Examining Guillain Barre Syndrome

Examining Guillain Barre Syndrome Guillain Barre Syndrome (GBS) is a rare immune mediated polyneuropathy that occurs in previously healthy individuals. The purpose of this paper is to provide readers with an understanding of Guillain Barre and conflictions GBS has with other medical resources and diseases. Included in this research paper are topics on origin, symptoms, treatments, medications and conflictions of medical resources with Guillain Barre. Guillain-Barre Syndrome is an acute autoimmune disease that changes the peripheral nervous system and less commonly the motor or cranial nerves. GBS is random producing no warning and is an inflammatory condition that can lead to progressive muscle weakness and paralysis. It is a very rare sight in emergency departments and differentiating its early stages from common viral illnesses is also extremely difficult. Inflammation of the peripheral nerves affect the arms and legs resulting in impaired function, weakness, loss of feeling and limb paralysis with or without pain. Guillain-BarreÂÂ ´ syndrome (GBS) is an immune-mediated polyneuropathy with a worldwide incidence of 1-4 patients per 100 000 inhabitants (European Journal of Neurology 2008, p. 1332). Disease Name and Synonyms The syndrome was named after the French physicians Guillain, Barre and Strohl, who were the first to describe it in 1916. It is sometimes called Landrys paralysis, after the French physician who first described a variant of it in 1859. (All about Guillain Barre Syndrome. (01-2009) symptoms. Retrieved from http://www.jsmarcussen.com/gbs/uk/symptoms.htm) GBS is not just one disease the syndrome has several variations differentiated by their symptoms, the infections preceding it, the extent of the inflammatory phase, severity, and disorder site. Common variations of the disorder are as follows: Acute Inflammatory Demyelinating Polyneuropathy (AIDP) which is the most frequent form of GBS in the Western part of the World. Acute Motor Axonal Neuropathy (AMAN), Acute Motor and Sensory Axonal Neuropathy (AMSAN) and the cranial nerve variant of GBS called Miller Fisher Syndrome (MFS) are all forms of GBS but are not as common as AIDP. Symptoms Symptoms usually begin in the patients feet, face or hands it spread to the arms or legs, it increase in potency as symptoms travel towards the midpoint of the body. The symptoms commonly play a part on both left and right sides of the body. GBS is so irregular that motor symptoms or interferences in the autonomous system may not be detected. It has been reported in rarer cases that GBS has affected an arm or leg without spreading to the rest of the individuals body. (All about Guillain Barre Syndrome. (01-2009) symptoms. Retrieved from http://www.jsmarcussen.com/gbs/uk/symptoms.htm) In some patients, the skin acquires hyperalgesia, or sensitivity to touch intensifies by bed sheets, socks and close-fitting shoes; in severe circumstances pain may limit walking. Patients with symptoms constrained to the feet and ankles may notice related symptoms in the fingertips; as the symptoms expand to the knees they possibly will extend to the wrists. Seldom do these symptoms spread out beyond the knees into other parts of the body. Elevation of leucocytes and protein in the cerebrospinal fluid strongly indicates a diagnosis of GBS. The patient loses the capacity to tell the difference amongst hot and cold, and may feel cold or may possibly start to sweat for no apparent reason. The patients may even receive injures without noticing; their sense of taste can be affected; motor nerve fibers may be damaged as well. The patient encounters a communication interruption between what he wants to perform and his ability to perform the desired act; because the motor nerves regulate movement, the damage inflicted to them triggers partial or complete blockage of the motor signals. The body surface affected by the damaged nerves drops its ability to function normally, causing reduced movement or coordination. The patients muscles dwindle and waste; tendon reflexes are diminished or lost. An example of this is when slightly striking on the front of the patients knee and that act not inducing a kick reaction. Advanced weakening or paralysis could occur, on average arising in the feet, hands or face. The paralysis characteristically consists of more than one extremity, most frequently the legs. The paralysis is persistent and usually rising; expanding to the rest of the limb, and from there may extend to other extremities such as the legs, arms and the remainder of the body. Legs feel heavy; it becomes problematic to stand or climb flight of steps, or even to walk. The patient may struggle holding and manipulating objects, such as pins and buttons. Arms may seem weak and the patient will no longer be able to lift heavy objects. The weakness may possibly be complemented by pain and involuntary muscle contractions. Constipation is more often a predicament, due to the condensed movement of the intestines, modification of diets, declining stomach muscles that contest the physical exertion by the individual to force out the intestinal contents. Around 28% of patients with the syndrome endure and are able to walk unaided. In certain cases, the face could be affected when injury occurs to the cranial nerves. These nerves attach the brain en route to the muscles of the face, tongue and jaw, and also regulate the muscles that move the patients head, neck and shoulders. While the paralysis evolves, all these regions may be paralyzed. The eyelids or one side of the face possibly will hang down resembling Bells palsy; the face loses its ability to express emotions. The individuals voice may change given that the vocal chords are impaired. Speech may be incomprehensible, because the number of muscles required to form speech are declining. Deafness is rare but then again has been reported. The progressive weakness has affected patients with varying intensities, and may be life threatening. The autonomic nerve system may be disrupted with the combination of pain, weakness, and sensory disruptions that are generally so frightening that the more inconspicuous alterations in the patients autonomous nerve system might be unnoticed. The autonomous nervous system controls the inner organs, the organs functions are carried out automatically, examples of this is when the body secrets hormones, creates vision, urination, breathing, heartbeat, etc. It is these functions that may be disrupted, which will result in arrhythmia, unstable blood pressure, blurred or double vision, vertigo, fainting spells, inability to regulate the body temperature, trouble breathing, reduced ability to control the function of the stomach, digestive system and bladder, loss of weight, vomiting after meals, reduced function of various glands, incontinence, impotency, and the bladder may feel as it is not being emptied no matter how many times it is expelled. It is also very well noted that most patients have had a common infection three weeks prior to GBS and it seems that the infection triggers the onset of GBS. Treatment Treatment options for GBS focus on lessening the severity of the symptoms and accelerating recovery. Three main therapies are used to achieve this: intravenous immunoglobulin, plasma exchange and CSF filtration. Intravenous immunoglobulin is understood to block the receptors on microphages preventing an attack on the Schwann cells and myelin. Plasma exchange works by circulating blood through a machine which removes antibodies, and replacing fluid loss with albumin. Cerebrospinal fluid filtration, which removes cells, including inflammatory mediators, is less commonly used. Research suggests that intravenous immunoglobulin and plasma exchange are the most common and effective treatment for GBS, when started within the first 2 weeks of syndromes onset. Quick intervention using either one of these treatments appears to be successful and may possibly reduce recovery time. Both treatments are very good and neither is superior to the other, and there is no advantage to merging these treat ments. The main treatment for GBS is preventing and dealing with the complications (such as breathing complications or infections) and providing supportive care until symptoms begin to improve. This may include; reducing your breathing difficulties, sometimes with the help of a breathing machine, monitoring your blood pressure and heart rate is also good preventative care. Providing adequate nutrition if you have problems chewing and swallowing is also a key to overcoming this syndrome. The patent should attend physical therapy to help maintain muscle strength and flexibility. Preventing and treating complications such as pneumonia, blood clots in the legs, or urinary tract infections. Other treatment of (GBS) depends on how severe your symptoms are. Careful monitoring is very important during the early stages of GBS because life threatening complications can occur within twenty four hours after symptoms first start. Conflictions of Medical Resources with Guillain Barre In 1976, vaccination against a new swine influenza A (H1N1) virus was linked to a substantial increased risk for GBS in the forty two days after vaccination (approximately 10 excess cases per 1 million vaccinations) considerations of ending the immunization program where taken into account despite the circumstantial severity of the influenza viruss transmission around the world. There are certain circumstances in which immunizing individuals, particularly those with a prior history of GBS, may call for caution. However, the benefit of inoculations in averting disease and decreasing morbidity and mortality, particularly for influenza, needs to be weighed against the potential risk of GBS. Destruction of the axonal or myelin membranes could presumably be mediated directly by vaccine virus or vaccine-associated products, or infection or damage of surrounding supporting cells by virus could lead to insertion of virus specified polypeptides into host cell membranes, resulting in a humeral or cell-mediated autoimmune response to the infected cell. Finally, axons or myelin cells could potentially be damaged by the introduction of sequestered myelin antigens into the circulation, inciting autoimmunity. Moreover, it is likely that host factors and genetic polymorphisms may result in a predisposition to GBS in some individuals. Several studies have suggested that various polymorphisms, including genes of the T-cell glycolipid. Recovery Making a prediction about recovery is impossible. Recovery begins as abruptly and mysteriously as when GBS symptoms first started to appear. The symptoms fade gradually, but could take weeks, months or even years to finally get rid of. The development of the disease fluctuates for each patient. Recovery takes 3 to 6 months for most people, and only about two thirds of them ever recover completely. As tingling, numbness and pain dissipates, strength comes back to the affected parts of the body, mostly in the reverse order of sequence as when the signs first appeared. This indicates that in most cases, the arms and fingers will regain their strength prior to the legs, however right handed patients may experience there muscle strength returning to their left hand before their right hand. Axonal damage begins to be repaired; the axon grows little by little and is increasingly wrapped by myelin. The myelin sheath can grow outward in as little as a couple of days, while it could take longer for the body to repair a damaged axon. Example of this is a motor nerve that is regenerated at a rate of 1 mm/day, so it can take weeks if not months to restore a damaged nerve. Demyelination is then repaired by the regeneration of the myelin sheath. The rate of regenerating myelination depends on the amount of damage. The sheath consists of multiple layers that grow back gradually; the myelin has to have a particular thickness prior to the nerve cells recapturing its ability to transmit impulses. The myelin sheath may never regain its normal thickness. These facets decrease the nerve signal transmission speed forever, after the patient has recovered from GBS. Research on the use of treatments that speed up the growth of motor nerves is under way but no one will know when they will arrive or if they will ever arrive. There is no feasible way in predicting which nerves will regenerate. Research states that damaged axons are not restored, and that the surrounding axons send branches out that take over the roles of the impaired nerves, in the affected part of the body. The area could function again, and it may seem as if the muscle has regained full strength, but the muscle and nerves have to work harder to carry out the same job and they end up tiring faster than was the case prior to GBS.

Peru Research Paper Essay

Madison Spence 17 February 2013 Spanish 2312 Professor Elsa Coronado-Salinas Santa Rosa de Lima The country of Peru is home to many holidays and festivals each year. From the New Year’s Day celebration to the Christmas day celebration, Peru has set aside an abundance of days to observe the country’s many historic events. A very popular holiday in the country is Santa Rosa de Lima which takes place each year on August 30. The holiday dates back to the 17th century and celebrates the death of the patroness of Lima, Santa Rosa. Santa Rosa was born on April 20, 1586 by the name of Isabel, but was later nick-named Rosa because of her looks and her rosy cheeks. She spent a majority of her childhood in the small town of Quive, in the hills of Lima. As Rosa grew up, she became extremely religious and started practicing very extreme forms of religion. She grew up to be a very very beautiful woman, but she came to resent her looks. She did everything to ‘undo’ her beauty. She fasted herself, cut her hair, and wore a thorn crown to divert attention away from her beautiful looks and towards God. Rosa wanted to join a monastery but her family was too poor to afford it so she moved away from her family and into a cottage she built herself. Rosa’s days consisted of praying and feeding and caring for the sick and poor people in her town. She sold flowers and needlework to support herself and her family. At the age of 20, Rosa was let into the â€Å"Third Order† without having to pay for it. Her religious practices took on a new extreme as she gave up all normal food and lived off of bread and water as well as herbs and juices from plants that she grew in her own garden. She constantly wore a metal crown around her head and an iron chain around her waist. After keeping up with this behavior for fourteen years, Rosa died at the young age of 31 on August 24, 1617. She was worshipped by so many people that all of the religious groups and public authorities attended her funeral. She was originally buried at the Dominican Convent but her remains were soon moved to the Church of Santo Domingo. She was later named the first saint in the New World by Pope Clemente X. Her shrine is still located inside the St. Dominic Convent in Lima. The holiday is a very celebrated day across the country, but has more of an emphasis in the city of Santa Rosa de Quives which lies in the Lima Highlands. Worshippers group together in a shelter in the middle of the city and is known as a day of feast in Peru. It is also tradition to drop a letter of good will into the tree that Santa Rosa tossed her key. Even though she died on August 24, her death is celebrated by feasting on August 30 because a Saint was already celebrated on the day of her actual death Easy, Lima, ed. â€Å"Santa Rosa De Lima.† Lima City Travel Guide. LimaEasy SAC, 03/009/2011. Web. 28 Jun 2012. http://www.limaeasy.com/index.php â€Å"Peru Celebrates Santa Rosa de Lima.† A Global World. A Global World, 2012. Web. 28 Jun 2012. .

Which Place Do You Prefer to Live?

Which place do you prefer to leave: in a small town or in a big city ? Small towns and big cities both have their good sides. First big cities have unlimited choices of things you can do. There is always a lot to do and visit. Living in a big city is more comfortable because there are cinemas, theaters, museums, shops, malls, lots of restaurants to choose. There are a lot of possibilities of shopping. Secondly the standard of education is also very high in big cities. People have many oportunities and it’s also much easier to find a well paid job.Teenagers can receive a good education in big cities because universities have different subjects. So, an argument in favour of living in a big city is that students can have more choices for their future careers. In a big city there are many people that you don't know and you can make many friends comparative to a small town where people always know something about you. Also famous singers or personalities come in big cities so you c an meet your favourite singer and take an autograph. Lastly big cities have other conveniences like airports and good hospitals.I think that to many teenagers big cities are exciting while the small towns are boring. Coming down to me I prefer living in a small town than in a big city because I don’t like noise and crowded places. I stayed in Bucharest for 2 weeks and it was too long for me. I had never ever been so tired than that time. Every night I had heard motorcycles, cars, dogs, horns, people talking very loudly. The first advantage of living in a small town is a healthy life. One of the conditions that helps us to be healthy is good weather and less population that exist in a small town.Also, in a small town there are less crowded and less traffic. Living in a place with less pollution such as air pollution or sound pollution helps us to have a healthier life and one of the main consequences is less stress and more happiness. In addition, in a small town foods and mat erials we need are healthier than in big cities. Therefore living in small towns is healthier than in big cities. Secondly, another advantage of small towns is living costs which is cheaper than in big cities.In particular, in a small town we can live in big houses with beautiful landscapes. Transportation cost is less than in big cities and we have less traffic so that we can save time and money. In conclusion, I prefer to live in a small town and I think it has some advantages such as less stress. In small town people know each other and have better relationships together than big cities therefore, in my opinion, in big cities people feel alone and depress. And it is obvious that people in small town have more happiness and friendships and less illness.

Solubility Rules for Inorganic Compounds

These are the general solubility rules for inorganic compounds, primarily inorganic salts. Use the solubility rules to determine whether a compound will dissolve or precipitate in water. Generally Soluble Inorganic Compounds Ammonium (NH4), potassium (K), sodium (Na) : All ammonium, potassium and sodium salts are soluble. Exceptions: some transition metal compounds.Bromides (Br–), chlorides (Cl–) and iodides (I–): Most bromides are soluble. Exceptions: salts containing silver, lead, and mercury.Acetates (C2H3O2–): All acetates are soluble. Exception: silver acetate is only moderately soluble.Nitrates (NO3–): All nitrates are soluble.Sulfates (SO42–): All sulfates are soluble except barium and lead. Silver, mercury(I), and calcium sulfates are slightly soluble. Hydrogen sulfates (HSO4–) (the bisulfates) are more soluble than the other sulfates. Generally Insoluble Inorganic Compounds Carbonates (CO32–), chromates (CrO42–), phosphates (PO43–), silicates (SiO42–): All carbonates, chromates, phosphates,  and silicates are insoluble. Exceptions: those of ammonium, potassium and sodium. An exception to the exceptions is MgCrO4, which is soluble.Hydroxides (OH–): All hydroxides (except ammonium, lithium, sodium, potassium, cesium, rubidium) are insoluble. Ba(OH)2, Ca(OH)2 and Sr(OH)2 are slightly soluble.Silver (Ag): All silver salts are insoluble. Exceptions: AgNO3 and AgClO4. AgC2H3O2 and Ag2SO4 are moderately soluble.Sulfides (S2–): All sulfides (except sodium, potassium, ammonium, magnesium, calcium,  and barium) are insoluble.Aluminum sulfides and chromium sulfides are hydrolyzed and precipitate as hydroxides. Table of Ionic Compound Solubility in Water at 25 °C Remember, solubility depends on the temperature of the water. Compounds that dont dissolve around room temperature may become more soluble in warm water. When using the table, refer to the soluble compounds first. For example, sodium carbonate is soluble because all sodium compounds are soluble, even though most carbonates are insoluble. Soluble Compounds Exceptions (are insoluble) Alkali metal compounds (Li+, Na+, K+, Rb+, Cs+) ammonium ion compounds (NH4+ Nitrates (NO3-), bicarbonates (HCO3-), chlorates (ClO3-) Halides (Cl-, Br-, I-) Halides of Ag+, Hg22+, Pb2+ Sulfates (SO42-) Sulfates of Ag+, Ca2+, Sr2+, Ba2+, Hg22+, Pb2+ Insoluble Compounds Exceptions (are soluble) Carbonates (CO32-), phosphates (PO42-), chromates (CrO42-), sulfides (S2-) Alkali metal compounds and those containing the ammonium ion Hydroxides (OH-) Alkali metal compounds and those containing Ba2+ As a final tip, remember solubility is not all-or-none. While some compounds completely dissolve in water and some are almost completely insoluble, many insoluble compounds are actually slightly soluble. If you get unexpected results in an experiment (or are looking for sources of error), remember a small amount of an insoluble compound may be participating in a chemical reaction.