25
June
2008
Otitis Externa: Inflammation of external auditory canal or auricle. Infectious, allergic, and dermal disease. Up to 10% of people develop during lifetime. Acute bacterial external otitis most common form seen. Other causes otomycosis, contact dermatitis, necrotizing otitis externa, chronic suppurative otitis media, and external auditory canal carcinoma
Lateral (outer) cartilaginous portion approximately two-thirds of canal, and medial (inner) bony portion other one-third. Outer cartilaginous portion lined by thicker skin with numerous adnexal structures including cerumen glands, sebaceous glands, and hair follicles. Cerumen is formed here: mixture of secretions from cerumen glands, sebaceous glands, and desquamated epithelium.
The inner osseous portion contains thin skin without subcutaneous tissue. The dermis direct contact with the underlying periosteum. Minimal inflammation or instrumentation of the bony canal causes significant pain. The inferior tympanic recess is a small depression in the inferior medial aspect of the ear canal, adjacent to the tympanic membrane. Debris can collect in this area and cause or perpetuate infection.
drjohnhong 
ENT 
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11
June
2008
erectile dysfunction is more recognized probably because of Viagra and the other ED medicines – and their huge ad campaigns. In 1994 the Massachusetts Male Aging Study found male sexual dysfunction begins 40 years of age and worsens each decade of life. 40 year old men: 40% some level of dysfunction and 10% had declining libido. Sexual dysfunction includes ED, decreased libido, less satisfaction with sex or orgasm, or abnormal ejaculation. ED worsens by age 50. One study showed 47% of men 55 or older had ED.
Risk Factors: smoking, obesity, depression, neurological disorders, diabetes, high blood pressure, high cholesterol, cardiovascular disease, alcohol, drugs, and some meds. Exercise decreases the risk of ED. In obese men, ED improves with exercise and weight loss.
drjohnhong Men issues, Sex Comments (0) » |
5
June
2008
Bipolar disorder involves mania. 2 types: bipolar disorder I and II. Focus on I: episodes of sustained mania and usually depressive episodes. bipolar disorder is often undetected and a person is treated for depression instead. 1% prevalence. Probably genetic component to this disorder. Men and women are equally affected, and usually onset age 15-30.
Mania has 5 criteria per American Psychiatric Association 1) at least 1 week of abnormally and persistently elevated, expansive, or irritable mood. 2) During this time of mood disturbance, 3 of the following (4 if mood is only irritable): a) inflated self-esteem or grandiosity b) decreased need for sleep c) more talkative than usual or pressure to keep talking d) flight of ideas or subjective experience that thoughts are racing e) distractibility f) increase in goal-directed activity g) excessive involvement in pleasurable activities that have a high potential for painful consequences 3) The symptoms don’t meet criteria for mixed episode 4) The mood disturbance a) is sufficiently severe to cause marked impairment in occupational functioning, usual social activities, or relationships with others, b) necessitates hospitalization to prevent harm to self or others, or c) has psychotic features. 5) The symptoms are not due to the direct physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment) or a general medical condition (eg, hyperthyroidism).
drjohnhong Psych Comments (0) » |
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