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Monthly Archives: Tháng Mười Một 2013

Is Asthma Dangerous During Pregnancy?

Asthma (asthma) is a chronic infection of the respiratory tract, leading to difficulty breathing in each episode due to bronchospasm. Pregnant women with bronchial asthma are very dangerous because they can cause hypoxia to the fetus.

1. Effects of bronchial asthma during pregnancy and fetus

Most bronchial asthma patients can become pregnant and give birth normally like other healthy people. However, severe, uncontrolled asthma cases can cause negative effects on the fetus due to prolonged hypoxia.

Pregnant women with bronchial asthma have a small increase in the risk of causing some complications during pregnancy. Many studies over the past 20 years have shown that cases of bronchial asthma in pregnant women are at risk of premature birth, low birth weight or some medical problems (tachycardia, seizures, hypoglycemia .. .) higher than those who don't.

However, this risk is very small if bronchial asthma in pregnant women Stable treatment and it can also be reduced by maintaining optimal control of asthma during pregnancy.

2. Managing bronchial asthma before pregnancy

These recommendations apply to any pregnant woman:

  • All women need to use at least 400 mg of folic acid. Using folic acid may reduce the risk of neural tube defects. Folic acid should start before pregnancy and continue until at least the first 3 months.
  • Women need to stop smoking and drink alcohol or recreational drugs like marijuana before they want to become pregnant
  • Some medicines are safe during pregnancy while others are unsafe. In some cases, alternating drugs may replace unsafe drugs
  • Drinking coffee needs to be limited to less than 250 mg daily during pregnancy and during pregnancy.
  • Blood tests for measles, chicken pox, HIV, and hepatitis B may be recommended before pregnancy.

3. Managing bronchial asthma during pregnancy

During pregnancy, caring for pregnant women with bronchial asthma is sometimes involved between asthma and obstetric specialists. Visiting with an asthma asthma specialist is arranged based on the severity of bronchial asthma during pregnancy. Most women need to see an obstetrician every two to four weeks until 28 weeks of pregnancy.

Between the 28th and 36th weeks, most pregnant women with bronchial asthma need to visit every two weeks. The pregnant women with asthma often visit once a week between the 36th week and at birth. During each visit, blood pressure and urine should be measured.

To assess the child's development in pregnancy, it is important to have the correct date. Pregnant women with bronchial asthma cannot remember the date of the last menstrual period or are unsure when to conceive and need to have an ultrasound before 12 weeks of pregnancy, the exact date when counted during this period. .

After the 10th to 12th week of pregnancy, the fetal heart can be measured at each visit. Ultrasound is usually recommended between the 18th week and the 20th week of pregnancy to ensure that the pregnancy is normal.

Women who need to take glucocorticoid tablets during pregnancy can do ultrasound to monitor the child's growth every four weeks after the 18th and 20th week of pregnancy.

Treatment of bronchial asthma in pregnant women is very similar to treating non-pregnant women. Treatment of bronchial asthma in pregnant women has many key parts, if they are used together, it will lead to high success:

3.1. Monitoring

Maternal lung function

Normal lung function is important for maternal health and the health of the baby. Lung function can be monitored at the hospital. Home monitoring often provides important information when asthma symptoms are worse, especially at night or when you wake up.

Pregnant women may be able to monitor home lung function with a peak flow meter to measure peak air flow. Depending on the frequency of episodes, health care providers may recommend measuring twice daily: once at waking and re-measuring 12 hours later. Reducing peak exhalation flow indicates a worsening of bronchial asthma and requires emergency treatment, even if patients feel well.

The lung function probe performed in the clinic is also beneficial for distinguishing shortness of breath associated with the worsening of bronchial asthma with shortness of breath that many women experience during pregnancy.

Healthy condition of child :

Your child's well-being is carefully monitored through visits throughout pregnancy. These visits are especially important for women with bronchial asthma.

In addition, pregnant women over 24 weeks need to be supervised by their movements. If your child does not move normally, you should see an obstetrician immediately. This is especially true for pregnant women with bronchial asthma or asthma attacks.

3.2. Avoid stimulants:

Many simple steps can help control environmental factors that worsen bronchial asthma in pregnant women and attacks. These steps include:

  • Avoid exposure to specific allergens, such as fur, dust, and nonspecific stimulants, such as cigarette smoke, pungent odor and pollen.
  • Wrap mattresses and pillows with special covers to reduce exposure to dust. Avoid sleeping in an upholstered bed.
  • Pregnant women should not smoke or let others smoke in the house.
  • Women who are pregnant with bronchial asthma during the flu season need to get a flu shot. There are no risks of flu vaccination on fetal development.

3.3. Education

Teaching asthma can help patients better manage symptoms, prevent asthma attacks and respond to asthma attacks. Bronchial asthma education can be reassuring and beneficial in pregnancy.

Bronchial asthma education helps patients with strategies to identify the symptoms and symptoms of bronchial asthma, avoiding the factors that can cause asthma attacks, and the use of asthma control drugs the right way. With these benefits, a personalized treatment plan should be established for sudden acute attacks.

3.4. Drug treatment

In a few exceptions, the drugs used to treat bronchial asthma in pregnant women are the same as those used to treat bronchial asthma at other times in human life. The type and dosage of bronchial asthma medications will depend on many factors. Generally, inhalation is recommended because there are few side effects on the mother and the baby.

It may be necessary to adjust the type or dose of the drug during pregnancy to avoid changes in maternal metabolism and changes in severity of bronchial asthma.

Safety of asthma control drugs: It is difficult to prove that asthma control drugs are completely safe during pregnancy. However, bronchial asthma medications have been used by pregnant women with asthma for many years, proving that most of them almost certainly bring little or no risk to mothers or children.

It is important to consider the risks of asthma control drugs compared to the serious harm of untreated bronchial asthma.

The asthma attacks in pregnant women can reduce the supply of oxygen to children. Indeed, it is important to use bronchial asthma medication in pregnant women to prevent asthma symptoms. In most cases, poorly treated bronchial asthma poses a greater risk for both mother and child than using asthma control drugs.


What Happens If Nephrotic Syndrome Is Not Treated?

Pathological nephrotic syndrome occurs when the kidney is damaged. If not diagnosed early and treated actively, prolonged proteinuria will cause a range of dangerous diseases and complications.

1. What is nephrotic syndrome?

Kidneys are an important part of the body with the function of eliminating harmful substances and absorbing needed substances, helping to control blood pressure and ensuring adequate blood supply.

In response to the question of what kidney damage is and how dangerous it is, doctors say that when the specific filtering function of the kidney is disturbed, it will lead to a protein from the body escaping with urine. significant amount. If this condition persists, the body is severely deficient in protein, thereby making it difficult to maintain normal living and living activities.

Nephrotic syndrome is a clinical and biochemical disease that is formed when glomerular is damaged by many different pathological factors. Common symptoms of nephrotic syndrome pathology as edema, proteinuria high blood protein decreased, dyslipidemia, can eliminate the fat and protein in the urine.

2. Causes and diagnosis

The cause of secondary nephrotic syndrome includes genetic factors, metabolic disorders, autoimmune disease, malignant disease, infectious diseases, drug poisoning or parasites. In addition, before leading to nephrotic syndrome, glomerulonephritis or fibrosis is a common disease in adults in some developing countries.

To diagnose nephrotic syndrome, in addition to relying on typical systemic edema symptoms, it is compulsory to base on the following criteria:

  • Proteinuria > 3.5 g / 24 hours
  • Blood protein decreased <60 g / liter, blood albumin decreased <30 g / liter

In addition, it is possible to test for hypercholesterolemia of ≥ 6.5 mmol / liter and with birefringent fat or urinary fat.

3. Dangerous complications of nephrotic syndrome

Clinical nephrotic syndrome is a rather complicated situation, which risks serious complications, such as:

  • Membrane fluid: Fluid in the body will creep everywhere, causing edema, followed by a multi-membranous effusion including ascites (peritoneal fluid), testicular effusion, lungs or even the heart.
  • Infection : Renal treatment with corticosteroids and long-term immunosuppressants will cause severe infections, difficult to control. Common and acute infections are cellulitis or peritonitis.
  • Peptic ulcer, osteoporosis: The following complications also stem from some side effects of drugs in the treatment regimen.
  • Hypertension, dyslipidemia : Reduced protein in the blood causes the liver to enhance the function of lipoprotein synthesis to compensate for increased blood lipids.
  • Vascular occlusion (thrombosis / blood clots): When blood albumin is severe, it leads to acute or chronic venous occlusion. In addition, there are cases of patients with pelvic occlusion or rarely, pulmonary embolism.
  • Acute or chronic renal failure : Nephrotic syndrome causes dehydration and electrolytes, especially blood albumin, to impair kidney function. This is the most common and dangerous complication of this disease, if severe, the patient may have to have dialysis or kidney transplantation.
  • Mass or microscopic hematuria: The condition of urine is brown or red, blood can be seen when urinating due to kidney injury. Hematuria is seen in nephrotic syndrome not merely.
  • Malnutrition : Because the amount of protein is lost too much in the urine, this condition is prolonged, causing the body to become depleted.
  • Other possible complications include: Diabetes, gastrointestinal bleeding, psychosis, cushing false syndrome, electrolyte disorders, ...

4. Treatment of nephrotic syndrome

How long is nephrotic syndrome treated or nephrotic syndrome cured is not a question many patients unfortunately suffer from this situation. In fact, nephrotoxicity is a chronic disease, progress is slow, the course of treatment is complicated and it is possible that patients need to be monitored for life. In order to limit the development of symptoms and complications, some of the following treatment principles need to be followed:

  • Prioritize treatment of edema: Patients can change their diet so as to ensure adequate dietary protein (0.8-1g / kg / day + protein loss through urine). Besides, it is necessary to limit salt and water tolerance when much swelling.
  • In addition, the doctor will prescribe additional solutions to increase colloid pressure such as Albumin or diuretics. The dosage is adjusted differently according to the response of each patient to the medication.
  • Need to monitor urine quantity, daily weight and blood electrolyte test.
  • Under no circumstances can a kidney biopsy be used according to the regimen of corticosteroids or other immunosuppressive drugs.
  • If the patient remains unresponsive, or cannot avoid the side effects of the drug, a kidney biopsy is recommended to treat the pathological injury.
  • Preventive treatment of some side effects of drugs as well as water and electrolyte balance, ensure adequate albumin compensation.
  • In the case of secondary nephrotic syndrome treatment should be considered according to the cause of the disease.

Clinical nephrotic syndrome is not difficult to diagnose, but is chronic and can recur. Therefore, if patients have been infected, patients should actively coordinate with doctors to monitor and treat long-term in accordance with the regimen. To prevent nephrotic syndrome should not use drugs and substances of unknown origin will cause kidney toxicity.



Can Yoo Much Vitamin C Be Harmful?

Vitamin C plays an important role in the body. It is necessary to maintain the health of the skin, cartilage, teeth, bones and blood vessels. It is also used to protect your body's cells from aging. The use of vitamin C in different doses will give good or bad effects.

1. Side effects of vitamin C

Pregnancy and lactation: Vitamin C is safe for pregnant or lactating women when taken in amounts not exceeding 2000mg per day for women over the age of 19 and 1800 mg daily for women aged 14-18 or when administered intravenously (by IV) or intramuscularly. Drinking too much vitamin C during pregnancy can cause problems for babies. Vitamin C may not be safe to drink by mouth in excessive amounts.

Infants and young children : Vitamin C is safe when taken orally with appropriate doses. Vitamin C may not be safe to take by mouth with a higher amount of 400 mg per day for children 1-3 years, 650mg daily for children 4-8 years, 1200mg daily for children aged 9 - 13 years old and 1800 mg daily for teenagers 14 - 18 years.

Alcoholism: Drinking alcohol can cause the body to excrete vitamin C in the urine. People who regularly use alcohol, especially those with other diseases, often lack vitamin C. These people may need to be treated for a longer period than usual to restore vitamin C to normal level.

Alzheimer's disease: Taking vitamin C along with vitamin E and alpha-lipoic acid may reduce the mood in Alzheimer's patients.

Coronary angioplasty, cardiac procedures: Avoid taking supplements containing vitamin C or other antioxidant vitamins (beta-carotene, vitamin E) just before and after coronary angioplasty without supervision doctor. These vitamins seem to interfere with the healing process.

Weight loss surgery: Weight loss surgery can make the body absorb more oxalate from food. This can increase the amount of oxalate in the urine. Too much oxalate in urine can cause problems like kidney stones.

Vitamin C can also increase the amount of oxalate in the urine. Drinking large amounts of vitamin C after weight loss surgery may increase your risk of excessive oxalate in your urine.

Cancer: Cancer cells also need to use high levels of vitamin C in cancer cell development. So, only use high doses of vitamin C under the guidance of a doctor treating cancer.

Kidney disease: Vitamin C can increase the amount of oxalate in urine. Too much oxalate in urine may increase the risk of kidney failure in people with kidney disease.

Diabetes: Vitamin C can increase blood sugar. In older women with diabetes, vitamin C in quantities greater than 300 mg per day increases the risk of death from cardiovascular disease. Do not take vitamin C in larger doses than basic multivitamins.

Lack of glucose-6-phosphate dehydrogenase (G6PD): A large amount of vitamin C can cause red blood cells to break down in people with this disease. Avoid excessive use of vitamin C when G6PD is lacking.

Blood iron disorders, including thalassemia and hemochromatosis: Vitamin C may increase iron absorption, which may make these conditions worse. Avoid taking large amounts of vitamin C when suffering from these diseases.

Kidney stones, or a history of kidney stones: A large amount of vitamin C can increase your chances of developing kidney stones. Do not take vitamin C in larger quantities than basic multivitamins.

Heart attack: Vitamin C levels are reduced in heart attacks. However, low vitamin C is not associated with an increased risk of heart attack.

Kidney transplantation: Long-term use of vitamin C at high doses before kidney transplantation may increase the risk of transplant rejection or delay time until kidney transplantation is active.

Schizophrenia: Taking vitamin C with vitamin E can exacerbate mental disorders in some people with schizophrenia when taking antipsychotics.

Smoking and chewing tobacco: Smoking and chewing tobacco reduces vitamin C. The amount of vitamin C in the diet should be increased in people who smoke or chew tobacco.

2. How to use vitamin C safely

Oral: Take oral vitamin C, with or without food, usually 1-2 times / day. Follow all instructions on the package, or follow your doctor's instructions.

Release capsules: If you are taking extended-release capsules, swallow them all. Do not crush or chew capsules or extended-release tablets. Doing so can release all drugs at the same time, increasing the risk of side effects.

In addition, do not split the extended release tablets unless they point out and your doctor or pharmacist asks you to do so. Swallow whole tablets or cups without crushing or chewing. Use this product with a full glass of water (8 ounces / 240 ml) unless your doctor instructs you otherwise.

Wafers or chewable tablets: If you are using a wafer or chewable tablet, chew carefully, then swallow. If you are taking lozenges, put the lozenges in your mouth and let them dissolve.

Powder: If you are using powder, mix well in the appropriate amount of liquid or soft food and stir well. Drink / eat immediately, not deducted for the next time. If you are using a liquid form of this vitamin, be careful to measure the dose using a special measuring instrument / spoon. Do not use a household spoon because you may not use the right dose.

Dosage is based on medical condition and ability to respond to treatment. Use this vitamin regularly to get the highest benefit from it. To help you remember, use it every day. If you have serious health problems using vitamin C, see your doctor immediately.

3. Preventive measures

Before taking vitamin C, tell your doctor or pharmacist if you have any allergies. This product may contain inactive ingredients (such as peanuts / soybeans), which may cause allergic reactions or other problems.

Before using this vitamin, tell your doctor or pharmacist about your medical history, especially: kidney disease (such as kidney stones), certain enzyme deficiencies (lack of G6PD).

During pregnancy, vitamin C is safe to use at the recommended dosage. Higher doses should only be used during pregnancy if necessary. Discuss the risks and benefits with a health counselor.

Vitamin C is passed into breast milk and is considered safe during breastfeeding when used with the recommended dose. Consult your doctor for more information.

Reference source: Webmd.com