Scleroderma means hard skin but the hardness is not limited to the skin - the internal organs and their blood supply may become damaged. The most characteristic feature of scleroderma is the build-up of tough scar-like fibrous tissue in the skin. Scleroderma is not a single disease, but rather a symptom of a group of diseases complicated by the abnormal growth of connective tissue which supports the skin and internal organs. Although scleroderma is more common in women, the disease also occurs in men and children. It affects people of all races and ethnic groups. However, there are some patterns by disease type. Scleroderma is a relatively uncommon problem affecting only 200 to 300 people per million in the U.S. Some 12 to 20 new cases per million are diagnosed annually.
Causes
The cause of scleroderma is unknown. Like many other rheumatic disorders, scleroderma is believed to be an autoimmune disease. An autoimmune disease is one in which the immune system, for unknown reasons, turns against one's own body. Although the cause is unknown, it is known that the body produces too much of a protein called collagen. Excess collagen is deposited causing thickening and hardening. Scleroderma is not believed to be contagious; you cannot get it by hugging or kissing someone or other intimate contact. There is an increased incidence of certain types other autoimmune diseases and cancer among scleroderma patients. Preliminary research suggests that patients with certain gene variations, or genetic polymorphisms, may be more susceptible to scleroderma than those who do not carry the polymorphism.
Symptoms
The skin begins to thicken and harden on the hands, feet, and face. The fingers may swell. Patients with diffuse scleroderma may have whole hand swelling before the skin significantly thickens.
Common symptoms are-
? Arthritis ? Muscle pain and weakness ? Dry eyes and mouth
Heartburn
* Difficulty swallowing * Diarrhea * Poor absorption of nutrients, weight loss * Liver blockage, jaundice * Shortness of breath * Abnormal heart rhythms * Heart failure * High blood pressure * Kidney failure
Treatment
Aggressive treatment of elevations in blood pressure have been extremely important in prevent kidney failure. Blood pressure medications, such as captopril, are frequently used.
As each person with scleroderma is affected in a different way, other treatments are used to treat problems if or when they occur. For example, there are acid-suppressant drugs for acid reflux and gullet inflammation, anti-hypertensive drugs for high blood pressure and anti-inflammatory drugs for lung inflammation.
For patients with weakness and muscle disease associated with scleroderma, glucocorticoids (such as prednisone) and/or immunosuppressive medications may be effective treatments.
Much research is ongoing into new treatments for scleroderma. Patients and their families should know that experts remain optimistic and work towards a cure will continue.
Septic shock is a serious illness that occurs when an overwhelming infection leads to low blood pressure and low blood flow. Its most common victims are children and the elderly, as their immune systems cannot cope with the infection as well as those of full-grown adults. People whose white blood cell counts are low such as those who have AIDS or cancer or are receiving chemotherapy and people who have a chronic disease (for example, diabetes or cirrhosis) are at greater risk of developing septic shock.
Causes
The problem may start with a small infection that overwhelms the body's defenses and spreads. Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. In some severe infections, the germs make harmful toxins that can cause fluid to leak from blood vessels out into the tissues. The loss of fluid from the blood may be so great that the normal circulation (the rate the heart pumps at) can't be maintained and blood pressure drops.
Symptoms
Septic shock is usually happened due tobacteremia, which is caused by fever, malaise, chills, and nausea. The first sign of shock is often confusion and decreased consciousness. In this starting stage, the extremities are usually warm. Later, they become cool, pale, and bluish. Fever may give way to lower-than-normal temperatures later on in sepsis. Other symptoms include: Rapid heartbeat Shallow, rapid breathing Decreased urination. Reddish patches in the skin
Treatment
Septic shock requires urgent treatment.It is treated with antibiotics. It is a medical emergency and is normally treated in an intensive care unit. Large doses of antibiotics, along with Infusions of fluids, are given to fight off the infection, and maintain the blood pressure. The shock may get worse initially as the bacteria release toxins as they are killed. Respiratory distress is treated with mechanical ventilation and supplemental oxygen, either using a nosepiece or a tube into the trachea through the throat. There are new drugs that act against the hyperinflammatory response seen in septic shock. These may help limit the damage to vital organs. Hemodynamic monitoring -- the evaluation of the pressures in the heart and lungs -- may be required. This can only be done with specialized equipment and intensive care nursing.
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