Wednesday, August 26, 2020

N. Fowleri Diagnosis, Treatment and Prevention

N. Fowleri Diagnosis, Treatment and Prevention Chronicled Aspect: Naegleria Fowleri (N. Fowleri ) is a free living, thermophilic protozoan that is a human explicit pathogen that assaults the focal sensory system. It very well may be found in tainted freshwater sources. It enters through the nose and goes to the mind causing essential amoebic meningoencephalitis1. It was first seen in 1899 and later named after Dr. M. Fowler, who watched the principal announced deadly instances of intense pyogenic meningitis in Australia in 19652. While these diseases have been recognized as right on time as the nineteenth century it is trying to distinguish in light of the fact that it mirrors a considerable lot of the side effects of bacterial meningitis[1]. Essential amoebic meningoencephalitis (PAM) is a necrotizing and hemorrhagic meningoencephalitis3. The side effects start 1-9 days after the beginning of disease these indications incorporate fever, queasiness, cerebral pain and regurgitating. The underlying side effects emulate those of bacterial meningitis, the later manifestations are one of a kind to this malady. Later side effects incorporate neck solidness, visualizations, seizures, a failure to center, absence of parity and in the long run trance like state and passing. The death rate for this infection is 95%. The malady advances rapidly and prompts demise inside 12 days of the underlying infection1. While this contamination has a high death rate, it is extremely uncommon. There have been 300 announced instances of PAM worldwide in the last 40 years4. Note this molded is regularly misdiagnosed so these numbers are gauges. In the United States there have been 138 cases in the last 50 years1. This contamination was previously a condition that tormented creating nations yet the rate is spreading everywhere throughout the world. Scientists presume that the expanded temperatures because of an unnatural weather change, expanded utilization of open water sources because of shortage and a general increment in oceanic recreational exercises are to blame3,18. While swimming and other sea-going recreational exercises help multiply this infection do as well customs. Aga Khan University in Pakistan saw an expanded number of passings brought about by PAM in youthful guys that had no history of swimming, yet were dedicated Muslims. The individuals who practice this confidence supplicate five times each day and before each petition, they perform bathing, bathing is the washing of the hands, face, ears, nose, mouth, arms and feet. While purging the nose, water is constrained up the nose putting people playing out this training with insufficiently sanitized water at a more serious hazard for PAM3. Strict celebrations like the Kumbh Mela where Hindus assemble and swim in the Ganges waterway put the individuals who take an interest in danger of creating sicknesses like PAM brought about by N. Fowleri 3. Notwithstanding strict practices, helpful intercessions like the Neti pot increment the danger of PAM. Nasal water system frameworks like the Neti pot work to mitigate the side effects of sinusitis and cold. It works by expelling flotsam and jetsam and bodily fluid from the nasal sections. The suggestion is that the water ought to be bubbled or blended in with a non-ionized sodium chloride. Fundamental structure: N. Fowleri are a piece of the free living single adaptable cell that cause contaminations in the focal sensory system. A portion of different protists are Acanthamoeba spp and Balamuthia mandrillas. Naegleria fowleri have been arranged by present day strategies which break down morphology, biochemical pathway and sub-atomic phylogeny2. The advanced methodology arranges N. Fowleri as a piece of the super gathering Excavata, in the gathering Heterolobosea and a piece of the family Vahlkampfiidae. Despite the fact that the genome for N. Fowleri isn't yet finished there are a few investigations creating data about its sub-atomic and hereditary qualities. N. Fowleri s sort incorporates in excess of 40 species, however N. Fowleri is the one in particular that is known to cause sickness in people. De Jonckheere made the most famous recognizable proof framework for N. Fowleri . The ID framework utilizes hereditary markers like inward deciphered spacers (ITS1) and 5.8S rDNA 2. This distinguis hing proof framework uncovered at any rate 8 unique genotypes. The genotypes are scattered among various landmasses America (I,II,III), Europe (III,IV,V,VI,VIII), Oceania (V), and Asia (II,III). Of the eight genotypes just four have been found in people, types 1-42. Naegleria are a piece of the gathering heteroloboseans that have a three-staged lifecycle. They are first one-celled critter, at that point whip and in conclusion growth formation5. N. Fowleri replicates in the one-celled critter structure by means of parallel splitting to deliver the sore and the beat structures. The whole cell cycle is 8 hours, N. Fowleri goes through 28 minutes in M stage, 180 minutes in G1, 183 minutes in S stage, and an hour and a half in G22. In the one-celled critter structure, the trophozoite extends in size from 15-25 Â µm. Trophozoites likewise have cytoplasmic projections called food cups which permit phagocytosis of microscopic organisms, yeast, erythrocytes and cell squander. Trophozoites are the type of the single adaptable cell that can take care of and separate, they are additionally the structure that enter the human host6.Trophozoites will change into the beat stage in the wake of being presented to a saline solution2. The beats can't take care of or separate, the progress additionally includes an adjustment fit as a fiddle from pleomorphic to pear formed with a couple of flagella. The flagella have the average 9+2 structure and are encircled by a cytoplasmic film. The 9+2 flagella structure portrays the cross-sectional game plan of microtubules that make up the flagella. There are nine doublet external tubules and two focal singlet tubules7. The blister structure is impervious to most sterilization. The blister development is round, smooth, twofold walled and refractive. They measure about 20â µm. The material of the sore divider is orchestrated and bundled by the unpleasant endoplasmic reticulum2. Course of Transmission: N. Fowleri is a thermophilic one-celled critter, its ideal temperature ranges from 1150 to 1220 F. N. Fowleri can regularly be found in warm freshwater like lakes and streams, warm water from modern parks, or deficiently artificially rewarded water, other warm water sources like water radiators and soil. In their common habitat N.Fowleri phagocytize cyanobacteria and eubacteria to manage levels. Tests from the pools of the southern United States uncover that N. Fowleri introphozoite formis present throughout the mid year. Throughout the winter months N. Fowleri in pimple structure make due in freshwater sources, however no type of N. Fowleri can withstand frosty temperatures1 . Most instances of PAM are brought about by swimming in warm freshwater, from drinking water, recreational exercises, custom abulation and sinus water system systems1. Disease happens when water containing N. Fowleri gets into the nose. The one-celled critter enters the nose and goes along the olfactory nerve, through a hard plate in the skull called the cribriform plate3. When it arrives at the mind it causes meningoencephalitis, cerebral edema and results in herniation. The olfactory bulbs and orbitofrontal cortices become necrotic and hemorrhagic. The information on the two people and mice bolster the end that passing is eventually brought about by expanded intracranial weight and herniation3. Swimming in water containing N. Fowleri builds the hazard for PAM however age and sex are likewise chance variables. From the 1962-2015 there have been 138 announced instances of PAM in the United States, 114 of the cases have been youngsters around the age of 12. About 75% of the diseases have influenced males1. Certain practices are related with an expanded danger of contamination, those tainted people detailed taking part in water related exercises like swimming, jumping and head dunking1. Despite the fact that N. Fowleri can be transmitted through water it can't be transmitted through pressurized canned products or beads, or by means of individual to individual contact. N. Fowleri can be found in different organs of the body, for example, the heart, lung, spleen and thyroid1. Pathogenesis: N. Fowleri enter the human host through the nose which gives access to the cerebrum. Inside eight hours of disease N. Fowleri is available in the bodily fluid layer of the olfactory epithelium. Inside 24 hours N. Fowleri are in the olfactory bulb and present in the cribriform plate. By 96 hours neutrophil polymorphs cause a serious provocative reaction in the olfactory bulb which prompts cerebrum tissue damage3. Contact subordinate systems are N. Fowleri interceded pathogenic procedures. The essential system of pathogenesis in N. Fowleri is grip. Attachment takes into account development and chemotaxis in the nasal mucosa and helps N. Fowleri with sickness movement. Adhesins are communicated on the outside of N. Fowleri, the adhesins are integrin like proteins encompassed by attachment like structures. Fibronectin restricting protein, protein kinase C and NFa1 are imperative to intruding on the host intervened cytotoxicity3. In a test testing cytopathicity of N. Fowleri, a culture would tie to Fibronectin and in the nearness protein kinase C the capacity of the single adaptable cell to follow increased8. N. Fowleri likewise creates Reactive Oxygen Species (ROS) which harm the host cell. Following cell harm, N. Fowleri utilizes phagocytosis and amoebastomes to help N. Fowleri in separating and expending the cells through a sucker structure on its surface. These procedures are interceded by me ans of actin and include the polymerization of monomeric G-actin and filamentous F-actin. Studies have discovered that a layer protein Mp2CL5 may likewise assume a job in pathogenicity, without this protein N.Fowleri are nonpathogenic3 .This protein is suspected to help in pathogenicity by exploring nature, and development toward food sources9. Notwithstanding contact subordinate systems of pathogenicity, N.Fowleri additionally uses contact autonomous components. N-PFP is a cytolytic pore shaping protein that depolarizes the cell layer and diminishes the uprightness. Naegleriapores An and B are pore shaping polypeptides that are fundamentally the same as in structure and capacity. Both are antimicrobial and cytolytic polypeptides3. The compounds phospholipase

Saturday, August 22, 2020

The End of Reading's Analysis Essay Example | Topics and Well Written Essays - 1250 words

The End of Reading's Analysis - Essay Example Pattern expresses that, his little girl (Emily) is ordinary in each viewpoint however she isn't acceptable in perusing and this can be ascribed to TV projects and computer games. She may find her friends as far as perusing however it might take her a long time as it is expressed in the book. Pattern has worked in different spots that have given him introduction to investigate material on examination of perusing and visual examinations. He worked for Journal of Media Arts and Cultural Criticism from 1980 to 1995, which bargains in distributing of expositions and articles through film studies, photos and media hypothesis. From the book it is clear that there is another kind of ignorance in America and individuals have depended on accusing schools, the media too hasn’t been deserted in this habitual pettiness. From the book, End of Reading: Gutenberg to Grand Theft Auto, I am going to concentrate on the writer’s thought on The New American proficiency, Blaming Schools, The media caused me to do it and Child advancement and human development to plainly show the significance of perusing and how it has been influenced over the progression of time. Examination Right from the beginning the essayist states about his daughter’s hesitance and failure to understand well and that numerous other kids are influenced by a similar issue, it is obvious that there is some type of absence of education. Besides insights in the book express that one out of seven grown-ups in America is unequipped for perusing a paper. Obviously there is another American lack of education, where individuals don't know much most definitely however lean toward different mechanisms of learning. The Verbal SAT scores of the youngsters in American schools have kept on diminishing throughout the decades that have passed. A scientist, Shieda White, expresses that the vast majority have a trouble in perusing associated sentences or sections. Numerous kids would prefer to play computer ga mes and sit in front of the TV than read a book. Perusing has gotten agonizing to numerous kids in America since many quality it with trouble. The measure of lack of education is expanding in America, this issue is a long way from being done since the vast majority of the individuals and associations that can really transform it have depended on accusing each other. Schools have transformed into the principle focuses of those in scan for somebody to fault about the persevering issue. These learning organizations have been resolutely attempting to instruct the kids and make them progressively associated with the understanding society yet the headway in innovation has bombed them. Youngsters no longer discover books fascinating as they would prefer to utilize PCs, play computer games and sit in front of the TV. During the 90s some author composed books on the impacts of PCs, this when they were beginning to manifest and while their notoriety consistently expanded, Marshall McLuhan and Raymond Williams are among the rare sorts of people who tended to the issue of innovation in schools. Virtual people group (1993) and Manual Castells’ The Information City (1989) are books that were composed just after PCs were presented for individual use, they address how the PCs would have consequences for the general public. On the off chance that at all schools need to make learning successful, at that point it is significant that they utilize visual expressions and present film examines. Some individual might not have the stuff to be acceptable authors so they need to look for different methods for articulation. Leonardo Di Vinci is one individual that can

Friday, August 21, 2020

You Arent Entitled to Anything

You Arent Entitled to Anything In this short video, Joshua Ryan talk about our inherent sense of entitlement, and why we, as people, arent entitled to anything. We know you may not always have time to listen to an entire podcast episode, so we’re posting Quickie Episodes of  The Minimalists Podcast every day on our YouTube channel. The average Quickie is less than 20 minutes and covers only a single topic or question. Subscribe to The Minimalists via email.

Sunday, May 24, 2020

The Gladiator Of The Roman Empire - 1150 Words

Scott Galati Mr. Berger World history 1010 11/30/14 Roman Gladiators The Romans liked watching other people die; their gladiator games were there live entertainment. It is believed that the first gladiators were slaves who were made to fight to the death at the funeral of a famous aristocrat, Junius Brutus Pera, in 264 BC. The fight between the two was arranged in his honor. Gradually the gladiator games became separated from funeral ceremonies and were staged by the wealthy as a means of displaying their power and influence among the people in the local community. The wealthy and elite classes could promote themselves by sponsoring the games, and paying to put the show on. The term Gladiator comes from the term gladius after the Roman sword. The gladiators were mostly prosecuted criminals, imprisoned soldiers and slaves. These people would be forced to fight other prisoners, sometimes until their death in the case that it was decided for him to die, usually by the spectators. Rarely gladiators would be free, men would sometimes volunteer to be a glad iator and take on the status of a slave to reap the benefits of fame that came along with the title, the fans and money .But the most likely reason why people volunteered was the down-payment that a volunteer received upon taking the gladiator oath. When this oath was taken it meant that the owner the now gladiator had total control over the gladiator s life, making him lowered the status of a slave. Gladiators were known forShow MoreRelatedThe Gladiator The Movie Directed Ridley Scoot Bases A Story During The Ancient Roman Empire977 Words   |  4 PagesThe Gladiator the movie directed Ridley Scoot bases a story during the ancient Roman Empire when the great philosopher and emperor of Rome was Marcus Aurelis. Who is portrayed in the begging of movie as very ill and on his last days, but still on the toe of his battles regarding his health. In the other hand his son and predecessor Commodus is not by his side to witness the battles instead his on safe grounds away from danger. Maxi mus His favored Commander of his army is out in the field riskingRead MoreThe Battle Of Carthage, Romans Were Thirsty For Violence1162 Words   |  5 Pages After the defeat of Carthage, Romans were thirsty for violence. In ancient Rome, gladiators were of the most notorious people on the planet. Deranked from society, they still managed to maintain a high charisma and attained significant amounts of glory. While at camps, they underwent intense training, were treated like animals, and had all their rights stripped from them. But despite the cruelties, they were highly honored and were gifted various rewards and ceremonial banquets on the days beforeRead MoreMovie Analysis : Gladiator 917 Words   |  4 PagesIn the movie Gladiator, Russell Crowe plays a battle hardened Roman General who, through a series of unfortunate events, becomes a gladiator. He starts out on the front lines of a battle against barbarians. The war against them has been going on for some time however this is the final battle that will end the war. The battle rages and the Romans come out victorious. The Caesar then emerges and praises Maximus (Russell Crowe) fo r his leadership. The Caesar then asks him if he will become CaesarRead MoreThe Importance Of Socialization In Ancient Roman Society1043 Words   |  5 Pagesbiggest and most indicative social activity in ancient Roman society was that of gladiatorial combat, and all of the additional components that went along with it. Roman’s of all ages, backgrounds, and social classes spent an exorbitant amount of time observing and enjoying this brutal pastime. For many, especially historians that hold Rome in high regard, it’s hard to believe that these games were such a critical and pervasive component of Roman social life. â€Å"To historians the games are scandalousRead MorePompeii, By Janet Scott Batchler And Lee Batchler929 Words   |  4 Pageswritten by Robert Harris. I chose Pompeii because I heard about the devastating event that took place in the ancient Roman city in various television programs and books. As a result, I wanted to learn more about the event and the daily life of Pompeii before the volcanic eruption occurred. I thought that watching the movie would give me insight about Pompeii and the ancient Roman civilization. In addition, I also chose this film because it features talented actors such as Kit Harington, Adewale Akinnuoye-AgbajeRead MoreThe Trail Of Tears1511 Words   |  7 Pagescommonly known as Gladiators. These fights were a very big thing during early Italy. This one the number one way on entertainment at this time. The barbaric thing about this entertainment is that at the end of the fight the loser has to die and if the in winner refuses to kill the loser they both will be killed. One of the most legendary gladiators of Italy was the name Spartacus. Spartacus was a born in Thrace, Bulgaria around 111-73 BC. During this time Rome was a rising empire and was spreadingRead MoreA Review of Gladiator Essay668 Words   |  3 PagesA Review of Gladiator Hail Caesar, and the return of the Roman Empire. From Quo Vadis to Spartacus, Hollywood has enjoyed a long and fore filling relationship with the sword-and-sandals epics and Ridley Scott (Alien Blade Runner), has released a monumental spectacle; managing to make this forgotten genre bigger, better and more bloody than ever before. Ridley Scott shines as a director through Gladiator. Not only has he managed to create the multiple plotsRead MoreThe Gladiators of Rome983 Words   |  4 PagesTHE GLADIATORS OF ROME In ancient times, the Romans enjoyed watching others get hurt, or even die in the form of Gladiator matches. Most Romans watched these fights in an arena. An arena is a central stage used for sports or spectators. Usually, people paid to watch these fights but on special occasions, the entire event was sponsored by one elite – wealthy Roman and the tickets were given to the general public for free. Although Gladiator fighting might seem barbaric to us today, in theRead MoreIs The Film Pompeii An Accurate Representation Of Slavery During The Ancient Roman Era?1505 Words   |  7 Pagesrepresentation of slavery in the Ancient Roman era? The movie Pompeii produced in 2014, by Paul W.S Anderson, explores the idea of social hierarchy and the class distinctions along with giving a portrayal of the role of slaves within the Roman Empire. While the film does not go in depth on the many different forms of slavery, it does provide minor examples on certain slaves work, and the way they are treated. Slavery played an integral role in the Ancient Roman society, and without it, Rome wouldRead MoreThe Rise and Fall of Ancient Rome656 Words   |  3 Pageswas one of the biggest and greatest empires there was. People might not know about the beginning, the wars, the developments, their life, and the end of the Ancient Rome Rome was started in the eighth century B.C. / 753 B.C. It was started by Romulus in a town by the Timber River. In a legend Romulus and his brother were left in the wild and they were found and raised by a wolf. Romulus killed his brother, then he could become king of Rome. The Roman Empire grew and it came into control of Britain

Wednesday, May 6, 2020

All About Essay about South African Food, Holidays, Famous Places Samples

All About Essay about South African Food, Holidays, Famous Places Samples Ruthless Essay about South African Food, Holidays, Famous Places Samples Strategies Exploited There are a couple places in Africa which are worth mentioning in regards to Africa's popular tourist destinations. The Khoisan, the very first known inhabitants of the nation, were mainly hunter-gatherers. Living up to its name for a nation with unique colours, South Africa also provides some intriguing dishes that's a mixture of dishes from several unique cultures, including Dutch, French, German and British, but using a mixture of the distinctive South African taste. It has several scenic wine routes, not only in the Western Cape, which is the main wine growing region in the country. AmaZink Live is an excellent African show in the little township next to Stellenbosch. They are open 7 days per week and are open late. The web site of one of the best chef schools in the nation, the SA Chefs Academy. Why Almost Everything You've Learned About Essay about South African Food, Holidays, Famous Places Samples Is Wrong Subsequently, essay was defined in various ways. Numerous alternative logical structures for essays are visualized as diagrams, making them simple to implement or adapt in the building of an argument. Therefore, the focus isn't merely descriptive. They're a chance to do some creative writing, even in the event the essay topic you decide on looks pretty boring at first. I was hoping to discover a copy of this book to purchase, but it seems to be out of print without even any used copies readily available on Amazon! Simply complete the form at the base of the page to post the essay question and it'll then be posted below. The questions may also provide you with a nation, which is the point where the particular person who posted it took the test. Click the button below to find out more regarding the book or get in contact with us to qualify for our distinctive on-line order discount. The number of these sorts of cultures is decreasing slowly. There are in fact a good deal of various African staple foods found across the full continents that are always prepared differently based on the nation and their culture. Something is differentiable to us through comparison, so for distinguishes culture we need to compare it with some other then we'll know about all facets of that culture thus the culture has to be social and without it there is not any no tion of culture. All in all a legitimate reflection of the nation's rainbow culture with something for everybody. KSAs are used together with resumes to pinpoint who the best applicants are when several candidates are eligible for a job. An increasing number of aid appears to be going to minorities in which there's a high density (for instance, African-American or Hispanic communities). There's a small cover charge for the music but it's well well worth it! Regardless of what the median income, unemployment or general prosperity level is, there'll always be people that are homeless and hungry. Culture is social it's not the individual phenomena. The culture gives solution to the important problem that's faced to community. Distinct cultures define family in various ways. They have different type of buildings. That coffee particularly if it is ordered at one of the numerous superb coffee shops is very likely to be the greatest outside Italy, due to an influx of Italian immigrants in the mid-20th century. It has links to a few other food websites and a few ezines. The very first step is to improve environmental conditions in the area where the projects will be put into place. Be aware this is street style dining there are a few rough looking tables and chairs there's truly no great decor! The New Angle On Essay about South African Food, Holidays, Famous Places Samples Just Released Side dishes include bread rolls and a good deal of various kinds of salads. Famous dishes include pickled fish, spicy curries and several different kinds of stew. The everyday dishes a vailable will grow but for the time being expect approximately four meat dishes every day. Among all the delicious cuisine. Grilled peri-peri chicken has turned into a national institution. Fried calamari are not easy to beat. Fried Mozzarella would earn an ideal dish for stater that is everyone's favorite. Fried calamari Fried calamari must be among the most popular restaurant dishes. If You Read Nothing Else Today, Read This Report on Essay about South African Food, Holidays, Famous Places Samples It goes nicely with Jam and Cheese. The two-day event provides a mixture of local and worldwide musicians performing on five unique stages for audiences of over 30,000. It's the ideal holiday because it's the just one where you get presents and find an awesome feast made for you. My holiday feast takes place in the month of December.

Tuesday, May 5, 2020

Menopause Essay Example For Students

Menopause Essay Menopause is the time in a womans life when the function of the ovaries ceases. The ovary, or female gonad, is one of a pair of reproductive glands in women. The process of menopause does not occur overnight, but rather is a gradualprocess. This so-called perimenopausal transition period is a different experiencefor each woman. The average age of menopause onset is 51 years old. There is no single method topredict when a woman will experience menopause. The age at which a woman starts having menstrual periods is not related to theage of menopause onset. A women is in menopause when she has had no menstrual periods (menses) for12 months and has no other medical reason for her menses to stop. Symptoms of menopause can be divided into early and late onset symptoms. Early symptoms include abnormal vaginal bleeding, hot flashes, and moodchanges. Late symptoms include vaginal dryness and irritation, osteoporosis, andheart disease. Treatments for menopause are directed toward alleviating the symptoms presentin the particular woman affected. *What is menopause?Menopause is the time in a womans life when the function of the ovaries ceases. Theovary, or female gonad, is one of a pair of reproductive glands in women. They arelocated in the pelvis, one on each side of the uterus. Each ovary is about the size andshape of an almond. The ovaries produce eggs (ova) and female hormones. During eachmonthly menstrual cycle, an egg is released from one ovary. The egg travels from theovary through a fallopian tube to the uterus. The ovaries are the main source of female hormones, which control the development offemale body characteristics such as the breasts, body shape, and body hair. The hormonesalso regulate the menstrual cycle and pregnancy. The process of menopause does not occur overnight, but rather is a gradual process. Thisso-called perimenopausal transition period is a different experience for each woman. Scientists are still determining all the factors that affect when this transition begins andthe details of how it occurs. The average age of menopause is 51 years old. Althoughwomen tend to undergo menopause at an age similar to that of their mothers, this is onlya rough rule of thumb. In fact, there is no single method to predict when a woman willexperience menopause. The age at which a woman starts having menstrual periods is notrelated to the age of menopause onset. When does a woman know she is in menopause?In order to be menopausal, a woman must have had no menstrual periods (menses) for 12months and have no other medical reason for her menses to stop. Therefore, a womancannot know she is menopausal unless she has not had a menstrual period for 12 months. Are hormone levels or other blood tests helpful in detecting menopause?Because hormone levels may fluctuate greatly in an individual woman, even from oneday to the next, hormone levels are not a reliable indicator for diagnosing menopause. Even if levels are low one day, they may be high the next day in the same woman. Although hormone levels of several blood tests are available, there is no particular singleblood test yet that reliably allows a doctor to predict when a women is going to gothrough menopause in the future, or if she is experiencing the beginning of themenopausal transition. At present, there is no proven role for blood testing regardingmenopause except for tests to exclude medical causes of erratic menstrual periods otherthan menopause. The only way to diagnose menopause is to observe lack of menstrualperiods for 12 months in a woman in the expected age range. *What are the symptoms of menopause?The symptoms of menopause can be divided into early and late onset symptoms. Treatment is directed toward the particular symptoms present. Early symptoms includeabnormal vaginal bleeding, hot flashes, and mood changes. Late symptoms includevaginal dryness and irritation, osteoporosis, and heart disease. These symptoms arediscussed in detail below:Early Onset Symptoms (Perimenopause)Abnormal Vaginal BleedingAbnormal vaginal bleeding may occur during menopause. In general, menstrual periods(menses) at first occur more frequently (meaning the cycle shortens in duration), andsubsequently get farther and farther apart (meaning the cycle lengthens in duration) untilthey stop. Because of this unpredictable pattern, many women will have a period aftergoing for several months without a period. In fact, this type of pattern is common. Thereis not any set length of time it takes for an individual woman to complete her menopausaltransition since all women have different experiences. Some women have minimalproblems with erratic bleeding whereas others have unpredictable, excessive bleeding. Bed-wetting EssayTreatment of Late Onset SymptomsVaginal SymptomsPrior to being treated for vaginal irritation, burning, and itching, women should firstundergo an evaluation by a doctor, including a pelvic exam, to verify that the symptomsare due to estrogen deficiency. There are local (meaning vaginal) and oral treatments forthe symptoms of vaginal estrogen deficiency. Local treatments include the vaginalestrogen ring, vaginal estrogen cream, or vaginal estrogen tablets. Oral treatments includemultiple types of estrogen either alone, or estrogen given with progesterone (seeMedicineNet.coms Hormone Replacement Therapy article). Local and oral estrogentreatments are both effective in relieving vaginal symptoms and are sometimes combinedfor this purpose. In women for whom oral or vaginal estrogens are deemed inappropriate,such as breast cancer survivors, or women who do not wish to take oral or vaginalestrogen, there are a variety of over-the-counter vaginal lubricants. However, they areprobably not as effective in relieving vaginal symptoms as replacing the estrogendeficiency with oral or local estrogen. OsteoporosisThe goal of osteoporosis treatment is the prevention of bone fractures by stopping boneloss and increasing bone density and strength. Although early detection and timelytreatment of osteoporosis can substantially decrease the risk of future fracture, none ofthe available treatments for osteoporosis are complete cures. In other words, it is difficultto completely rebuild bone that has been weakened by osteoporosis. Therefore, theprevention of osteoporosis is as important as treatment. Osteoporosis treatment andprevention measures are:Lifestyle changes including quitting cigarette smoking, curtailing alcoholintake, exercising regularly, and consuming a balanced diet with adequatecalcium and vitamin D. Estrogen replacement therapy for postmenopausal women and those with otherlow estrogen conditions. Medications that stop bone loss and increase bone strength, such as alendronate(Fosamax), risedronate (Actonel), raloxifene (Evista), and calcitonin (Calcimar). Heart DiseaseTher e is much controversy regarding whether or how much oral estrogen replacementaffects the risk of heart disease in postmenopausal women. Research with a large enoughnumber of women in well-designed studies is needed. Additionally, we need to be able toseparate out the effects of different types of estrogen preparations to get the answer. Itseems so far that estrogen replacement may protect against heart disease in women whodo not yet have heart disease, but may not be protective in women who are alreadyknown to have heart disease. In the near future, we will have more information frombetter-designed research studies regarding this issue. Menopause At A GlanceMenopause is the time in a womans life when the function of the ovaries ceases. The ovary, or female gonad, is one of a pair of reproductive glands in women. The process of menopause does not occur overnight, but rather is a gradualprocess. This so-called perimenopausal transition period is a different experiencefor each woman. The average age of menopause onset is 51 years old. There is no single method topredict when a woman will experience menopause. The age at which a woman starts having menstrual periods is not related to theage of menopause onset. A women is in menopause when she has had no menstrual periods (menses) for12 months and has no other medical reason for her menses to stop. Symptoms of menopause can be divided into early and late onset symptoms. Early symptoms include abnormal vaginal bleeding, hot flashes, and moodchanges. Late symptoms include vaginal dryness and irritation, osteoporosis, andheart disease. Treatments for menopause are directed toward alleviating the symptoms presentin the particular woman affected. HTML1DocumentEncodingutf-8What is menopause? When does a woman know she isin menopause? Are hormone levels or other blood tests helpful in detecting menopause?What are the symptoms of menopause? Abnormal Vaginal Bleeding Hot Flashes Mood Symptoms Vaginal Symptoms Osteoporosis Heart disease What are the treatment options for menopause? Abnormal Vaginal Bleeding Hot Flashes Mood Symptoms Vaginal Symptoms Osteoporosis Heart Disease