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Wheezing in children

Wheezing is one of the most common symptoms in children and adults. Wheezing refers to the high pitched, "musical" sounds generated from the respiratory tract. It may originate in multiple areas, from the nose, to the throat, to the lungs. When physicians use the term "wheezing", they are usually indicating the sounds produced by tightness in the lower airways ("bronchial tubes").

Wheezing is especially important in pediatrics because children have frequent respiratory infections. These infections are generally caused by viral infections which cause much irritation in the airways. In addition, the airways of children are small and more "sensitive," predisposing them to wheezing. The location of the irritation may be in the upper or lower respiratory tract. This means that wheezing can occur with just a cold as well as bronchitis or pneumonia.

Wheezing in most children will respond to treatment with ...

Gallstone disease and gallbladder removal

Gallstone disease is one of the most common reasons for patients needing surgery and the source of a great deal of misery.  Fortunately, for the vast majority of patients, gallstone disease can be dealt with safely and fairly easily.

What is Gallstone Disease?

One of the many things your liver does is produce bile. This bile is secreted into your intestine through the bile ducts. In the intestine, it acts to dissolve the fat that we eat that the fat can be absorbed by the intestine.

In between meals, a small muscular valve closes where the bile duct enters the intestine.  The bile that is produced then gets backed up into the gallbladder, which acts as a reservoir, both holding and concentrating the bile.  After a person eats, the presence of food in the stomach and duodenum sets off a signal to the gallbladder which then contracts, adding bile to mix in with the food.

Approximately 20% of people (1 out of 5) form gallstones in their gallbladder. Most stones are made of ...

Ketogenic diet as a treatment for seizures

The ketogenic diet is a high-fat, low-carbohydrate diet that has proven to be effective in the treatment of seizures. In fact, the ketogenic diet is one of the oldest and most effective treatments available for patients with seizures regardless of age, from infancy through adulthood. The ketogenic diet must only be started under direct medical supervision.

Here are some frequently asked questions about the ketogenic diet:

What is the ketogenic diet?
The ketogenic diet is a special high-fat diet that often includes heavy cream, butter and vegetable oils to provide the necessary fat. The diet eliminates carbohydrate rich foods such as bread, rice, cereals, pasta, cookies, and cakes.

How effective is the diet at controlling or eliminating seizures?
Studies that have followed children on the diet for long periods reveal that at least 2/3 of all children on the diet have a significant reduction in seizures by over half. 1/3 of children on the diet will have a greater than 90% reduction in seizures, with half of these children ....

Fecal incontinence: New treatment options

If you have been living with incontinence, you may have modified your daily activities around bowel movements.  Some people become homebound, fearing an accident in public. 

The good news is that you don’t have to live with incontinence.  Over the last few years, more treatment options have become available which can provide additional ways of improving lifestyle.

What is the cause of incontinence?

Both men and women can be affected by incontinence.  There are several causes of incontinence.  The most common causes include damage to the anal muscles or nerves during childbirth.

After a thorough history and physical examination, you and your physician will formulate a treatment plan that is right for you.  One or more treatment options may be recommended to address your particular symptoms:

Do you know the symptoms of a brain aneurysm?

It’s easy to get caught up in day-to-day demands and ignore changes in our health. It may not be wise, however, to dismiss those changes as symptoms of a hectic life. Blurred vision, dizziness or headaches that don’t get better can signal something serious.

Anywhere from 1 to 6 percent of Americans have a brain aneurysm but don’t know it. An aneurysm is a blister-like bulge on the wall of a blood vessel. It can go unnoticed for a long time. If it’s not treated, the pressure of the blood weakens the vessel, and the aneurysm grows like a balloon filling with air. If the aneurysm bursts, it causes a stroke.

An aneurysm can put pressure on nerves or tissue in the brain, which may cause:

  • Headache or neck pain
  • Vision problems, enlarged pupil, drooping eye lid
  • Numb face
  • Severe drowsiness

If you have a brain aneurysm, your doctor may ...

What is Muscle Tension Dysphonia (MTD)?

Muscle tension dysphonia (MTD) is one of the more confounding and misunderstood conditions of the voice.  With this condition the vocal cords and supporting structures may be healthy but they are working too hard.  MTD is caused by the throat muscles being too tight and out of balance with the rest of the voice production system.  The person with MTD may feel that it takes more effort to talk and their voice gets worse the more they talk.  Many patients may feel a soreness of their neck, throat and often their shoulders. Sometimes MTD may develop in trying to compensate for a weak vocal fold or a vocal fold lesion.

MTD is characterized by the following:

  • Voice that sounds rough, hoarse, gravely, or raspy
  • Voice that sounds weak, breathy, airy, or is only a whisper
  • Voice that sounds strained, pressed, squeezed, tight, or tense
  • Voice that suddenly cuts out, breaks off, changes pitch, or fades away
  • Voice that “gives out” or becomes weaker the longer the voice is used
  • Pitch that is too high or too low
  • Difficulty singing notes that used to be easy
  • Pain or tension in the throat when speaking or singing
  • Feeling like the throat is tired when speaking or singing
  • Voice that may sound normal sometimes, such as during laughing or coughing

Once an otolaryngologist has examined you and diagnosed you with MTD, you will typically be referred to a speech pathologist for voice therapy.  In some cases there may be some underlying physical or emotional stress contributing to the dysphonia.  Our voices are very emotional instruments and help to convey a spectrum of emotions including happiness, sadness and anger.  “I’m all choked up” is more than just a figure of speech.  As such, you may ...

What is Pilonidal Disease?

Pilonidal disease is a subcutaneous skin infection that occurs in the upper half of the gluteal cleft (the tailbone area, and/or between the buttocks). 

Etiology

The term “Pilonidal” means nest of hairs.  Interestingly, in 50% of reported cases, there was not any hair found within the pilonidal abscess.  This is routinely the case for females.  Although hair can contribute, the most common cause of pilonidal disease is an exploded follicle called a pit, which is located in the gluteal cleft, or midline region (between the buttocks). 

Who is at risk for Pilonidal disease?

Pilonidal disease is only slightly more common in men than women, and is most likely to occur between the ages of 16 – 26, correlating with puberty.  It should be noted that pilonidal disease can develop in younger and older age groups.  Pilonidal disease occurs less in Asian and black populations.  Other risk factors of pilonidal disease include:

  • Obesity
  • Sedentary lifestyle
  • Individuals with more body hair
  • Occupations with prolonged sitting

Diagnosing Pilonidal Disease

Pilonidal disease, similar to a large pimple, can burst through the skin by itself or may need to be lanced or drained to let the infected fluid escape.  Pilonidal disease is classified into three stages:

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