Painlessly to determine the level of glucose in the blood can now be using a special device - a touch of gas analyzer or atsetonomera.
The fact that this will give people with diabetes, says one of the developers of the project, Ph.D., deputy director of the Moscow Center for Analysis of Substances "Vitaly V. Baranov.
- Until recently, medicine was not taken into account the fact that the air exhaled by man, there is acetone. And in quite a fair brand name viagra amount - from 1 to 5 milligrams per cubic meter. Besides acetone in exhaled air appears much earlier than in the urine.
Its concentration is created in the body due to incomplete oxidation of fats and proteins. The result is energy, and the lack of which often leads to such serious diseases as diabetes. Simply put, there is a direct correlation between the disease and the content of acetone in the air exhaled by man. This conclusion was the basis for creating a new instrument, which we call touch the gas analyzer, or atsetonomerom. - And why diabetics need to monitor acetone in blood and exhaled air? - Because otherwise you can not control the flow and the blood fatty acids, or, as they are called specialists, ketone bodies. Until recently, patients with diabetes mellitus were simply unable to ignore these processes.
But with the accumulation of ketone bodies lowers the pH of the blood, which is a very alarming symptom, which can lead to diabetic coma. In other words, information about the acetone is for diabetics is not as important as knowledge of the concentration of glucose in the blood. In addition, the data shows a device can be used to control blood sugar. In general, the device can significantly enhance and supplement the system of monitoring human health - control blood sugar in the morning after sleep and at night before bedtime, the definition of the content of acetone was constantly on the exhalation, at any time convenient to you. There are a number of advantages that became obvious after testing the new device. It turned out that he can help in the following cases: l for the diagnosis of patients with so-called family-diabetes, which often can not recognize for a long time;
l for the control of people's health, reduces weight;
l for athletes;
l for the diagnosis and treatment of childhood diabetes, as the state of the sick child can be determined quickly, painlessly and without trauma. - What is the appliance? It is in circulation?
- The device is small size, is placed in an ordinary briefcase. " The appeal is quite simple. Analysis time is 10 to 300 seconds - it depends on the concentration of acetone in the sample. In addition, as determined by acetone in exhaled air analysis is absolutely painless and even a comfortable, patient is able to serve itself, without help. And, in my opinion most importantly, there was, finally, the possibility is continuous monitoring of glucose metabolism of the organism without causing yourself microtraumas. You just need to know that the presence of acetone in exhaled air above the norm is a sufficient indication that the carbohydrate metabolism you have been violated.
Regardless of the causes of this disorder should consult a physician, endocrinologist, since it does not exclude the development of diabetes. For comparison, I note that blood Viagra getting rid of impotence and even more glucose concentrations, even far above the norm. is not always indicative of a glucose metabolism. In this sense, the device - no doubt a major breakthrough in solving the problem of painless and accurate diagnosis of diabetes.
Bone marrow stem cells
Kindergarten
mercredi 29 décembre 2010
lundi 27 décembre 2010
Intracranial pressure
Imagine a woman interested in issues of child health and has not heard of intracranial pressure - intracranial pressure, it is simply impossible.
Phrases such as "we have intracranial" or "we treat intracranial pressure is so firmly established in the lexicon of the average visitor to child health clinics, many simply stopped thinking about the meaning of those words.
Nevertheless, the frequency of calls, the frequency of diagnosis and frequency of treatment - does not suggest that the very notion of intracranial pressure or a diagnosis of increased intracranial pressure, in turn, understood by the masses of workers.
Although at first glance, everything seems as obvious. And the essence of the problems (in terms of average man) looks like. Have a head. Inside there is a brain, blood vessels, in vessels of pressure - it is there all know - get out and pressure the grandmother and grandfather. But the grandparents heart is damaged, while a child is different. The heart of a healthy, but the pregnancy was unsuccessful, during childbirth, not enough oxygen, or the umbilical cord wrapped, or even what a sore befallen, or banged his head, or a medicine given bad - that's blood vessels and damaged, and now the pressure in his head high, hence the pile problems: a headache, crying, does not listen to mom, not sleeping, trembling chin, pulling his foot, walking on tiptoe, bad (wrong) said fighting in the sandbox, thumb-sucking, refuses to eat and tens if not hundreds, of the consequences of these injuries -promotions. And as the above complaints, the symptoms may be a greater or lesser degree in virtually every child, so it becomes easily understandable why the presence, in fact, an epidemic of intracranial pressure, and the epidemic is gaining momentum. Of course, doctors are struggling with it actively, and most children recover well - thanks to medicine, or both would say the classic: "Glory, glory Dolittle! Glory to the good doctor! "
Trying to doctor to approach the problem of intracranial pressure correctly, modern, treated as in the world's best hospitals - not to be implemented. For CIS countries the epidemic is sweeping treatment of intracranial pressure is limited by these countries. That is, our overseas friends, somehow detached from the topic - whether misunderstood and disregard relate to the neurological health of children, it is not diagnosed, or whether they have other children?
Perhaps something is wrong here: how it can be a disease which neurologists detect children in our clinics for at least 50% of children (this is the most-presamaya optimistic figure), and at the same time, the disease completely absent outside the CIS .
No, the phrase ICP is, its increase is regarded in brand name viagra scientific articles, in fact, the tactics of struggle against this very dangerous phenomenon of study, but the list of states associated with an increased intracranial pressure, very small, and it's more creepy horror such a diagnosis that can be easily done conclusion: with increasing intracranial pressure, can be accessed quickly in an emergency department and intensive care, than sit through all the reception to a pediatric neurologist at the district hospital.
That is, globally here and there approaches to ICD fundamentally different: it is very rare, very dangerous (threatening life and health) status, usually requiring hospitalization and emergency room, well, we have - a very common disease, easily diagnosed, almost always easy to cure and almost always on an outpatient basis.
No, something is definitely wrong. And it seems necessary to understand: either we are something we do not understand, or we amicably misleading, or our children are special - not like the rest of the world. Since the last statement seems very unlikely, but to be misguided and neponyavshimi really do not want - look at the theme slowly and in order.
So what is the ICP and where does it come from? That at that crushes and how it all goes?
In the cranial cavity is a brain, there is blood, there is a special fluid called liquor (synonym - cerebrospinal fluid). CSF is formed from the blood to specific vascular plexus, circulates, washing the brain and spinal cord, and then again absorbed into the blood through special venous sinuses. CSF has a number of important functions, without the implementation of these functions is simply not possible the normal function of the brain.
Liquor is not standing still, and in the same way as blood, all the while moving. For the movement of blood is blood vessels. For fluid motions have special anatomical cavity - brain ventricles and spinal canal.
That is to say, elementary, to be precise - surface-primitive anatomical and physiological information.
But now you can understand where intracranial pressure is taken. Thus, some fluid is constantly formed and continuously absorbed. You probably have remembered the school with math puzzles about the pool, and two pipes - just as with liquor. From one tube (vascular plexus) - follows in the other tube (venous sinus) - flows. While it flows, puts pressure on the pool wall (inner surface of the ventricles of the brain and the spinal canal).
That's all.
Now, some obvious conclusions.
Intracranial pressure is at all, just as they all have noses, hands and priests. The phrase "my child intracranial" at least funny and certainly no indication that this child has something that others do not.
Another issue is that the specific figures indicating the value of intracranial pressure in a specific period of time, do not have a concept of stable, which actually derives from the fact that the intracranial pressure and changes all the time. And the formation of CSF, and its velocity, and the activity of absorption depends on many factors: the child is asleep or awake, lying, sitting or standing, silent or crying, normal body temperature or increased, and in general what the temperature around - comfortable, or hot, or cold. Link-level ICP with all the listed parameters is not obvious at first glance, but the ultimate illustration: if the room is hot and the child is actively sweating, blood clots occur as a result - reduced the rate at which the vascular plexus will produce liquor. It is clear that many of the variety of diseases will in turn affect the level of intracranial pressure - and vomiting, and cough, and prolonged crying, and painful incubation on the pot in connection with constipation, and much more.
And in this aspect may be entirely appropriate analogy between blood pressure and intracranial.
I absolutely healthy child, it is not suffering from hypertension, blood pressure can vary quite widely. Ran, wept, laughed, got scared - to increase; sleep, calmed down, his breath - has dropped. But a concrete and obvious physiological fact fluctuations in blood pressure from anyone because no cause desire to run for a child with a tonometer and constantly pressure is correct.
With ICP situation is exactly the same, but logic and common sense do not answer the basic question: why is the level of ICP and its fluctuations is given so much attention? Why talk about the ICD as popular as he was allegedly treated so common?
The answer we give a little bit later, but now let's talk about actually increased intracranial pressure (synonym - intracranial hypertension).
From the perspective of a modern, civilized, and evidence-based medicine, increased intracranial pressure - is one manifestation of a number of diseases. Rare diseases and very serious. I emphasize again: intracranial hypertension is not a disease, not an independent disease but a symptom of other very specific and certain diseases. In order to significantly increased ICP must implement certain pre-conditions, such as sharply increased production of liquor, what happens when meningitis and encephalitis. All the defeat of the substance of the brain: stroke, tumor, abscess, trauma - also affects all three factors that determine the level of intracranial pressure - and the production of liquor, and its absorption, and its circulation. The excess production of cerebrospinal fluid can be observed in some very serious metabolic disorders, such as very severe forms of diabetes.
Nevertheless, there is quite a particular disease, when the rise in intracranial pressure is quite palpable - hydrocephalus. Hydrocephalus is usually associated with congenital abnormalities of the brain, or when there is a very active production of CSF, or violated reabsorption of CSF, or because of certain anatomical defects in violation of its circulation, or when there is a combination of these factors. Sometimes the hydrocephalus is not congenital, but arises as a complication after a very severe disease (meningoencephalitis, for example) and neurosurgical intervention.
With hydrocephalus, the excess or not in the CSF exit puts pressure on the ventricles of the brain, they are seriously expanding, a consequence of all this - the rapid increase in head size, a corresponding increase in the size of the fontanelles, gapping between the bones of the skull. Hydrocephalus can be of different severity. Compensated forms, when not suffering from mental development and the symptoms are mild, are treated conservatively, with special drugs that reduce CSF production and outflow of activating it, well, and in severe variants of the disease is carried out fairly complex neurosurgical operations.
It is clear that hydrocephalus is not befall all at once - ie, walking myself walking normal in all respects a child, and suddenly you - on level ground hydrocephalus happened. Hydrocephalus - congenital disease and its symptoms are already in the first months of life.
Because the main symptom of hydrocephalus - a rapid increase in head size, measure the head circumference is in the Lucky standards of any routine inspection, starting, of course, from the moment of birth. It is very important to emphasize that the value has no concrete, expressed in centimeters size, namely the dynamics of this indicator. That is, the statement of the fact that the boy Petit in 3 months the head circumference is already 45 cm - does not cause depressed and urgently to rescue the boy. But the fact that the head circumference increased over the past month at 7 cm - is already alarming and dangerous, and requires a serious attitude, and active control. I stress again - no immediate treatment, namely, control. And if the trend continues - and even then take action.
Nevertheless, hydrocephalus, which we have dedicated four whole paragraphs - quite a rare disease and occurs with a frequency of 1 to 4.2 thousand children. A problem with the intracranial pressure detected almost every second child - a paradoxical situation ...
Here is another problem looms. When a child is growing rapidly in size head, so all the increase in intracranial pressure can be seen - look how crushes ... But when everything seems as normal, but the doctor looked at me and says - high blood pressure, should be treated, how he found out about this? Based on what parameters, indicators and symptoms?
When it comes to high blood pressure with my grandmother, because here everything seems to be clear - to get the device (tonometer) measured - yes, high blood pressure - 190 to 120. Offered treatment, and measured again - we see clearly was the best - 160 for 90 - thus treated is not in vain, and the right medicine ... Plus, the improvement was not limited because only a change in numbers. Grandma was really bad - a headache, could not even stand up, and now where is it, exactly? In the store for potatoes ran - well, it certainly means that helped ...
And with the ICD as to be - where to get a magic device, to show - that is, Mom, look how high intracranial pressure. That drug - save yourselves. Come in a week, compete once again, we'll see.
And here we must sadly admit: there is no such device! No magic, no real, no roads, no cheap - no no!
With all the wonderful progress of medical science, with all the variety of special equipment to measure intracranial pressure significantly only one way: to introduce a needle into the spinal canal (lumbar puncture), or in the ventricles of the brain. Once the needle begins to flow from the cerebrospinal fluid, connects the simplest gauge - a graded glass tube. Measurement is performed on the same principle as in an ordinary home alcohol or mercury thermometer: the level of fluid (CSF) corresponds to the specific lines and specific numbers on the glass tube. Cerebrospinal fluid pressure is generally measured in millimeters of water column. Incidentally, it should be noted that so far, among academics there is no single opinion about to what intracranial pressure as normal. Some argue that the norm - from 80 to 140 mm of water. Art., others insist that the boundaries of the norm is much wider and the pressure may well vary from 60 to 200 mm of water. Art. The above rules - for horizontal body position. If the patient is sitting, the rules are quite different.
But the main thing for us is not in specific numbers, but in ascertaining the fact that the simple, affordable, convenient and at the same time reliable way of measuring intracranial pressure does not exist. It is understandable after all, that any talk of a puncture in the outpatient - is simply not serious.
There are nevertheless survey methods, allowing to infer the value of intracranial pressure in a number of indirect signs.
One of those methods - ultrasonography (USG) of the brain. This method is not used in adults, because ultrasound can not penetrate the skull. In children, the situation is quite different, since there fontanelle - a wonderful window for the ultrasound. Neurosonography, namely the so-called ultrasound of the brain - a method available and is absolutely safe. It allows us to estimate the size of brain ventricles, and the increase of this size may well be regarded as an indirect sign of increased intracranial pressure. At the same time, as with the head circumference is important is not so much the width of the ventricles of the brain, how the dynamics of this indicator.
After the closure of fontanel see and appreciate the size of the ventricles of the brain can only help tomography - computerized (CT) or magnetic resonance imaging (MRI). At the same time tomography - a method of serious, unsafe, expensive, it is used rarely - only when the real suspicions of serious intracranial pathology.
Another method - an outdated but still used quite widely - echoencephalograph (EhoEG). With the help of a special apparatus (echoencephalograph) through all of the same ultrasound estimated number of parameters, including pulsation of cerebral vessels. The amplitude of vibration of the ultrasonic signal is regarded as an indicator that could assess ICP.
We emphasize once more: all of these methods are not reliable, they do not ascertain, do not argue, but only allow for the possibility, suggested, allow suspected increase in intracranial pressure.
So it turns out as a result: Existing to date survey methods only give the doctor additional information for consideration, but to dot the i can not. Hence, relying mainly on account of specific symptoms. Here my problem: it is not you Granny, which is under increased pressure - is as normal - running to the shops. This is a very young child, rather malomesyachnoe, which is unreasonable and anything not specifically zhaluyuscheesya.
But the problems not only in age and the inability of a finger to point to the place where it hurts. The main problem is that almost all the symptoms that can be suspected in a child raising intracranial pressure can occur in perfectly healthy children.
For example, the child's anxiety, trembling limbs, cries could be signs of increased intracranial pressure, but it may not have to ICP generally irrelevant. And it can either confirm the mother, because to find a child, always quiet, and who never would have nothing trembling, it is simply impossible. Another symptom of increasing intracranial pressure - a squint, but it is common knowledge that infants have not yet formed the eye muscles and infant squint every now and physiological phenomenon, ie, completely normal.
It should nevertheless acknowledge: words such as "anxiety", "shake", "cries" and "Strabismus", not able to seriously scare the above average domestic Mom, because everyone's ears and are often used in everyday life.
It is quite another thing when a doctor from the mouth to be heard, or at an outpatient card found such terrible expressions as "a symptom of Graefe," or "spontaneous reflex Moro" - there is no place for jokes and not to peace: it is clear in fact that the situation is serious.
We will try to explain what these wise words.
The essence of the symptom Graefe - behind the upper eyelid moving downward eyeball. In a further translation into Russian, this means that when a child looking down, frightened, then over the iris of the eye can see a few millimeters whites of the eyes. Looks like a goggle-eyed. If the child looks straight, then everything is fine.
Phrases such as "we have intracranial" or "we treat intracranial pressure is so firmly established in the lexicon of the average visitor to child health clinics, many simply stopped thinking about the meaning of those words.
Nevertheless, the frequency of calls, the frequency of diagnosis and frequency of treatment - does not suggest that the very notion of intracranial pressure or a diagnosis of increased intracranial pressure, in turn, understood by the masses of workers.
Although at first glance, everything seems as obvious. And the essence of the problems (in terms of average man) looks like. Have a head. Inside there is a brain, blood vessels, in vessels of pressure - it is there all know - get out and pressure the grandmother and grandfather. But the grandparents heart is damaged, while a child is different. The heart of a healthy, but the pregnancy was unsuccessful, during childbirth, not enough oxygen, or the umbilical cord wrapped, or even what a sore befallen, or banged his head, or a medicine given bad - that's blood vessels and damaged, and now the pressure in his head high, hence the pile problems: a headache, crying, does not listen to mom, not sleeping, trembling chin, pulling his foot, walking on tiptoe, bad (wrong) said fighting in the sandbox, thumb-sucking, refuses to eat and tens if not hundreds, of the consequences of these injuries -promotions. And as the above complaints, the symptoms may be a greater or lesser degree in virtually every child, so it becomes easily understandable why the presence, in fact, an epidemic of intracranial pressure, and the epidemic is gaining momentum. Of course, doctors are struggling with it actively, and most children recover well - thanks to medicine, or both would say the classic: "Glory, glory Dolittle! Glory to the good doctor! "
Trying to doctor to approach the problem of intracranial pressure correctly, modern, treated as in the world's best hospitals - not to be implemented. For CIS countries the epidemic is sweeping treatment of intracranial pressure is limited by these countries. That is, our overseas friends, somehow detached from the topic - whether misunderstood and disregard relate to the neurological health of children, it is not diagnosed, or whether they have other children?
Perhaps something is wrong here: how it can be a disease which neurologists detect children in our clinics for at least 50% of children (this is the most-presamaya optimistic figure), and at the same time, the disease completely absent outside the CIS .
No, the phrase ICP is, its increase is regarded in brand name viagra scientific articles, in fact, the tactics of struggle against this very dangerous phenomenon of study, but the list of states associated with an increased intracranial pressure, very small, and it's more creepy horror such a diagnosis that can be easily done conclusion: with increasing intracranial pressure, can be accessed quickly in an emergency department and intensive care, than sit through all the reception to a pediatric neurologist at the district hospital.
That is, globally here and there approaches to ICD fundamentally different: it is very rare, very dangerous (threatening life and health) status, usually requiring hospitalization and emergency room, well, we have - a very common disease, easily diagnosed, almost always easy to cure and almost always on an outpatient basis.
No, something is definitely wrong. And it seems necessary to understand: either we are something we do not understand, or we amicably misleading, or our children are special - not like the rest of the world. Since the last statement seems very unlikely, but to be misguided and neponyavshimi really do not want - look at the theme slowly and in order.
So what is the ICP and where does it come from? That at that crushes and how it all goes?
In the cranial cavity is a brain, there is blood, there is a special fluid called liquor (synonym - cerebrospinal fluid). CSF is formed from the blood to specific vascular plexus, circulates, washing the brain and spinal cord, and then again absorbed into the blood through special venous sinuses. CSF has a number of important functions, without the implementation of these functions is simply not possible the normal function of the brain.
Liquor is not standing still, and in the same way as blood, all the while moving. For the movement of blood is blood vessels. For fluid motions have special anatomical cavity - brain ventricles and spinal canal.
That is to say, elementary, to be precise - surface-primitive anatomical and physiological information.
But now you can understand where intracranial pressure is taken. Thus, some fluid is constantly formed and continuously absorbed. You probably have remembered the school with math puzzles about the pool, and two pipes - just as with liquor. From one tube (vascular plexus) - follows in the other tube (venous sinus) - flows. While it flows, puts pressure on the pool wall (inner surface of the ventricles of the brain and the spinal canal).
That's all.
Now, some obvious conclusions.
Intracranial pressure is at all, just as they all have noses, hands and priests. The phrase "my child intracranial" at least funny and certainly no indication that this child has something that others do not.
Another issue is that the specific figures indicating the value of intracranial pressure in a specific period of time, do not have a concept of stable, which actually derives from the fact that the intracranial pressure and changes all the time. And the formation of CSF, and its velocity, and the activity of absorption depends on many factors: the child is asleep or awake, lying, sitting or standing, silent or crying, normal body temperature or increased, and in general what the temperature around - comfortable, or hot, or cold. Link-level ICP with all the listed parameters is not obvious at first glance, but the ultimate illustration: if the room is hot and the child is actively sweating, blood clots occur as a result - reduced the rate at which the vascular plexus will produce liquor. It is clear that many of the variety of diseases will in turn affect the level of intracranial pressure - and vomiting, and cough, and prolonged crying, and painful incubation on the pot in connection with constipation, and much more.
And in this aspect may be entirely appropriate analogy between blood pressure and intracranial.
I absolutely healthy child, it is not suffering from hypertension, blood pressure can vary quite widely. Ran, wept, laughed, got scared - to increase; sleep, calmed down, his breath - has dropped. But a concrete and obvious physiological fact fluctuations in blood pressure from anyone because no cause desire to run for a child with a tonometer and constantly pressure is correct.
With ICP situation is exactly the same, but logic and common sense do not answer the basic question: why is the level of ICP and its fluctuations is given so much attention? Why talk about the ICD as popular as he was allegedly treated so common?
The answer we give a little bit later, but now let's talk about actually increased intracranial pressure (synonym - intracranial hypertension).
From the perspective of a modern, civilized, and evidence-based medicine, increased intracranial pressure - is one manifestation of a number of diseases. Rare diseases and very serious. I emphasize again: intracranial hypertension is not a disease, not an independent disease but a symptom of other very specific and certain diseases. In order to significantly increased ICP must implement certain pre-conditions, such as sharply increased production of liquor, what happens when meningitis and encephalitis. All the defeat of the substance of the brain: stroke, tumor, abscess, trauma - also affects all three factors that determine the level of intracranial pressure - and the production of liquor, and its absorption, and its circulation. The excess production of cerebrospinal fluid can be observed in some very serious metabolic disorders, such as very severe forms of diabetes.
Nevertheless, there is quite a particular disease, when the rise in intracranial pressure is quite palpable - hydrocephalus. Hydrocephalus is usually associated with congenital abnormalities of the brain, or when there is a very active production of CSF, or violated reabsorption of CSF, or because of certain anatomical defects in violation of its circulation, or when there is a combination of these factors. Sometimes the hydrocephalus is not congenital, but arises as a complication after a very severe disease (meningoencephalitis, for example) and neurosurgical intervention.
With hydrocephalus, the excess or not in the CSF exit puts pressure on the ventricles of the brain, they are seriously expanding, a consequence of all this - the rapid increase in head size, a corresponding increase in the size of the fontanelles, gapping between the bones of the skull. Hydrocephalus can be of different severity. Compensated forms, when not suffering from mental development and the symptoms are mild, are treated conservatively, with special drugs that reduce CSF production and outflow of activating it, well, and in severe variants of the disease is carried out fairly complex neurosurgical operations.
It is clear that hydrocephalus is not befall all at once - ie, walking myself walking normal in all respects a child, and suddenly you - on level ground hydrocephalus happened. Hydrocephalus - congenital disease and its symptoms are already in the first months of life.
Because the main symptom of hydrocephalus - a rapid increase in head size, measure the head circumference is in the Lucky standards of any routine inspection, starting, of course, from the moment of birth. It is very important to emphasize that the value has no concrete, expressed in centimeters size, namely the dynamics of this indicator. That is, the statement of the fact that the boy Petit in 3 months the head circumference is already 45 cm - does not cause depressed and urgently to rescue the boy. But the fact that the head circumference increased over the past month at 7 cm - is already alarming and dangerous, and requires a serious attitude, and active control. I stress again - no immediate treatment, namely, control. And if the trend continues - and even then take action.
Nevertheless, hydrocephalus, which we have dedicated four whole paragraphs - quite a rare disease and occurs with a frequency of 1 to 4.2 thousand children. A problem with the intracranial pressure detected almost every second child - a paradoxical situation ...
Here is another problem looms. When a child is growing rapidly in size head, so all the increase in intracranial pressure can be seen - look how crushes ... But when everything seems as normal, but the doctor looked at me and says - high blood pressure, should be treated, how he found out about this? Based on what parameters, indicators and symptoms?
When it comes to high blood pressure with my grandmother, because here everything seems to be clear - to get the device (tonometer) measured - yes, high blood pressure - 190 to 120. Offered treatment, and measured again - we see clearly was the best - 160 for 90 - thus treated is not in vain, and the right medicine ... Plus, the improvement was not limited because only a change in numbers. Grandma was really bad - a headache, could not even stand up, and now where is it, exactly? In the store for potatoes ran - well, it certainly means that helped ...
And with the ICD as to be - where to get a magic device, to show - that is, Mom, look how high intracranial pressure. That drug - save yourselves. Come in a week, compete once again, we'll see.
And here we must sadly admit: there is no such device! No magic, no real, no roads, no cheap - no no!
With all the wonderful progress of medical science, with all the variety of special equipment to measure intracranial pressure significantly only one way: to introduce a needle into the spinal canal (lumbar puncture), or in the ventricles of the brain. Once the needle begins to flow from the cerebrospinal fluid, connects the simplest gauge - a graded glass tube. Measurement is performed on the same principle as in an ordinary home alcohol or mercury thermometer: the level of fluid (CSF) corresponds to the specific lines and specific numbers on the glass tube. Cerebrospinal fluid pressure is generally measured in millimeters of water column. Incidentally, it should be noted that so far, among academics there is no single opinion about to what intracranial pressure as normal. Some argue that the norm - from 80 to 140 mm of water. Art., others insist that the boundaries of the norm is much wider and the pressure may well vary from 60 to 200 mm of water. Art. The above rules - for horizontal body position. If the patient is sitting, the rules are quite different.
But the main thing for us is not in specific numbers, but in ascertaining the fact that the simple, affordable, convenient and at the same time reliable way of measuring intracranial pressure does not exist. It is understandable after all, that any talk of a puncture in the outpatient - is simply not serious.
There are nevertheless survey methods, allowing to infer the value of intracranial pressure in a number of indirect signs.
One of those methods - ultrasonography (USG) of the brain. This method is not used in adults, because ultrasound can not penetrate the skull. In children, the situation is quite different, since there fontanelle - a wonderful window for the ultrasound. Neurosonography, namely the so-called ultrasound of the brain - a method available and is absolutely safe. It allows us to estimate the size of brain ventricles, and the increase of this size may well be regarded as an indirect sign of increased intracranial pressure. At the same time, as with the head circumference is important is not so much the width of the ventricles of the brain, how the dynamics of this indicator.
After the closure of fontanel see and appreciate the size of the ventricles of the brain can only help tomography - computerized (CT) or magnetic resonance imaging (MRI). At the same time tomography - a method of serious, unsafe, expensive, it is used rarely - only when the real suspicions of serious intracranial pathology.
Another method - an outdated but still used quite widely - echoencephalograph (EhoEG). With the help of a special apparatus (echoencephalograph) through all of the same ultrasound estimated number of parameters, including pulsation of cerebral vessels. The amplitude of vibration of the ultrasonic signal is regarded as an indicator that could assess ICP.
We emphasize once more: all of these methods are not reliable, they do not ascertain, do not argue, but only allow for the possibility, suggested, allow suspected increase in intracranial pressure.
So it turns out as a result: Existing to date survey methods only give the doctor additional information for consideration, but to dot the i can not. Hence, relying mainly on account of specific symptoms. Here my problem: it is not you Granny, which is under increased pressure - is as normal - running to the shops. This is a very young child, rather malomesyachnoe, which is unreasonable and anything not specifically zhaluyuscheesya.
But the problems not only in age and the inability of a finger to point to the place where it hurts. The main problem is that almost all the symptoms that can be suspected in a child raising intracranial pressure can occur in perfectly healthy children.
For example, the child's anxiety, trembling limbs, cries could be signs of increased intracranial pressure, but it may not have to ICP generally irrelevant. And it can either confirm the mother, because to find a child, always quiet, and who never would have nothing trembling, it is simply impossible. Another symptom of increasing intracranial pressure - a squint, but it is common knowledge that infants have not yet formed the eye muscles and infant squint every now and physiological phenomenon, ie, completely normal.
It should nevertheless acknowledge: words such as "anxiety", "shake", "cries" and "Strabismus", not able to seriously scare the above average domestic Mom, because everyone's ears and are often used in everyday life.
It is quite another thing when a doctor from the mouth to be heard, or at an outpatient card found such terrible expressions as "a symptom of Graefe," or "spontaneous reflex Moro" - there is no place for jokes and not to peace: it is clear in fact that the situation is serious.
We will try to explain what these wise words.
The essence of the symptom Graefe - behind the upper eyelid moving downward eyeball. In a further translation into Russian, this means that when a child looking down, frightened, then over the iris of the eye can see a few millimeters whites of the eyes. Looks like a goggle-eyed. If the child looks straight, then everything is fine.
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