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Hip Surgery / Video











What to expect during and after a hip replacement



When contractor Greg Rogers went to his construction sites in Bakersfield, Calif., he had trouble walking around the job sites. After his active quality of life began to suffer he looked into getting a hip replacement after consulting his physician. Noting Community Regional Medical Centers award winning total joint program, Greg chose Dr. Kevin Lester to do his surgery. While his hip had fused over the years and was almost immobile before the surgery, Greg was up hours after his hip replacement and surprised to find he had very little pain and his mobility back. Just a day after the surgery, Greg was surprised there was little or no pain, even without pain medication. A couple days later, Greg returned home and was back to walking and his rehabilitation.

Rehabilitation After Total Joint Replacement




This video explains the long term goals and gives an in depth look of a total joint replacement. This video will clear up any misconceptions and answer any questions you might have about having a total joint replacement.

Hip Replacement Surgery




Total joint replacement involves surgery to replace the ends of both bones in a damaged joint to create new joint surfaces.

Total hip replacement surgery replaces the upper end of the thighbone (femur) with a metal ball and resurfaces the hip socket in the pelvic bone with a metal shell and plastic liner.

Total hip replacement surgery replaces damaged cartilage with new joint material in a step-by-step process.

Doctors may attach replacement joints to the bones with or without cement.

Cemented joints are attached to the existing bone with cement, which acts as a glue and attaches the artificial joint to the bone.
Uncemented joints are attached using a porous coating that is designed to allow the bone to adhere to the artificial joint. Over time, new bone grows and fills up the openings in the porous coating, attaching the joint to the bone.







Doctors often use general anesthesia for joint replacement surgeries, which means you'll be unconscious during surgery. But sometimes they use regional anesthesia, which means you can't feel the area of the surgery and you are sleepy, but you are awake. The choice depends on your doctor, on your overall health, and, to some degree, on what you prefer.

Your doctor may recommend that you take antibiotics before and after the surgery to reduce the risk of infection. If you need any major dental work, your doctor may recommend that you have it done before the surgery. Infections can spread from other parts of the body, such as the mouth, to the artificial joint and cause a serious problem.

Some doctors are doing hip replacement surgery through smaller incisions. This is called minimally invasive surgery. It may mean less blood loss and a smaller scar. But it can also mean a longer time in surgery because the surgery is harder to do. And if the new hip cannot be fitted properly through the smaller incision, the doctor may have to make a larger opening anyway. Minimally invasive surgery is not done often for hip replacement. If you are interested in this type of surgery, talk to your doctor. Whether the procedure is a good idea for you depends on your doctor's opinion and also on his or her training and practice.



The first few days


You will probably still be taking some medicine. You will gradually take less and less pain medicine. You may continue anticoagulant medicines for several weeks after surgery.

Rehabilitation (rehab) after hip replacement surgery may vary depending on whether the surgeon used cement or cementless methods to attach the joint replacement surfaces. Whether your surgeon used cement also determines how much weight you can put on your leg. Your surgeon will let you and your rehab team know what limitations you have. Usually, you cannot put any weight on an uncemented hip for about 6 weeks. With a cemented or hybrid (one piece cemented and one piece uncemented) hip, you can usually put some weight on your leg right away. But you'll still need a walker, a cane, or crutches for several weeks.

In general, most people get out of bed with help on the day after surgery. Over the next few days, you will learn how to walk with a walker or crutches. Your physical therapist and sometimes an occupational therapist will teach you how to exercise, walk, and do activities such as dressing and cooking while you allow your hip to heal. Depending on the type of surgery you had and your doctor's instructions, you may learn the following precautions to keep your hip from dislocating:

*Avoid combinations of movement with your new hip. For example, do not sit with your legs crossed because in that position you both bend your hip and bring your hip across your body.
*Your doctor may not want your hip to bend more than 90 degrees. If so, your therapist may suggest these ideas:
*Do not sit on low chairs, beds, or toilets. You may want to get a special raiser for your toilet seat temporarily.
*Do not raise your knee higher than your hip.
*Do not lean forward while you are sitting down, or as you sit down or stand up.
*Do not bend over more than 90 degrees. This means you can't bend down to tie your shoes for a while.
*For about 8 weeks, your doctor may not want your leg to cross the center of your body toward the other leg. If so, your therapist may suggest these ideas:
*Do not cross your legs.
*Be careful as you get in or out of bed or a car, so your leg does not cross that imaginary line in the middle of your body.
*Your doctor may not want your leg to rotate in or too far out. If so, your therapist may suggest that you keep your toes pointing forward or slightly out.
Most people go home within a few days to a week after surgery. Some people who need more extensive rehab or those who don't have someone who can help at home go to a specialized rehab center for more treatment.




    Continued recovery

    After you go home, monitor the surgery site and your general health. If you notice any redness or drainage from your wound, notify your surgeon. You may also be advised to take your temperature twice each day and to let your surgeon know if you have a fever over 100.5°F (38.1°C).

    For a while, you may need to sit only in high chairs (not on low seats that flex your hip more than 90 degrees), use a toilet seat raiser, and sleep on your back.

    You may need to use a walker or crutches for several weeks after surgery until you can bear your full weight, have less pain, and can safely move around without falling. How long you need to use crutches or a walker depends on the condition of your bones and what type of procedure your doctor used as well as his or her experience working with other people who had similar surgery.

    Physical therapy typically continues after you go home from the hospital until you are able to function more independently. Total rehabilitation after surgery will take at least 6 months.

    You will have an exercise program to follow when you go home, even if you are still having physical therapy. You should also take a short walk several times each day. If you notice any soreness, try a cold pack on your hip and perhaps decrease your activity a bit, but don't stop completely. Staying with your walking and exercise program will help speed your recovery.

    For most people it is safe to have sex about 4 to 6 weeks after a hip replacement. Talk to your doctor about how and when it is safe. And ask your physical therapist or occupational therapist about positions that will not put your new hip joint at risk.


    Living with a hip replacement





    Your doctor will probably want to see you at least once every year to monitor your hip replacement. Gradually, you will return to most of your presurgery activities. If you drive a car, your doctor will probably allow you to start driving an automatic shift car in 6 to 8 weeks, as long as the seat is not too low and you are no longer taking pain medicine.

    Because of the way the hip is structured, every added pound of body weight adds 3 pounds of stress to the hip. Controlling your weight will help your new hip joint last longer. For suggestions, see the topic Weight Management.

    Stay active to help maintain strength, flexibility, and endurance. Your activities might include walking, swimming (after your wound is completely healed), dancing, golf (don't wear shoes with spikes, and do use a golf cart), and bicycling on a stationary bike or on level surfaces. More strenuous activities, such as jogging or tennis, are not advised after a hip replacement.

    Your doctor may want you to take antibiotics before dental work or any invasive medical procedure for at least 2 years after your surgery. This is to help prevent infection around your hip replacement. After 2 years, your doctor and dentist will decide whether you still need to take antibiotics. Your general health and the state of your other health conditions will help them decide.


    Why It Is Done


    Doctors recommend joint replacement surgery when hip pain and loss of function become severe and when medicines and other treatments no longer relieve pain. Your doctor will use X-rays to look at the bones and cartilage in your hip to see whether they are damaged and to make sure that the pain isn't coming from somewhere else.

    Total hip replacement may not be recommended for people who:

    *Have poor general health and may not tolerate anesthetic and surgery well.
    *Have an active infection or are at high risk for infection.
    *Have osteoporosis (significant thinning of the bones).
    *Are involved in heavy manual labor or physically demanding sports.
    *Are severely overweight (replacement joints may be more likely to fail in people who are very overweight).

    But doctors evaluate each person individually.


    How Well It Works

    People who have hip replacement surgery have much less pain than before the surgery and are usually able to resume daily activities. You will probably be able to do your daily activities more easily because the joint moves better.





    *It probably will be easier for you to do things such as climb stairs, get in and out of a car, walk without tiring, walk without a limp or with less of a limp, and take care of your feet.
    *You probably will be able to resume activities, such as golfing, biking, swimming, or dancing, that you did before surgery.
    *Your doctor may discourage you from running, playing tennis, and doing other things that put a lot of stress on the joint.
    Most artificial hip joints will last for 10 to 20 years or longer without loosening, depending on such factors as:

    *Your lifestyle and how much stress you put on a joint.
    *How much you weigh (being very overweight puts extra stress on the joint).
    *How well your new joint and bones mend.
    The younger you are when you have the surgery and the more stress you put on the joint, the more likely it is that you will eventually need a second surgery to replace the first artificial joint. Over time, the components wear down or may loosen and need to be replaced.

    Your artificial joint should last longer if you are not overweight and if you do not do hard physical work or play sports that stress the joint. If you are older than 60 when you have joint replacement surgery, the artificial joint probably will last the rest of your life.

    Doctors continue to discover new ways to improve the life span of artificial hip joints. What we know today about the long-term outcomes of hip replacement surgery comes from studies of joints that were replaced 10 to 20 years ago or longer. People who have hip replacement surgery today may expect the artificial joint to last longer than joints replaced 10 to 20 years ago.




    Long-term risks

    *Loosening of the artificial hip joint parts . Over time, loosening is the most common problem associated with total hip replacement. Tissue may grow between the components and the bone, leading to loosening. Loosening usually doesn't cause any symptoms and is visible only on X-rays. If a loosened joint causes severe pain, you may need a second joint replacement.

    *Infection. People who have any sort of artificial material in their bodies, including artificial joint components, have a higher risk of infections around the artificial material. They may need to take antibiotics before and after procedures such as surgery, tests that involve inserting instruments into the body, and dental work to help reduce the risk of infection.


    What To Think About

    Continued exercise (such as swimming and walking) is important for your general well-being and muscle strength. Discuss with your doctor what type of exercise is best for you.




    El curio, un elemento químico como homenaje


    Esta pareja significó para el mundo un gran adelanto por sus grandes descubrimientos. Pierre Curie fue un físico francés (París 1859–1906), que estudió en la Sorbona. En colaboración con uno de sus hermanos, Paul-Jacques, realizó estudios sobre las radiaciones infrarrojas y sobre los cristales. En 1895 presentó su tesis sobre las propiedades magnéticas de los cuerpos a diversas temperaturas. Ese año se casó con la polaca Marie Sklodowska, que le ayudó en todas sus investigaciones. Tras el descubrimiento de la radioactividad por H. Becquerel, se consagró al estudio de este fenómeno, consiguiendo aislar, junto a su esposa, el polonio y el radio. En 1903 compartió el Nobel de Física con Marie. Murió tres años después atropellado por un coche de caballos. Así nacieron las radiografías. Fue la primera mujer en recibir el premio Nobel (de Física, en 1903, compartido con su marido y Becquerel). En 1911 fue premio Nobel de Química.








    Marie Sklodowska (Varsovia 1867 –Sallanches 1934) fue a París en 1891 para ampliar estudios en la Sorbona y conoció a Pierre Curie con quien se casó en 1895. Luego se graduó en Ciencias. Tuvo dos hijas: Irene y Eve. A la muerte de su marido ocupó la cátedra de física que él mismo había fundado, con lo que fue la primera mujer que accedió a tal cargo. Además de lo hecho con su marido ella descubrió la radioactividad del torio (1898), la existencia del polonio y aisló el radio en estado metálico. Madame Curie estaba segura de que los rayos X serían un gran avance médico y pensó que podrían funcionar para localizar las balas en los pacientes. Para no mover a los heridos, ella organizó camiones con máquinas de rayos X y entrenó a 150 enfermeras, para que aplicaran sus conocimientos.

    Marie Curie murió por anemia aplásica, el 04 de julio de 1934, a los 67 años causada probablemente por la sobreexposición a altos niveles de radiación durante sus trabajos y estudios. Después de su muerte, en su honor, el Instituto del Radio se convirtió en el Instituto Curie.
    Una de las aficiones menos conocidas de Marie Curie era la escritura de poemas.

    “¡Ah, qué amargamente transcurre la juventud del estudiante mientras que a su alrededor, con eterna pasión lozana, otros jóvenes buscan ávidamente los fáciles placeres!”

    ¿Y dónde está la vena?



    Este dispositivo de visualización del sistema vascular subcutáneo utiliza una ingeniosa combinación de luz infraroja (la misma que se usa en los controles remotos), cámara de vídeo, circuito "DLP" y una poderosa computadora, lo que permite a los profesionales de la salud localizar con rapidez la vena a la que específicamente quieran acceder.

    Esto se realiza mediante la proyección de dicha luz infraroja en la extremidad o parte del cuerpo a examinar, la que penetra profundamente debajo de la piel sin afectar los tejidos u órganos internos.




    El efecto de la luz hace que los glóbulos rojos de la sangre se destaquen, es entonces que la cámara de video, que es parte del dispositivo, recoge la imagen infraroja, la cual es analizada por la computadora y luego proyectada en el área de la piel que se encuentra por encima de las venas.

    La imagen es totalmente en vivo, permitiendo que se vea en tiempo real, por ejemplo, si la aguja está llegando a la vena correcta.



    Hay que tener en cuenta que la presencia de relojes, joyas metálicas y productos con capacidad reflectante pueden afectar a la imagen proyectada.

    Este dispositivo es de gran ayuda en flebología, cirugía vascular y, sobre todo, para las áreas de enfermería. La gran desventaja es el costo pero, como todos los avances electrónicos, con el transcurso del tiempo se va haciendo más accesible.

    Syndrome Burnout




    Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Research indicates general practitioners have the highest proportion of burnout cases; according to a recent Dutch study in Psychological Reports, no less than 40% of these experienced high levels of burnout. Burnout is not a recognized disorder in the DSM although it is recognized in the ICD-10 as "Problems related to life-management difficulty".
    The most well-studied measurement of burnout in the literature is the Maslach Burnout Inventory. Maslach and her colleague Jackson first identified the construct "burnout" in the 1970s, and developed a measure that weighs the effects of emotional exhaustion and reduced sense of personal accomplishment This indicator has become the standard tool for measuring burnout in research on the syndrome. The Maslach Burnout Inventory uses a three dimensional description of exhaustion, cynicism, and inefficacy.Some researchers and practitioners have argued for an "exhaustion only" model that sees that symptom as the hallmark of burnout.
    Maslach and her colleague, Michael Leiter, defined the antithesis of burnout as engagement. Engagement is characterized by energy, involvement and efficacy, the opposites of exhaustion, cynicism and inefficacy.
    Many theories of burnout include negative outcomes related to burnout, including job function (performance, output, etc.), health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues) and mental health problems (depression, etc.).
    The term burnout in psychology was coined by Herbert Freudenberger in his 1974 Staff burnout, presumably based on the 1960 novel A Burnt-Out Case by Graham Greene, which describes a protagonist suffering from burnout.


    Organizational burnout


    Tracy in her study aboard cruise ships describes this as "a general wearing out or alienation from the pressures of work" (Tracy, 2000 p. 6) "Understanding burnout to be personal and private is problematic when it functions to disregard the ways burnout is largely an organizational issue caused by long hours, little down time, and continual peer, customer, and superior surveillance".
    How the stress is processed determines how much stress is felt and how close the person is to burnout. One individual can experience few stressors, but be unable to process the stress well and thus experience burnout. Another person, however, can experience a significant amount of stressors, but process each well, and avoid burnout. How close a person is to a state of burnout can be determined through various tests.





    Phases


    Psychologists Herbert Freudenberger and Gail North have theorized that the burnout process can be divided into 12 phases, which are not necessarily followed sequentially, nor necessarily in any sense be relevant or exist other than as an abstract construct.


    1. The Compulsion to Prove Oneself
    Often found at the beginning is excessive ambition. This is one's desire to prove themselves while at the workplace. This desire turns into determination and compulsion.


    2. Working Harder
    Because they have to prove themselves to others or try to fit in an organization that does not suit them, people establish high personal expectations. In order to meet these expectations, they tend to focus only on work while they take on more work than they usually would. It may happen that they become obsessed with doing everything themselves. This will show that they are irreplaceable since they are able to do so much work without enlisting in the help of others.


    3. Neglecting Their Needs
    Since they have devoted everything to work, they now have no time and energy for anything else. Friends and family, eating, and sleeping start to become unnecessary or unimportant, as it reduces the time and energy that can be spent on work.


    4. Displacement of Conflicts
    Now, the person has become aware that what they are doing is not right, but they are unable to see the source of the problem. This could lead to a crisis in themselves and become threatening. This is when the first physical symptoms are expressed.


    5. Revision of Values
    In this stage, people isolate themselves from others, they avoid conflicts, and fall into a state of denial towards their basic physical needs while their perceptions change. They also look at their value systems. The work consumes all energy they have left, leaving no energy and time for friends and hobbies. Their new value system is their job and they start to be emotionally blunt.


    6. Denial of Emerging Problems
    The person begins to become intolerant. They don't like being social, and if they were to have social contact, it would be merely unbearable. Outsiders tend to see more aggression and sarcasm. It's not uncommon for them to blame their increasing problems on time pressure and all the work that they have to do, instead of on the ways that they have changed, themselves.


    7. Withdrawal
    Their social contact is now at a minimum, soon turning into isolation, a wall. Alcohol or drugs may be sought out for a release since they are obsessively working "by the book". They often have feelings of being without hope or direction.


    8. Obvious Behavioral Changes
    Coworkers, family, friends, and other people that are in their immediate social circles cannot overlook the behavioral changes of this person.


    9. Depersonalization
    Losing contact with themselves, it's possible that they no longer see themselves or others as valuable. as well as losing track of their personal needs. Their view of life narrows to only seeing in the present time, while their life turns to a series of mechanical functions.


    10. Inner Emptiness
    They feel empty inside and to overcome this, they might look for activity such as sex, alcohol, or drugs. These activities are often exaggerated and overreacted.


    11. Depression
    Burnout may include depression. In that case, the person is exhausted, hopeless, indifferent, and believe that there is nothing for them in the future. To them, there is no meaning of life. Typical depression symptoms arise.


    12. Burnout Syndrome
    They collapse physically and emotionally and should seek immediate medical attention. In extreme cases, usually only when depression is involved, suicidal thoughts have passed through the minds of these people to use as an escape from their situation and only few people will actually commit suicide






    Preventing burnout


    While individuals can cope with the symptoms of burnout, the only way to truly prevent burnout is through a combination of organizational change and education for the individual. Organizations address these issues through their own management development, but often they engage external consultants to assist them in establishing new policies and practices supporting a healthier worklife. Maslach and Leiter postulated that burnout occurs when there is a disconnect between the organization and the individual with regard to what they called the six areas of work life: workload, control, reward, community, fairness, and values. Resolving these discrepancies requires integrated action on the part of both the individual and the organization. A better connection on workload means assuring adequate resources to meet demands as well as work/life balances that encourage employees to revitalize their energy. A better connection on values means clear organizational values to which employees can feel committed. A better connection on community means supportive leadership and relationships with colleagues rather than discord.
    One approach for addressing these discrepancies focuses specifically on the fairness area. In one study employees met weekly to discuss and attempt to resolve perceived inequities in their job. This study revealed decreases in the exhaustion component over time but did not affect cynicism or inefficacy indicating that a broader approach is required.


    Coping with burnout

    There are a variety of ways that both individuals and organizations can deal with burnout. In general, resting proves to be very effective. This may include a temporary reduction of working hours, slowly rebuilding the endurance of the individual. In his book, Managing stress: Emotion and power at work (1995), Newton argues that many of the remedies related to burnout are motivated not from an employee's perspective, but from the organization's perspective. Despite that, if there are benefits to coping strategies, then it would follow that both organizations and individuals should attempt to adopt some burnout coping strategies. Below are some of the more common strategies for dealing with burnout.


    Organizational aspects


    Employee assistance programs (EAP)
    Stemming from Mayo's Hawthorne Studies, Employee Assistance Programs were designed to assist employees in dealing with the primary causes of stress. Some programs included counseling and psychological services for employees. There are organizations that still utilize EAPs today, but the popularity has diminished substantially because of the advent of stress management training (SMT).


    Stress management training

    Stress Management Training (SMT) is employed by many organizations today as a way to get employees to either work through stress or to manage their stress levels; to maintain stress levels below that which might lead to higher instances of burnout.
    Stress interventions
    Research has been conducted that links certain interventions, such as narrative writing or topic-specific training to reductions in physiological and psychological stress.


    Individual aspects
    Problem-based coping


    On an individual basis, employees can cope with the problems related to burnout and stress by focusing on the causes of their stress. Various therapies, such as Neurofeedback therapy, claim to assist in cases of burnout. This type of coping has successfully been linked to reductions in individual stress.


    Appraisal-based coping

    Appraisal-based coping strategies deal with individual interpretations of what is and is not a stress inducing activity. There have been mixed findings related to the effectiveness of appraisal-based coping strategies.


    Social support

    Social support has been seen as one of the largest predictors toward a reduction in burnout and stress for workers. Creating an organizationally-supportive environment as well as ensuring that employees have supportive work environments do mediate the negative aspects of burnout and stress.


    Celiac Disease (Gluten Enteropathy)

    ,





    What is celiac disease?


    Celiac disease is a disease of the small intestine. The small intestine is a 22 foot long tube that begins at the stomach and ends at the large intestine (colon). The first 10 inches (25cm) of the small intestine (the part that is attached to the stomach) is called the duodenum, the middle part is called the jejunum, and the last part (the part that is attached to the colon) is called the ileum. Food empties from the stomach into the small intestine where it is digested and absorbed into the body. While food is being digested and absorbed, it is transported by the small intestine to the colon. What enters the colon is primarily undigested food. In celiac disease, there is an immunological (allergic) reaction within the inner lining of the small intestine to proteins (gluten) that are present in wheat, rye, barley and, to a lesser extent, in oats. The immunological reaction causes inflammation that destroys the lining of the small intestine. This reduces the absorption of the dietary nutrients and can lead to symptoms and signs of nutritional, vitamin, and mineral deficiencies.
    The other terms used forceliac disease include sprue, nontropical sprue, gluten enteropathy, and adult celiac disease. (Tropical sprue is another disease of the small intestine that occurs in tropical climates. Although tropical sprue may cause symptoms that are similar to celiac disease, the two diseases are not related.)
    Celiac disease is common in European countries, particularly in Ireland, Italy, Sweden, and Austria. In Northern Ireland, for example, one in every 300 people has celiac disease. In Finland, the prevalence may be as high as one in every 100 persons. Celiac disease also occurs in North America where the prevalence has been estimated to be one in every 3000 people. Unfortunately, most population studies underestimate the prevalence of celiac disease because many individuals who develop celiac disease have few or no symptoms until later in life. Moreover, a study suggests that the prevalence of celiac disease in the United States is similar to that in Europe.








    Celiac disease facts


    • Celiac disease is a chronic digestive disorder in which damage to the lining of the small intestine leads to the malabsorption of minerals and nutrients.

    • The destruction of the inner lining of the small intestine in celiac disease is caused by an immunological (allergic) reaction to gluten.

    • Gluten is a family of proteins present in wheat, barley, rye, and sometimes oats.

    • Individuals with celiac disease may develop diarrhea, steatorrhea, weight loss, flatulence, iron deficiency anemia, abnormal bleeding, or weakened bones. However, many adults with celiac disease may have either no symptoms or only vague abdominal discomfort such as bloating, abdominal distension, and excess gas.

    • Children with celiac disease may have stunted growth, and if untreated, childhood celiac disease can result in short stature as an adult.

    • Small intestinal biopsy is considered the most accurate test for celiac disease.

    • Blood tests can be performed to diagnose celiac disease; these include endomysial antibodies, anti-tissue transglutaminase antibodies, and anti-gliadin antibodies.

    • There is no cure for celiac disease. The treatment of celiac disease is a gluten free diet.

    • In most individuals, a gluten free diet will result in improvement in symptoms within weeks. Many individuals report symptom improvement within 48 hours.

    • In children with celiac disease, successful treatment with a gluten free diet can lead to the resumption in growth (with rapid catch up in height).

    • Failure to respond to a gluten free diet can be due to several reasons; the most common reason is failure to adhere to a strict gluten free diet.

    • Refractory celiac disease is a rare condition in which the symptoms of celiac disease (and the loss of villi) do not improve despite many months of a strict gluten free diet. It may progress to cancer.

    • The treatment of refractory celiac disease is first to make sure that all gluten is eliminated from the diet. If there still is no improvement, corticosteroids such as prednisone, and immunosuppressive agents (medications that suppress a person's immune system) such as azathioprine and cyclosporine may be used.

    • Adults with celiac disease have a several-fold higher than normal risk of developing lymphomas (cancers of the lymph glands) in the small intestine and elsewhere. They also have a high risk of small intestinal and, to a lesser degree, of esophageal carcinomas (cancers of the inner lining of the intestine and esophagus).

    • The prognosis of individuals with celiac disease who develop lymphoma, collagenous celiac disease, or jejunal ulcers is poor.


    What is Sjogren's syndrome?




    Sjogren's syndrome is an autoimmune disease characterized by dryness of the mouth and eyes. Autoimmune diseases feature the abnormal production of extra antibodies in the blood that are directed against various tissues of the body. This particular autoimmune illness features inflammation in glands of the body that are responsible for producing tears and saliva. Inflammation of the glands that produce tears (lacrimal glands) leads to decreased water production for tears and dry eyes. Inflammation of the glands that produce the saliva in the mouth (salivary glands, including the parotid glands) leads to dry mouth and dry lips.

    Sjogren's syndrome with gland inflammation (resulting dry eyes and mouth, etc.) that is not associated with another connective tissue disease is referred to as primary Sjogren's syndrome. Sjogren's syndrome that is also associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjogren's syndrome.


    What causes Sjogren's syndrome?


    While the exact cause of Sjogren's syndrome is not known, there is growing scientific support for genetic (inherited) factors. The genetic background of Sjogren's syndrome patients is an active area of research. The illness is sometimes found in other family members. It is also found more commonly in families that have members with other autoimmune illnesses, such as systemic lupus erythematosus, autoimmune thyroid disease, type I diabetes, etc. About 90% of patients with Sjogren's syndrome are female.


    What are the symptoms of Sjogren's syndrome?


    Symptoms of Sjogren's syndrome can involve the glands, as above, but there are also possible affects of the illness involving other organs of the body (extraglandular manifestations). When the tear gland (lacrimal gland) is inflamed from Sjogren's, the resulting eye dryness can progressively lead to eye irritation, decreased tear production, "gritty" sensation, infection, and serious abrasion of the dome of the eye (cornea). Dry eyes can lead to infections of the eyes. Inflammation of the salivary glands can lead to mouth dryness, swallowing difficulties, dental decay, gum disease, mouth sores and swelling, stones and/or infection of parotid gland inside of the cheeks. Dry lips often accompany the mouth dryness. Other glands that can become inflamed, though less commonly, in Sjogren's syndrome include those of the lining of the breathing passages (leading to lung infections) and vagina (sometimes noted as pain during intercourse recurrent vaginal infections). Extraglandular (outside of the glands) problems in Sjogren's syndrome include joint pain or inflammation (arthritis), Raynaud's phenomenon, lung inflammation, lymph-node enlargement, kidney, nerve, and muscle disease. A rare serious complication of Sjogren's syndrome is inflammation of the blood vessels (vasculitis), which can damage the tissues of the body that are supplied by these vessels.