Bleeding nose

What is it?

Hemorrhage (bleeding) coming from the nostrils and externalized
– through the nostril or the nasopharynx.

Bleeding can be of two types:

Previous: originates from the anterior portion of the nasal cavity, generally in the area of Kiesselbach above the posterior end of the nasal vestibule or on the anterior end of the inferior turbinate.

Rear: originates from the back of the nasal cavity and nasopharynx, usually in the rear half of the middle turbinate, or nasal cavity ceiling.

Age groups most affected: below 10 and above 50 years.

It will be embroidered from now:
– What cause?
– What are the signs and symptoms?
– What condition can be confused with epistaxis?
– There is need for hospitalization?
– Can complicate? How it evolves?

– Unknown most often
– Trauma / Injury mucosal: wiping his nose with his finger, low humidity, foreign object in the nasal passages.
– Rhinitis or sinusitis
– Generalized infections (scarlet fever, malaria, typhoid fever).
– Rheumatic fever
– Abnormalities of vessel
– Nasal Tumor
– High pressure
– Medicines
– heparin and warfarin
– Changes of blood cells
– Leukemia
– Opening of the septum
– leishmaniasis or cocaine use
– Deviated septum
– Endometriosis (endometrium that is found in the nasal passages)

Signs and symptoms:
– Bleeding through the nose or nasopharynx
– Posterior bleeding may have no symptoms or show up in various forms
– To find the bleeding uses
– is light, nasal speculum and vacuum
– clean up the nose, bring the gore with tweezers and asks the patient to blow your nose
– Bleeding spread remember because generalized
– If bleeding on both sides may be difficult to find the specific location

Differential diagnosis:

If further differentiate bleeding hemoptysis (coughing up blood) and hematemesis (vomiting up blood).

Exams (only in selected cases):
– CBC and Coagulation
– Rx of the paranasal sinuses
– Nasal Videoencoscopia with optical fiber

– Sinusitis
– Hematoma (collection of blood) or abscess (pus concentration) septal
– during application of the cap
– Disruption of the septum by cauterization
– Necrosis (tissue death) of the septum by high pressure cap or balloon

How to treat the patient?

They may be admitted if bleeding is severe or elderly patients with posterior bleeding.

If previous bleeding, pressing area for 5 to 10 minutes and put compress on the affected area with vasoconstrictor (oxymetazoline or phenylephrine hydrochloride) and local anesthetic (lidocaine). Remove pad and observe if necessary cauterized with silver nitrate.

If subsequent bleeding arises a roll of gauze wrapped and folded 10 cm thick silk tied with two wires. A tip of the wires is tied to a catheter that is introduced in the nasal cavity and removed through the mouth. The cap is fixedin the nasopharynx. Buffering is sustained for 2 to 4 days. This buffering is being replaced by balloon use.

Refractory bleeding (rare cases, especially in the elderly) may be required surgical ligation.

As the patient progresses? Bleeding can come back?

Often bleeding is contained with appropriate treatment, but relapses may occur.

Final considerations:1. When measuring the pressure of the patient, because high pressure is the cause of nosebleeds.2. Bleeding from one side only suggests traumatic cause bleeding or local defect and the two sides may indicate (very high pressure, confusion or blood clotting)

High triglycerides

Triglycerides are fatty substances in the blood, common in all people. Display up to 150 mg per dl blood triglycerides are considered a normal rate, have been cases where the person has the highest index of substance it means that the level is high and may cause some complications.

People with high triglyceride levels are more likely to have heart attacks, strokes and other health problems. In addition, they may also have inflammation of the pancreas (pancreatitis), which is responsible for producing hormones and fluids to aid in food digestion.

That the standard rate of triglycerides?
• Normal – below 150 mg / dL;
• Moderate – between 150 and 199 mg / dL;
• High – between 200 and 499 mg / dL;
• Very high – greater than or equal to 500 mg / dL.

What are the symptoms of high triglycerides?

The increase in triglyceride does not cause any symptoms, only the blood test is able to demonstrate its increase.

What are the causes of high triglycerides?

Triglycerides can rise for several reasons. Some people have genetic changes that predispose to this increase in these cases is common to find families with high triglycerides. Other develop elevated triglycerides errors due to food, the use of some drugs or the presence of certain diseases.

Some diseases that cause increased triglycerides are obesity, diabetesmellitus, hypothyroidism, kidney disease.

Other causes are: Diet rich in fats, excessive alcohol consumption, pregnancy.

What to do in case of high level of triglycerides?

If the doctor identifies the patient with high levels of triglycerides in the blood, it is important to inform people of the risks of heart attack and stroke. The first step is to take measures that can prevent these complications. Among them are: Avoid the use of cigarettes, not remain overweight, be aware of diseases like diabetes.

Some risk situations that deserve greater attention are: high blood pressure, heart disease family history, advanced age, patients being male.

Medicines and Treatment

Not everyone who has a high level of triglycerides in the blood need to take medicines. The doctor or physician should make the diagnosis and then prescribe the best treatment. Some factors that should be taken without regard include the patient’s age, family history of diseases and other health problems.

Since people who have coronary heart disease, in most cases, require the use of drugs to reduce the rate of triglyceride in blood. Drugs to reduce the levels of those substances usually include fenofibrate, nicotinic acid or fish oil.

Furthermore, statins are drugs used to reduce the risk of heart attacks or strokes and reduce the level of cholesterol in the body. It is important that patients with high rate of triglycerides in the blood also check cholesterol levels, because in most cases, these two high rates are related to the same causes.

It is recommended, however, that patients attempt to reduce blood triglycerides rates without the use of medicines. This is possible through a number of measures, which include: losing weight if overweight; physical exercise regularly; avoid foods and drinks high in sugar and carbohydrates such as white bread, fruit juice, soft drinks and sweets; avoid the intake of red meat, butter, frying, cheese, oils and nuts; control the consumption of alcohol, especially for males, who are more likely to develop complications.

Diet for high triglycerides – How to lower triglycerides through diet?

Individuals with high triglycerides should avoid foods rich in carbohydrates and fats. They should prioritize high-fiber foods and avoid those high in saturated fats. Give preference to whole foods such as brown rice and pasta based on wheat. Beverages, avoid alcohol and prefer the sugar-free soft drinks. The milk must be skimmed, which has lower fat content.

How does the diet of the points?

Are you tired of the routine diets and that ultimately do not bring good results? No more suffering for nothing, innovate a little in the way of changing your habits can help a lot in search of an ideal weight and good health. To begin this new diet you have to like calculations or at least be able to realize them, the rest is easy and practical, that over time ends up becoming something routine in your life.

This famous recipe that is so feared by those who do not like math and still end up practicing, is known as diet points. The same has been around for a long time and was created by a Brazilian who had the intention to a basic principle: a food calorie count. Counting calories is not easy or simple to do, so we created a method to facilitate the counting.

How do the diet of points

First let us understand the basis of this diet. For each 3.6 kcal, regardless of its source, either carbohydrate, protein or fat, will amount to 1 point. The advantage of this conversion mechanism is that it takes into account basically what makes up this calorie, which ends up being an advantage in practical terms is easy, but at the same time is a disadvantage because we do not take into account the amount of macronutrients thus may have a margin of error greater good on this diet if not performed correctly.

This diet is based on the points in the body of each, but the first instrument that we have is the calculator, which will accompany you in all your meals and be its main ally, and learn how to do the math correctly. Always pay close attention, because if err on that score will not be able to fulfill all the necessary requirements.

Calculating basal metabolism

The first part before starting the diet of points to calculate the basal metabolic rate of each. We all spend energy, independent of physical activity daily practice, because even sleeping spend energy.

Many factors can influence the calculations, such as gender (male / female), weight and age. So it was created by the World Health Organization a table which specifies which calculation below according to each feature.

For women it is indicated:
• From 10 to 18 years 12,2x weight (kg) + 746
• From 19 to 30 years: 14,7x weight (kg) + 496
• From 31 to 60 years: 38,7x weight (kg) + 829
• Above 61 years: 10,5x weight (kg) +529

For men:
• From 10 to 18 years: 17.5 Weight (kg) + 651
• From 19 to 30 years: 15,3xpeso (kg) + 679
• From 31 to 60 years: 8,7x weight (kg) + 879
• Above 61 years: 13,5x weight (kg) +459

When we are talking about points, we are saying that we have greater freedom in our power to choose what we eat, so the tables have undergone certain adjustments to correct this issue, having a daily schedule which shows what is allowed in the amount of trans fats and other foods, as the sum of the daily intake will generate a problem in the future. Begin to realize tables which you control the amount of fat eaten.

Learn how to check the labels and understand the amounts

All that is consumed should be verified through the labels, it is they who will indicate the amount of their food and support points.

Carry out activities and calculate your points

The activities also fall into this diet, being classified as:
• Light Well (driving, work done sitting, etc.): basal rate x 1.2
• Lightweight (bowling, practice stretching, play in the pool, etc.): basal rate x 1.4
• Moderate (running light, do swimming, etc.): basal rate x 1.6
• Strenuous (tennis, basketball, football, running, etc.): basal rate x 2.9
• Exceptional (running marathons, cycling, swimming competition, etc.): basal rate x 2.3

Each will be multiplied to consistent value to your basal rate and then to calculate both will reach the result of how much you spend Kcal to keep the activities of your workouts and your basal metabolism, and to find out how much you should consume per day their feeds.

In case of difficulty in the accounts in relation to the metabolism and exercise, there are websites that provide help and facilitate this activity, since the rest will have to be done on a daily basis with your calculator, which should never leave your purse.

Finally, do not eat unless the calculated limit and try not to exceed the stated limit. If you follow the diet correctly and not fail to seek the guidance of a professional you will get good results.

Skin sins: smoking, alcohol & caffeine

Besides the fact that smoking as well as drinking alcohol and caffeine are bad for your health, they are also bad for your beauty as these can accelerate the aging process of your skin.

Smoking promotes wrinkles

It is a fact that the accumulated nicotine from smoking causes narrowing of the blood vessels in the outermost layers of your skin, reduces blood flow to the skin,  depriving the skin cells of vital oxygen and robbing it of even more nutrients.  Besides reducing the body’s store of vitamin A which protects against skin damage and vitamin C which protects against free radicals,  studies have also shown that smoking reduces the production of collagen and elastin and in some reports, by up to 40%.   As a result, skin begins to sag and wrinkle prematurely.

Smoking also adversely affects the nerve endings in the skin, causing sensitivity and has a drying effect on the skin, causing dehydration and eventually wrinkles.  And it’s not just the face as according to an article from BBC News, Research in Archives of Dermatology showed that smoking ages skin across the body, including the inner upper arms.

All these plus repeated exposure to the heat from burning cigarettes and facial expressions such as squinting of eyes and puckering of lips during smoking can eventually contribute to more prematured wrinkles.

Alcohol dehydrates our skin

In the book “Your Future Face” by Dr Dennis Gross, alcohol is said to be a diuretic and so it dehydrates our bodies, resulting in skin that loses its plump, firm and dewy appearance.  Not only that.  Our face can appear puffier and our undereye becomes darker because alcohol is a vasodilator which opens blood vessels.   In fact, when we have too many drinks, our bodies have to divert blood flow, oxygen and nutrients away from our skin to our vital organs, resulting in skin having poorer blood circulation. Drinkers also have a sallowness in their faces,  a direct result of an overstressed liver having difficulty with its detoxifying duties.  And alcohol actually promotes the growth of “bad collagen” or scar tissue in both the skin and liver.

Caffeine contributes to dark undereye circles

According to Dr Gross, caffeine also affects our body the way alcohol does.  Hence, excess caffeine can cause dehydration, disrupt sleep, trigger stress hormones and because it engorges viens, it can also cause broken capillaries.  Too much caffeine also contribute to dark undereye circles!  So limit your caffeine consumption to only one or two cups of coffee a day.