Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Researchers suggest that M. leprae are spread person to person by nasal
secretions or droplets. They speculate that infected droplets reach other
peoples'
nasal passages and begin the infection there. Some investigators
suggest the infected droplets can infect others by entering breaks in the skin.
M. leprae apparently cannot infect intact skin. Rarely, humans get leprosy from
the few animal species mentioned above. Occurrence in animals makes it difficult to eradicate leprosy from these endemic sources. Routes of transmission are still being researched for leprosy. Recent genetic studies have demonstrated that several genes (about seven) are associated with an increased susceptibility to leprosy; some researchers now conclude that susceptibility to leprosy may be partially inheritable.
How is leprosy diagnosed?
The majority of cases of leprosy are diagnosed by clinical findings, especially
since most current cases are diagnosed in areas that have limited or no
laboratory equipment available. Hypopigmented patches of skin or reddish skin
patches with loss of sensation, thickened peripheral nerves, or both clinical
findings together often comprise the clinical diagnosis. Skin smears or biopsy
material that show acid-fast bacilli with the Ziehl-Neelsen stain or the Fite
stain (biopsy) can diagnose multibacillary leprosy, or if bacteria are absent,
diagnose paucibacillary leprosy. Other tests can be done, but most of these are
done by specialized labs and may help a clinician to place the patient in the
more detailed Ridley-Jopling classification and are not routinely done (lepromin
test, phenolic glycolipid-1 test, PCR, lymphocyte migration inhibition test or
LMIT). Other tests such as CBC test, liver function tests, creatinine test, or a
nerve biopsy may be done to help determine if other organ systems have been
affected.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
There are many causes of scalp hair loss. This featured article covers the common ones such as patchy hair loss (alopecia areata, trichotillomania, and tinea capitis), telogen effluvium, and androgenetic alopecia (male-pattern baldness, female-pattern baldness).
Alopecia areata is a condition that causes hair loss on the scalp and sometimes other parts of the body. It is believed to be caused by an abnormality of the immune system that causes the body's immune system to attack the hair follicles. Typically, hair regrows within a year without treatment. Steroid injections, creams, and shampoos may be used during treatment.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Aseptic necrosis (avascular necrosis or osteonecrosis) is a condition that develops when blood supply diminishes to an area of bone and causes bone death. Though aseptic necrosis may be painless, pain is often associated when the degenerating bone is used. If caught early, aseptic necrosis may be treated by grafting new bone into the degenerating area. In later stages, joint replacement surgery may be required.
Blindness is the state of being sightless. Causes of blindness include macular degeneration, stroke, cataract, glaucoma, infection and trauma. Symptoms and signs may include eye pain, eye discharge, or the cornea or pupil turning white. Treatment of blindness depends upon the cause of the blindness.
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