, laparascopic electoracutery, mechanical hair removal, etc.
All methods break the cycle of overproduction. The medications are either hormones themself or hormone-like substances that occupy receptor site and prevent regular hormone to work.
The medications act on different levels. Normal hormones have very complicated regulation. There are loops and feedbacks in the pathways.
To suppress a hormone production or action, you give similar hormone or another hormone or non-hormone at all, that goes to the feedback loop and breaks it and so on. It's really long separate discussion.
Basically, you either decrease hormone production or shift ratio toward female hormones.
Another way, the best probably, is weight loss. No fat cells - no conversion of andrgoens etc… You can make conclusions yourself. It's the first line of treatment.
For a simple follicular ovarian cyst (not PCOS) doctor rules out ectopic pregnancy. Then he may send patient home and repeat pelvic exam in 6-8 weeks. Especially, if the cyst was small, less than five cm in diameter.
For larger cysts, doctor would order pelvic ultrasound.
Most follicular cyst will resolve on their own in six to eight weeks. Though, a physician may give oral contraceptives. Again, this suppresses stimulation of cyst by hormones from the hypophysis. The hormones are named gonadotropins.
If the cyst is still there after 6-8 weeks, a suspicion arises that the cyst maybe malignant. Then doctor orders other studies. CT scan. Physician may perform surgical procedures also. He looks what is this cyst really.
Corpus luteum cyst is usually not treated. However, oral contraceptives may be used.
Rupture of any kind of those cysts leads to another story. Acute pain, bleeding into peritoneum. Sometime bleeding is very severe and is true emergency. You need also to distinguish other process in the abdomen. For example, appendicitis looks similar. You can treat mild case of non-complicated cyst rupture with just observation. Appendicitis almost always requires surgery.
There are many other problems arise. Surgeon scratches his head: what's going on? Is this this or is this that? Here is the CT scan gives big advantage.
Now, going back to the question of Ms. L.
If the cyst was infected, I don't' see a reason why a ruptured cyst wouldn't become infected. Cyst content is very nutrient-rich. Remember? All those cells and their products are dedicated to feeding the oocyte (future baby). Should be very tasty for any bacteria.
Rupture may cause significant bleeding as well. This blood is also different from the blood in your vessels.
This blood is sitting in the pelvis, not moving, quickly clotting. Clotting prevents entry of white blood cells. "No flow" prevents entry of antibodies. Absence of flow prevents entry of other protective chemicals (complement etc).
So, it is very nutrient-rich media for bacteria growth.
They can go wild. Why not? If a female had another pelvic infection before, that infection can flare up. In a normal person peritoneal cavity should be sterile. However, any gynecological or gastrointestinal infection may supply bacteria. Now, mix these bacteria with the content of the leaking cyst. It just destined to become infected.
Actually Ms. L later answered her own question in another e-mail. She had cysts multiple times and they became infected several times.
So, to answer the question: Will the ruptured cyst become infected? Not necessarily. Rather not. Can it become infected? Yes.
About the Author
Aleksandr Kavokin MD/PhD, Phila
http://www.kavokin.com http://www.appendicitis.uni.cc/ Aleksandr Kavokin, MD1994 Russia,PhD1997 Russia - Immunology and Allergy, postdoc at Cancer Center at Med U of South Carolina, postdoc at Yale - Cardiology, Molecular Medicine. http://www.geocities.com/aging_rejuvenation/ http://www.appendicitis.uni.cc/ http://www.geocities.com/appendicitis_disease/
|
|
|
|
|
American Diabetes Association Home Page |
Their mission is to prevent and cure diabetes and to improve the lives of all people affected by this disease. Available in English and Spanish. |
www.diabetes.org |
  |
Diabetes Information - American Diabetes Association |
The American Diabetes Association recommends the FPG because it is easier, ... Take the first steps toward better diabetes care by visiting the Diabetes ... |
www.diabetes.org |
  |
Diabetes UK home page - Diabetes UK |
Diabetes UK is the largest organisation in the UK working for people with diabetes, funding research, campaigning and helping people live with the ... |
www.diabetes.org.uk |
  |
Canadian Diabetes Association |
To promote the health of Canadians through diabetes research, education, service, and advocacy. |
www.diabetes.ca |
  |
Diabetes information including treating type 2 diabetes at ... |
Offers dietary recommendations, including recipes and tips on managing blood sugar levels. From GlaxoSmithKline. |
www.diabetes.com |
  |
Diabetes |
Web site for Diabetes. ... publishes Diabetes. Stanford University Libraries' HighWire Press ® assists in the publication of Diabetes Online ... |
diabetes.diabetesjournals.org |
  |
CDC Diabetes Public Health Resource |
The diabetes information homepage of the US Centers for Disease Control and Prevention, provided by the CDC’s Division of Diabetes Translation. |
www.cdc.gov |
  |
CDC - Health Topic: Diabetes |
Diabetes · Diabetes and Research Diagnostics · Diabetes Surveillance Report · FAQ's on Diabetes · Physical Activity and Health: A Report of the Surgeon ... |
www.cdc.gov |
  |
National Diabetes Information Clearinghouse |
Provides educational materials to increase knowledge and understanding about diabetes among patients, health care professionals, and the general public. |
diabetes.niddk.nih.gov |
  |
Diabetes mellitus - Wikipedia, the free encyclopedia |
For diabetes mellitus in pets, see diabetes in cats and dogs. ... Type 1 diabetes mellitus - formerly known as insulin-dependent diabetes (IDDM), ... |
en.wikipedia.org |
  |
MedlinePlus: Diabetes |
(National Institute of Diabetes and Digestive and Kidney Diseases) - Links to PDF ... Select services and providers for Diabetes in your area. ... |
www.nlm.nih.gov |
  |
MedlinePlus Medical Encyclopedia: Diabetes |
Diabetes affects about 18 million Americans. There are many risk factors for ... These levels are considered to be risk factors for type 2 diabetes and its ... |
www.nlm.nih.gov |
  |
Diabetes |
What to expect from your diabetes diagnosis? Get up-to-the-minute information about medications, insulin, blood sugar management, nutrition requirements, ... |
diabetes.about.com |
  |
WebMD Diabetes Health Center - Information on Type 1 and Type 2 ... |
Find in-depth information here about diabetes prevention, diet, ... Study Shows Burned-Out Staffers More Likely to Get Type 2 DiabetesGo To Article ... |
www.webmd.com |
  |
WebMD Health - 404 Error |
Allergies|Anxiety Disorders|Arthritis|Asthma|Back Pain|Bipolar Disorder|Cancer|Children's Health|Cholesterol|Depression| Diabetes|Diet & Nutrition|Erectile ... |
www.webmd.com |
  |
Diabetes Overview |
Defines diabetes, including the various types and treatments. Provides information on the impact and cost of the disease, its increasing prevalence, ... |
www.niddk.nih.gov |
  |
Diabetes News - The New York Times |
A free collection of articles about diabetes published in The New York Times. |
topics.nytimes.com |
  |
children with DIABETES Online Community |
An online community for kids, families, and adults with diabetes, featuring message boards, chat rooms, and questions/answers from medical professionals. |
www.childrenwithdiabetes.com |
  |
International Diabetes Institute - Diabetes Research, Education ... |
The International Diabetes Institute is the leading national and international centre for diabetes research, diabetes education and diabetes care. |
www.diabetes.com.au |
  |
Diabetes New Zealand |
Educates and informs people about diabetes, its treatment, prevention, and cure of diabetes. |
www.diabetes.org.nz |
  |
|