Alternative Health

Abuse
Abuse is defined as anything that is harmful, injurious, or offensive. Abuse also includes excessive and wrongful misuse of a substance. There are several major types of abuse: physical and sexual abuse of a child or an adult, substance abuse, elderly abuse, and emotional abuse.
Description
Physical abuse of a child is the infliction of injury by another person. The injuries can include punching, kicking, biting, burning, beating, or pulling the victim’s hair. The physical abuse inflicted on a child can result in bruises, burns, poisoning, broken bones, and internal hemorrhages. Physical assault against an adult primarily occurs with women, usually in the form of domestic violence. It is estimated that approximately three million children witness domestic violence every year.
Sexual abuse of a child refers to sexual behavior between an adult and child or between two children, one of whom is dominant or significantly older. The sexual behaviors can include touching breasts, genitals, and buttocks; either dressed or undressed. The behavior also can include exhibitionism, cunnilingus, fellatio, or penetration of the vagina or anus with sexual organs or objects.
Pornographic photography also is used in sexual abuse with children. Reported sex offenders are 97% male. Reports of child pornography have increased since with the popularity of the Internet. Females more often are perpetrators in child-care settings, since children may confuse sexual abuse by a female with normal hygiene care. The 1990s and early 2000s were rocked by reports of sexual abuse of children committed by Catholic priests. Most of the abuse appeared to have occurred during the 1970s and a prominent report released early in 2004 stated that as many as 10.667 children were sexually abused by more than 4,300 priests. Sexual abuse by stepfathers is five times more common than with biological fathers. Sexual abuse of daughters by stepfathers or fathers is the most common form of incest.
Sexual abuse also can take the form of rape. The legal definition of rape includes only slight penile penetration in the victim’s outer vulva area. Complete erection and ejaculation are not necessary. Rape is the perpetration of an act of sexual intercourse whether:
·will is overcome by force or fear (from threats or by use of drugs).
·mental impairment renders the victim incapable of rational judgment.
·if the victim is below the legal age established for consent.
Substance abuse is an abnormal pattern of substance usage leading to significant distress or impairment. The criteria include one or more of the following occurring within a 12-month period:
·recurrent substance use resulting in failure to fulfill obligations at home, work, or school.
·using substance in situations that are physically dangerous (i.e., while driving).
·recurrent substance-related legal problems.
·continued usage despite recurrent social and interpersonal problems (i.e., arguments and fights with significant other).
Abuse of the elderly is common and occurs mostly as a result of caretaker burnout, due to the high level of dependency frail, elderly patients usually require. Abuse can be manifested by physical signs, fear, and delaying or not reporting the need for advanced medical care. Elderly patients also may exhibit financial abuse (money or possessions taken away) and abandonment.
Emotional abuse generally continues even after physical assaults have stopped. In most cases it is a personally tailored form of verbal or gesture abuse expressed to illicit a provoked response.

Causes and symptoms
Children who have been abused usually have a variety of symptoms that encompass behavioral, emotional, and psychosomatic problems (body problems caused by emotional or mental disturbance). Children who have been physically abused tend to be more aggressive, angry, hostile, depressed, and have low self-esteem. Additionally, they exhibit fear, anxiety, and nightmares. Severe psychological problems may result in suicidal behavior or posttraumatic stress disorder. Physically abused children may complain of physical illness even in the absence of a cause. They also may suffer from eating disorders and encopresis, or involuntary defecation caused or psychic origin. Children who are sexually abused may exhibit abnormal sexual behavior in the form of aggressiveness and hyperarousal. Adolescents may display promiscuity, sexual acting out, and–in some situations–homosexual contact.
Physical abuse directed towards adults can ultimately lead to death. Approximately 50% of women murdered in the United States were killed by a former or current male partner. Approximately one-third of emergency room consultations by women were prompted due to domestic violence. Female victims who are married also have a higher rate of internal injuries and unconsciousness than victims of stranger assault (mugging, robbery). Physical abuse or rape also can occur between married persons and persons of the same gender. Perpetrators usually sexually assault their victims to dominate, hurt, and debase them. It is common for physical and sexual violence to occur at the same time. A large percentage of sexually assaulted persons were also physically abused in the form of punching, beating, or threatening the victim with a weapon such as a gun or knife. Usually males who are hurt and humiliated tend to physically assault people whom they are intimately involved with, such as spouses and/or children. Males who assault a female tend to have experienced or witnessed violence during childhood. They also tend to abuse alcohol, to be sexually assaultive, and are at increased risk for assaultive behavior directed against children. Jealous males tend to monitor a women’s movements and whereabouts and to isolate other sources of protection and support. They interpret their behavior as betrayal of trust and this causes resentment and explosive anger outbursts during periods of losing control. Males also may use aggression against females in an effort to control and intimidate partners.
Abuse in the elderly usually occurs in the frail, elderly community. The caretaker is usually the perpetrator. Caretaker abuse can be suspected if there is evidence suggesting behavioral changes in the elderly person when the caretaker is present. Additionally, elderly abuse can be possible if there are delays between injuries and treatment, inconsistencies between injury and explanations, lack of hygiene or clothing, and prescriptions not being filled.

Diagnosis
Children who are victims of domestic violence frequently are injured attempting to protect their mother from an abusive partner. Injuries are visible by inspection or self-report. Physical abuse of an adult may also be evident by inspection with visible cuts and/or bruises or self-report.
Sexual abuse of both a child and an adult can be diagnosed with a history from the victim. Victims can be assessed for signs of ejaculatory evidence from the perpetrator. Ejaculatory specimens can be retrieved from the mouth, rectum, and clothing. Tests for sexually transmitted diseases may be performed.
Elderly abuse can be suspected if the elderly patient demonstrates a fear of the caretaker. Additionally, elderly abuse can be suspected if there are signs indicating intentional delay of required medical care or a change in medical status.
Substance abuse can be suspected in a person who continues to indulge in their drug of choice despite recurrent negative consequences. The diagnosis can be made after administration of a comprehensive exam and standardized chemical abuse assessments by a therapist.

Treatment
Children who are victims of physical or sexual abuse typically require psychological support and medical attention. A complaint may be filed with the local family social services agency that will initiate investigations. The authorities usually will follow up the allegation or offense. Children may also be referred for psychological evaluation and/or treatment. The victim also may be placed in foster care pending the investigation outcome. The police also may investigate physical and sexual abuse of an adult. The victim may require immediate medical care and long-term psychological treatment. It is common for children to be adversely affected by domestic violence situations and the local family services agency may be involved.
Substance abusers should elect treatment, either inpatient or outpatient, depending on severity of addiction. Long term treatment and/or medications may be utilized to assist in abstinence. The patient should be encouraged to participate in community centered support groups.
Prognosis
The prognosis depends on the diagnosis. Usually victims of physical and sexual abuse require therapy to deal with emotional distress associated with the incident. Perpetrators require further psychological evaluation and treatment. Victims of abuse may have a variety of emotional problems including depression, acts of suicide, or anxiety. Children of sexual abuse may enter abusive relationships or have problems with intimacy as adults. The substance abuser may experience relapses, since the cardinal feature of all addictive disorders is a tendency to return to symptoms. Elderly patients may suffer from further medical problems and/or anxiety, and in some cases neglect may precipitate death.

Prevention
Prevention programs are geared to education and awareness. Detection of initial symptoms or characteristic behaviors may assist in some situations. In some cases treatment may be sought before incident. The professional treating the abused persons must develop a clear sense of the relationship dynamics and the chances for continued harm.

Abscess
An abscess is an enclosed collection of liquefied tissue, known as pus, somewhere in the body. It is the result of the body’s defensive reaction to foreign material.
Description
There are two types of abscesses, septic and sterile. Most abscesses are septic, which means that they are the result of an infection. Septic abscesses can occur anywhere in the body. Only a germ and the body’s immune response are required. In response to the invading germ, white blood cells gather at the infected site and begin producing chemicals called enzymes that attack the germ by digesting it. These enzymes act like acid, killing the germs and breaking them down into small pieces that can be picked up by the circulation and eliminated from the body. Unfortunately, these chemicals also digest body tissues. In most cases, the germ produces similar chemicals. The result is a thick, yellow liquid–pus–containing digested germs, digested tissue, white blood cells, and enzymes.
An abscess is the last stage of a tissue infection that begins with a process called inflammation. Initially, as the invading germ activates the body’s immune system, several events occur:
· Blood flow to the area increases.
· The temperature of the area increases due to the increased blood supply.
· The area swells due to the accumulation of water, blood, and other liquids.
· It turns red.
· It hurts, because of the irritation from the swelling and the chemical activity.
These four signs–heat, swelling, redness, and pain–characterize inflammation.
As the process progresses, the tissue begins to turn to liquid, and an abscess forms. It is the nature of an abscess to spread as the chemical digestion liquefies more and more tissue. Furthermore, the spreading follows the path of least resistance–the tissues most easily digested. A good example is an abscess just beneath the skin. It most easily continues along beneath the skin rather than working its way through the skin where it could drain its toxic contents. The contents of the abscess also leak into the general circulation and produce symptoms just like any other infection. These include chills, fever, aching, and general discomfort.
Sterile abscesses are sometimes a milder form of the same process caused not by germs but by non-living irritants such as drugs. If an injected drug like penicillin is not absorbed, it stays where it was injected and may cause enough irritation to generate a sterile abscess–sterile because there is no infection involved. Sterile abscesses are quite likely to turn into hard, solid lumps as they scar, rather than remaining pockets of pus.
Causes and symptoms
Many different agents cause abscesses. The most common are the pus-forming (pyogenic) bacteria like Staphylococcus aureus , which is nearly always the cause of abscesses under the skin. Abscesses near the large bowel, particularly around the anus, may be caused by any of the numerous bacteria found within the large bowel. Brain abscesses and liver abscesses can be caused by any organism that can travel there through the circulation. Bacteria, amoeba, and certain fungi can travel in this fashion. Abscesses in other parts of the body are caused by organisms that normally inhabit nearby structures or that infect them. Some common causes of specific abscesses are:
· skin abscesses by normal skin flora
· dental and throat abscesses by mouth flora
· lung abscesses by normal airway flora, pneumonia germs, or tuberculosis
· abdominal and anal abscesses by normal bowel flora
Specific types of abscesses
Listed below are some of the more common and important abscesses.
· Carbuncles and other boils. Skin oil glands (sebaceous glands) on the back or the back of the neck are the ones usually infected. The most common germ involved is Staphylococcus aureus . Acne is a similar condition of sebaceous glands on the face and back.
· Pilonidal abscess. Many people have as a birth defect a tiny opening in the skin just above the anus. Fecal bacteria can enter this opening, causing an infection and subsequent abscess.
· Retropharyngeal, parapharyngeal, peritonsillar abscess. As a result of throat infections like strep throat and tonsillitis, bacteria can invade the deeper tissues of the throat and cause an abscess. These abscesses can compromise swallowing and even breathing.
· Lung abscess. During or after pneumonia, whether it’s due to bacteria [common pneumonia], tuberculosis, fungi, parasites, or other germs, abscesses can develop as a complication.
· Liver abscess. Bacteria or amoeba from the intestines can spread through the blood to the liver and cause abscesses.
· Psoas abscess. Deep in the back of the abdomen on either side of the lumbar spine lie the psoas muscles. They flex the hips. An abscess can develop in one of these muscles, usually when it spreads from the appendix, the large bowel, or the fallopian tubes.
Diagnosis
The common findings of inflammation–heat, redness, swelling, and pain–easily identify superficial abscesses. Abscesses in other places may produce only generalized symptoms such as fever and discomfort. If the patient’s symptoms and physical examination do not help, a physician may have to resort to a battery of tests to locate the site of an abscess, but usually something in the initial evaluation directs the search. Recent or chronic disease in an organ suggests it may be the site of an abscess. Dysfunction of an organ or system–for instance, seizures or altered bowel function–may provide the clue. Pain and tenderness on physical examination are common findings. Sometimes a deep abscess will eat a small channel (sinus) to the surface and begin leaking pus. A sterile abscess may cause only a painful lump deep in the buttock where a shot was given.
Treatment
Since skin is very resistant to the spread of infection, it acts as a barrier, often keeping the toxic chemicals of an abscess from escaping the body on their own. Thus, the pus must be drained from the abscess by a physician. The surgeon determines when the abscess is ready for drainage and opens a path to the outside, allowing the pus to escape. Ordinarily, the body handles the remaining infection, sometimes with the help of antibiotics or other drugs. The surgeon may leave a drain (a piece of cloth or rubber) in the abscess cavity to prevent it from closing before all the pus has drained out.
Alternative treatment
If an abscess is directly beneath the skin, it will be slowly working its way through the skin as it is more rapidly working its way elsewhere. Since chemicals work faster at higher temperatures, applications of hot compresses to the skin over the abscess will hasten the digestion of the skin and eventually result in its breaking down, releasing the pus spontaneously. This treatment is best reserved for smaller abscesses in relatively less dangerous areas of the body–limbs, trunk, back of the neck. It is also useful for all superficial abscesses in their very early stages. It will “ripen” them.
Contrast hydrotherapy, alternating hot and cold compresses, can also help assist the body in resorption of the abscess. There are two homeopathic remedies that work to rebalance the body in relation to abscess formation, Silica and Hepar sulphuris . In cases of septic abscesses, bentonite clay packs (bentonite clay and a small amount of Hydrastis powder) can be used to draw the infection from the area.
Prognosis
Once the abscess is properly drained, the prognosis is excellent for the condition itself. The reason for the abscess (other diseases the patient has) will determine the overall outcome. If, on the other hand, the abscess ruptures into neighboring areas or permits the infectious agent to spill into the bloodstream, serious or fatal consequences are likely. Abscesses in and around the nasal sinuses, face, ears, and scalp may work their way into the brain. Abscesses within an abdominal organ such as the liver may rupture into the abdominal cavity. In either case, the result is life threatening. Blood poisoning is a term commonly used to describe an infection that has spilled into the blood stream and spread throughout the body from a localized origin. Blood poisoning, known to physicians as septicemia, is also life threatening.
Of special note, abscesses in the hand are more serious than they might appear. Due to the intricate structure and the overriding importance of the hand, any hand infection must be treated promptly and competently.
Prevention
Infections that are treated early with heat (if superficial) or antibiotics will often resolve without the formation of an abscess. It is even better to avoid infections altogether by taking prompt care of open injuries, particularly puncture wounds. Bites are the most dangerous of all, even more so because they often occur on the hand.

Abdominal wall defects
Abdominal wall defects are birth (congenital) defects that allow the stomach or intestines to protrude.
Description
Many unexpected and fascinating events occur during the development of a fetus inside the womb. The stomach and intestines begin development outside the baby’s abdomen and only later does the abdominal wall enclose them. Occasionally, either the umbilical opening is too large, or it develops improperly, allowing the bowels or stomach to remain outside or squeeze through the abdominal wall.
Causes and symptoms
There are many causes for birth defects that still remain unclear. Presently, the cause(s) of abdominal wall defects is unknown, and any symptoms the mother may have to indicate that the defects are present in the fetus are nondescript.
Diagnosis
At birth, the problem is obvious, because the base of the umbilical cord at the navel will bulge or, in worse cases, contain viscera (internal organs). Before birth, an ultrasound examination may detect the problem. It is always necessary in children with one birth defect to look for others, because birth defects are usually multiple.
Treatment
Abdominal wall defects are effectively treated with surgical repair. Unless there are accompanying anomalies, the surgical procedure is not overly complicated. The organs are normal, just misplaced. However, if the defect is large, it may be difficult to fit all the viscera into the small abdominal cavity.
Prognosis
If there are no other defects, the prognosis after surgical repair of this condition is relatively good. However, 10% of those with more severe or additional abnormalities die from it. The organs themselves are fully functional; the difficulty lies in fitting them inside the abdomen. The condition is, in fact, a hernia requiring only replacement and strengthening of the passageway through which it occurred. After surgery, increased pressure in the stretched abdomen can compromise the function of the organs inside.
Prevention
Some, but by no means all, birth defects are preventable by early and attentive prenatal care, good nutrition, supplemental vitamins, diligent avoidance of all unnecessary drugs and chemicals–especially tobacco–and other elements of a healthy lifestyle.

Acrocyanosis

Acrocyanosis is a decrease in the amount of oxygen delivered to the extremities. The hands and feet turn blue because of the lack of oxygen. Decreased blood supply to the affected areas is caused by constriction or spasm of small blood vessels.
Description
Acrocyanosis is a painless disorder caused by constriction or narrowing of small blood vessels in the skin of affected patients. The spasm of the blood vessels decreases the amount of blood that passes through them, resulting in less blood being delivered to the hands and feet. The hands may be the main area affected. The affected areas turn blue and become cold and sweaty. Localized swelling may also occur. Emotion and cold temperatures can worsen the symptoms, while warmth can decrease symptoms. The disease is seen mainly in women and the effect of the disorder is mainly cosmetic. People with the disease tend to be uncomfortable, with sweaty, cold, bluish colored hands and feet.
Causes and symptoms
The sympathetic nerves cause constriction or spasms in the peripheral blood vessels that supply blood to the extremities. The spasms are a contraction of the muscles in the walls of the blood vessels. The contraction decreases the internal diameter of the blood vessels, thereby decreasing the amount of blood flow through the affected area. The spasms occur on a persistent basis, resulting in long term reduction of blood supply to the hands and feet. Sufficient blood still passes through the blood vessels so that the tissue in the affected areas does not starve for oxygen or die. Mainly, blood vessels near the surface of the skin are affected.
Diagnosis
Diagnosis is made by observation of the main clinical symptoms, including persistently blue and sweaty hands and/or feet and a lack of pain. Cooling the hands increases the blueness, while warming the hands decreases the blue color. The acrocyanosis patient’s pulse is normal, which rules out obstructive diseases. Raynaud’s disease differs from acrocyanosis in that it causes white and red skin coloration phases, not just bluish discoloration.
Treatment
Acrocyanosis usually isn’t treated. Drugs that block the uptake of calcium (calcium channel blockers) and alpha-one antagonists reduce the symptoms in most cases. Drugs that dilate blood vessels are only effective some of the time. Sweating from the affected areas can be profuse and require treatment. Surgery to cut the sympathetic nerves is performed rarely.
Prognosis
Acrocyanosis is a benign and persistent disease. The main concern of patients is cosmetic. Left untreated, the disease does not worsen.