How Do You Get Rid Of A Yeast Infection Under Your Breast?

How Do You Get Rid Of A Yeast Infection Under Your Breast?


How do I get rid of a yeast infection under
my breast? This is a question I’ve been asked a couple of times. Not so much as many of
the other ones, but it’s an important one to answer. First thing to determine is whether it is
a yeast infection or not, and sometimes a swab will do this. Sometimes a good visual
inspection will give you that idea, but generally in areas like the folds of the skin around
the belly or under the breast or between the buttocks or even around the thigh area, if
a person’s quite large, of course, this is going to be a perfect breeding ground for
Candida. You’ve got the darkness, the moisture, perspiration, all that in that area and Candida
is going to like to grow in that area. The most obvious thing to do is to if it’s
possible is to look at some kind of breast reduction or how we can stop this skin from
sort of like hanging together there creating that. Maybe a bra or some kind of a device,
but you’re going to spend regular attention to that area to help overcome it. This condition
needs to be treated both locally as well as systemically.
I’ve had many women from Australia, New Zealand; I’ve treated with this condition over the
past many years, and generally I find my satisfactory long-term resolution is weight loss. Weight
loss will help because it’s going to help the body generally strengthen the immune system,
increase digestive function, we can get the bowel back in order again, reduce the ability
of the body to grow Candida internally, and also help it, therefore, externally. And externally,
we apply things like calendula cream or tea tree oil. We have showers twice per day. We
can get a natural kind of a powder and put dry powder under the breast area there to
keep the moisture away from the region that’s causing it. I wouldn’t use fungal creams if
I were you. I’d probably use a tea tree oil cream, as you can get these kind of products
at a good health food shop, a good cream with tea tree oil.
So dryness, sunshine, these are enemies of Candida. Allowing sun exposure to that area.
Keeping the area dry. Maybe some form of barrier for a while. Weight loss. Local application.
Internal treatment. Internal treatment follow my Candida Crusher program. Go to yeastinfection.org.
Do my quiz on CandidaCrusher.com to determine if you’re mild, moderate or severe and then
definitely treat the outcome based on the quiz. The quiz is amazing. We spent a lot
of time and money on that quiz to get it perfect. It’s the best quiz online. So you’ll be able
to determine with a high degree of accuracy how bad this is affecting you internally as
well as around the breast region. So give those suggestions a go. Thanks for
tuning in.

What is HIV and AIDS? | Infectious diseases | NCLEX-RN | Khan Academy


– [Voiceover] What is
HIV, and what is AIDS? Well, let’s first look at HIV. HIV is a virus that
attacks our immune system, and if we expand this out, we can see that that’s reflected in its name: Human Immunodeficiency Virus. So this implies that it
does something to our immune system somehow, and we’ll actually explore that a little bit later on. And if we don’t treat HIV,
it’ll eventually cause AIDS in the infected person. Acquired Immune Deficiency Syndrome. So right away you already get a sense that HIV attacks your immune
system so destructively, that you end up acquiring
an immune deficiency system. It puts you into a state
of immune-system failure, so you end up not being able to fight off even the most basic infections. And this immune-less state,
is what we call AIDS. So let’s explore this a
little bit further now. Let’s actually use the help of a graph, this might be helpful. So here’s our graph, and
we’ll put time down here on our X-axis, and actually
just to make this extra useful, we’ll put weeks in this
beginning part here, and then we’ll transition
to years here, and you’ll see how this is relevant in
a few more minutes here so, on the Y-axis here, we’ll
put CD4 T-lymphocyte count. T-lymphocytes are a
really really important type of immune system cell. And CD4 just refers to a
type of protein that’s stuck through their cell membranes,
that’s kinda how we like to identify them, by this
protein on their membranes. And the reason they get a
special spot on an entire axis of our graph here is
because they’re super important in the progression from
HIV infection to AIDS. Because as you might have
suspected, it turns out that HIV preferentially
loves to infect these CD4 cells of our immune system. And why is this so bad? Well, these CD4 cells,
also called helper T cells, play a huge role in signalling
your other immune cells to come and destroy every
given infectious particle that our body discovers. Like maybe strep throat
bacteria, or flu viruses, or even HIV viruses, for that matter. So these CD4 cells are kinda central. They’re almost like little
amplifiers of our immune system. So because HIV loves to
infect and kill these cells, it completely disrupts how
our immune systems function, and renders it essentially useless. So let’s say you acquire HIV in your body, either in your bloodstream
or your tissues, maybe through unprotected
sex with an infected partner, that would be the most
common method of becoming infected with HIV, in adults at least. What happens? Well, the main thing is that
the virus really quickly gets into your white blood cells, so these T-helper cells, the
CD4 cells we’ve talked about. But also some other white blood cells, like your macrophages and so on. And from inside a white blood
cell, it can do two things. One, it can sorta hijack
your cell’s machinery, so it manages to insert
its genetic material into your own cell’s DNA. And from there it starts to
make lots and lots and lots of copies of itself, lots
of new HIV particles. Actually that’s really really important, so let’s put that on our
graph too, let’s say, “viral load” here on another Y-axis here. Viral load referring to the amount of HIV in your bloodstream. So we can see that after
our primary infection here, the viral load starts to increase. It’s hijacked our T helper cells, and now new HIV particles
are being churned out, and our viral load is
majorly on the upswing. And you’ll notice that the
viral load is starting to rise at around the two to three week mark, and that’s just ’cause it
takes a bit of time for the HIV virus production to start sort of ramping up within our bodies. And of course a major
concern here is well, the more HIV there is in your bloodstream, the more CD4 cells get
infected, get hijacked, right? But the biggest problem
here, thing number two here, is that HIV infection of your CD4 cells, triggers a self-destruct
sequence within these cells. So you end up losing these CD4 cells. And even worse, the
self-destruct sequence doesn’t just destroy the infected
cells, it even destroys nearby immune cells that
maybe have come into the area to try to help out. So I won’t go into the
mechanism in this video, but you do end up losing
lots more immune cells than just the infected
ones, and that’s part of why you see this massive dropoff
here, this line representing our CD4 T-cell numbers has this
really steep downward slope, we’re losing lots of T-cells. While at the same time our
HIV viral load is going up and causing more and more
infection of our cells. The other thing I wanna point
out here is you can see this massive rise in viral load
and this pretty massive drop in CD4 levels, and this
huge viral load means that this time period right,
early on in an infection, is when someone with HIV
has the highest risk of transmitting it to someone else. I guess one good thing
here is that eventually, maybe a month or so in,
your immune system gets somewhat of a handle on the virus, and it starts to make
anti-HIV antibodies, right? Those are just antibodies against HIV. So they start to fight off
the virus to some extent. And this is called seroconversion,
when you make antibodies to something, so now we’ve
seroconverted to HIV. So now the antibodies
get to work on helping to destroy the viral particles. And that’s why we see this decrease here in viral load in the bloodstream. Because our immune system
is starting to control the viral levels to some degree. And this also gives our CD4
cells a chance to recover, to some extent, because there’s less virus around to infect them. So you might be wondering, how
you’re gonna feel during all of this, with this massive
battle going on inside your body? Well, you’re gonna feel
sick, you’re probably gonna feel like you’re having the
worst flu you’ve ever had. So about here, about a month
or so in, at seroconversion, you start to fight the infection. And as a result, most
people get some serious flu-like symptoms, so things
like headache, and fever, and sore throat, muscle
pains, joint pains, some people get swollen glands, just sort of fatigue and feeling unwell. Some people get a rash, some people get some open sores in their mouth. These are some of the more common symptoms of an acute infection with HIV. And this flu-like illness
that people experience is referred to as Acute HIV Syndrome. And the reason for a lot of
these symptoms is because well, when immune system
cells get really active, or when they die off, both
of which are happening here of course, they tend
to release these little chemical signals that cause inflammation, sort of all throughout your
body, and so this is what underlies a lot of these symptoms here. So back to our graph,
the immune system can’t completely kill off the
HIV, even though we have antibodies now, right? And that’s because A, remember the rate of immune system killing is
roughly matching up with the rate of new viral
particles being produced. And B, because the virus has
sort of taken up residence in some really really hard-to-reach
reservoirs in our body. Like within the brain and
within our bone marrow, and within our genital tract. Because of these two
reasons, these curves tend to sort of stabilize at some
point, they reach a set point, where again, our immune
system is killing off HIV at a pretty similar rate to
which HIV is replicating. So the curves start to
come together a bit more and stabilize somewhat. So this period here is
thought of as the start of the second phase of HIV
infection, what’s called the latency period, or Chronic HIV. This acute infection back
here being phase one. So in this latency period, we
don’t tend to see any clinical signs of HIV illness, the
person is often asymptomatic. They’re still infectious, but
there are few or no symptoms during this phase, and without treatment, this phase will last on
average about 10 years. And I said that our curves
here stabilized, right? But it turns out that
HIV’s actually replicating, killing our immune cells
just a teensy little bit more than our CD4s are recovering. So over this long period
of time, phase two, eventually, again, without treatment, HIV will start to overwhelm
our immune system, and we’ll start to see symptoms again. So things like fever or muscle
pains or swollen glands, really similar to the
acute infection, and again, much for the same reasons as before. And many people at this
stage of the illness experience significant weight loss. HIV causes you to use
more energy than usual, and also prevents you
from absorbing nutrients from your food as well
as you normally would. So we often see some
significant weight loss for these and a few other reasons as well. Eventually, if our CD4 cells
get to a critically-low number, and result in our having no
functional immune system, that’s what AIDS is. Essentially a state of being
where we have no immune system. So at this point, this
is when certain bugs, bacteria and viruses that
would never stand a chance against even a
minimally-effective immune system, these things start to infect the person. And we refer to these
specific infections as AIDS-defining illnesses,
because we just know that if somebody has
one of these illnesses, they just cannot have a
functioning immune system, it just wouldn’t happen,
or at least it would be really really unusual. So there’s a high suspicion
of this person having AIDS and not just an HIV infection anymore if they have any of these
AIDS-defining illnesses. Two examples of
AIDS-defining illnesses are two fungal pneumonias, one
called pneumocystis pneumonia, and one called cryptococcal pneumonia. These are two common
AIDS-defining illnesses. And again, these aren’t the
types of infections that you get when your immune system
works even a little bit. So actually one of two
criteria has to be met before we can say someone has AIDS. Either they have to have
extremely low amounts of CD4 cells in their blood,
and to get a little bit technical here, it’s if they
have less than 200 CD4 cells per microliter of blood,
with the normal count, the normal CD4 count in
this amount of blood, it should be around
1000 to 1100 CD4 cells. Or, regardless of CD4 count, if they have any of the
AIDS-defining illnesses, like either of these, for example, then we can say that
they have developed AIDS. And so you might have suspected
this, but it’s actually the overwhelming impact,
and the complications of serious infections that you pick up because of the immune deficiency in AIDS that actually results in
the death of the person. So from HIV infection to
eventually an incredibly high amount of viral particles,
and low amount of CD4 cells in the bloodstream, to
development of a completely non-functional immune system in AIDS, very quickly leading to
overwhelming infection by essentially every infectious
pathogen from A to Z. And because of this, death results.

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What is tertiary syphilis? | Infectious diseases | NCLEX-RN | Khan Academy


– The last stage of syphilis is referred to as tertiary syphilis. This occurs three years
after the initial infection, and has its own set of
characteristics, signs, and symptoms. I don’t have space to write
it down here, so, instead, I’ll write up here that tertiary
syphilis is not contagious. There are three main sets
of symptoms you’ll have with tertiary syphilis. The first occurs across the
body and can appear anywhere, but seems to occur most
commonly in these three places. That is the development
of what are called gummas. A gumma just refers to a
large bump that appears where it’s not supposed to. That means if syphilis
spreads into your liver from the bloodstream, you’ll
get these bumps on the liver that may have the same
color and consistency as the standard, normal
liver tissue that I have right underneath here, but
this is mainly the result of the syphilis treponemes
fighting white blood cells over a long period of time, three years. You can see the same thing when syphilis spreads to your bones. I’ll show this big deformity
of the femur right here, all due to the syphilis treponeme. If this treponeme, or this spirochete, spreads up to your skin, and attacks the blood
vessels that live there, you’ll start to see bumps
from the battle of syphilis and white blood cells as well. These gummas can be so deforming, that you can have a result like this here. This is a bust of a patient
that had tertiary syphilis, that has these very striking deformities. One right here, I can see
another there, the nose, and maybe one over here as well. If you ever visit the Musee, or Museum, de, or of, l’Homme, or the Museum of Man in Paris, you can see this bust of this patient with tertiary syphilis as well. In addition to gummas,
a patient can also have what’s referred to as neurosyphilis, which, exactly as you
might expect from the name, is the invasion of the central
nervous system by syphilis. Down here, you can see
this is a cross-section of the spinal cord, so
I’ve cut it in half, like if I had put a samurai sword through this patients’ spinal
cord, going this way to that. You should notice that
there are two blood vessels that supply the spinal cord in the back, or on the posterior aspect, and there’s one main
blood vessel that supplies the spinal cord to the front,
or the anterior aspect. Now, remember that syphilis, specifically, likes to invade the walls
of the blood vessels, and sets up shop in the
endothelial cells that line them, so you’ll see some characteristic
symptoms that occur because syphilis will
invade the blood vessel wall that’s supposed to supply
oxygen and nutrients to the spinal cord, so
if the treponeme goes and infiltrates the endothelial cells that line the blood vessels on the back or the posterior aspect
of the spinal cord, you can develop symptoms
that are grouped together and referred to as tabes dorsalis, which is just Latin for decay in the back, or on the dorsal aspect,
so decay in the back of the spinal cord. I don’t wanna go into too
much detail about the anatomy of the spinal cord, but
just know that there are specific tracks that are bundled, so if we deprive the back of the spinal
cord of oxygen and nutrients, you’ll see a different set of symptoms than if we do that in the front, so if we have a decay in the
back, you can have a loss of vibration sense. The other thing the
back of the spinal cord is responsible for is position sense, which lets you know where your body parts, like your hands and your
arms are, relative to space. Another term for that is proprioception, so you’ll also lose your
proprioception as well. If syphilis invades the endothelial cells that line the blood vessels in
the front of the spinal cord, you’ll get a different set of symptoms that are grouped together
and referred to as general paresis. Paresis is just a fancy
word for paralysis. The paralysis that we have here is, classically, localized in the legs, so you can have a loss of sensation, so if someone touches your leg, you won’t even notice that, and you may not even be able to move them, so you could lose motor function. The last thing I’ll mention
here about general paresis, sometimes, this is also referred to as general paresis of the insane because, in addition to the spinal cord, syphilis can also spread up to the brain to cause mental disorders as well. Another classic symptom that you can have, as part of neurosyphilis,
is referred to as having Argyll Robertson pupils. I’ve drawn this set of eyes down here, and here are the pupils in brown. Now, what the pupils let us do is regulate the amount of
light that we’re perceiving. I’m gonna draw this tree
here cuz we’re taking a look on a nice, bright, sunny day, and we see this tree. If it’s a really sunny day outside, we might have some
trouble seeing this tree, just like how a camera would have trouble taking a picture with very high exposure. In order to make a better
image for our brain to process, our pupils will constrict. I’ll draw this pupil narrowing, and I’ll do the same on this side. These pupils will constrict
to limit the amount of light that enters and is
processed by the retina, or the back of the eye. The same thing happens
if we take this tree, and we move it closer to the eyes. The way you can think
of it is that the light that the tree bounces off and gives off a green color of the leaves
and a brown color of the trunk, is still light that may be too
much for the eyes to process if it’s too close, so the
pupils will constrict as well, when they try to focus on a nearby object. That process is called accommodation. I’ll just write here accommodate. These pupils are able to accommodate. The interesting thing about
having Argyll Robertson pupils, is that we’re able to accommodate, so someone with tertiary
syphilis can accommodate, I’ll put a check mark right there, but they can’t react to light, so I’ll cross out the
light source over here. The reason why this happens is that there are two different
nerves that process this. There’s a separate nerve that
allows the eyes to accommodate when focusing on a nearer object, and there’s a different nerve that causes the pupils to constrict in response to just light. Syphilis will preferentially
attack the blood vessels that supply the nerve that
help us react to light. Finally, the last type
of symptom we can get, associated with tertiary syphilis, is what’s referred to as cardio syphilis. Just as the name suggests,
and I’ll draw down here, that involves an infection related to the cardiovascular system. I’ll draw the heart first
and the blood vessels that come off of it. I mentioned earlier that syphilis likes to attack our blood vessels, so it only makes sense that
syphilis, in its final stages, will finally reach and attack the largest blood vessel in our body. That’s the aorta, and an
infection of the aorta is referred to as aortitis, so you can get syphilitic aortitis when you get syphilis, or this treponeme, to
infiltrate the endothelial cells that line this giant blood vessel, which will lead to widening of the aorta. I’m drawing it wider over
here, so it’s going to become a lot bigger than it’s supposed to be, so, as the aorta widens,
it will cause the heart to work much harder to get
the same amount of blood out to the rest of the body. On top of that, the walls of the aorta will even become thinner, up until a point when the aorta, which is now turned into an aneurysm over here, will pop. Again, we refer to this
dilation as an aortic aneurysm, where an aneurysm is just
a dilation or a widening, which will continue to a point when the walls are just too
weak to hold the blood in, then all of a sudden, you’ll
get a rupture, and bleed out, which can either be
closed, and, in which case, you’re pumping blood not
to the rest of the aorta, but within the walls of the aorta. You can have a closed rupture or you can tear through
all the walls of the aorta, and have what’s referred
to as an open rupture, which will bleed out
into the chest and cause a person to die within seconds to minutes. which is why it’s
important to catch syphilis and start treating it earlier on, before all of these symptoms can manifest.

What Causes Recurring Yeast Infections?

What Causes Recurring Yeast Infections?


I’ve got a question here on somebody. What
causes a recurring yeast infection? Recurring yeast infections are caused by probably
a partial recognition of the problem and some treatment that’s been effective to a degree,
so you may know you’ve got this problem, you’ll fix it up a little bit. It’ll go away to a
degree, but then it will recur; it will come back again, so I commonly see this with people,
many different people, who are quite busy and active. They sort of want to get rid of
their yeast infection, but don’t invest the right amount of time or effort to really eradicate
it properly. This is very common with working people, busy
people, with moms with a couple of children, for example, or guys that are self-employed
or working quite hard, you know, have got jock itch, for example. These people are very
busy. They go about their life. They get symptoms. They treat the symptoms. The symptoms go away.
They feel good for a while, and then their symptoms recur. The only way you’re going
to prevent these recurring symptoms is by tackling this thing properly and by getting
on top of the problem or making the right lifestyle and diet changes long enough, usually
four to six months, consistently making these changes to eradicate this infection. Then
being vigilant, being very careful that you don’t get recurrence while monitoring this
condition. And then if the symptoms come up slightly, is to knock them on the head really
fast while making those changes again. I write about this a lot in my book, Candida
Crusher, that the big danger period for a lot of people is when they’re actually in
the recovery phase. Many people have got a lot to learn about a full recovery because
partial recovery with many chronic conditions is much more common than full recovery. I’d
say 75 percent of people partially recover. Partial recovery can be meaning as symptom
free for weeks to months, but full recovery means no symptoms for 12 months plus. There’s
a big difference. Most websites and books and practitioners you see will pitch to you
partial recovery through their treatments because they don’t push you hard enough or
give the patient the right information they need to fully recover. What causes recurring yeast infections is
a partial application of wanting to get well, not fully committing. It’s almost like you’ve
got a job and from eight to five, five days a week, but you turn up at the job three or
four times a week. You don’t go five days a week. You’re not really fully committed
to that job. You’re going to annoy a lot of people. You’ll probably end up getting fired
from that job. It’s the same with a yeast infection. Some
people say to me, Look, I will do everything you say, but I’m not going to give up alcohol.
Of course they’re going to get recurrence. Or as soon as they get a cough or a cold,
they go straight for the antibiotic. Bang! Recurrence. Or they’re over at a wedding and
they’re feeling really good. They’ve felt good for two or three months. They’re at a
wedding, and they get offered some champagne, some nice cakes, and some candies and things
like that, and then they really go into this. They binge on this. They come home and a day
later, Oh, I feel so bad. I’ve got bad bloating, or things like that. Recurrence. So Recurrence is more common if you’ve had
a period of feeling really good, and then you go all out and you go crazy and have a
bit of a binge on something, and then wham, the symptoms recur. It pays to be vigilant
and to be careful with your diet and lifestyle for a good four to six months at a minimum
before you start going back into some of your old habits that lead you to the yeast infection
in the first place. If you can bear some of those points in mind,
you can prevent recurrence of Candida infections. I hope that answers some of your questions. Thank you.

Infection After Joint Surgery? Call The Goldwater Law Firm! 1-800-494-8686

Infection After Joint Surgery? Call The Goldwater Law Firm! 1-800-494-8686


Attention:
If you had hip, knee, or other joint surgery and were then hospitalized for an infection,
call the Goldwater Law Firm! The air-heated blanket or gown used during
your surgery may be to blame! If this has happened to you or a loved one,
call us right now. You may be entitled to substantial compensation. If you had hip, knee or other joint surgery
and then had an infection, call 1-800-494-8686! That’s 1-800-494-8686!

Are you at risk of an adenovirus infection?

Are you at risk of an adenovirus infection?


Adenoviruses have been in the news recently
as there was a recent outbreak of adenovirus infections in New Jersey that has been responsible
for the deaths of at least 10 children. So what are adenoviruses and how dangerous
are they? Adenoviruses are, actually, a common group
of viruses that are mostly known for causing mild upper respiratory illnesses like a mild
cold, but they can also cause severe problems like pneumonia. They can also cause diarrhea, pink eye, bladder
infections, and even neurological diseases if the infection hits the brain or spinal
cord. These viruses circulate year round and are
spread when a person sneezes or coughs which releases the viruses into the air. If the virus lands on another person’s nose,
mouth, or eyes – bullseye! Alternatively, the virus might land on nearby
objects like a light switch—where they can be difficult to remove with cleaning products,
and remain infectious for weeks. They can also be passed by close personal
contact, like when that aggressive aunt pinches your cheek at family dinners. The good news is that hand washing with soap
and water, and avoiding close personal contact with infected people—usually removes the
threat. On the flip side, if you are sick, it’s
good to stay home to avoid spreading the illness, to cover your nose and mouth when you sneeze,
cough into your elbow when you cough, and to wash your hands frequently. There is a vaccine for adenoviruses, but it’s
only given to soldiers and the risks of the vaccine are unknown for children. Now, unfortunately, adenovirus infections
are more severe in children with underlying heart or lung diseases as well as children
with weakened immune systems. This brings us back to the outbreak in New
Jersey, which has devastated already sick children at a nursing and rehabilitation center. In these outbreak settings, the adenovirus
infection can be diagnosed and identified with a viral culture, adenovirus-specific
viral antigen assays, and polymerase chain reaction assays that look for the viral DNA. Fortunately, most adenovirus infections are
mild, and improve with hydration and a few days of rest. In extreme cases, particularly among individuals
who have underlying medical problems like stem cell transplants, the infection can be
severe and require antiviral drugs like cidofovir and brincidofovir—both of which have been
shown to treat the infection, but come with their own side effects. Alright, as a quick recap. Adenoviruses are common viruses that cause
a wide range of illnesses—the vast majority of which are mild, like the common cold. Unfortunately, these infections can become
life threatening if they strike someone with underlying medical problems. While there is no widely available vaccine
for adenovirus, taking a common sense approach, like avoiding close contact with sick people
and washing your hands can protect you.

Urinary Tract Infections in Children (UTIs)

Urinary Tract Infections in Children (UTIs)


Hi, I’m Steve Hodges, Associate Professor
of Pediatric Urology at Wake Forest University School of Medicine. I want to talk to you
about urinary tract infections in children- primarily little girls, because that’s who
gets most of them. Many of you may not be familiar with the urinary
tract. Blood goes through your kidneys- you have two of them which produce urine- which
flows down to the tubes called the ureters into your bladder, where you store the urine
and then evacuate it when you need to. Every urinary tract infection in a little
girl happens when bacteria from the colon comes out of the colon, travels up into the
urethra and bladder and sets up shop. And that’s what causes urinary tract infections.
They can present with varying symptoms- typically urgency and peeing very quickly- dysuria or
pain while urinating. Sometimes it can even progress to urinary frequency and sometime
fever, chills, nausea, vomiting. And those there are actual kidney infections- which
we won’t talk about right now- we’re going to focus primarily on the bladder infections.
I want to talk about how urinary tract infections happen and some of the myths about them. So
we discussed that every infection happens when bacteria travel into the bladder from
the colon. So there’s only three risk factors that girls
can have that cause infections: the primary one is constipation, if you don’t let all
of the stool out of the colon, that can lead to infections; second, is vulvitis or inflammation
of the skin between the rectum and the urethra, that allows bacteria that cause infections
to live on the skin more easily and make its way into the bladder; and the third is incomplete
or irregular emptying of the bladder, kids hold their urine too long and that is a definite
way to lead to infection. A good reminder about that is that I very
rarely see urinary tract infections in children prior to toilet training. That’s because they
have less instance of constipation, their moms usually take really good care of their
bottoms, and they never hold their urine because they don’t have a reason to.
Some common myths for infection include the way you wipe. In fact it’s never been proven
that wiping front-to-back or back-to-front has any effect on the incidence of infections.
Also, a lot of physicians will tell kids not to take baths and to take showers instead
and that really has no bearing on infections- depending on what kind of bath you take. If
you’re in irritating soaps or bubble baths sometimes it can cause inflammation which,
as we mentioned, vulvitis, is a factor in infections.
But sitting in tubs can be beneficial sometimes especially if you use non-irritating soaps.
And sometimes if you have irritation on your bottom, just using baking soda or oatmeal
or a cup of apple cider vinegar can actually soothe the irritation.
People often use cranberry juice to help treat infections. Cranberry juice- there’s rare
data that may help prevent infections, but it’s not very strong and it definitely cannot
treat infections. So the main thing for little girls to do to
help prevent infections is number one: treat the constipation; number two: make sure the
bottom is clean and dry; and number three is urinate on time. If you do those three
things, it’s impossible to get an infection. If you think your daughter has an infection
because she’s peeing frequently, peeing very urgently, or having new onset incontinence,
or pain with urinating, then you should take her to the physician where they will check
a urine study- it’s called a urinalysis. The child voids into a cup and they look at
it under a microscope and there are certain findings on that analysis that will tell them
there’s an infection. If the infection has no fever- just those
bladder symptoms we discussed- then it’s very simple to treat: you just take some antibiotics
and it gets better. If the child has fever and nausea/vomiting
and flank pain, then that could mean a kidney infection which is much more severe and you
may need some imaging studies such as a renal ultrasound or a voiding cystourethrogram to
evaluate the child’s anatomy to see why they are at risk for these worse infections.
It’s important though, if you have these new bladder symptoms, to see your pediatrician
to get this evaluated quickly.

Pathophysiology of chlamydia | Infectious diseases | NCLEX-RN | Khan Academy

Pathophysiology of chlamydia | Infectious diseases | NCLEX-RN | Khan Academy


– [Voiceover] Pathophysiology
is the study of how a disease occurs. And so if we’re talking
about the pathophysiology of chlamydia, we’re talking about how this bacterial organism hijacks
the cells of our body to multiply and cause an infection. Now the unique thing
about chlamydia is that it’s not a very powerful organism that carries a lot of its own nutrients. It relies on the nutrients of
the host cell that it infects. Which means that chlamydia
must live inside of the host cell in order to reproduce and survive. So the way I’m gonna start
off designating chlamydia will be in green. So this initial green dot
right here actually has a very fancy name. This is referred to as an elementary body. An elementary body. Which is just a fancy way of saying it looks like a dot. So the first step of
chlamydia infecting our body is that it needs to somehow enter a cell. And the way that works is
because of our white blood cells. So I’ll draw this guy right here, make him look rather ferocious with these red teeth right here. Now this white blood cell is similar to most cells in our body
in that it has a nucleus. So I’ll draw this nucleus up here. And this is where all the
genetic information for the cell on how to survive and
make proteins is stored. So when a white blood cell
sees this elementary body, this unusual particle that
shouldn’t exist in our body, it wants to eat it. And this process by which
this white blood cell swallows the elementary body, or
any foreign particle, is referred to as phagocytosis. Phagocytosis. Where if you’ve heard this
term before you might recognize that cyt just means cell and phago is just a fancy way of saying to eat. So this cell is eating
this elementary body. And after a nice big gulp, you’ll see that the elementary body is now
contained within this vesicle. We can also refer to it as a phagosome. A phagosome. Some just means a body
that has been eaten, phago. And I just want to point out, I know I drew it as a cartoon here, but the teeth are actually
the cell membrane lining of the white blood cell
that sort of envelops around the elementary body to
turn it into this pocket, this phagosome within the cell. Now, once the chlamydia elementary body is within the white blood cell, it’s game time. Now it uses whatever nutrients it has within this dinky little dot, and let me just redraw the
white blood cell right here. This dinky little dot will convert from an elementary body to this
guy that looks like a star. And because it looks like a star, scientists refer to this
as a reticulate body. A reticulate body. and that’s just a fancy
way of saying reticular, or reticulate means a star. Now once the chlamydia has
turned into a reticulate body, it’s going to use the nutrients
the white blood cell has. So here’s our white blood cell, and the phagosome that I’m
going to purposely draw larger. And the phagosome will have
a lot of reticular bodies, because these will
start using the proteins and the machinery that the cell has to reproduce itself with binary fission, meaning it just splits in half. So I’ll write that term over here. This is using binary fission, where you take something that grows and just cut it in half and now you’ve got two smaller versions of it. Binary fission. And while all this is happening, we’re directing nutrients the
cell should have been using to fortify its cell membrane, to get nutrients from the outside, towards the chlamydia. So you’ll notice that it doesn’t look like it’s doing too well. I’ll draw the nucleus
very small to indicate that it’s not having a great time here. And once we’ve made
enough reticular bodies and we’ve reproduced enough, the chlamydia will decide that it’s time to infect another cell. So here’s our white blood cell again. And I’ll draw an even larger endosome, it’s ridiculous how big it is, and there are these reticulate
bodies that are here still that we have reproduced. But in addition to the reticulate bodies, we’ve started making elementary bodies, these infectious forms of chlamydia. So the elementary bodies
are the infectious version of chlamydia,
the reticulate bodies are the growth versions of chlamydia. That’s a good way to think about it. And so these guys start mass
producing within the cell. And the cell is not
having a good time now. It is basically on the verge of death because we are not using our nutrients to fortify and grow this cell membrane or to generally help it survive. So as a result of this, the
cell will literally pop. It will burst open and rupture. It will rupture and therefor die, causing the reticulate
bodies that were converting, as well as the majority of
the chlamydia organism now in elementary bodies to be released into the extracellular matrix. To be released outside of the cell. And you’ll have some
reticulate bodies, of course, but you’re going to have a
majority of elementary bodies that can be picked up again
by another white blood cell and we can repeat this cycle. Another variant of this you might see is instead of a white
blood cell swallowing up these elementary bodies, you might have an epithelial cell. So I’ll write epithelial cell here. Like the epithelial cells
that line the vagina or even line the urethra. That can swallow the
elementary bodies by a process known as endocytosis, which is really just an umbrella term for phagocytosis. Phagocytosis is a type of endocytosis. And doing that will produce and endosome. An endosome. And the rest of the cycle is all the same. Especially the very
unfortunate outcome right here. So this is how chlamydia will spread from cell to cell and
make it’s way further up the genital or the urinary tract.

Do no harm: Some hospitals let a preventable infection kill their patients

Do no harm: Some hospitals let a preventable infection kill their patients


When a plane crashes, it’s kind of a big deal. “Continuing coverage now on the Asiana plane crash investigation.” “Investigators try to figure out what went so terribly wrong.” People freak out. There’s usually a big investigation and a bunch of policy changes to make planes safer. A plane crash investigation committee from several nations including the United States are meeting in Tripoli to try and figure out what happened. There’s pretty much a ”zero-tolerance policy” for plane crashes in our society –and luckily planes are very safe because of it. But when a car crashes it’s not really a big deal. No one hears about car crashes on the news. We’ve decided as a society that car crashes are a cost of a really convenient thing. It’s not worth a big investigation or a bunch of news coverage. This video isn’t about cars and planes. It’s about hospitals. Sometimes doctors and nurses, despite their best intentions, hurt patients. A tricky procedure goes wrong, and the patient suffers or dies. This happens all the time in hospitals. One estimate says that at least 210,000 people die every year due to preventable harm in hospitals. That’s a huge number. You know I think we think of hospitals as this place where you go to get better and that’s just what happens, but there’s a lot of risk in, like, going to a hospital, like, there’s, like, a lot of things that go wrong and they don’t necessarily have to. Some hospitals treat medical harm incidents like plane crashes. An unacceptable problem that needs investigation and policy change Other hospitals treat them like car crashes Just a tragic loss of a risky business, but not ultimately preventable. The way hospitals react to harming their patients can have a huge impact on how often these errors occur. And that’s what this video is about–how hospitals react when they harm their patients. So I got interested in medical errors Because it’s this massive problem that we don’t really talk about in health care Sara and I headed to California to visit some people who would help us figure out how and why people are being harmed in hospitals–and whether or not it’s preventable. I quickly realized that we were looking into something that was rarely talked about, but had a huge effect on hospital patients around the country She loved dancing and running and jumping and she never sat down. I mean it’s funny because we had these, like, family… That’s Claire. Her daughter, Nora, was born with an underdeveloped lung, that required her to be in the hospital for quite a bit of time So we were using the beater and I was like, oh, yeah, there’s a song called Beat It so we put it on, and I mean, she used the beater as a microphone, and like I had a spoon and we would Just play it like as loud as possible and she would just sing like “Beat it” During her treatment, Nora contracted something called a central line infection, which I’ll explain in a minute. The day before she got that first line infection, I had a friend over with her daughter and like she was showing Nora how to do push-ups, I mean it was just you know, like totally fine. And then, that was like just that, and then like two days later she got the infection… Our lives, completely, and Nora’s life, completely changed with that first line infection. A central line is a tube that is placed in a vein that goes right to the heart. It’s given to patients who need medicine that’s too acidic to go through a normal IV or to those who need to get their blood drawn often The tube stays there. People walk around with this thing in, and it gives doctors and nurses really quick access to the blood stream. It’s a super useful invention. But we’re talking about putting a tube, through veins that go right to your heart Just as it’s good for giving medicine quickly into your bloodstream, it’s also a foreign object in your most vital organ. So if any bacteria gets in there, it’s a very bad news Nora had four of these central line infections over the course of her life. That’s way above average. Claire thinks that the Stanford hospital, where she was being treated, could have prevented them– and that’s the question we’re trying to answer: Can these infections be prevented? There has to be a better solution! Like this cannot be, because every line infection just… …took it out of her. Every line infection, you know, just took more out of her and more out of her… She’s saying, “Hi, Nora!” Yeah, because I turned it that– you know, I turned it so she could see herself. Doctors and nurses have sanitation protocols when dealing with central lines. But, even so, she contracted three more line infections while she was in the hospital. Her health was rapidly deteriorating as she approached her fourth birthday… And she just like turned to me and was like, “Hold me.” And so I picked her up, and she… like, put her arms and legs around me, and her head kind of went back and she was sort of like gasping to breathe, and then she… She said, “please help me feel better” And she just grabbed me around my neck, like so… …I mean I can still feel it, like it’s so much strength, you know, like just squeezing me, and then she just basically lost consciousness, and just kind of… Nora died. Her arms around her mother’s neck, on November 22nd 2013. Just three weeks before her fourth birthday. There are so many points along the way where like things could have gone differently, you know And there were so many… …unnecessary mistakes that just led to that moment. It’s hard to know whether or not the line infections were the direct cause of her death It’s hard to disentangle everything that was going on with her to give a neat causal story of how she died. But what’s sure is that these line infections caused her and her family immense suffering. Claire thinks that they should have never happened in the first place. She wrote a letter to the Stanford Hospital where Nora died. She basically lined out the mistakes that she saw in the hospital, and offered feedback on patient safety failures. She got this letter in return: “Unfortunately, the placement of center lines is associated with a risk of infection… ” “There is a risk of infection even in the best of circumstances which can never be entirely eliminated… ” “Please be assured, that multiple procedural protocols are in place, to promote hand washing techniques and minimize the chance of infection…” “We understand and recognize your feelings regarding Nora’s care. And we apologize that you were dissatisfied with your experience of LPCH.” So were Nora’s line infections just the result of a risky business, or could they’ve been prevented? Stanford looked at central line infections with the car crash mentality, just an inevitable tragedy, – instead of with a zero tolerance plane crash mentality. But we headed north to a hospital outside of Sacramento, that went seven years in a row without a single central line infection. We wanted to figure out what they were doing to achieve this perfect record I was really interested in this concept of like, should there be any central line infections given what we know… Is zero possible? Like what does it take to get to zero? What are the obstacles there? In 2005 this hospital had 11 central line infections. Research was just starting to come out on how to avoid these central line infections. And this Roseville hospital began to implement it. They had a few powerhouse nurses, that were dedicated to making a difference, and they did. We kind of thought you had infections. Yeah, there was no biggie. It was no big deal it developed over time You know we looked at people we looked at equipment we looked at skill set and Kind of all that came together to really develop the bundle that has been quite effective here. You can’t accept Good enough You know You have to go for eliminating those. If you’ve been at zero and you have an episode you go in and you say you pick it apart and you do a root cause analysis and you say what went wrong? They treated land infections like plane crashes A zero tolerance policy was instituted and they began to see results We got to see these nurses in action as they inserted a central line They suited us up in sterile dressing and began their work. The nurses were meticulous about the procedure They’d instituted standards of sterilization that assured minimum risk of infection Now what I’m going to do is because my hand is not sterile, I touched a tourniquet I’m going to take my first glove out, that I’m going to throw away. Now I’m still sterile. And these weren’t just compassionate nurses who had an intrinsic motivation to do right instead They were operating in a culture where they were expected to do it right. It was a team effort where they had ownership and accountability Where the line infections were unacceptable. When you have an outcome that isn’t what you wanted If you don’t say is there anything we could have done better? Is there any way we could have changed our interventions and resulted in a different outcome? People are gonna get really really sick and they’re gonna die We left the hospital understanding how they had made it to zero central line infections …you just get this very different approach from the two hospitals. One saying: Every error is a mistake, every error can be prevented in this particular type of error. And then one saying this is inevitable, this is the cost of doing business. And… It’s just really striking, two hospitals like three hours away from each other with, very diferent attitudes. As I headed back to DC I kept thinking of Nora If Stanford had an attitude a little bit more like Roseville, maybe she would still be alive today. Just another five year old little girl Surely she and her family wouldn’t have suffered as much To get the final word on this subject. We went to Baltimore to talk to Peter Pronovost at Johns Hopkins Medical Center He’s basically the Godfather of all of the research behind preventing central line infections we started investigating every infection as a defect again a very Important culture change where in the past we just accepted them and we said no no if we really view these as defects Everyone needs to be investigated and reported on and find out why they would happen We routinely invite patients back to inform us to learn with us to share with us It is both healing for them and our clinicians But importantly it also is wise and fruitful for us to learn and improve mistakes We finished up reporting, Sarah and I realized that Nora’s death actually represents two tragedies The first was of course the fact that a little girl suffered and died, but the second and perhaps more harmful tragedy Is that the hospital where it happened didn’t take the opportunity to learn from it. I think that’s worse for patients who are gonna be treated there in the future. It really makes a world of difference in healthcare whether you see patient harm as something that’s preventable or inevitable and Getting people to the preventable mindset from the inevitable one. It has the potential to alleviate a lot of suffering, to prevent a lot of deaths. I became convinced, like attitude towards harm makes all the difference, and That there’s space for our healthcare system to improve to taking a more preventable attitude towards patient harm.