condition present at birth ( congenital ) in which the intestine doesn ' t develop correctly ( malrotation ) also is a risk factor for intussusception. - a prior history of intussusception. once you ' ve had intussusception, you ' re at increased risk to develop it again. - aids. there is some evidence of an increased incidence of intussusception in people with acquired immune deficiency syndrome. intussusception can cut off the blood supply to the affected portion of the intestine. if left untreated, lack of blood causes tissue of the intestinal wall to die. tissue death can lead to a tear ( perforation ) in the intestinal wall, which can cause an infection of the lining of the abdominal cavity ( peritonitis ). peritonitis is a life - threatening condition that requires immediate medical attention. signs and symptoms of peritonitis include : - abdominal pain - abdominal swelling - low urine output peritonitis may cause your child to go into shock. signs and symptoms of shock include : - cool, clammy skin that may be pale or gray - a weak and rapid pulse - abnormal breathing that may be either slow and shallow or very rapid - lackluster eyes that seem to stare blankly - profound listlessness a child who is in shock may be conscious or unconscious. if you suspect your child is in shock, seek emergency medical care right away. preparing for your appointment emergency medical care is required to treat intussusception. you may not have much time to prepare for an appointment. what to expect from your doctor your child ' s doctor is likely to ask you a number of questions, including : - when did your child begin experiencing abdominal pain or other symptoms? - does your child ' s pain appear to be continuous — or is it occurring off and on? - does the pain begin and end suddenly? - has your child experienced nausea, vomiting or diarrhea? - have you noticed any blood in your child ' s stool? - have you noticed any swelling or a lump in your child ' s abdomen? what you can do in the meantime don ' t give your child any over - the - counter medications to treat symptoms before the appointment. tests and diagnosis your or your child ' s doctor will start by getting a history of the symptoms of the problem. he or she may be able to feel a sausage - shaped lump in the abdomen. to confirm the diagnosis, your doctor may order : - ultrasound or other abdominal


your child ' s doctor will start by getting a history of the symptoms of the problem. he or she may be able to feel a sausage - shaped lump in the abdomen. to confirm the diagnosis, your doctor may order : - ultrasound or other abdominal imaging. an ultrasound, x - ray or computerized tomography ( ct ) scan may reveal intestinal obstruction caused by intussusception. imaging will typically show a " bull ' s eye, " representing the intestine coiled within the intestine. abdominal imaging also can show if the intestine has been torn ( perforated ). - air or barium enema. an air or barium enema is basically a colon x - ray. during the procedure, the doctor will insert air ( the preferred choice in most cases ) or liquid barium into the colon through the rectum. this makes the images on the x - ray clearer. an air or barium enema will fix intussusception 90 percent of the time in children, and no further treatment is needed. a barium enema can ' t be used if the intestine is torn. treatments and drugs treatment of intussusception typically happens as a medical emergency. emergency medical care is required to avoid severe dehydration and shock, as well as prevent infection that can occur when a portion of intestine dies due to lack of blood. when your child arrives at the hospital, the doctors will first stabilize his or her medical condition. this includes : - giving your child fluids through an intravenous ( iv ) line - helping the intestines decompress by putting a tube through the child ' s nose and into the stomach ( nasogastric tube ) correcting the intussusception to treat the problem, your doctor may recommend : - a barium or air enema. this is both a diagnostic procedure and a treatment. if an enema works, further treatment is usually not necessary. this treatment is highly effective in children, but rarely used in adults. intussusception recurs as often as 15 to 20 percent of the time and the treatment will have to be repeated. - surgery. if the intestine is torn, if an enema is unsuccessful in correcting the problem or if a lead point is the cause, surgery is necessary. the surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died. surgery is the main treatment


a lead point is the cause, surgery is necessary. the surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died. surgery is the main treatment for adults and for people who are acutely ill. in some cases, intussusception may be temporary and go away without treatment. - kitigawa s, et al. intussusception in children. http : / / www. uptodate. com / index. accessed oct. 25, 2012. - hodin ra, et al. small bowel obstruction : causes and management. http : / / www. uptodate. com / index. accessed oct. 25, 2012. - pepper vk, et al. diagnosis and management of pediatric appendicitis, intussusception, and meckel diverticulum. surgical clinics of north america. 2012 ; 92 : 505. - lindor ra, et al. adult intussusception : presentation, management, and outcomes of 148 patients. the journal of emergency medicine. 2012 ; 43 : 1. - askmayoexpert. intussusception. rochester, minn. : mayo foundation for medical education and research ; 2012.


homocysteine, total, plasma as an aid for screening patients suspected of having an inherited disorder of methionine metabolism including : - cystathionine beta - synthase deficiency ( homocystinuria ) - methylenetetrahydrofolate reductase deficiency ( mthfr ) and its thermolabile variants : - methionine synthase deficiency - cobalamin ( cbl ) metabolism : - combined methyl - cbl and adenosyl - cbl deficiencies : cbl c2, cbl d2, and cbl f3 deficiencies - methyl - cbl specific deficiencies : cbl d - var1, cbl e, and cbl g deficiencies - transcobalamin ii deficiency : - adenosylhomocysteinase ( ahcy ) deficiency - glycine n - methyltransferase ( gnmt ) deficiency - methionine adenosyltransferase ( mat ) i / iii deficiency clinical information discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test to be used in conjunction with plasma amino acids and urine organic acids to aid in the biochemical screening for primary and secondary disorders of methionine metabolism. homocysteine is an intermediary in the sulfur - amino acid metabolism pathways, linking the methionine cycle to the folate cycle. inborn errors of metabolism that lead to homocysteinemia / - uria include cystathionine beta - synthase deficiency ( homocystinuria ) and various defects of methionine re - methylation. genetic defects in vitamin cofactors ( vitamin b6, b12, and folate ) and nutritional deficiency of b12 and folate also lead to abnormal homocysteine accumulation. homocysteine concentration is an indicator of acquired folate or cobalamin deficiency, and is a contributing factor in the pathogenesis of neural tube defects. homocysteine also was thought to be an independent predictor of cardiovascular disease ( atherosclerosis, heart disease, thromboembolism ), as early observational studies prior to 2000 linked homocysteine to cardiovascular risk and morbidity and mortality. however, following fda - mandated folic acid supplementation in 1998, homocysteine concentrations decreased by approximately 10 % without a similar change in cardiovascular or ischemic events. currently, the use of homocysteine


don ' t skip necessary tests for fear of radiation risk " people should not skip necessary medical imaging procedures, such as mammography, radiography ( x - ray ) and computed tomography ( ct ), because they are afraid the radiation exposure might cause cancer, " said dr. stewart bushong, professor of radiology at bcm. " there is no measurable increased risk when imaging procedures are administered appropriately. " it is important to understand the different kinds of imaging procedures and the amount of radiation exposure, bushong said. " when you look at the amount of radiation exposure in each, the doses are very low. " radiation dose is measured in millisieverts, or msv. procedures and doses bushong ranked common diagnostic imaging procedures from low to high dose and pointed out that natural background radiation contributes approximately 3 msv each year to our individual radiation dose. - mammography : a diagnostic procedure to detect breast tumors by the use of x - rays ( 0. 1 msv ). - radiography : an x - ray of a bone or particular body part ( 1 msv ). - positron emission tomography or pet scan : a technique to examine the metabolic activity in various tissues, especially in the brain ( 5 msv ). - fluoroscopy : examination of body structures using a fluoroscope. these are commonly used to examine the lungs and gastrointestinal tract ( 10 msv ). - ct scan : uses special x - ray systems and computers to create cross - sectional images of the body ( 10 msv ). " many people think magnetic resonance imaging ( mri ) and diagnostic ultrasound result in radiation exposure, but they do not, " said bushong. " these tests are harmless. " approximately 100 msv would be an example of a dose of radiation which could cause concern, bushong said. bushong said the average amount of medical radiation exposure has been on the rise, but many professional organizations are keeping a close eye on such radiation exposures and any inappropriate overutilization. " we worry about people who are frequently having these tests repeated when they do not need repeats, especially children, " said bushong. " organizations including the american college of radiation, american association of physicists in medicine, radiological society of america, and the center for devices and radiological health have convened to address these concerns. " these organizations have set guidelines on radiation exposure doses and developed educational programs to reduce unnecessary and inappropriate diagnostic medical imaging. bushong said patients should not be scared or refuse


| impact of orphanhood on underweight prevalence in sub - saharan africa | | | rivers, jonathan ; mason, john ; silvestre, eva ; gillespie, stuart ; mahy, mary ; monasch, roeland | | food and nutrition bulletin, volume 29, number 1, march 2008, pp. 32 - 42 ( 11 ) accepting attitudes toward people living with hiv ( plhiv ) multiple african countries background. in africa, approximately 25 million people live with hiv / aids and 12 million children are orphaned. although evidence indicates that orphans risk losing opportunities for adequate education, health care, and future employment, the immediate effects of orphanhood on child nutritional status remain poorly understood. objective. this paper assesses the nutritional impact of orphanhood, with particular emphasis on taking account of various factors potentially confounding or masking these impacts. methods. child anthropometry and orphan status were examined in 23 multiple indicator cluster surveys and demographic and health surveys throughout sub - saharan africa, which were subsequently merged into larger, region - specific datasets ( east, west, and southern africa ). to compare orphans and nonorphans, linear regression and probit models were developed, taking account of orphan status and type, presence of a surviving parent in the household, household structure, child age and sex, urban versus rural residence, and current wealth status. results. few differences emerged between orphans and nonorphans in controlled and uncontrolled comparisons, regardless of orphan type, presence of surviving parent, or household structure. age differentials did confound nutritional comparisons, although in the counterintuitive direction, with orphans ( who were 8 months older on average ) becoming less malnourished when age differences were taken into account. wealth did appear to be associated with orphanhood status, although it did not significantly confound nutritional comparisons. conclusions. orphans were not consistently more malnourished than nonorphans, even when potential confounding variables were examined. since household wealth status is likely to change after becoming affected by hiv, ruling out wealth as a potential confounder would require more detailed, prospective studies. keywords : child anthropometry ; fostering ; hiv / aids ; orphanhood ; sub - saharan africa


diet & nutrition faqs reviewed by melissa conrad stoppler, md take the diet & nutrition quiz first! before reading this faq, challenge yourself and test your knowledge! q : according to the usda, there is no difference between a “ portion ” and a “ serving. ” true or false? a : false. a “ portion ” is how much food you choose to eat at one time, whether in a restaurant, from a package, or in your own kitchen. versus a portion, a “ serving ” size is the amount of food listed on a product ' s nutrition facts. sometimes, the portion size and serving size match ; sometimes they do not. keep in mind that the serving size on the nutrition facts is not a recommended amount of food to eat. it is a quick way of letting you know the calories and nutrients in a certain amount of food. q : a serving of what kind of vegetables should be about the size of a baseball? a : a serving of broccoli. a serving of broccoli should be about the size of a baseball, which is equivalent to about one cup. q : from which foods can we get carbohydrates? a : milk products and fruits, whole grain breads and cereals, table sugar, starchy vegetables, and legumes. carbohydrates are called " simple " or " complex, " depending on how fast your body digests and absorbs the sugar. you get simple carbohydrates from fruits, milk products, and table sugar. complex carbohydrates include whole grain breads and cereals, starchy vegetables, and legumes. complex carbohydrates and some simple carbohydrates provide vitamins, minerals, and fiber. products made with refined sugar provide little nutrition. it is wise to limit these products. q : which has more calories : a plain bagel with cream cheese or a toaster waffle with syrup? a : a toaster waffle with syrup. a 4 - inch regular toaster waffle with syrup has 129 calories. q : a good rule of thumb is to drink 10 - 12 glasses of water per day. true or false? a : false. there is no evidence to show that drinking 10 - 12 glasses of water is necessary. generally, nutritionists recommend we follow the “ 8x8 ” rule, which is to drink eight 8 - ounce glasses of water per day. drinking more water does indeed boost metabolism - especially


show that drinking 10 - 12 glasses of water is necessary. generally, nutritionists recommend we follow the “ 8x8 ” rule, which is to drink eight 8 - ounce glasses of water per day. drinking more water does indeed boost metabolism - especially if your glass is icy cold. your body must work to warm the water up, burning a few extra calories in the process. as for other benefits of water, 85 % of your brain tissue is water, which means that if you ' re dehydrated, both your body and your mind will be stressed. q : according to the usda ’ s famous food pyramid, we need 2 - 3 servings of which food group every day? a : milk, cheese, and yogurt products. the usda ' s famous food pyramid confirms that we need 2 - 3 daily servings from the milk, yogurt, and cheese group ; 2 - 3 daily servings from the meat, poultry, fish, dry beans, eggs, and nuts group ; 3 - 5 daily servings of vegetables ; 2 - 4 servings from the fruit class ; 6 - 11 daily servings from the bread, cereal, rice, and pasta category, and to use fats, oils, and sweets very sparingly. q : one serving of peanut butter is about the size of a ping pong ball. true or false? a : a ping pong ball. one serving of peanut butter is equivalent to two tablespoons, which, together are about the size of a ping pong ball. q : diet is a major contributor to overweight and obesity. how many u. s. adults would you guess are overweight or obese? a : nearly 70 % of all u. s. adults are overweight or obese! more than two - thirds ( 68 % ) of all u. s. adults are overweight or obese. this breaks down to 64. 1 % of u. s. women and 72. 3 % of u. s. men. more than two - thirds ( 68 % ) of all u. s. adults are overweight or obese. this breaks down to 64. 1 % of u. s. women and 72. 3 % of u. s. men. q : a burrito should be the size of a checkbook. true or false? a : a burrito. while mypyramid. gov states that a serving of chicken breast should be about the size of a deck of cards,


. q : a burrito should be the size of a checkbook. true or false? a : a burrito. while mypyramid. gov states that a serving of chicken breast should be about the size of a deck of cards, ideally, a burrito should be no larger than the size of a checkbook. q : people with a body mass index ( bmi ) value of what or more are considered obese? a : 30. bmi values between 18. 5 and 24. 9 are considered to be a “ normal ” or “ healthy ” weight. bmi values between 25 and 29. 9 are considered “ overweight, ” while bmi values of 30 and above are considered “ obese. ” bmis above 25 are unhealthy and have been shown to increase the risk of certain chronic diseases. bmis under 18. 5 are considered “ underweight. ” q : according to the usda, pasta falls into the “ grain ” category. true or false? a : pastas. food made from wheat, rice, oats, corn, or another cereal is a grain product. bread, pasta, oatmeal, cornflakes, and grits may not seem like it, but they are all grain products. q : what food should be no larger than an ordinary computer mouse? a : a baked or sweet potato. when choosing baked or sweet potatoes, be sure to choose a medium – sized potato. q : to keep your diet in check, a correct - sized portion of what food should be near the size of a package of dental floss : chocolate or butter? a : chocolate. according to mypyramid. gov, an ounce of chocolate should be about the size as a package of dental floss. q : a serving of what food should be about the size of a deck of playing cards? beef or bread? a : a deck of playing cards. beef ' s bundle of nutrients is beneficial for growing, developing and maintaining overall health through all life ' s stages. q : most americans consume the greatest amount of calcium from milk. true or false? a : cheese. while calcium is derived from various sources in the u. s. food supply, more than one - quarter ( 27 % ) of americans get their calcium from cheese sources. source quiz on medicinenet improve your health i. q. on diet & nutritionback to top ↑ diet & nutrition related slideshowsback to top ↑


researchers studying mice have identified a potential target for treating diabetes and obesity. scientists at washington university school of medicine in st. louis, found that when the target protein was disabled, the animals became more sensitive to insulin and were less likely to get fat even when they ate a high - fat diet that caused their littermates to become obese. the researchers studied how the body manufactures fat from dietary sources such as carbohydrates. that process requires an enzyme called fatty acid synthase ( fas ). mice engineered so that they don ' t make fas in their fat cells can eat a high - fat diet without becoming obese. " mice without fas were significantly more resistant to obesity than their wild - type littermates, " first author irfan j. lodhi, phd, said. " and it wasn ' t because they ate less. the mice ate just as much fatty food, but they metabolized more of the fat and released it as heat, " he said. to understand why that happened, lodhi, a research instructor in medicine, analyzed their fat cells. mice have two types of fat : white fat and brown fat. white fat stores excess calories and contributes to obesity. brown fat helps burn calories and protects against obesity. in mice genetically blocked from making fatty acid synthase in fat cells, lodhi and his colleagues noticed that the animals ' white fat was transformed into tissue that resembled brown fat. " these cells are ' brite ' cells, brown fat found where white fat cells should be, " lodhi said. " they had the genetic signature of brown fat cells and acted like brown fat cells. because the mice were resistant to obesity, it appears that fatty acid synthase may control a switch between white fat and brown fat. when we removed fas from the equation, white fat transformed into brite cells that burned more energy. " determining whether humans also have brown fat has been somewhat controversial throughout the years, but recent studies elsewhere have confirmed that people have it. " it definitely exists, and perhaps the next strategy we ' ll use for treating people with diabetes and obesity will be to try to reverse their problems by activating these brown fat cells, " senior investigator clay f. semenkovich, md, said. semenkovich, the herbert s. gasser professor of medicine, professor of cell biology and physiology and director of the division of endocrinology, metabolism and lipid research, said that the new work is exciting because fas provides a target that may be able


a cortisol level is a blood test that measures the amount of cortisol, a steroid hormone produced by the adrenal gland. how the test is performed a blood sample is needed. for information on how this is done, see : venipuncture how to prepare for the test usually, the health care provider will ask that the test be done in the morning. this is important, because cortisol levels vary throughout the day. the health care provider may ask you to stop taking drugs that can affect the test. drugs that can increase cortisol measurements include : human - made ( synthetic ) glucocorticoids, such as prednisone and prednisolone drugs that can decrease cortisol measurements include : how the test will feel when the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. afterward, there may be some throbbing. why the test is performed the test is done to check for increased or decreased cortisol production. cortisol is a steroid hormone released from the adrenal gland in response to acth, a hormone from the pituitary gland in the brain. cortisol affects many different body systems. it plays a role in : metabolism of fats, carbohydrates, and protein different diseases, such as cushing ' s disease and addison ' s disease, can lead to either too much or too little production of cortisol. cortisol levels are often measured to help diagnose these conditions and to evaluate how well the pituitary and adrenal glands are working. normal values for a blood sample taken at 8 in the morning are 6 - 23 micrograms per deciliter ( mcg / dl ). the examples above are common measurements for results for these tests. normal value ranges may vary slightly among different laboratories. some labs use different measurements or may test different specimens. talk to your doctor about the meaning of your specific test results. what abnormal results mean higher than normal levels may indicate : the pituitary gland near the brain makes too much of the hormone acth ( called cushing ' s disease ) because of excess growth of the pituitary gland, or a tumor in the pituitary gland or elsewhere in the body ( such as the pancreas, lung, and thyroid ) veins and arteries vary in size from one patient to another and from one side of the body to the other. obtaining a blood sample from


the pituitary gland or elsewhere in the body ( such as the pancreas, lung, and thyroid ) veins and arteries vary in size from one patient to another and from one side of the body to the other. obtaining a blood sample from some people may be more difficult than from others. other risks associated with having blood drawn are slight but may include : fainting or feeling light - headed hematoma ( blood accumulating under the skin ) infection ( a slight risk any time the skin is broken ) normally, cortisol levels rise and fall during the day, repeating on a 24 - hour cycle ( diurnal variation ). highest levels are at about 6 - 8 a. m. and lowest levels are at about midnight. physical and emotional stress, as well as illness, can increase cortisol levels, because during the normal stress response the pituitary gland releases more acth. higher than normal cortisol levels are expected in women who take estrogen or birth control pills. stewart pm, krone np. the adrenal cortex. in : kronenberg hm, melmed s, polonsky ks, larsen pr, eds. williams textbook of endocrinology. 12th ed. philadelphia, pa : saunders elsevier ; 2011 : chap 15. nancy j. rennert, md, chief of endocrinology & diabetes, norwalk hospital, associate clinical professor of medicine, yale university school of medicine, new haven, ct. review provided by verimed healthcare network. also reviewed by david zieve, md, mha, medical director, a. d. a. m., inc.


effective cues will also emphasize stabilization of the pelvis and lumbar spine both statically and dynamically in all positions and throughout all movements. cueing pelvic stability during an exercise will ensure optimal performance of the movement and help prevent any unnecessary stress on the lumbar spine. the abdominal muscles must often be recruited to maintain the rib cage, and indirectly, the thoracic spine, in proper alignment. instructors must cue participants to prevent the rib cage from lifting up in the supine position or deviate forward in a sitting position, causing the thoracic spine to extend. instructors should remain aware of cueing stabilization of the scapulae and shoulders and realize the importance during the initiation of every exercise. when stability is absent, there is a tendency to overwork muscles around the neck and shoulders. since they lack a direct bony attachment to the rib cage and spine, the scapulae have a great deal of mobility in making a greater range of motion available to the arms. although the scapulae move with the arms, a sense of stability, not rigidity, should always be maintained. regarding head and cervical spine placement, the cervical spine should hold its natural curve and the skull should balance directly above the shoulders when sitting in neutral. this position should also be maintained when lying on the back. in most instances, the cervical spine should be encouraged to continue the line created by the thoracic spine during flexion, extension, lateral flexion and rotation. continually referring to these biomechanical principles will ensure that the cues an instructor is providing will help all clients or groups perform the exercises to the best of their ability. ineffective cues & understanding your client according to research, one of the most overused cues in the pilates industry at large is ‘ slide your shoulders down. ’ “ while this may be effective with a small percentage of client groups, it can also have some very detrimental effects on others, ” says moira. “ in many participants, sliding the shoulders down may overly depress them, produce compression on nerves of the neck and shoulders and decrease the range of motion in the shoulder joint. to be more effective, instructors should look at each client their individual needs to determine what the optimal cue is for them. ” “ it is important to understand what type of a learner the client is and then be able to select cues that will be appropriate for that individual. someone who is a “ thinker learner ” will want to know the intricacies of a movement and may not respond


understand what type of a learner the client is and then be able to select cues that will be appropriate for that individual. someone who is a “ thinker learner ” will want to know the intricacies of a movement and may not respond as well to visual images. in this case, using phrases such as ‘ feel the head of the femur rotating freely within the hip socket ’ may elicit a better response. to conclude, an effective pilates instructor will be able to relate to any type of client, no matter how they learn best, by having a well stocked tool box of cues available at a moment ’ s notice. a good practice exercise for instructors on their own is to go through 5 ‑ 10 repetitions of an exercise and use a different cue for each repetition. instructors should be clear in their own mind why they are teaching a client a particular exercise or modification. this will ensure they will be able to develop a rapport with any client who walks in their door. more importantly, emphasizing positive reinforcement when working with clients is crucial to effective cueing, and therefore effective pilates instruction. many clients will react quicker if they are told why they are doing a particular exercise a certain way as opposed to it being thrown at them because it comes next on the chart. so next time you ’ re thinking about how to approach your client with a new exercise or movement – remember to think about their individual needs and how to approach them with the change. it ’ ll make all the difference.