Cushings Disease: Symptoms, Treatment and Causes

Cushings Disease: Symptoms, Treatment and Causes Julie Seel   Introduction Cushings disease is relatively rare and is commonly in adults. Cushings is a hormonal disorder that the bodys tissues care exposed to increased levels of the hormone cortisol. (NIH) The cortisol hormone is released when there is stress and with exercise in some people. The main things that the cortisol does are: throttling or suppressing the immune system, metabolizing fats and carbohydrates, and increases blood sugar. (healthline) The Cushings disease is more commonly observed in women, and about 90% of those cases are due to pituitary microadenoma or corticotroph hyperlplasia. (virtual library) Signs and Symptoms Signs and symptoms vary, but most cases have upper body obesity, round face (moon face), increased fat around the neck and shoulder area (buffalo hump), osteoporosis, high blood pressure, increased blood sugars. Also women can have increased hair on face and chest, abdomen and thighs. Men may get a decrease in fertility and absence of sexual desire and possibly erectile dysfunction. (Nih)(Lab) the ICD-10 code for the Cushings disease is E24.9. In some rare cases people have had inherited the gene for Cushings disease, such as multiple endocrine neoplasia type 1 or Men-1. This can increase risk for tumors developing throughout the endocrine system and sometimes include the pituitary and adrenal glands. People who are obese and have diabetes are at a high risk for this disease (Lab). Diagnostic Testing There are a number of tests the doctor can give for the Cushings disease diagnosis. A 24-hour urine cortisol, dexamethasone suppression test (low dose), salivary cortisol levels are taken in early morning and late at night. These three tests will confirm too much cortisol in the body. Also, the tests can determine the cause of the disease are: blood ACTH level, brain MRI, corticotropin-releasing hormone test, dexamethasone suppression test (high dose), and inferior petrosal sinus sampling (IPSS). Other tests that can be done but isnt necessary are: fast blood glucose and A1c for diabetes, lipid and cholesterol testing, bone mineral density can too check for osteoporosis. (Medline Plus) Treatment Options At the follow-up appointment the doctor will go over all the test results, and the next plan of action will be. The treatment would be surgery to remove the pituitary tumor and the pituitary gland may return to normal and start to work slowly again. During the recovery process, cortisol replacement therapy, so the pituitary needs to be able to have time to make ACTH again. Also, if the doctor could not remove the whole tumor completely radiation might be done to the pituitary gland. If surgery and radiation doesnt work on the tumor, medication may be needed to stop making the coritsol in the body. The last resort if none of these treatments work, the adrenal glands will be removed, and it will stop the increased levels of the cortisol. Also, if the adrenal glands are removed the tumor on the pituitary gland will get much, much bigger. (medline) Prognosis/ Summary If Cushings disease is left untreated, it can lead to severe complications. People can have excessive fatigue, obesity, nausea and vomiting, diabetes, hypertension and can lead to premature death. (Skull) Removal of the tumor can be a full recovery, but lifelong replacement medication to keep your hormones in balance. Two medications that have been approved by the FDA are: mifepristone and pasireotide, for the treatment of Cushings disease. (Medline Plus) Very rare the tumor can grow back, and the patients will need to go back to the doctor and see what can be done the treatment options are. REFERENCES Cuevas-Ramos, D. (n.d.). Update on medical treatment for Cushings Disease. [online] Available at: http://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-016-0033-9. Ilias I, N. (2012). National institute of diabetes and digestive and kidney diseases. [online] Available at: https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome [Accessed 5 Mar. 2017]. Krause, L. (2005). Pituitary-dependent Cushings disease. [online] Available at: http://www.healthline.com/health/cushings-disease [Accessed 28 Jan. 2016]. Labtestonline.org. (2016). Labtestonline.org. [online] Available at: http://www.labtestonline.org/conditions/cushing [Accessed 10 Mar. 2017]. Mayoclinic.org. (2016). Overview Cushing syndrome Mayo Clinic. [online] Available at: http://www.mayoclinic.org/diseases-conditions/cushing-syndrome/home/ovc-20197169 47k [Accessed 10 Mar. 2017]. Medlineplus.gov. (2016). Cushing Syndrome | Hypercortisolism | MedlinePlus. [online] Available at: https://medlineplus.gov/cushingssyndrome.html [Accessed 10 Mar. 2017]. Skullbaseinstitute.com. (n.d.). Cushings Disease: Surgery, Treatment Symptoms | Skull Base Institute. [online] Available at: http://www.skullbaseinstitute.com/pituitary-gland-tumor-surgery/cushings-disease-endoscopic-surgery.htm [Accessed 10 Mar. 2017].

Abortion :: essays research papers

As of right now, abortion is legal in all nine months of the pregnancy for any reason. This controversial issue is a question of how important the value of life is. The turning point came in 1973 when the Supreme Court's decision in Roe vs. Wade saying, that women have the right to murder an innocent child only up to 24 weeks . This false perception is fueled part by groups supporting abortion rights and it is then uncritically unaccepted by the media. The fact is that the current law allows a woman to get an abortion for any reason she deems necessary.It seems ironic that a people can get so emotional when it comes to animal rights, yet see no wrong in ripping a developed baby from the protection of the mother. It is not the child's fault that he or she was conceived. Some people argue that the developing is not technically a child yet because it cannot live on its own. Most of the procedures in murdering the growing child can be painful to the baby and be harmful to the mother. So how can we as a nation make sure criminals are executed painlessly and let children be murdered by extremely painful measures. At 18 days after conception, a baby's heart is already beating, and at 6 weeks, brain waves can be measured. At 8 weeks, the stomach, liver, and kidneys are functioning, and the fingerprints have formed. At 9 weeks, the baby can feel pain . Here are some methods of early abortion:Vacuum Curettage: powerful suction tube inserted through the cervix and into the womb. The unborn child is torn apart by the force of the suction; the fetal body parts and placenta are sucked into a jar. Possible complications include infection, cervical laceration and uterine perforation. Mifepristone: also known as RU-486, the chemical causes an abortion by interfering with the function of the placenta, starving the unborn child to death. Prostaglandins are then administered to expel the fetus. This method of abortion takes place over the span of several days; the average woman using it bleeds heavily for more than nine days, but some women have bled for over four weeks. Mifepristone is just beginning to be used in the US. Long-term health risks are not yet known. Methotrexate: though not approved by the FDA for this use, a methotrexate injection kills the unborn child by interfering with the growth process (cell division).

Critical Analysis of a Child’s Reading Essay

Reading is an essential skill in modern society. Not only does it enable people to access information, it provides people with a great deal of pleasure. It is vital that primary schools equip children with effective strategies for reading as well as foster a desire to read that will stay with them throughout their lives. This analysis of reading will firstly give a brief outline of the context of my school placement. It will analyse two pupils as readers and their strategies. The school’s policy indicates that the context of teaching reading is very important – suggesting a variety of text styles. English & Williamson (2005) inform us that the introduction of the National Literacy Strategy (DfES 2001) broadened the range of texts children are introduced to at primary level. The school is superbly resourced, with thousands of books available to all pupils. Silent reading is also practised daily. X Primary is a larger than average three-form entry primary school with 472 pupils. It’s in an area of average to high socio-economic status and the majority of pupils are from White British backgrounds with few pupils who speak English as an additional language. The number of pupils with learning difficulties is below average. (Ofsted 2010). Below is an analysis of a child’s reading. I will focus on analysing the child’s mistakes in reading, called miscues (Hall, 2003) to gain information of the child as a reader. See more: how to write a critical analysis outline Pupil A was chosen for assessment as he enjoys reading and is a strong reader. He has had several school moves due to family issues, and has received intervention and support throughout his time at Primary X due to his level of absence. He is eager to learn, and was keen to read for me. The assessment involved analysing his word recognition and comprehension skills. This provides an opportunity to understand how Pupil A as a fairly fluent reader may process a text. The text which was read by Pupil A was chosen as it was unknown to him. It was also chosen as a text that was suitable for his level of reading. Many of Pupil A’s miscues take place in the form of substitution. These miscues often relate to his syntactic knowledge. He reads ‘a’ instead of ‘one’ (line 3) and ‘but’ instead of ‘and’ (line 8). He also produces the miscue ‘even’ (line 9) as an insertion. These miscues suggest that he is making predictions about a text using his syntactic knowledge. This suggests that Pupil A brings his own knowledge to a text which causes him to make ‘predictions’ (Smith cited in Hall, 2003), resulting in a miscue. This suggests that Pupil A uses his syntactic knowledge to obtain meaning in what he reads (Hall, 2003). This miscue can also alter the meaning of the text which may affect his understanding. Pupil A makes the same miscue when he substitutes ‘for’ for ‘from’ (Page 2 line 1). He self corrects and asks for reassurance in his correction. Pupil A also corrects himself on the word ‘quickly’ (Pg 3 line 3). This self-correction reveals that he uses syntactic knowledge to process the text, but also that the text Pupil A sees is different from the text on the page (Goodman cited in Hall, 2003). Goodman suggests that there are two texts in question when reading takes place, being the actual text, and the perceived text. Pupil A demonstrated a comprehensive understanding of the text. He demonstrated an understanding for the organisation of the text and recalled events of the story. Pupil A demonstrated an ability to infer from the text and evaluate it. When questioned, he was able to express that he liked the text and expressed why. He demonstrated emotional or psychological response to the text and characters feelings. This suggests that Pupil A engaged with the text and was interested in the plot. In conclusion Pupil A demonstrates a clear ability to read fluently and uses different strategies for decoding words. His ability to decode unknown words could be extended by knowledge of consonant digraphs. Pupil A shows an ability to understand a text on a literal level, as well as engaging in a text by making inferences and evaluating a text. We could improve this motivation to read by encouraging Pupil A to read regularly for pleasure. Pupil B was chosen as although she receives literacy support, she does not enjoy reading. She has accessed literacy support since starting at Primary school in Year 3 and has made considerable progress and is able to read certain texts independently however she also shows little interest in reading for pleasure. She is willing to read with me, as she is used to reading with adults, in a 1-1 situation, and is comfortable with me as I have been in her class for several weeks. She is reluctant to pick a book she in unfamiliar with and cannot think of a favourite author/book when questioned. Pupil B begins well, with her decoding strategies revealing her processing of a text but also her phonic knowledge. She reads the word ‘spider lings’ (line 8) correctly, by segmenting the word in her head first. She then blends ‘ling’ quietly, to herself, and then asks for reassurance to put both words together. This is because this is an unusual, unknown word, and Pupil B is unfamiliar with the term. She stumbles over the word ‘different’ (line9). She did not segment the word out loud and so it is difficult to determine which strategy she used to decode the word. Nevertheless, it is possible that Pupil B may have used one of two strategies. For the first strategy, it’s possible that she segmented and blended the word in silently. This suggests that Pupil B is confident in segmenting and blending. For the second strategy, Pupil B may have used her graphophonic knowledge to decode the word. Therefore it is possible that she recognised the word from previous reading exercises. She demonstrates her grapheme-phoneme correspondence knowledge in her unsuccessful attempt to decode the word ‘notice’ (line 10). She fell silent which suggests she attempted to segment the word in her head. However, Pupil B finds this strategy unsuccessful and then chooses to segment the word out loud Pupil B often falls silent throughout the exercise, and waits for a prompt. I feel this is due to her lack of confidence rather than lack of knowledge. Pupil B demonstrates her grapheme and phonemic knowledge (Hall, 2003) by successfully sounding out the first syllable of the word ‘children’ (line11). She was unable to sound out the second syllable. This suggests that she struggled to sound out a particular grapheme. It’s possible that Pupil B was unfamiliar with the consonant digraph ‘il’. However, Pupil B demonstrates a fluency in reading which may suggest that she uses sight reading as a strategy (Ehri cited in Hall, 2003) to process a text. Erhi (cited in Hall, 2003) suggests that readers find new ways of identifying words. Finding new methods to identify a word can help a reader to become a more fluent in reading. My reading assessment can provide an insight to how a reader may process a text (Ellis & Lewis, 2006 but it’s only an insight. I cannot be certain that the suggested reading strategy is the method used. The child’s responses is dependent on the text. Another influence could be the text’s difficulty. Too difficult a text may cause them to make miscues and create an unfair representation of the reader (Campbell, 2011). A reader’s inability to engage in the text may be because the reader is not interested in the text. To remedy this, it would be useful to find out what books the reader prefers. Another strategy for developing reading is shared reading which provides opportunities for children to peer assess. Iversen & Reeder (1998) suggest that this allows children to actively participate when they feel comfortable. This is useful when children haven’t developed full confidence in their own reading ability, it provides a ‘safe’ structure encouraging contribution. This would be beneficial if both pupils could work together as Pupil A may help Pupil B become more engaged with the text. After analysing both Pupil A and Pupil B, I was surprised at how both pupils used similar techniques, however they were different when reading aloud. I felt there was a gap in understanding and intonation from both pupils, despite being close in age, and both receiving support. I believe another difference was the pupils was desire to read, with Pupil A keen to read books, demonstrating a clear opinion on authors or genre, however Pupil B was reluctant to name a book she’d read, and didn’t have a favourite author/style. I believe this lack of enthusiasm for reading will hinder her development, regardless of support put in. In conclusion, both pupils show an understanding and varying strategies to break down a text, however the major difference seems to be their attitude towards reading itself. References EDP 4120 Assessing Reading Riley, J & Reedy, D. (2000) Developing writing for different purposes: teaching about genre in the early years. Paul Chapman Publishing, London. Iversen, S. & Reeder, T. (1998) Organising for a Literacy Hour, London: Kingscourt Publishing. Hall, K 2003 Listening to Stephen Read: Multiple perspectives on Literacy Buckingham: Open University English, E. and Williamson, J. (2005) Meeting the Standards in Primary English. Routledge Falmer. DfES. (2006) The Primary Framework for literacy and mathematics, London: Department for Education and Skills. DfES. (2006) The Primary Framework for literacy and mathematics: Core position papers underpinning the renewal of guidance for teaching literacy and mathematics, London: Department for Education and Skills. DfEE. (1999) The National Curriculum: Handbook for primary teachers in England, London: Department for Education and Employment. Ofsted 2010 Campbell, R 2011 Miscue Analysis in the Classroom Leicester: UKLA

Globalization Effects on Jamaica and Thailand Essay

Globalization Effects on Jamaica and Thailand Introduction Globalization through dam building (for electricity) and tourism (for economic security), has imposed positive and negative effects on many countries and cultures. This paper focuses on tourisms impact on Jamaica and the consequences dams have had in Thailand. For both countries globalization has had both advantages and disadvantages. Tourisms Effect on Jamaica Globalization through tourism has had a significant effect on Jamaica. Originally, tourism was intended to profit the country by tourist spending. It was believed the economy would grow from an increase in job availability. Also, the conjecture of most Jamaicans was the hotels generated tourist spending†¦show more content†¦Although there were advantages for the Thailand people, for many Thai it has had more negative than positive effects. â€Å"Major Challenges in balancing the benefits of clean electricity, water storage and flood control from the dams against negative impacts. These include population displacement, obstruction to fish movements up and down the river, and changes in water and sediment flow†. (Richardson, Michael 2009). The disadvantages began to out way the advantages. Building of Pac Moon Dam and other Dams have affected Thailand in several other adverse methods. It severely decreased fish up to 60%. â€Å"Accord ing to the Foundation for Ecological Recovery, the rivers fishing industry alone is worth up to 3 billion annually, and the existing dams are already decreasing that profit.† (Blake, Haley 2009). Whole species became extinct. The river had 50 different rapids that flowed with river dependent fish. Riverbank vegetation, Bamboo, and mushrooms began to disappear. Liver fluke, Blood fluke, and Schistosomiasis increased due to stagnant water. Villagers were dependent on income generated from fish, bamboo and mushrooms. Food and income deteriorated. Many Villagers moved away. Their lives and livelihood depended on the river. The people of Pac Moon Dam had already experienced the ill ecosystem change from past dams built as expressed inShow MoreRelatedThe Economic Development Of A Nation1852 Words   |  8 Pagesconstrains the development of the economy moreover. As Primaria is a developing nation there are numerous regions we can work to pull the economy and also the gene ral development of the country. The foreign investment in the nation can have a major effect on the economy. 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