| How to Recognize the Signs and Symptoms of Tuberculosis Posted: 04 Jun 2016 05:00 PM PDT Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis and spread from person to person through the air. TB usually affects the lungs (typically the primary site of inoculation), though it can affect any organ.[1] In the latent form, the bacteria remains dormant with no signs or symptoms, whereas the active form shows signs and symptoms. The vast majority of TB infections remain latent. If left untreated or treated improperly, TB can kill, so you must be able to recognize the signs of respiratory tuberculosis.[2] EditKnowing the Risk Factors - Beware of areas that leave you vulnerable to TB.[3] If you live in or have traveled to these areas, or even if you come into contact with someone else who has, you could be at risk. In many parts of the world, the prevention, diagnosis or treatment of TB is a challenge due to health care policy, financial/resource constraints, or overpopulation. This allows TB to go undetected and untreated, causing it to spread. Traveling on an airplane to and from these areas can also harbor the bacteria due to isolated ventilation.
- Sub-Saharan Africa
- India
- China
- Russia
- Pakistan
- Southeast Asia
- South America
- Examine your working and living conditions.[4] Overcrowded conditions and places with poor ventilation allow the bacteria to spread easily from one person to another. A bad situation can be made even worse if the people around you have poor health background checks or screenings. Conditions to be wary of include:
- Prisons
- Immigration offices
- Retirement/nursing homes
- Hospitals/clinics
- Refugee camps
- Shelters
- Consider your own immune health.[5] Having a medical condition that lowers your immune system's natural defenses can be problematic. If your immune system can't function properly, you're vulnerable to all sorts of infections, including TB. Such conditions include:
- HIV/AIDS
- Diabetes
- End-stage kidney disease
- Cancers
- Malnutrition
- Age (the very young lack developed immune systems, and the aged may have less than optimal immune health)
- Determine whether drugs might interfere with immune function.[6]Any drug abuse, including alcohol, tobacco, and IV substances, can lower your body's natural defenses. While some cancers put you at higher risk for TB, so too does the chemotherapy treatment for cancer. Long-term use of steroids, as well as drugs to prevent the rejection of transplanted organs can also affect immune function. So too can drugs used to treat autoimmune conditions such as rheumatoid arthritis, lupus, inflammatory bowel disease (Crohn's and Ulcerative Colitis), and psoriasis.
EditRecognizing the Signs and Symptoms of Respiratory TB - Notice any unusual coughing.[7] TB usually infects the lungs, breaking down the tissue there. Our body's natural response is to remove the irritant by coughing. Figure out how long you've been coughing; TB usually lasts for more than 3 weeks and may include such worrisome signs as bloody sputum.
- Consider how long you've taken over the counter cold/flu medications or antibiotics for a respiratory infection with no relief. TB needs very specific antibacterial drugs, and to start therapy requires screening and confirming TB.
- Look for discharge when coughing.[8] Have you noticed any sputum (sticky discharge) when coughing? If it smells and is dark, it can be any type of bacterial infection. If it's clear and odorless, it can be a viral infection. Take notice if there's been any blood when coughing into your hands or tissues. When TB cavities and nodules form, nearby blood vessels may get destroyed, leading to hemoptysis — coughing up blood.
- You should always seek expert medical advice when you cough up blood. He or she will be able to advise you on how to proceed.[9]
- Pay attention to chest pain.[10] Chest pain can suggest a wide variety of issues, but when taken together with other symptoms, they can point to TB. If you feel a sharp pain, it can you point to a specific, localized area. Note particularly if it hurts when you apply pressure to that area, or if it hurts when you breath in and out or when you cough.
- TB forms hard cavities and nodules against the lungs/chest wall. When we breath, these hard masses cause damage to the area, leading to inflammation at the site. Pain tends to be sharp, localized to a specific area, and reproducible when we put pressure on it.
- Take note of unintentional weight loss and lack of appetite. The body has a complex response to the Mycobacterium tuberculosis bacteria that results in poor nutrient absorption and altered protein metabolism.[11] These changes might persist for months without your noticing them.
- Look in the mirror and note any changes to your body. If you can see the outline of your bones, this indicates you don't have enough muscle mass due to lack of protein and fat.
- Measure your weight on a scale. Use a previous but recent weight from when you were feeling healthy as a comparison. Weight changes vary, but you should address any drastic changes with your healthcare provider.
- Note whether your clothes feel looser
- Keep track of how often you've been eating and compare it to when you last felt healthy.
- Do not ignore fever, chills and night sweats. Bacteria usually reproduce at around normal body temperature (98.6 F). The brain and immune system respond by raising the body's temperature to stop the bug from reproducing. The rest of the body detects this change, then attempts to adjust to this new temperature by contracting muscles (shivers), making you feel chills. TB also causes specific inflammatory proteins that aid in fever production to be produced.[12]
- Beware of latent TB infection. A latent TB infection is dormant and not infectious. The bacteria simply resides in body with no harm. Reactivation can occur in those with reduced immunity, as listed above. It can also occur with increased age due to weakening of the immune system. Reactivation sometimes also occurs for other, unknown reasons.[13]
- Be able to distinguish TB from other respiratory infections.[14][15] There are many other conditions that TB could be mistaken for. You don't want to wait out a simple cold virus only to find out that you have something more serious on your hands. To differentiate between TB and other conditions, ask yourself the following questions:
 - Is there clear mucus liquid dripping from my nose? A cold will cause congestion/inflammation of the nose and lungs that leads to mucus dripping or running out from the nose. TB will not present with a runny nose.
- What is being produced by my coughing? Viral infections and the flu tend to have a dry cough or produce a white mucus. Bacterial infections found in the lower respiratory tract produce brownish sputum. TB, though, typically produces a cough over 3 weeks and can produce a hallmark bloody sputum.
- Am I sneezing? TB does not cause sneezing. This is usually a sign of the cold or flu.
- Do I have a fever? TB can cause a fever of all levels, but those who have the flu typically have fevers of more than 100.4°.
- Do my eyes appear watery/itchy? The cold typically presents with these symptoms, but not TB.
- Do I have a headache? The flu typically presents with headaches.
- Do I have joint and/or body aches? The cold and flu can cause this but it is more severe with the flu.
- Do I have a sore throat?Look inside your throat and see if it appears red, swollen and painful when swallowing. This is seen mainly with cold but can appear with the flu as well.
EditGetting Tested for TB - Know when to seek immediate medical attention.[16] Certain signs and symptoms require immediate help. Even if these TB symptoms don't result in a TB diagnosis, they might point to other severe illness. Many conditions, both harmless and dangerous, can cause chest pain, but you should always report it and allow a doctor to perform an EKG exam.
- Consistent weight loss might indicate malnutrition or cancer.
- When combined with bloody cough, weight loss can more specifically suggest lung cancer.
- High fever and chills can also be caused by an underlying blood infection or sepsis, though this usually causes a drop in blood pressure, dizziness, delirium and high heart rate.[17] If left untreated, it can be potentially deadly, or lead to severe dysfunction.
- The doctors will order IV antibiotics and blood work looking at the white blood cells (immune cells that fight infection).
- Arrange for latent TB infection screening if called for.[18] Even if you don't suspect you have tuberculosis, there are cases in which you may have to be screened for latent TB anyway. Those starting work in a healthcare environment require a test followed by yearly screening. If you're traveling to or returning from at-risk countries, have decreased immunity, or work or live in crowded, poorly ventilated conditions, you should also get screened. Simply make an appointment with your primary care doctor to get tested for TB.
- A latent TB infection will not cause any symptoms or sickness, and cannot be spread to other people. However, five to ten percent of people with a latent TB infection will eventually develop TB.[19]
- Ask for a purified protein derivative (PPD) test.[20] This test is also referred to as tuberculin skin test (TST) or Mantoux test. The doctor will clean the area with a cotton swab and water, then inject you with a purified protein derivative (PPD) near the top of your skin. A small bump will appear from the liquid injection. Do not cover the location with a bandage as this may alter the liquid in place. Instead, give the liquid a few hours to be absorbed.
- If you have antibodies to TB, it will react to the PPD and form an "induration" (thickening or swelling around the area).
- Note that it is not the redness that gets measured but the size of the induration. After 48 to 72 hours you will return to the doctor for measurement of the induration.
- Understand how to interpret the results.[21] For different categories of people, there is a maximum induration size considered negative for screening. However, any induration over that size indicates that the patient has TB. If you have no risk factors for TB, an induration of up to 15mm (0.59 inches) is considered a negative result. However, if you have any of the risk factors listed earlier in this article, an induration of up to 10 mm (0.39 inches) is considered negative for screening. If any of the following describes you, an induration of up to 5 mm is considered a negative result:
- Immunosuppressive drugs like chemotherapy
- Chronic steroid use
- HIV infection
- Close contact with a TB-positive individual
- Organ transplant patients
- Those who show fibrotic changes on a chest x-ray
- Request an IGRA blood test as an alternate to a PPD.[22] IGRA stands for "interferon gamma release assay," and this blood test is more accurate and quick than a PPD. However, it does cost more to perform. If your doctor opts for this test, he will take a sample of your blood and send it to a lab for analysis. Your results should be ready within 24 hours, and a subsequent appointment will be made to go over test results. A high level of interferon (determined by a preset normal range by the lab) is a positive result that indicates you have TB.
- Follow up on test results.[23] A positive result in either the skin or blood test indicates, at minimum, a latent TB infection. To determine whether you have active TB, your healthcare provider will order a chest x-ray. A patient with a normal chest x-ray will be diagnosed with a latent TB infection and given preventive treatment. An abnormal chest x-ray on top of a positive skin or blood test indicates active TB.
- The doctor will also order a sputum culture. A negative result indicates latent TB infection, and a positive result indicates TB.
- Note that sputum can be difficult to collect from infants and young children, and diagnosis is often made without it for children.[24]
- Follow your doctor's advice after diagnosis. If the x-ray and sputum cultures confirm active tuberculosis, your doctor will prescribe a multi-drug regimen.[25] However, if the x-ray is negative, patients are considered to have latent TB. Follow your doctor's treatment directions carefully to prevent latent TV from becoming active. TB is an infection that is reported to the CDC, and treatment may include Directly Observed Therapy (DOT), which consists of a healthcare worker observing a patient take each dose.
- Consider getting the Bacillus Calmette–Guérin (BCG) vaccine. The BCG vaccine may decrease the risk of infection, but does not eliminate it. BCG vaccination causes a false-positive PPD test, so individuals who have been vaccinated should be screened for TB with the IGRA blood test.
- The BCG vaccine is not recommended in the US, which has a low incidence of TB, because of its interference with PPD screening. However, individuals from other, less developed countries are commonly vaccinated.
- TB is spread by coughing and sneezing.
- Not everyone infected with TB becomes sick. Some people have a "latent TB"; although such people are not contagious, they can go on to become sick much later it their immune system weakens. It is possible to have latent TB for a lifetime and never develop active TB disease.
- military TB can have the same symptoms as respiratory TB in addition to organ specific signs and symptoms.
- Tuberculosis has had a resurgence, and the CDC has changed its guidelines about who must be treated. The prior cut off age of 34 for being treated with Isoniazid has been lifted-virtually anyone testing positive is prescribed medication as a precaution for themselves and others. For your own health and those around you, take the course of medicine.
- It is important to be aware, albeit controversial, that even people who are have latent TB and have received a course of treatment can retest positive for TB. It is something to be discussed and assessed with your doctor.
- BCG (bacille calmette-guerin) vaccines may contribute to false positives on the PPD test. A false positive calls for a chest x-ray.
- Those with military TB require more testing, including MRI imaging of the suspected organ involved and a biopsy.
- For those with history of BCG vaccination and false-positive PPD tests, an IGRA is recommended. However, your doctor may still prefer the PPD test due to the cost and availability.
- PPD is preferred over IGRA for children under 5 years due to lack of studies.[26]
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| How to Say Good Morning in French Posted: 04 Jun 2016 09:00 AM PDT The standard way to say "good morning" in French is "bonjour," but there are a few other things you can say to greet someone in the morning using the French language. Here are some of the most common phrases for you to know. EditCheat Sheet EditBasic "Good Morning" - Say "bonjour."[1] This is a standard French greeting use to say "good morning," "good afternoon," "good day," and "hello."
- This is the standard way to say "good morning" in French, and you can use this greeting in any French-speaking country or region.
- This term is a combination of the French words "bon" and "jour." Bon means "good" and jour means day. Translated literally, the phrase means "good day."
- Pronounce bonjour as bon-zhoor.
EditGreeting Specific People - Add "madame," "mademoiselle," or "monsieur" to the end. A polite way to address someone after saying "bonjour" is to address that person by his or her appropriate title.[2]
- State "bonjour" first before stating the listener's title.
- Madame is the French equivalent of the English "ma'am." Use this term for married women and pronounce it as mah-dahm.
- Mademoiselle is the French equivalent of the English "miss."[3] Use this term for unmarried women and pronounce it as mah-dahm-wuh-zell.
- Monsieur is the French equivalent of the English "sir" or "mister." Use this term for any man, married or unmarried, and pronounce it as mer-syer.
- Tell a group "bonjour à tous." Greet a crowd or audience with this phrase.
- Translated, à tous means "to all" or "everyone." This phrase translates roughly into "good morning, everyone" or "good morning to everyone."
- You would usually use this greeting when addressing an audience rather than when addressing a group of friends or family. It would generally be considered more polite and more commonplace to greet each person in a friendly group individually instead of all at once. If you are in a position that prevents you from doing so, however, "bonjour à tous." becomes appropriate.
- Pronounce bonjour à tous as bon-zhoor ah toos, with the "s" sounding close to a soft "z."
EditOther Morning Greetings - Say "bon matin" or "bonne matinée" in certain settings. Both bon matin and bonne matinée translate literally into "good morning," but neither phrase is used often as a greeting.
- This greeting is rarely used in France, but it can be used in French-speaking Québec as an informal greeting between people who are close, such as family members, friends, classmates, or close co-workers.
- Matin and matinée both mean "morning."
- Pronounce bon matin as bohn mah-tahn.
- Pronounce bonne matinée as bohn mah-teen-ay.
- Rouse someone awake with "Réveille-toi!"[4] This is an informal way to command someone to wake up when he or she is still asleep in bed.
- Use this imperative command with children or loved ones you live with. The phrase should be used to tell someone "wake up!"
- The term comes from the reflexive verb "se réveiller," meaning, "to wake oneself." Translated more literally, it means, "wake yourself."
- Pronounce réveille-toi as rheh-vay-twa.
- Tell someone "Lève-toi!"[5] Like "réveille-toi," "lève-toi" is an imperative command used to rouse someone awake.
- Use this command with loved ones you live with, especially sons and daughters or grandsons and granddaughters. It is a casual command and should not be used with anyone you are not on familiar terms with.
- This phrase comes from the French reflexive verb "se lever," meaning "to get oneself up" or "to rise."
- Pronounce lève-toi as layv-twa.
EditSources and Citations (This wikiHow is partially French. Please disregard all pronunciations and French phrases, as is the topic of this page.)
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| How to Avoid Eye Strain While Working at a Computer Posted: 04 Jun 2016 01:00 AM PDT Eye strain is a common complaint among many people today. This is in large part because we spend so much time looking at computer screens, tablets, and phones. Long periods of gazing at the same spot strains the ciliary muscle of your eye, which can tire your eyes, causing temporary blurriness. It's possible that this strain in children can lead to near-sightedness.[1] This occurs because of a breakdown of the eye muscles' ability to accommodate, producing a flattening the lens. Eye strain can also cause headaches, dry eyes and even blurred vision. The good news is, there are are many ways to avoid this condition, and most are inexpensive or even free. EditRelaxing Your Eyes - Use the 20-20-20 rule. When you are working at the computer, rest your eyes for at least 20 seconds by looking at something away after using the computer for 20 minutes. If you have a window nearby, looking at something outdoors is a great option. [2]
- Alternatively, you can move your eyes from something close to something far away, switching between the two every 10 seconds at least 10 times for a little eye "workout."[3]
- Blink more. Some eye strain occurs because you tend to blink less when focusing on something, like your computer screen. Try to be conscious of your blinking while you work, and do it more often.[4]
- Roll your eyes. Closing and then rolling your eyes can help lubricate them. It also helps to relax straining muscles.
- Close your eyes and roll them around in a circular motion. Roll them clockwise, then counter-clockwise. This not only helps relax your eyes, but also feels good.[5]
- Scan the room. After a long period focusing on the screen, take a break to slowly look around the room, keeping your eyes constantly in motion and looking at things that are varying distances from you.[6]
- Do some glances. Close your eyes and glance up as far as you can without discomfort. Hold your eyes still for a moment, then look down, eyes still closed.[7]
- Repeat a few times and then rest your eyes for a moment.
- Next, keeping your eyes closed like before, look to the right and the left. Repeat.[8]
- Try palming. The eye muscle is like a spring that should not be over-extended for long periods of time. Otherwise, it's ability to recoil can weaken. To prevent this, there are several things you can do to relax your eyes. Palming involves resting and warming your eyes using friction heat. Here's how it's done:[9]
- Rub your palms together to create some heat.
- Close your eyes.
- Put one palm gently over each eye and rest them like this for a few minutes.
- Re-warm your palms as necessary.
EditChanging the Environment - Reposition your screen. The angle at which you look at your screen can affect the amount of strain on your eyes. Start by adjusting your screen position to slightly lower than eye level.[10]
- Specifically, the top of the screen/monitor should be aligned with your eyes, when looking straight ahead.
- This angle keeps your neck in a more natural position, and results in less work for your eyes.
- Reposition your face. Try to position your face as far as you can from the monitor: 20-40 inches or 50-100 cm is about the right distance.[11]
- This may seem like it will make your eyes work harder, but eyes are relaxed at this distance.
- To read your screen at this distance, you may a need larger screen or bigger font sizes.
- Adjust the brightness and contrast. Turn down the brightness, turn up the contrast. This will make your screen easier on the eyes.[12]
- Screens that are too bright are hard on the eyes.
- When there's not enough contrast between blacks and whites on your computer screen this is also hard on your eyes. This is because they have a harder time distinguishing between different items. This can add to eye strain.[13]
- Clean your screen. Cleaning your screen removes electrostatic particles that may be emitted from the computer screen. These particles can push dust toward your eyes, causing irritation and strain. Cleaning your screen can also reduce glare.[14]
- Wipe down your screen daily with an anti-static solution sprayed onto a cloth.
- Adjust the lighting. You should try to create an environment that has lighting similar to that of your monitor. The ideal work space will have soft lights, limited natural light, no fluorescent lighting, and surfaces that don't reflect too much light.[15]
- It is important to get the right amount of lux, or light that passes through a surface. Lux is the standard unit of illumination. For ordinary office work you should illuminate the room at about 500 lux.[16] The packaging on your light bulbs should help you select the right amount of light in terms of lux.
- Switching your bulbs and adjusting window blinds in your office may cut down on your eyestrain.
- If you can't control the lighting, adjust the colors on your monitor. This is also known as adjusting your color temperature. Often, turning down the blue a little can reduce eye strain.[17] On Windows computers, you can adjust the color using the control panel.
- There is software available that automatically adjusts your monitor colors based on the time of day to compensate for changes in the natural lighting.[18] One such software is called f.lux.[19] This can make it easier to view a monitor screen in dim light or at night.[20]
- Reduce glare. Harsh glare off your computer screen can also strain the eyes.[21] If you can't control the lighting in your work environment, consider buying an anti-glare screen for your monitor or anti-glare glasses for you to wear.
- Anti-glare screens have the added benefit of increasing privacy. They make it harder for anyone not directly in front of your screen to see what's there.
- These are easier to get to for desktop computers than laptops.
- Upgrade your screen. Consider purchasing a high-resolution monitor. These are often easier on the eyes.
- Older monitors tend to flicker more, whereas the new high-resolution models provide a more consistent illumination. Flickering can increase eye strain.[22]
- Older monitors also have a slower refresh rate, causing your eyes to constantly readjust every time image refreshes on your screen.[23]
- Reposition your work materials. Eye shifting can increase eye strain and frustration, unless performed as an exercise. To avoid this, buy a stand for your books and papers so your resources can be easily located. Put the stand directly next to the screen, so your eyes aren't shifting as much.[24]
- Constantly shifting eyes means making your eyes focus and refocus on different reading materials.
- When objects are only a few inches away from each other, your eyes don't need to refocus.[25]
- If you can master "touch-typing" so that you don't need to look at your keys or screen, this is even better. You can keep your eyes on your other materials while typing, which cuts down on screen time.
EditDealing with Severe Strain - Take a break. If you are experiencing eye strain which is severely uncomfortable or affecting your vision, step immediately away from your computer and any bright lights. If possible, go outdoors into natural light. Alternately, dimming the lights indoors and giving yourself a break from all bright lights may feel comforting.
- Get some glasses. If you need glasses but don't have them, or if your glasses aren't the right prescription, this can increase eye strain. Make sure you've got the right prescription so your eyes don't have to work any harder than necessary.
- If you wear bifocals, you may tilt your head at an awkward angle when using your computer. Talk to your optometrist to see if progressive lenses may work better.
- Computer glasses can be helpful, but an eye doctor must prescribe them. They work by reducing the amount of effort required by eyes to focus, thus reducing eye strain.[26]
- In addition, purchasing lenses with an anti-reflective coating will help cut down on computer glare. There are plain, nonprescription lenses with this coating available for those who don't need vision correction.
- Look into glasses with tinting that is specific to computer use. Some glasses are tinted a soft pink, which helps with glare, while others have a coating which blocks the blue wavelength known to cause eyestrain. [27]
- See a doctor. If your symptoms get worse or do not go away, ask someone to call a doctor for immediate medical help.
- If eye strain is an an-going problem for you, it's probably a good idea to see a doctor as soon as possible.[28] You may need an eye exam to make sure that you are wearing the correct prescription of eyeglasses.
- You may need to change to bifocals, or another type of eyeglass to reduce this problem.
- It is also possible you are having a migraine, which is a type of severe headache you can treat medically. It is also important to diagnose so you can learn what can trigger these migraines. This can help you prevent them.[29]
- Hydrate yourself. Dry eyes can cause eyestrain and a great way to prevent both is by drinking 8-10 glasses of water a day.[30]
- Use artificial tears to refresh your eyes when they feel dry.[31]
- To help prevent dry eyes while working indoors, use an air cleaner to filter dust and a humidifier to add moisture to the air.[32]
- Severe eye strain or eye strain with symptoms like headache, migraine, or blurry vision require attention by a professional. Severe eyestrain or any eyestrain plus symptoms like: headache, migraine, blurry vision, or any others requires attention by a professional. See your eye doctor or go to your nearest emergency room.
- Just like the rest of your muscles, your eye muscles need exercise, reduction of harsh lighting as well as rest. If are experiencing eye strain after using these methods, ask your eye doctor for advice and help. You may be experiencing eye pain as well as strain, and therefore should make it a priority to visit with your doctor.
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