Tibial muscular dystrophy

Reviewed November 2008

What is tibial muscular dystrophy?
Tibial muscular dystrophy is a condition that affects the muscles at the front of the lower leg. The signs and symptoms of this condition appear after age 35. The first symptom is usually weakness and wasting (atrophy) of a muscle in the lower leg called the tibialis anterior. This muscle helps control up-and-down movement of the foot. Weakness in the tibialis anterior muscle makes it difficult or impossible to walk on the heels, but it usually does not interfere significantly with regular walking.

Muscle weakness worsens very slowly in people with tibial muscular dystrophy. Ten to 20 years after the onset of symptoms, weakness may develop in muscles that help extend the toes (long-toe extensors). Weakness in these muscles makes it difficult to lift the toes while walking, a condition known as foot drop. Later in life, about one third of people with tibial muscular dystrophy experience mild to moderate difficulty with walking because of weakness in other leg muscles. However, most affected individuals remain able to walk throughout their lives.
A small percentage of people with tibial muscular dystrophy have a somewhat different pattern of signs and symptoms than those described above. In addition to weakness of the tibialis anterior muscle, these individuals may have generalized muscle weakness starting in childhood, weakness and atrophy of the thigh muscles (quadriceps) or other muscles in the legs, and weakness affecting muscles in the arms.

How common is tibial muscular dystrophy?
Tibial muscular dystrophy is most common in Finland, where it is estimated to affect at least 10 per 100,000 people. This condition has also been found in people of Finnish descent living in other countries.
Additionally, tibial muscular dystrophy has been identified in several European families without Finnish ancestry.
What genes are related to tibial muscular dystrophy?
Mutations in the TTN gene cause tibial muscular dystrophy. This gene provides instructions for making a very large protein called titin. Titin plays an important role in muscles the body uses for movement (skeletal muscles) and in heart (cardiac) muscle.
Within muscle cells, titin is an essential component of structures called sarcomeres. Sarcomeres are the basic unit of muscle contraction; they are made of proteins that generate the mechanical force needed for muscles to contract. Titin has several functions within sarcomeres. One of its most important jobs is to provide structure, flexibility, and stability to these cell structures. Titin also plays a role in chemical signaling and in assembling new sarcomeres.
Mutations in the TTN gene alter the structure and function of titin. Researchers suspect that these changes may disrupt titin's interactions with other proteins within sarcomeres. Mutations may also interfere with the protein's role in chemical signaling. The altered titin protein disrupts normal muscle contraction, which causes muscles to weaken and waste away over time. It is unclear why these effects are usually limited to muscles in the lower legs.

How do people inherit tibial muscular dystrophy?
This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.
In most cases, an affected person has one parent with the conditionReviewed November 2008

What is dengue fever?

This is an infection from a type of virus known as a flavivirus, spread by mosquitoes in tropical and subtropical areas. The illness is found in both rural and suburban environments.
There are four different subtypes of flavivirus that cause dengue fever. Infection provides life-long immunity to the subtype causing the illness, but not to other subtypes. This means a person living in a dengue-endemic area can have more than one dengue infection during their lifetime.
Symptoms
Dengue causes a high fever, headache, nausea and weakness. It usually occurs in two phases - the initial fever, accompanied by a skin rash, usually settles after a few days only to return (usually not so severely) along with a second rash before finally disappearing again.
Dengue fever can cause severe pain in the bones, muscles and joints, and because of this is also known as 'breakbone fever'.
Most cases of dengue fever don’t lead to any permanent harm, but in a small percentage of cases there are complications. The virus can cause blood vessels to become leaky, leading to haemorrhage or bleeding from the gums, nose and various organs, along with clotting problems.
This is known as dengue haemorrhagic fever or DHF, and if untreated has a high mortality rate. In as many as one in three cases of DHF, another serious complication, known as dengue shock syndrome or DSS, occurs.
There's a much greater risk of DHF/DSS when a person has immunity to one of the other types of dengue virus as a result of previous infection.
Treatment and Recovery
Drinking plenty of fluids, taking painkillers and resting is very important since there's no specific treatment. Painkillers based on paracetamol (also known as acetaminophen) should be used as aspirin, ibuprofen and other non-steroidal anti-inflammatory painkillers can aggravate the risk of clotting problems and bleeding, and should be avoided. Those who are severely affected may need to be admitted to hospital for observation. Although it may take a number of weeks, most people recover fully without further problems.
There's no vaccination available yet, although trials are under way. So it's important when travelling to tropical regions to use mosquito repellents and to cover up with suitable clothing.
Unlike the mosquito that carries malaria, which bites in the evening or at night, the mosquito that carries dengue (Aedes aegypti) bites during the day, so it's vital to protect yourself against mosquito bites during this time.
Dr.Rob Hicks

This article was last medically reviewed by Dr Trisha Macnair in April 2009.
http://www.bbc.co.uk/health/ask_the_doctor/dengue.shtml#top

Reviewing your knowledges in Anatomy.

Please check the Anatomy tutorial link, look at the skeleton and learn names of bones, and where they are.

After that, please check next link and answer in your left side, then click to score:
If it is low than 50, please try again this task.

http://msjensen.cehd.umn.edu/webanatomy/skeletons_skulls/skeleton_anterior_1_s.htm

How to prevent flu.

Watch this video where you can find measures for prevention.


How many of those measures do you practice for avoiding flu?

What is the new influenza A(H1N1)?

Updated 11 June 2009

What is the new influenza A(H1N1)?

This is a new influenza A(H1N1) virus that has never before circulated among humans. This virus is not related to previous or current human seasonal influenza viruses.

How do people become infected with the virus?

The virus is spread from person-to-person. It is transmitted as easily as the normal seasonal flu and can be passed to other people by exposure to infected droplets expelled by coughing or sneezing that can be inhaled, or that can contaminate hands or surfaces.
To prevent spread, people who are ill should cover their mouth and nose when coughing or sneezing, stay home when they are unwell, clean their hands regularly, and keep some distance from healthy people, as much as possible.
There are no known instances of people getting infected by exposure to pigs or other animals.
The place of origin of the virus is unknown.

What are the signs and symptoms of infection?

Signs of influenza A(H1N1) are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting and diarrhoea.

Why are we so worried about this flu when hundreds of thousands die every year from seasonal epidemics?

Seasonal influenza occurs every year and the viruses change each year - but many people have some immunity to the circulating virus which helps limit infections. Some countries also use seasonal influenza vaccines to reduce illness and deaths.
But influenza A(H1N1) is a new virus and one to which most people have no or little immunity and, therefore, this virus could cause more infections than are seen with seasonal flu. WHO is working closely with manufacturers to expedite the development of a safe and effective vaccine but it will be some months before it is available.
The new influenza A(H1N1) appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people (from ages 10 to 45). The severity of the disease ranges from very mild symptoms to severe illnesses that can result in death. The majority of people who contract the virus experience the milder disease and recover without antiviral treatment or medical care. Of the more serious cases, more than half of hospitalized people had underlying health conditions or weak immune systems.

Most people experience mild illness and recover at home. When should someone seek medical care?

A person should seek medical care if they experience shortness of breath or difficulty breathing, or if a fever continues more than three days. For parents with a young child who is ill, seek medical care if a child has fast or labored breathing, continuing fever or convulsions (seizures).
Supportive care at home - resting, drinking plenty of fluids and using a pain reliever for aches - is adequate for recovery in most cases. (A non-aspirin pain reliever should be used by children and young adults because of the risk of Reye's syndrome.)
Source: http://www.who.int/csr/disease/swineflu/frequently_asked_questions/about_disease/en/index.html

Mad cow disease. Is our food safe?

If you want to know more about prions related with Mad cow disease, kuru, fatal familial insomnia and Creutzfeldt Jakob disease, you can find information in the next video:

http://www.youtube.com/watch?v=oECHOITMWMk

Duration time: aprox. 30 min.
Please post your opinion about this new health problem.

Mad cow disease

This short video helps to understand prions.

Please read next articles:
Novel methods for disinfection of prion-contaminated medical devices:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)16810-4/abstract

Prions key in Alzheimer's disease: http://news.bbc.co.uk/2/hi/health/6254308.stm

What is a prion?

The word Prion is a compound word derived from the initial letters of the words proteinaceous and infectious, with -on added by analogy to the word virion.
In animals is called scrapie or cow mad disease.
In humans: Creutzfeldt Jakob, Kuru, fatal familial insomnia and Alzheimer disease.