Wednesday, March 23, 2005

Life on your own brings challenges, successes

I am an adult. It is somewhat hard to believe this as I am sitting here wearing my raspberry lip gloss and my hair in double braids. I'm grooving to pop star Teddy Gieger and the teen magazine I've been flipping through is open to the story about boys.

I am an adult, though. These past few months have made me grow up faster than ever. Perhaps it's because Mom is almost 1,500 miles away and can't take care of me the way she used to. She always was there to lean on when it came to responsibility, and I always was scared of having to take over my life completely after moving away from home.


But I have managed to do it all on my own since January and I must admit it's been quite the experience.

Setting up the electricity and Internet service in my name was a big step. I even had to fight with the phone company because they charged me more than they had initially promised. The fight didn't end up in my favor. They won, but offered me 50 percent off my first month's bill. It's a good lesson -- you probably can't win against big corporations, but if you're persistent enough, you might get something out of it.

Paying rent every month is another thing I have had to get used to. This is my very first real apartment. (I lived in on-campus apartments in college, so this is a bit different.) Rent comes out of my pocket now and I have to remember to pay it at the first of the month instead of with tuition like in my previous experience. It's working out and there's nothing better than walking into your apartment knowing you worked for it.

During my full-time job hunt I have managed to get full-time freelance work with multiple publications. With this, I've learned the art of negotiation. Many offers for freelance work have come my way (exciting, right?!), so some of them have had to be turned down because of lack of time. I used this opportunity to ask for a pay increase for my hourly rate, and with a confident pitch, my wish was granted! It's nice to be in the adult-world where hard work literally pays off.

With no full-time job, though, I had to find insurance on my own, which is kind of scary. But I found there are a lot of programs that companies offer for people right out of college (be sure to research all of them if this is your situation too). Choosing a primary-care physician is kind of exciting, though. This is when it really hits that you are in the grown-up world.

So, with all this new-found responsibility, instead of calling Mom and asking her what to do, I'm actually calling her to tell her of my adulthood successes. Does this mean I'm actually looking forward to doing taxes and worrying about my 401k? Well, as long as I still feel young at heart, then bring it on.

Sunday, March 13, 2005

Intussusception

Intussusception occurs when a segment of bowel telescopes (similar to closing of a telescope) into a segment just distal to it. It is the most common cause of intestinal (bowel) obstruction (blockage) between 3 months and 6 years of age. The ileocolic (small bowel into the colon) intussusception is the most common type although it may occur anywhere in the small bowel and colon.

Anatomy


The demarcation between the duodenum (1st part of small bowel) and the jejunum (2nd part of small bowel) is the ligament of Treitz (see Surgery of the Duodenum) (Figure 1)

The jejunum makes up about one third of the proximal small bowel

The ileum is the distal two thirds of the small bowel

The jejunum, ileum, and associated mesenteries (supporting and suspending structures) are attached to the back wall of the abdomen. They are completely covered with peritoneum (single layer of cells that line the surface of the abdomen and bowel)

The ileum joins the cecum (first part of the colon) in the right lower quadrant at the ileocecal valve near the appendix

The small bowel possesses an extensive lymphatic network that aids in the absorption of nutrients. It drains from the bowel wall into adjacent lymph vessels and lymph nodes and ultimately getting into larger lymphatics that finally empty into the left subclavian vein. The lymphatics of the small bowel play a major role in immune response (response to infection)
Pathology


The telescoping process is known as intussusception (Figure 2)

The leading proximal segment (intussusceptum) almost always telescopes into the distal segment (intussuscipens)

There may be a leading edge in the form of a polyp, inverted appendiceal stump, Meckel's diverticulum (See Surgery of the Jejunum and Ileum) or tumor

The leading edge gets caught up in the downstream peristalsis (wavelike action of the bowel wall that propels food) and is pulled into the distal bowel

In most cases the cause is unknown but viruses are thought to induce hyperplasia (increased size) of Peyer's patches (lymphoid tissue) in the end of the ileum

Friday, March 11, 2005

Glossary for Intussusception

Abdominal pain: Pain in the abdominal area or stomach.
Acute Appendicitis: Infection of the appendix
Bowel Obstruction: Blockage in the bowel of the digestive tract.
Colorectal Polyps: Polyp growths in the colon or rectum.
Diverticular Disease: Protrusions of the colon wall (diverticulosis) or their inflammation (diverticulitis)
Gangrene: Tissue death
Intestinal obstruction: Blockage in the intestines of the digestive tract.
Vomiting: Vomiting or retching symptoms.

Statistics by Country for Intussusception

Prevalance of Intussusception:
Incidence (annual) of Intussusception: about 2 per 1000 cases in infants
Incidence Rate for Intussusception: approx 1 in 500 or 0.20% or 544,000 people in USA [about data]
Extrapolation of Incidence Rate for Intussusception to Countries and Regions: The following table attempts to extrapolate the above incidence rate for Intussusception to the populations of various countries and regions. As discussed above, these incidence extrapolations for Intussusception are only estimates and may have limited relevance to the actual incidence of Intussusception in any region:


Country/Region
Extrapolated Incidence
Population Estimated Used
Intussusception in North America (Extrapolated Statistics)
USA
587,310
293,655,4051
Canada
65,015
32,507,8742
Mexico
209,919
104,959,5942
Intussusception in Central America (Extrapolated Statistics)
Belize
545
272,9452
Guatemala
28,561
14,280,5962
Nicaragua
10,719
5,359,7592
Intussusception in Caribbean (Extrapolated Statistics)
Puerto Rico
7,795
3,897,9602
Intussusception in South America (Extrapolated Statistics)
Brazil
368,202
184,101,1092
Chile
31,647
15,823,9572
Colombia
84,621
42,310,7752
Paraguay
12,382
6,191,3682
Peru
55,088
27,544,3052
Venezuela
50,034
25,017,3872
Intussusception in Northern Europe (Extrapolated Statistics)
Denmark
10,826
5,413,3922
Finland
10,429
5,214,5122
Iceland
587
293,9662
Sweden
17,972
8,986,4002
Intussusception in Western Europe (Extrapolated Statistics)
Britain (United Kingdom)
120,541
60,270,708 for UK2
Belgium
20,696
10,348,2762
France
120,848
60,424,2132
Ireland
7,939
3,969,5582
Luxembourg
925
462,6902
Monaco
64
32,2702
Netherlands (Holland)
32,636
16,318,1992
United Kingdom
120,541
60,270,7082
Wales
5,836
2,918,0002
Intussusception in Central Europe (Extrapolated Statistics)
Austria
16,349
8,174,7622
Czech Republic
2,492
1,0246,1782
Germany
164,849
82,424,6092
Hungary
20,064
10,032,3752
Liechtenstein
66
33,4362
Poland
77,252
38,626,3492
Slovakia
10,847
5,423,5672
Slovenia
4,022
2,011,473 2
Switzerland
14,901
7,450,8672
Intussusception in Eastern Europe (Extrapolated Statistics)
Belarus
20,621
10,310,5202
Estonia
2,683
1,341,6642
Latvia
4,612
2,306,3062
Lithuania
7,215
3,607,8992
Russia
287,948
143,974,0592
Ukraine
95,464
47,732,0792
Intussusception in the Southwestern Europe (Extrapolated Statistics)
Azerbaijan
15,736
7,868,3852
Portugal
21,048
10,524,1452
Spain
80,561
40,280,7802
Georgia
9,387
4,693,8922
Intussusception in the Southern Europe (Extrapolated Statistics)
Italy
116,114
58,057,4772
Greece
21,295
10,647,5292
Intussusception in the Southeastern Europe (Extrapolated Statistics)
Albania
7,089
3,544,8082
Bosnia and Herzegovina
815
407,6082
Bulgaria
15,035
7,517,9732
Croatia
8,993
4,496,8692
Macedonia
4,080
2,040,0852
Romania
44,711
22,355,5512
Serbia and Montenegro
21,651
10,825,9002
Intussusception in Northern Asia (Extrapolated Statistics)
Mongolia
5,502
2,751,3142
Intussusception in Central Asia (Extrapolated Statistics)
Kazakhstan
30,287
15,143,7042
Tajikistan
14,023
7,011,556 2
Uzbekistan
52,820
26,410,4162
Intussusception in Eastern Asia (Extrapolated Statistics)
China
2,597,695
1,298,847,6242
Hong Kong s.a.r.
13,710
6,855,1252
Japan
254,666
127,333,0022
Macau s.a.r.
890
445,2862
North Korea
45,395
22,697,5532
South Korea
96,467
48,233,7602
Taiwan
45,499
22,749,8382
Intussusception in Southwestern Asia (Extrapolated Statistics)
Turkey
137,787
68,893,9182
Intussusception in Southern Asia (Extrapolated Statistics)
Afghanistan
57,027
28,513,6772
Bangladesh
282,680
141,340,4762
Bhutan
4,371
2,185,5692
India
2,130,141
1,065,070,6072
Pakistan
318,392
159,196,3362
Sri Lanka
39,810
19,905,1652
Intussusception in Southeastern Asia (Extrapolated Statistics)
East Timor
2,038
1,019,2522
Indonesia
476,905
238,452,9522
Laos
12,136
6,068,1172
Malaysia
47,044
23,522,4822
Philippines
172,483
86,241,6972
Singapore
8,707
4,353,8932
Thailand
129,731
64,865,5232
Vietnam
165,325
82,662,8002
Intussusception in the Middle East (Extrapolated Statistics)
Gaza strip
2,649
1,324,9912
Iran
135,006
67,503,2052
Iraq
50,749
25,374,6912
Israel
12,398
6,199,0082
Jordan
11,222
5,611,2022
Kuwait
4,515
2,257,5492
Lebanon
7,554
3,777,2182
Saudi Arabia
51,591
25,795,9382
Syria
36,033
18,016,8742
United Arab Emirates
5,047
2,523,9152
West Bank
4,622
2,311,2042
Yemen
40,049
20,024,8672
Intussusception in Northern Africa (Extrapolated Statistics)
Egypt
152,234
76,117,4212
Libya
11,263
5,631,5852
Sudan
78,296
39,148,1622
Intussusception in Western Africa (Extrapolated Statistics)
Congo Brazzaville
5,996
2,998,0402
Ghana
41,514
20,757,0322
Liberia
6,781
3,390,6352
Niger
22,721
11,360,5382
Nigeria
35,500
12,5750,3562
Senegal
21,704
10,852,1472
Sierra leone
11,767
5,883,8892
Intussusception in Central Africa (Extrapolated Statistics)
Central African Republic
7,484
3,742,4822
Chad
19,077
9,538,5442
Congo kinshasa
116,634
58,317,0302
Rwanda
16,477
8,238,6732
Intussusception in Eastern Africa (Extrapolated Statistics)
Ethiopia
142,673
71,336,5712
Kenya
65,964
32,982,1092
Somalia
16,609
8,304,6012
Tanzania
72,141
36,070,7992
Uganda
52,780
26,390,2582
Intussusception in Southern Africa (Extrapolated Statistics)
Angola
21,957
10,978,5522
Botswana
3,278
1,639,2312
South Africa
88,896
44,448,4702
Swaziland
2,338
1,169,2412
Zambia
22,051
11,025,6902
Zimbabwe
7,343
1,2671,8602
Intussusception in Oceania (Extrapolated Statistics)
Australia
39,826
19,913,1442
New Zealand
7,987
3,993,8172
Papua New Guinea
10,840
5,420,2802

Cure Research for Intussusception

Medical research for Intussusception: medical news summaries: The following medical news items are relevant to medical research for Intussusception:

Rotavirus vaccine development (Rotavirus is a common cause of gastroenteritis in children, which can cause excessive diarrhea and vomiting, leading to dehydration, occasional hospitalization, and possible death. Immunization against rotavirus was originally available in the late 1990's, however it was shown to increase the risk of intussusception (twisted bowel). Medical health authorities are anticipating the global benefit that the vaccine will bring. )

Doctors and Medical Specialists for Intussusception

Doctors for Intussusception: This section presents information about some of the possible medical professionals that might be involved with Intussusception. Ask your doctor to recommend what other types of doctors, physicians, medical specialists, or other medical professionals should be part of the team for your medical issues.

Doctor and medical specialist list for Intussusception: The following types of doctors or medical specialists have been listed as possibly involved in diagnosis, treatment or management for Intussusception:

Pediatrician (A medical doctor who diagnoses and treats conditions and diseases in children )

Misdiagnosis of Underlying Causes of Intussusception

Underlying conditions list: The list of possible underlying conditions mentioned in various sources for Intussusception includes:

Colon polyp
Colorectal Polyps information: Polyp growths in the colon or rectum.


Colorectal Polyps information: Most types of colorectal cancer begin with polyps (or grape-like growths on the lining of the colon and rectum). Polyps are very common in people over age 50 and usually are benign (not cancerous). But some polyps do develop slowly over the years into cancer, often causing no symptoms. Screening tests can find polyps that can be removed, preventing cancer. Screening tests can also pick up colorectal cancer at an early stage, when it can be cured.


Diverticular disease
Information on Diverticular Disease: Diverticular disease includes both "diverticulosis" which is just protrusion of the colon wall, and "diverticulitis" which is actual inflammation or infection of these protrusions.


Diverticular Disease information: Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis.

Misdiagnosis of Intussusception

Intussusception as an alternative diagnosis: The other diseases for which Intussusception is listed as a possible alternative diagnosis in their lists include:

Acute Appendicitis

Information on Acute Appendicitis

Information on Acute Appendicitis: The main symptom of acute appendicitis is abdominal pain or abdominal sensitivity. However, abdominal pain occurs with many conditions and only an estimated 5% of cases of abdominal pain are actually appendicitis. Although uncommon, appendicitis is very serious, and difficulty in diagnosing appendicitis in the emergency department makes appendicitis the 3rd leading cause of malpractice lawsuits. Misdiagnosis of appendicitis is particularly common in children and infants with abdominal pain with estimates of initial misdiagnosis rates from 28% to 57% for under age 2-12 and almost 100% misdiagnosis for appendicitis in infants.


Acute Appendicitis information: Appendicitis is inflammation of the appendix, a small portion of the large intestine that hangs down from the lower right side. Although the appendix does not seem to serve any purpose, it can still become diseased. If untreated, an inflamed appendix can burst, causing infection and even death. About 1 in 500 people has appendicitis each year.

Appendicitis may occur after a viral infection in the digestive tract or when the tube connecting the large intestine and appendix is blocked by trapped stool. The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency. Anyone with symptoms needs to see a doctor immediately.

Complications of Intussusception

Complications list for Intussusception: The list of complications that have been mentioned in various sources for Intussusception includes:

Abdominal colic (see Abdominal pain below)
Bowel obstruction
Gangrene
Bowel perforation

Abdominal pain


Pain in the abdominal area or stomach.
Introduction: Abdominal pain can range from various harmless conditions to extremely severe life-threatening conditions. Any symptom of abdominal pain needs prompt professional medical advice. Sudden and very severe abdominal pain should be treated as a medical emergency.
Abdominal pain is a very common symptom, and also common in children. Unfortunately, many cases of acute appendicitis are misdiagnosed each year as gastroenteritis or some other condition, especially in children and infants. Although appendicitis is an uncommon condition, it can be fatal. And there are many other serious conditions that may cause abdominal pain.

Signs of Intussusception

What are the signs of Intussusception?


The phrase "signs of Intussusception" should, strictly speaking, refer only to those signs and symptoms of Intussusception that are not readily apparent to the patient. The word "symptoms of Intussusception" is the more general meaning; see symptoms of Intussusception.

The signs and symptom information on this page attempts to provide a list of some possible signs and symptoms of Intussusception. This medical information about signs and symptoms for Intussusception has been gathered from various sources, may not be fully accurate, and may not be the full list of Intussusception signs or Intussusception symptoms. Furthermore, signs and symptoms of Intussusception may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Intussusception symptoms.

List of symptoms of Intussusception: The list of medical symptoms mentioned in various sources for Intussusception includes those listed below. Note that Intussusception symptoms usually refers to various medical symptoms known to a patient, but the phrase Intussusception signs may often refer to those signs that are only noticable by a doctor:

Severe abdominal colic
Screaming infant
Vomiting
Blood in feces
Bowel obstruction - see also symptoms of bowel obstruction


More symptoms of Intussusception: More detailed symptom information may be found on the symptoms of Intussusception article. In addition to the above medical information, to get a full picture of the possible signs or symptoms of this condition and also possibly the signs and symptoms of its related medical conditions, it may be necessary to examine symptoms that may be caused by complications of Intussusception, underlying causes of Intussusception, associated conditions for Intussusception, risk factors for Intussusception, or other related conditions.

Diagnostic Tests for Intussusception

Diagnostic Test list for Intussusception: The list of diagnostic tests mentioned in various sources as used in the diagnosis of Intussusception includes:

Physical examination
Barium enema - this test may also actually resolve the condition in some cases.

Symptoms of Intussusception

General information about signs and symptoms of Intussusception: The symptom information on this page attempts to provide a list of some possible signs and symptoms of Intussusception. This signs and symptom information for Intussusception has been gathered from various sources, may not be fully accurate, and may not be the full list of Intussusception signs or Intussusception symptoms. Furthermore, signs and symptoms of Intussusception may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Intussusception symptoms.

List of symptoms of Intussusception: The list of signs and symptoms mentioned in various sources for Intussusception includes those listed below. Note that Intussusception symptoms usually refers to various symptoms known to a patient, but the phrase Intussusception signs may refer to those signs only noticable by a doctor:

Severe abdominal colic
Screaming infant
Vomiting
Blood in feces
Bowel obstruction - see also symptoms of bowel obstruction
More symptoms of Intussusception: In addition to the above information, to get a full picture of the possible symptoms of this condition and its related conditions, it may be necessary to examine symptoms that may be caused by complications of Intussusception, underlying causes of Intussusception, associated conditions for Intussusception, risk factors for Intussusception, or other related conditions.

Risk Factors for Intussusception

Risks factors for Intussusception: medical news summaries: The following medical news items are relevant to risk factors for Intussusception:

Childhood gastro preventable with 2 vaccines

A major cause of gastroenteritis in children, rotavirus, now has 2 effective vaccines to protect against the common and occasionally deadly disease. Rotavirus kills 20-70 people each year in America by inducing dehydration that often requires hospitalization. An earlier attempt at a rotavirus vaccine was associated with a slight increased risk of inducing intussusception, or twisting of the bowel, and was removed from the market. Immunization with the 2 new vaccines decreases the amount of inflammation in the intestine, which is responsible for causing diarrhea and therefore dehydration. Studies conducted on the vaccinations found that young children were far less likely to develop the bowel inflammation and therefore the symptoms of rotavirus.



Rotavirus vaccine development

Rotavirus is a common cause of gastroenteritis in children, which can cause excessive diarrhea and vomiting, leading to dehydration, occasional hospitalization, and possible death. Immunization against rotavirus was originally available in the late 1990's, however it was shown to increase the risk of intussusception (twisted bowel). Medical health authorities are anticipating the global benefit that the vaccine will bring.

Causes of Intussusception

Underlying condition causes of Intussusception: The list of possible underlying conditions (see also Misdiagnosis of underlying causes of Intussusception) mentioned in various sources as possible causes of Intussusception includes:

Colon polyp
Diverticular disease
Causes of Intussusception: medical news summaries: The following medical news items are relevant to causes of Intussusception:

Childhood gastro preventable with 2 vaccines
Rotavirus vaccine development
What causes Intussusception?: Related information for Intussusception causes, as with all medical conditions, there may be many causal factors. Further relevant information on causes of Intussusception may be found in the risk factors for Intussusception, medications that may cause Intussusception, contagiousness for Intussusception, genetics of Intussusception, and underlying causes of Intussusception.

Prevalence and Incidence of Intussusception

Incidence (annual) of Intussusception: about 2 per 1000 cases in infants
Incidence Rate: approx 1 in 500 or 0.20% or 544,000 people in USA [about data]
Incidence extrapolations for USA for Intussusception: 544,000 per year, 45,333 per month, 10,461 per week, 1,490 per day, 62 per hour, 1 per minute, 0 per second.

Basic Summary for Intussusception

Main name of condition: Intussusception




What is Intussusception?
Brief description of Intussusception: Bowel folding into itself sometimes creating bowel obstruction
Parent types of Intussusception: Bowel Obstruction, Intestinal obstruction
Organs Affected by Intussusception: bowel


How many people get Intussusception?
Incidence (annual) of Intussusception: about 2 per 1000 cases in infants
Incidence Rate of Intussusception: approx 1 in 500 or 0.20% or 544,000 people in USA [about data]


Who gets Intussusception?
Patient Profile for Intussusception: Many cases in infants 1 month to 2 years; other ages possible.


How serious is Intussusception?
Complications of Intussusception: see complications of Intussusception


What causes Intussusception?
Causes of Intussusception: see causes of Intussusception
Risk factors for Intussusception: see risk factors for Intussusception


What are the symptoms of Intussusception?
Symptoms of Intussusception: see symptoms of Intussusception


How is it treated?
Research for Intussusception: see research for Intussusception

Contents for Intussusception

Basic Summary for Intussusception
Prevalence and Incidence of Intussusception
Causes of Intussusception
Risk Factors for Intussusception
Symptoms of Intussusception
Diagnostic Tests for Intussusception
Signs of Intussusception
Complications of Intussusception
Misdiagnosis of Intussusception
Misdiagnosis of Underlying Causes of Intussusception
Doctors and Medical Specialists for Intussusception
Cure Research for Intussusception
Statistics about Intussusception
Statistics by Country for Intussusception
Medical News Summaries About Intussusception
Books about Intussusception
Articles about Intussusception
Glossary for Intussusception
Clinical Trials for Intussusception
Surveys relating to Intussusception