Chiropractic  is a  profession dealing with health care in alternative medicine branch. It was created in the 1890’s and then officially declared in 1895 by Daniel David Palmer, who had already gained some notoriety healer. His son, Joshua Bartlett, reserve colonel in the National Guard, has continued his work in developing and adapting to the scientific knowledge of the time. He founded the first school of chiropractic near Chicago in 1902; school remained open (as opposed to 95% of medical schools), according to the findings of Flexner Report (1910), as conforming to the new standard school health for States United States. Chiropractors are official partners of the WHO since 1990. They are officially recognized only natural health profession in this case by the International Olympic Committee since 1992. Chiropractic is officially the third healthcare profession in the world, the second in North America after dental surgery. It is not a discipline annex but in a health profession independent and autonomous in its own right, with its organization and faculties.

  The chiropractic therapy

The diagnostic chiropractic is a differential diagnostic procedure specific, peculiar to the profession, which allows removal of diseases that are not within the purview of the chiropractic and detect what chiropractors call “vertebral subluxation.” The identification of these functional disturbances of the functional spinal unit is obtained by intersecting various means (not exhaustive): The nerve interference, neurological consequences of these subluxations, statements involve painful or functional disturbances and even organic, which affect overall vitality and, a fortiori, the general state of health. After identifying the “subluxation” with a specific diagnosis and analysis Chiropractic, Chiropractor began correcting “subluxation” (according to a protocol of care) through chiropractic adjustments. 
 

  Efficiency and security

Numerous studies have concluded that chiropractic had an effect at least equal, if not superior medical treatment in the case of chronic low back pain]; the cost-benefit ratio is there for this pathology, for the chiropractic. However, studies are still unclear about the case of acute low back pain and sciatica.

There are several instances of accidents handling, which may require surgery to release the spinal dorsal or cone terminal or a root of the sciatic crushed by a herniated disc post-manipulation. These manipulations accidents are most often wrongly attributed to chiropractors as they are usually carried out by manipulative little or poorly trained. Chiropractic is one of the safest therapeutic in its scope, with fewer side effects than the drugs most commonly prescribed in its most common indications (non steroidal anti-inflammatory drugs) Chiropractic Doctors may, after their studies, to specialize in chiropractic care techniques (applied kinesiology) or in categories like chiropractic sports, pediatric chiropractic, chiropractic game or “upper - cervical. For the former, they receive post-doctoral certification in the techniques chosen; the latter will receive certificates of post-graduate specialization in selected categories.

 Statute of the profession

In United States, England, Sweden, Japan, Australia, South Africa, Canada, there are twenty universities giving formation on chiropractic doctor. These degrees are officially recognized for a long time in most major industrialized countries such as the United States, Canada, Switzerland, the United Kingdom, Denmark, Australia, New Zealand.  Chiropractic is an official partner of the World Health Organization through the World Federation of Chiropractic. In addition, WHO has issued its “Guidelines for the education and safety of chiropractic. There are now real specialties within the chiropractic profession as radiology (Doctor of Chiropractic + 3-year internship), orthopedics, neurology and chiropractic sports.

Childbirth, also called birth, or giving birth, is the culmination of human pregnancy, the period for withdrawal of infant maternal uterus. It is considered by many to be the beginning of a person’s life, and contrary to death. The age of an individual is defined by this event in many cultures. It is believed that woman starts childbirth with the appearance of painful uterine contractions, which are increasing in intensity and frequency, accompanied by physiological changes in the diameter of the cervix. While most women experience childbirth as painful, some concern not to have suffered from pain. Childbirth can be assisted with medicines such as oxytocin and certain anesthetics and a possible episiotomy, while high-risk pregnancies, usually end up with a caesarean section. When the baby is born, he weighed and subjected to certain special care.

  Medical Professionals

 The traditional medical specialty that is responsible for the management of pregnancy is the Obstetrics and doctors specializing in childbirth are known as obstetrician-gynecologists, obstetricians or midwives.

 Types of delivery

 There are several ways in which the baby is born at the end of the term of pregnancy, or in some cases, before 40 weeks of gestation or 9 months:

 Vaginal spontaneous delivery

 Natural delivery, the baby is born through the maternal vagina following signs of health professional, with the assistance of little or no technology and without the help of drugs. In most health centers vaginal delivery occurs in a position gynecological, with the pregnant woman in dorsal decubitus position, ie, lying on his back and his feet sustained rise to the buttocks. It was known as the lithotomy position. However, it’s a controversial position, since childbirth can occur naturally in the upright position, for example - and more common birth in water.

Vaginal delivery with forceps

 Occasionally vaginal delivery should be watched with special instruments, such as forceps or tweezers obstetric press that the head of the newborn for the go outside the birth canal. It indicates infrequently in some difficult deliveries.  

Abdominal Childbirth

Cesarean

About 20% of births in developed countries like the United States, are performed by a surgical abdominal operation called caesarean section. Not all Caesareans are medically indicated in cases of high-risk births, a percentage of them are elective when the mother chooses preference for your baby not born vaginally.  

  Home confinement

 It is hoped that the birth occurs 40 weeks ± 2 weeks from the date of the last menstrual period. The onset of labor varies between a woman and the other being the most common signs, the removal of cervical mucus plug, the emergence of mild spasms to uterine intervals under one every ten minutes, increased pressure pelvic with urinary frequency, rupture of the membranes that surround the amniotic fluid-with the consequent spillage of the liquid-with voluminous evidence of blood secretions. If these signs appear before 38 weeks, it should immediately contact a professional health specialist maternal.
Although there is no scientific evidence to support it, it is common to hear that mothers feel an urgency to “cleanse” the nest, shortly before the French labor, or give the final touches to the fourth of the baby, claiming lifted until dawn with such faenas.

False birth

 The onset of uterine contractions and irregular short-interval in both duration is unchanged cervical-called labor untrue or false work. It is often confrontational, especially during the final days of pregnancy, has begun deciding whether labor or the appearance of certain signs is a hoax, especially if they feel contractions that cause no increase in intensity and frequency. mild contractions prior to the real contractions of labor are normal and named after contractions of Braxton Hicks. Besides being mild contractions are sporadic, they do not have a definite pattern and tend to disappear with the rest, change position, lukewarm baths and hydration. It is appropriate to consult with a health specialist with the emergence of signs that tend precede the onset of labor.

Stages childbirth

 It is unknown what are the causes of precipitated childbirth, but it is believed that certain substances produced by the placenta, the mother and / or the fetus, and mechanical factors such as the size of the baby and its effect on uterine muscle contributing to childbirth. Therefore coordinated effects of all these factors are likely to cause the appearance of the work of childbirth

First Period of Childbirth

 The first stage of labor is known as the latent period and aims to dilate the cervix. It occurs when uterine contractions begin to appear more frequently, approximately every 3 to 15 minutes, with duration of 30 s or more each and an increasing intensity. The contractions are becoming more frequent and more intense, until one every two minutes and produce modification or thinning and dilation of the cervix, making it possible to call this period as a period of expansion. The duration of this period varies depending on mother (2-8 hours)). The stage ends with the complete dilatation (8-10 cm) and borramiento neck Uterine. By then, the presentation of the baby gets closer to the lower pelvis in contact with the Hodge planes.

Second Period of childbirth

 Also called second stage or period of bidding and ends with the birth of the baby. It is the passage of baby through the birth canal, from the womb to the outside world, thanks to the powerful and involuntary contractions uterine contractions. This phase can last from 30 seconds to women who have given birth before, up to 2 hours to women in their first birth.

  Third Period of childbirth

Mother and newborn with her umbilical cord still attached, called “beginning at birth” and the expulsion of the placenta, the umbilical cord and membranes and this takes between 5 and 30 minutes. The fall of umbilical cord at the vulva after childbirth is an indication of the final detachment of the placenta, the more you get the cord, placenta moving more towards outside the uterine cavity. The detachment of the placenta occurs in two possible mechanisms. The first is, detachment occurring in the center of the union utero-placental, mechanism known as a mechanism for Baudelocque-Schultze and are usually about 95% of cases. Less common is when the placenta tears initially the sides of the union utero-placental, known as the Baudelocque-Duncan mechanism. The uterine contractions during the continuing decline in the placenta, which helps compress vessel terminals myometrium who lose their usefulness after childbirth, a process that is known in obstetrics as ligatures live Pinard. For many authors childbirth ending the period of confinement, but others considers fourth period would be the immediate recovery and ending two hours after childbirth. During this period, called “immediate postpartum”, the mother and child should be closely monitored because of the greater possibility of complications such as uterine atony.

   During the mechanics of childbirth, diameters smaller fetus through diameters greater than the maternal pelvis. In order not to be embedded in some point during his career outside the womb, the baby goes through a series of movements that represent the natural mechanism of confinement.
Descent: happens by action of gravity once the dilated cervix, as well as the powerful uterine contractions and the maternal abdominal muscles. The decline tends to be slowly progressive based on the maternal pelvic structure. Flexion: the fetal head is flexiona, so that the fetal chin touches his chest, to be the first point of resistance of the pelvic floor. Engagement: the diameter of the fetal head a bone that runs from the opposite wall, called biparietal diameter, narrow upper reaches of the pelvis at the ischiatic bones. Usually occurs in the late stage of pregnancy, just at the beginning of the labor. Internal Rotation: etrecho happens in the middle of the pelvis, when the foetus, to continue its decline, makes a rotation of 90 degrees in the opposite direction to clockwise, so as to adapt to the diamond-shaped configuration of the pelvic floor muscles , the elevator muscle between the anus and ileo-coxígeos. Thus, the face of the baby is aimed looking straight mother. Extension: the head of the fetus passes through the birth canal, stretches so that the front moves first hole vulvar. The head is below the pubic symphysis, and has relaxed the most of the perineum.
External Rotation: once it has left the head is rotated 45 ° for restoring its original position before the internal rotation and get into normal position in relation to the shoulders. It’s called by her restitution, making the transition from the shoulders more feasible. Expulsion: the shoulder pubic tends to leave first, followed by the perineal shoulder. The rest of the body alone leaves with a mild maternal drive assisted by the facilitator childbirth.
These movements are all due to the relationship between bonehead and shoulders of the fetus and the ring of the pelvis bone substitutes. The episiotomies, if indicated, should be performed when the baby’s head begins to defuse the perineum. Both episiotomies as perineal tears are repaired without delay, at the end of the delivery of the placenta.

  Physiology childbirth

 The onset of uterine contractions could be due to an increase in the concentration of certain prostaglandins and the increase in the number of receptors for oxytocin. The amnion and corion produce phospholipids to be metabolized in arachidonic acid, which are synthesized eicosanoid prostaglandin I (PGI) and F (PGF), which increases during childbirth humans. In all, the biochemical changes that predate labor are aimed at ridding the myometrium of the elements inhibitory present during pregnancy, such as progesterone, prostaciclinas, relaxin, lactógeno human placental and nitric oxide. In turn, the uterus is activated, or stimulated by other proteins associated with muscle contraction; such as stimulate oxytocin and prostaglandins.

Control of labor

 Care centers equipped with birthing rooms have different procedures and protocols in the childbirth attention. Among the most frequently used for monitoring of the mother and her baby, are: Auscultation: fetal heart rate using a stethoscope or ultrasound. In some centers is routinely print control of the heartbeat of the fetus, and others are outlined in a partograph by staff care delivery.
Dynamic uterine: control uterine contractions can be done mechanically, using a manometer and occasionally intrauterine pressure catheter, which provides more accurate readings of uterine contractions in fetal heartbeats. Monitoring vital signs: such as pulse, blood pressure and respiratory rate of the mother during labor. All these values are recorded in partograph that lasts for the duration of labor. Clinical surveillance of the evolution of labor can prevent, detect and manage the emergence of complications that can trigger damage, sometimes irreversible or fatal to both mother and newborn.

Soft Injuries in birth canal

 Childbirth may be accompanied by injury disarranges of soft parts of the mother. The risks that increase the likelihood of injury during childbirth include:

Fetal large head,

Presentations fetal deflexionadas: face, or front,
Increased narrowness of the vulva, because of the size of the mother, or swelling of external genitalia, for example,
Perineum little elastic, as in certain diseases of collagen;
Scars tears earlier;
Extraction forceps; Injuries infectious, as a condyloma or abscesses of the gland Bartolino;
Bulky tumors, as fibroids;
Although it is not always indicated an episiotomy, it is likely that some jobs are labor with long periods expulsivos warrant soft expand the channel through an incision vulvoperineal.

Anesthesia for delivery

Although for centuries childbirth has been done without any anesthesia because the birth produces a very significant pain, in recent decades have developed much the options of childbirth without pain. There are drugs to relieve pain that can be taken without affecting the baby, even if it is decided to have a vaginal birth. Additional to the preferences of women, some indications warrant the use of analgesics or anesthetics during labor, which can jeopardize the health or life of the fetus or the mother. 

 Anesthetics

  Initially infiltrating the skin of the perineum with local anesthetics to ease the pain of episiotomies or incision of the perineum to prevent tearing. Since thirty years ago is increasingly the number of deliveries with epidural anesthesia or epidural anesthesia. This is the introduction into the epidural space for a catheter to be injecting small doses or continuous infusion of local anesthetic to the right amount and enough to remove the pain but not the force of contraction. This way you can truly enjoy childbirth without pain, it can contribute to the contraction and stays awake at the time of delivery so that you can enjoy the moment the baby is born. The epidural anesthesia should be done by experts anesthesiologists to minimize adverse effects. The epidural anesthesia is also used in the event that becomes a cesarean delivery. You only need to reinforce the dose of local anesthetic by the epidural catheter. The complications of epidural anesthesia are minimal in the hands of experts.

  Relaxation techniques

  The methods of breathing and relaxation techniques are frequent and helpful to alleviate the pain of labor. Other techniques used to prepare the mother for natural childbirth include hypnosis Yoga, massage, walking, relaxing music, bathing in lukewarm water and Jacuzzi.

  Complications of childbirth

 
The delivery complications can occur during any periods of confinement and require a rapid and effective action to prevent damage to the mother and her baby. The progression of childbirth may not be very weak uterine contractions irregular or non-cervical dilation and it is usually with intravenous oxytocin or synthetic prostaglandin gel topical neck. It may also be due to a pelvic disproportion fetus due to fetal macrosomia or pelvic narrowness of the channel.
The fetal distress is the emergence of signs that the deterioration of biophysical fetus. The term fetal distress lately is falling into disuse in the clinical literature, and is using the “suspicion of fetal loss of welfare ‘or’ final loss of fetal well-being.” The signs to which reference basically did before the alteration of the normal pattern of the fetal heart rate. It monitors the mother with a tococardiography fetal which establishes a certain relationship of two variables that are fetal heart rate and the frequency and intensity of uterine contractions. In turn another sign that suggests the loss of fetal well-being, is the emergence of amniotic fluid or dyed green meconium (fetal feces), which is expelled when the fetus circumstantial or has a chronic form shortfall in the supply of oxygen.
Both the non-progression of childbirth as shortening the period of expansion, either by forceps, treats fetal distress vacuum extractor or practicing emergency caesarean section. Puerperal fever has in the past been a major cause of maternal death because of the poor asepsis during childbirth, as well as the increased susceptibility to infection by the mother if you have anemia or malnutrition. For childbirth elapses in the most physiologically possible both the mother and her partner must be adequately prepared for the “proof” that they face.

  Psychological aspects of childbirth

Giving birth can be a stressful event for women, their partners and both families. Some women reported symptoms consistent with post-traumatic stress disorder following childbirth. The postpartum depression is more prevalent or postnatal women who give birth to their partners and family companions. Studies show between 5% and 25% prevalence but methodological differences of these studies is that the true prevalence rate is not clear. The fear or phobia is called tocofobia childbirth.
If it persists without being treated, postpartum depression may promote the occurrence of situations of child abuse and neglect. The prophylactic treatment of postnatal depression has proved eficaz in clinical studies. The incidence variable in various regions of the world seems to draw a factor socio-cultural located conducive to onset of postpartum mood disorders. 

  Social aspects of the childbird

 Childbirth, which in most cases occurs without incident, it has become a high-tech medical process, which occurs in priories large hospitals, with a team composed of multidisciplinary health obstetrician, midwife, an anesthetist, a pediatrician, and so on. In most cultures of the world, birth is considered the beginning of the life of an individual and his age defined relative to the date of delivery. The location where the birth occurs is an important factor in determining the nationality of the newborn, especially in cases where the birth takes place outside the country of origin of their parents, such as birth aircraft, boats or for tourism.

  Cesarean

  In Western society of the developed countries the birth of a child has been medicalized to dangerous extremes, where the emphasis is on obtaining a healthy baby at any price and where it tends to the growing practice of births by caesarean section. Sometimes cesareans are more common in private hospitals than in public for various reasons. The birth was conceived by certain elements of society as a painful process, almost like an illness, when it is a physiological process in which the pain is present. There is much panic pain, spinal anesthesia (epidural) is a medical act increasingly frequent deliveries of the Western world.

  Participation of family

Childbirth, where the main actors are the mother and the child who is born, traditionally the father had been deprived of the presence and collaboration in childbirth. In some societies childbirth is vetoed all male. In the last decades of the twentieth century, the father ever had more active presence. 

Occasionally referred to women who experience an orgasm during childbirth. There are similar events during an orgasm and giving birth, both involving involuntary contractions of muscles many common. The orgasm releases endorphins, which helps mediate pain, as well as the hormone oxytocin, which plays an important role in childbirth and the mother-child attachment. Some authors suggest that orgasm during or shortly before delivery can be interpreted as a painful event because of the expectation of uterine contractions during dynamics.
For 2007, the discussion of this phenomenon was absent in the medical and scientific literature. The only partnerships between orgasm and give birth are based on the way in which new mothers experiencing their orgasms after childbirth compared with their experiences before their first childbirth. This relationship pre - and post-natal the experience of orgasm can bring into relief some etiology of dyspareunia and orgasms inhibited after pregnancy.

Chickenpox is a contagious disease caused by the varicella-zoster virus, a virus of the herpes family that is also causing shingles. It is one of the classics of childhood diseases, which in children is often mild but in adolescents and adults have a higher risk of complications. The illness lasts about a week.

Epidemiology

Chickenpox can be seen at any time of year, although it is more common in the winter and spring. The virus was only transmitted from person to person, either by direct contact with skin lesions or by air to eject through coughing or sneezing. The incubation period appears until the disease is 2 to 3 weeks. Patients are contagious from approximately 2 days before the rash appears until about 5 days later (when all the blisters have dried and have become crusts). It can be contracted chickenpox from injury of a person with herpes zoster.The family contacts (those who contracted the disease from another member of his family) usually show more severe forms that the first cases, probably by a more intense and continuous contact with the virus. Chickenpox is highly contagious, so that when there is a sick person at home 80-90% of the people who live there could end up contracting the disease.

Chickenpox usually heal in 7-10 days and generates permanent immunity, which is reinforced by regular exposure to the virus. However, there are instances in which loses immunity and second episodes occurring chickenpox, but are exceptional. After spending some chickenpox virus refuge in the lymph sensory neurons, where they remain inactive. In some people after many years the virus reactivates and appears herpes zoster, or shingles.

Clinical signs and symptoms

The most characteristic sign of Chickenpox is a rash that appears in the form of small grains that in a short time become vesicles (blisters filled with fluid). The vesicles usually appear first on the face, scalp and trunk, then spread throughout the body. It may also affect the mouth and the vulva. One or two days after the vesicles become scabs. During the first few days are several waves of vesicles, which can be viewed at the same time in several injuries evolutionary phases (known as pattern “starry sky”). The skin lesions are usually pruritic (snack).

In the proteomic period (the time that elapses before the rash appears, usually one or two days before) usually present other symptoms such as fever, headache, malaise, loss of appetite and / or vomiting. These symptoms tend to persist during the first days of illness.

Complications

Although chickenpox is generally a benign disease, sometimes appears complications, especially among adolescents, adults and people with low defenses. The most common are infections of the skin and subcutaneous tissue, favored by the scraping of injuries. Another complication is typical pneumonia, which can be caused by the varicella virus or bacteria. They are also typical neurological complications, especially cerebella ataxia (altered balance and unstable motion, which usually disappear by itself). Exceptionally are most serious complications such as encephalitis or necrotizing fasciitis.

Pregnant women who have not undergone chickenpox are particularly sensitive because, in addition to having a higher risk of complications, chickenpox can convey to the fetus. When chickenpox is contracted in the first two trimesters of pregnancy can cause congenital varicella in 1-2% of cases with neurological disorders, scars on the skin and eye and skeletal abnormalities. If chickenpox appears between 5 days before and 2 days after birth, it can causes in the newborn a very serious neonatal varicella.

Other possible complications are the second and subsequent resurgence, which is called Herpes Zoster. And it is more severe the higher the age of the person concerned, especially the possible post-herpetic neuralgia, a pain sometimes terrible intensity that can be permanently in the affected areas of skin. For these risks it is advisable to be vaccinated at a young age to avoid them if possible.

Diagnosis

Small eruptions may be seen typical patient with the varicela. Generally chickenpox diagnosed by their typical clinical signs, without specifying any type of analysis. The vesicular rash and pruritic in waves, especially if there is recent history of contact with a sick chickenpox, it is sufficient to establish the diagnosis.

For borderline cases or for research purposes can be used diagnostic tests to detect the virus in the fluid extracted from the vesicles, as the cultivation, immunofluorescence or reaction polymerase chain. To know whether a person is immune to chickenpox is used serology.

Treatment

Sleep and treatment as directed permissive with their drugs.

General measures

Some series of measures are often enough for healthy children to alleviate the symptoms. To fever is used paracetamol or ibuprofen, always avoiding aspirin (acetylsalicylic acid), which are being used for chickenpox is associated with Reye syndrome. Although the use ibuprofen in children with chickenpox was related in a case-control study with the emergence of necrotizing fasciitis, prospective studies have not found such an association. Itching can be alleviated through antipruriginics lotions or oral antihistamines, talcum powders of colloids, or of calamine lotion. Other measures that help prevent injuries by scraping and skin infections are cut nails and a daily bath with a mild soap. (The bathroom should be short so as not to encourage the emergence of more blisters).

It is important to isolate the sick during the contagious phase of those who have not passed the disease, especially those at greatest risk (adults, adolescents, pregnant or immunocompromised). Although traditionally in many places it is recommended to facilitate the spread of the children to prevent them from contracting the older they are, we must not forget that the chicken pox, although usually benign, can lead to serious complications. Today is available vaccines do not prevent the child will get sick but that the injuries are less severe.

The vaccine does not apply to those who have suffered and seek to avoid second and subsequent resurgence (or Culebrilla Herpes Zoster). It is experimenting with another vaccine that would be useful in these cases.

Prevention

Immunization: varicella vaccine

Vaccine against the varicella-zoster virus is a live attenuated virus vaccine that was developed in Japan in 70 years of the twentieth century, although it was not authorized until the next decade. All vaccines marketed at are present from the Oka, so named because it was isolated from the vesicles of a child of 3 years with that name. It is a very effective vaccine, particularly with respect to the most serious forms of chickenpox. In about 5% of those vaccinated can show mild eruption Varicella, with very few injuries, two or three weeks after vaccination.

The varicella vaccine was introduced in the childhood immunization schedule in the United States in 1995 for children from 12 months of age. Subsequently, other countries followed suit, such as Canada, Australia and Germany. In other countries such as Spain in 2005, has opted to vaccinate between 10-14 years of age to children who have not gone chickenpox. The vaccine is also useful to prevent or reduce the disease in susceptible individuals who have been exposed to the virus, if administered in the first 3 days after contact.

Passive Immunization: immunoglobulin
Immunoglobulin antivaricela administered intramuscularly, is used to prevent the disease in high-risk groups who have had contact with a sick chickenpox and who may not receive the vaccine, such as pregnant or immunocompromised newborn babies whose mothers have not gone chickenpox

The disease Charcot-Marie-Tooth disease, or CMT, is a prevalent neurological disease. This rare genetic disease generally affects about 1 birth in 2500 people. The CMT should not be confused with Charcot’s disease or amyotrophic lateral sclerosis, which is much more serious.
Described by three doctors in 1886, CMT is a hereditary sensory neuropathy driving, which does not affect life expectancy and does not lead to mental retardation. It equally affects men and women. Schematically, the CMT is linked to the achievement of the peripheral nerves, the spinal cord connects to muscles, which interferes with the conduction of impulses. It involves walking and often a distortion of the feet. The disease can occur quite late and even into adulthood. In general, the CMT is slowly changing but it can also pushed forward by. There are several types.

Demyelinating forms of CMT

 In these types of CMT, it is myelin, insulating sheath surrounding nerves, which is reached. It is causing a decline characteristic of the speed of transmission of impulses, often less than 20 m / s. This type of CMT often results from infancy by difficulties in gymnastics.
There are:

Disease Charcot-Marie-Tooth type 1, which is autosomal dominant transmission
Disease Charcot-Marie-Tooth type 4, whose transmission is autosomal recessive

Axonal forms of CMT

 In these types of CMT, the axon leading impulses, which is reached. The speed of conduction of impulses is not affected (on the order of 40 m / s), but the intensity of the electrical signal which is diminished. These are referred to as CMT disease Charcot-Marie-Tooth type 2. This type of CMT often begins around age 15.

Intermediate forms of CMT

It includes
Disease Charcot-Marie-Tooth type X, the transmission of which is dominant X-linked Autosomal dominant forms of intermediate CMT, where the speed of conduction of impulses is between 25 m / s and 40 m / s. The classification of these CMT is probably led to evolve as the advancement of knowledge. It is known as the DI-CMT acronyms. 

Chagas disease also called trypanosomiasis, is a tropical infection caused by a protozoan parasite, Trypanosoma cruzi. It is transmitted through an blood-sucking insect, Triatoma infestans, which transmits the parasite when zbistrimo on the bite that he has done for food. These insects carry various names according to the country, including benchuca, vinchuca, kissing bug, chipo, chupança, barbeiro and bedbugs. Other modes of transmission include less frequent eating food contaminated with the parasite, blood transfusions and fetal transmission. It is estimated that are infected with Chagas disease between 15 and 17 million people each year, of whom about 50,000 die.  The Trypanosome cruzi is a member of the same genus that the infectious agent that causes African sleeping sickness, and the same order that the agent that causes leishmaniasis, but its clinical features, geographical distribution, life cycle and its vector are significantly different  Carlos Chagas  disease was named in recognition of Brazilian medician and infectolog Carlos Chagas, who in 1909 had first described. At that time, the disease was not considered a public health problem of importance , but until the 1960’s, for example, the outbreak of Chagas disease in Brazil in the years 1920 went largely ignored. Chagas found that the intestines of Triatomidae housed a flagellate protozoan, a new species of the genus Trypanosoma, and was able to demonstrate experimentally that it could be transmitted to the genus Callithrix marmoset monkeys that had been chopped by the insect carrier. Subsequent studies showed that the squirrel monkey were also vulnerable to infection.
A pathogenic parasite that causes the disease, Chagas called Trypanosoma cruzi and then Schizotrypanum cruzi,  honor in both cases Oswaldo Cruz, the famous Brazilian physician and epidemiologist who successfully fought epidemics of yellow fever, smallpox and bubonic plague in Rio de Janeiro and other cities at the beginning of the 20th century. The work Chagas was special in the history of medicine, being the only investigator who could completely describe an infectious disease, ie pathogen, and its vector host, the clinical manifestations and epidemiology. However, Chagas mistakenly believed that the infection was mainly through the bite of insects rather than by the feces of this, proposed by his colleague Emile Brumpt in 1915 and demonstrated by Silveira Dias in 1932, Cardoso in 1938 and Brumpt same in 1939. Chagas was also the first to discover and illustrate the kind of fungus Pneumocystis parasite, and then link to the classic by pneumocystis pneumonia (PCP) in patients with AIDS. “[2] The entanglement between the two pathogens and their life cycles carried Chagas to define the protozao responsible for Chagas’ disease that belongs to the genus Schizotrypanum, but then that other researchers describe the pneumocysitis as an independent genre, Chagas returned to the use of the name Trypanosoma cruzi.
In Argentina often is called Chagas disease-Mazza, in honour of the Argentine doctor Salvador Mazza, who in 1926 began investigating the disease and over the years became the leading scholar of this disease in the country. As Chagas is a disease affecting prevalentemente the poor, were not given importance, and denied the medicine as pathology. In countries at risk include the test in the blood tests of patients who donate blood for transfusions in order to avoid contagion.
The importance of the work of Salvador Mazza lived precisely noted that the disease was a matter of relevance and preach in medical schools. However, this would only be accepted globally since the 1960’s, along with the great impact of the disease to public health.
In another historical point of view, are speculating on the possibility that Charles Darwin has suffered from the disease as a result of a bite of the so-called Great Black ace of the Pampas (vinchuca). The episode was reported by Darwin on his daily trip from Beagle.  In 1837, nearly a year after returning to England, he began to suffer a few common symptoms of intermittent, making becomes incapacitated for almost the rest of his life. Several attempts to examine the remains of Darwin in Westminster Abbey, using modern technology PCR has been denied by the curator of the museum.

Epidemiology  

World Health Organisation (WHO) estimates that the Chagas disease affects between 16-18 million people. About 100 million (25% of the population of Latin America) of people would be at risk of contracting the disease [3], and every year 50 thousand people would die. The chronic Chagas disease remains a major health problem in many countries Latin America, despite the effectiveness of preventive measures and hygienic standards, such as eliminating insect transmitters, which has reduced to zero the emergence of new infections in at least two countries in the region (Chile and Uruguay). With the increase in the migration of populations, the possibility of transmission by blood transfusion has become substantial in the United States. [10] Approximately 500,000 people infected live in the United States. Further, it was found that T. Cruzi has infected raccoons and marsupials in regions that stretch into North Carolina .
Chagas disease is distributed throughout America, from the southern United States to Argentina, mostly in poor and rural areas of Central and South America. The disease is set almost exclusively in rural areas, where the insect transmitter, corresponding to the subfamily losTriatominae can feed and reproduce in their natural reservoir (the most common are Armadillo and marsupials). Depending on the specific interactions local vectors and their hosts, other infected animals like humans, pets like cats, dogs, mice domestic and wild animals can also serve as reservoirs. Although Triatominae feed on birds, they seem to be immune to infection and therefore are not considered reservoirs of T. Cruzi, although there may be a link between birds as a source of insect food and proximity to human dwellings.   

 Clinical manifestations  

 Children with acute infection and swelling of the right eye (sign of Romagna). Source: CDC.En man, the disease has three stages: the acute phase, shortly after infection, and indeterminate phase chronic phase that can develop even after ten years.
In the acute phase, a local skin nodule called chagoma may appear at the site of inoculation. When the site of inoculation is the mucous membrane of the conjunctiva, the patient may develop periorbital oedema unilateral conjunctivitis and preauricular lymphadenitis. This constellation of events referred to as a sign of Romagna which is present in very few cases. The acute phase is usually asymptomatic, but can occur fever, anorexia, lymphadenopathy, mild hepatosplenomegaly and myocarditis. Some acute cases (10 to 20%) are resolved in a period of two to three months leading to a chronic asymptomatic phase now called indeterminate phase, which is characterized by persistent infection without presenting clinical problems only to reappear several years later.
The chronic phase is symptomatic and can appear years or even decades after the initial infection. The disease affects the nervous system, the digestive system and heart. Chronic Infection resulting in neurological disorders such as dementia, damage to the heart muscle (cardiomyopathy) and sometimes swelling of the digestive tract (megacolon and megaesophagus), and may also have weight loss. Problems swallowing can lead to malnutrition patient. After spending several years in an asymptomatic state, 27% of those infected develop cardiac damage, 6% will damage digestive and 3% presented with disorders of the peripheral nervous system. Without treatment, Chagas disease can be fatal, usually due to component cardiomyopathy.

Infection

 Triatoma infestansLos triatomine redúvidos, known as bug (in El Salvador), insect vector (in Ecuador, Bolivia, Chile and Argentina), chipo (in Venezuela), pito (Colombia), chirimacha (Peru) and barbeiro (Brazil) are hematophagous insects, ie sucking blood, living in the cracks, holes and spaces desaseados of houses and stores in the regions of South America and Central America. They become infected after biting an animal or person already suffering from the disease. In general, the infection spreads to humans when an infected insect feces deposited on the skin while the person is sleeping at night. The person often rubbed the stings, accidentally introducing feces into the wound, a cut open, eyes or mouth. The animals can be infected in the same way and also contracted the disease by eating an infected insect. Infected people may not show symptoms of the disease until 10 or 15 years after being infected, so their detection becomes more difficult.

Treatment

 In the initial phase acute, administration of drugs such as nifurtimox and benzinidazol heal completely and decrease the likelihood of chronicity in over 90% of cases. In Phase indeterminate (when no longer acute, but not yet show symptoms of the disease) treatment is effective but demonstrates healing in patients may take years. For that reason is that for many years some researchers argued that the treatment was not effective at this stage. The effect of nifurtimox, and benzinidazol in chronic phase has not yet been adequately tested. But there is treatment for the symptoms caused by damage to organs such as the heart and nervous system.

Chronic fatigue syndrome (abbreviation: CFS), formerly known as nervous fatigue or neurasthenia, consists of a state of fatigue reiterated that even after the rest, does not disappear. 

  History of chronic fatigue syndrome

 This syndrome has been identified in the Anglo-Saxon countries in the mid-1980’s. The World Health Organization sees it as a serious neurological disease, and it appears on the US list of new infectious diseases, recurrent and resistant to drugs.

The chronic fatigue syndrome is diagnosed by the absence of any other disorder that might explain the state of fatigue. Thus, in the absence of depression, cancer, endocrine disease, inflammatory or mental, is diagnosed chronic fatigue syndrome.

This syndrome is the subject of many scientific controversies, because of the difficulty of linking a wide variety of symptoms to a particular disease, and as a result of the lack of blood tests certainties. There is a double suffering on the one hand by the absence of satisfactory therapeutic solutions, and by the rejection, or the denial of the existence of their illness by the medical community and their entourage (sick imaginary).

In 1988 the Japanese Fukuda proposed a definition of this symptom with a grid of scores. The researcher is at the origin of isolation exact and precise symptoms of the disease, but today too many patients are still being treated for depression or chronic anxiety, while the disease would affect 1% of the population with symptoms more or less disabling. The higher intellectual professions are not affected by the SFC as other segments of the population, but they are the ones who visit the most and most complain of symptoms, the disease starts with difficulty concentrating and memory. After the stock market crash of 1987, it had mistakenly attributed the SFC as occupational disease psychosomatic brokers of the New York Stock Exchange because of the stress of their work, dismissing or ridiculing once again the reality of the disease.

Diagnosis of chronic fatigue syndrome

Standards for the diagnosis of chronic fatigue syndrome have been defined by the Center for Disease Control, “which defines a protocol in the guidelines for the early detection, diagnosis and monitoring of the SFC. This syndrome was identified in the Anglo-Saxon countries in the mid-80’s. The World Health Organization considers it a serious neurological disease and appears on the American list of new infectious diseases, recurrent and resistant to medication.

Those standards include:

Asthenia (fatigue) and intense fatigue easily, which does not decline with the sleep, even without having made physical effort
Home usually sudden, sometimes after a table similar to a flu. It can also occur after an infectious mononucleosis and other viral diseases
It starts with disorientation, loss of short-term memory, confusion and irritability (affectation neuro-cognictiva)
Sleep Disorders: Sleep not repairer and sleepiness.
Muscle pain.
Mialgica pharyngitis (sore throat).
Pain with palpation of lymph nodes in neck or armpit.
Mild fever (38.3 ° or less).
Headaches.
Fotofobia (hypersensitivity to light).
Duration of at least six months and may persist years. 

  Symptoms chronic fatigue syndrome

The SFC associate clinical signs two etiologies as fibromyalgia and irritable bowel. There are mixed forms (very disabling) of chronic fatigue syndrome which combines fibromyalgia and irritable bowel. The symptoms vary in terms of their degree of severity and presentation time. There are cases where the symptoms disappear for a while. It is known that chronic fatigue syndrome is not infectious, and the laboratory tests are of little value, although toxic components have been detected in some patients. The prevalence and intolerance for a wide variety of chemicals in many patients is called “multiple chemical sensitivity .
It is often closely linked to another rheumatic disease called fibromyalgy and / or Multiple Chemical. The SFC is not fatal, and does not reduce life expectancy, it is a crippling disease. In all forms of SFC found that fatigue is the main symptom, as well as peripheral symptoms:

Fibromyalgy
Irritable Colon = chronic diarrhea
Joint pain
Muscle Pain
Muscular Weakness
Migraines
Tachycardia
Cognitive Disorders
Tremor
Dizziness
Sudations
Depression
Generalized anxiety
It is considered that there is a genuine front SFC when fatigue is associated with at least 4 symptoms peripherals and systematically one of the first symptoms of peripheral list, however it may not point cause fainting.

  Causes of chronic fatigue syndrome 
 

The SFC has caused abnormally high production of interferon by the immune system in response to abnormal yeast and staphylococci naturally in the intestines, making the SFC in autoimmune diseases. The SFC is a breach of the tolerance of bacteria naturally present in the body. The failure follows a microbial or viral infection that caused this immune dysfunction.

The therapy is intended to eliminate the vectors that over-stimulate the patient’s immune system leading to its depletion and restore the natural ecosystem of the human body which rests on a delicate balance bacteria / antibodies.

However, in the absence of sufficient evidence replicable who demonstrate an organic etiology frankly independent psychosocial risks, and because of the very process that led to their clinical-definition process based on descriptions of symptoms grouped by infections statistically and rheumatologists and not demonstrate a specific physiology of their own-chronic fatigue syndrome and fibromyalgia-strongly correlated both with regard to demographic and psychiatric submitted by cohorts of subjects studied to date-continue ‘ moult be considered by researchers and clinicians as a manifestation psychosomatic that psychiatrists North American categorize under the name as  trouble.somatoform   

Cervical cancer is a form of cancer that develops anywhere in the cervix or in the lower portion of the uterus of a woman. Cervical cancer or uterine cervix is the third most common cancer in women, and it is the most frequently seen especially western-developed contries.  Cervical cancer is directly related to sexual activity. Indeed, long time, doctors have noticed that this cancer rarely appears in women who never have sex.   

Description  

Cervical cancer, as its name suggests, is located in the uterine cervix, and narrow lower portion of the uterus which flows into the vagina. At this point, the cells of the cervix are malignizan causing cancer.

Causes and risk factors 

Human Papilloma Virus
Having an active sex life early (before age 18)
Having multiple sexual partners.
 genital warts.
Snuff.
Alcohol
Have cervical dysplasia (abnormalities in the size, shape and number of cervical cells).
Other factors that may contribute include: The use of oral contraceptives.
 genital herpes.
Being exposed to the synthetic DES hormone before birth.

  Signs and symptoms

The main symptoms are:

Abnormal Bleeding
Increased vaginal discharge
Pain in the pubis
Pain during intercourse.

  Call the doctor An incipient cervical cancer rarely causes symptoms, so that the Pap smear is essential. However, any flow or abnormal bleeding from the vagina need immediate medical research. While these symptoms may be caused by other problems, could also indicate cervical cancer.

The result of abnormal Pap smears, examination in which a sample is extracted from cells of the cervix, which are then evaluated in a laboratory, is the initial diagnosis. The test results are given in 5 “classes” ranging from class 1 (normal) to Class 5 (invasive cancer present). Classes 2 to 5 require further analysis including biopsy, (take a small piece of tissue to study it) in order to determine the nature and extent of anomalies and for diagnosing cancer.

The Pap makes the physician recommends other evidence in order to more clearly establish the diagnosis:

Colposcopy: Technique to study the cervix, or neck of the uterus through the vision) to discuss the cervical cells in more detail with special equipment increased. Conization is a more extensive biopsy in which extracts a wedge of the cervix.

Biopsy is an extract sample to be studied with a microscope. Curettage takes samples for uterine cervical canal and uterus and thus makes examinations under the microscope.

During the pelvic examination can be used a special device called colposcope

If confirmed the presence of cervical cancer, can be recommended other tests to determine how far the disease has spread.

These may include:

Analysis of blood and urine. Radiographs and ultrasound examinations of the pelvic and abdominal areas.

Treatment  

 Treatment depends on the diagnosis. According to the extent of the cancer, treatment can consist of one or more therapies: Surgery, ranging from the removal of the abnormal tissue, only until the cervix complete, and also of the entire uterus and other adjacent tissues. Radiation therapy for killing cancer cells may apply after surgery. Chemotherapy that destroying cancer cells that have on the body by drugs is another important treatment method. An emerging and non-invasive cancer (carcinoma in situ) can be treated with a minimum operation, while an invasive cancer often requires a hysterectomy (removal of the cervix and uterus and possibly other organs of the pelvis.The treatment of dysplasia and incipient cancers has a high success rate. The survival rate at 5 years for women with carcinoma is almost 100 percent. However, if the disease is already invasive treatment efficacy declines. The 5-year survival for all patients of cervical cancer is 66 percent. Even after successful treatment, women should consult a doctor regularly.   Prevention [ How to guard against cervical cancer:Perform Pap smears on a regular basis
Avoid relationships with multiple sex partners.
No smoking.
Do not drink
If you have a history of genital warts, get a Pap smear every 6 months
If you have more than one sexual partner, insist on using condoms to prevent the transmission of a sexually transmitted disease.
Recently approved vaccine against cervical cancer, and in some countries it is used, the vaccine is recommended for women over 11 years. Remember that the vaccine prevents this type of cancer but not cure, remember that no vaccine cure, but all prevent a given disease. This does not imply that not be complied with the various precautions listed above.