In Solomon 's lavish praise of his love – the country girl, Sulaimi – the navel is mentioned as follows: " thy navel is like a round goblet , which wanteth not liquor: thy belly is like a heap of wheat set about with lilies . " (7:2). [56] [57] [58] American poet May Swenson in her poem "Little Lion Face" wrote, " Now I'm bold to touch your swollen neck, put careful lips to slick petals, snuff up gold pollen in your navel cup. " [59] and poem "August Night" wrote, " Your navel a little pool in pulsing tide an aura round your knees ". [60] Czech -born writer Milan Kundera in his 2015 book The Festival of Insignificance conveys about the eroticism of exposed female navels. [61] [62] [63] Alain, one of the characters in the book, observes to his friend how most of the young women in Paris wear T-shirts or blouses that expose their midriffs, displaying their navels for all to see.
He allegedly had attempted to break her ankles and burn her with a hot iron on the night of her attack. Accusing him of domestic violence and marital rape , she claimed provocation.
For example, in the northeastern regions of Ethiopia and Kenya, which share a border with Somalia, the Somali people practise FGM at around the same rate as they do in Somalia. [100] But in Guinea all Fulani women responding to a survey in 2012 said they had experienced FGM, [101] against 12 percent of the Fulani in Chad, while in Nigeria the Fulani are the only large ethnic group in the country not to practise it. [102] Reasons Support from women 1996 Pulitzer Prize for Feature Photography Kenyan FGM ceremony — Stephanie Welsh, Newhouse News Service [103] Dahabo Musa, a Somali woman, described infibulation in a 1988 poem as the "three feminine sorrows": the procedure itself, the wedding night when the woman is cut open, then childbirth when she is cut again. [104] Despite the evident suffering, it is women who organize all forms of FGM. [105] [r] Anthropologist Rose Oldfield Hayes wrote in 1975 that educated Sudanese men who did not want their daughters to be infibulated (preferring clitoridectomy) would find the girls had been sewn up after the grandmothers arranged a visit to relatives. [110] Gerry Mackie has compared the practice to footbinding .
The rise in temperature has increased evaporation in certain forest environments that as a result has promoted cloud formation. [14] Experts propose that increased cloud cover might actually be decreasing the daytime temperature by blocking the sun, while at night the cloud cover serves as insulation to raise the nighttime temperature from its normal range.
Generally speaking, retinoids increase the skin's sensitivity to sunlight and are therefore recommended for use at night. [1] Tretinoin is the least expensive of the topical retinoids and is the most irritating to the skin, whereas adapalene is the least irritating but costs significantly more. [1] [87] Most formulations of tretinoin are incompatible for use with benzoyl peroxide. [15] Tazarotene is the most effective and expensive topical retinoid but is not as well tolerated. [1] [87] Retinol is a form of vitamin A that has similar but milder effects and is present in many over-the-counter moisturizers and other topical products.
Acne is principally a disorder of adolescence but persists into middle age in a small minority of individuals. Goulden et al. (1999) quoted evidence, primarily from twin studies, suggesting that acne may be an inherited disorder. Clinically, the condition consists of a spectrum of diseases varying in age of onset and resolution as well as in severity, type, and distribution of lesions. It can be argued that, when investigating the inheritance of acne, particular subgroups must be considered separately. Goulden et al. (1999) investigated the familial risk of persistent adult acne by studying the occurrence of this condition in first-degree relatives of patients with adult persistent acne compared with the relatives of unaffected volunteers.
Fever Hearing loss Pain may disrupt sleep Perforated tympanic membrane Discharge followed by pain improvement Mastoiditis * Children History of URI >10 days Recent history of URI or ear infection Fevers/chills May see signs of otitis media on exam Pain is located behind the ear with postauricular (i.e. near mastoid process ) swelling* Diagnose with CT Chronic suppurative otitis media Conductive hearing loss Relapsing/remitting or chronic discharge May see perforation of tympanic membrane or cholesteatoma on exam Serous otitis media (otitis media with effusion) No signs of infection Prominent hearing loss May have history of URI or acute otitis media Otitis externa Swimming Psoriasis Seborrheic dermatitis Q-tips in the ear Bilateral pain Scaling Itching Pain exacerbated when ear is pulled May see granulation tissue in canal on exam Necrotizing/malignant otitis externa* Diabetes Immuno-compromised Constant pain with increasing severity at night* Purulent discharge* Pain out of proportion to exam findings* Biopsy granulation tissue for culture Chondritis vs perichondritis Recent ear trauma (i.e. ear piercing) External ear appears inflamed Chondritis more likely than perichondritis if ear shape is distorted Referred causes Diagnosis Features [4] [8] [9] GERD Bilateral pain Neuralgia Pain described as tingling/sharp/burning sensation; episodes can start with light touch Malignancy* Weight loss* Arthritis of the neck Pain exacerbated by neck movement Eagle syndrome Swallowing exacerbates pain Infected 3 rd molar Extreme food temperatures exacerbate pain Temporal arteritis* Patient age > 50* Chewing exacerbates pain* TMJ dysfunction Patient grinds teeth Bilateral pain Pain + crepitus with TMJ palpation Jaw clicking *Indicates a "Can't Miss" diagnosis or a red flag.
Overview Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder. Agoraphobia involves fearing and avoiding places or situations that might cause panic and feelings of being trapped, helpless or embarrassed. You may fear an actual or upcoming situation. For example, you may fear using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd. The anxiety is caused by fear that there's no easy way to escape or get help if the anxiety gets overwhelming. You may avoid situations because of fears such as getting lost, falling, or having diarrhea and not being able to get to a bathroom.
These symptoms may also become more severe at night. [8] [9] [10] [11] [12] As the condition progresses and worsens, a spontaneous hematoma occurs following the rupture of the liver capsule, which occurs more frequently in the right lobe.
A rare hemorrhagic disorder due to an acquired platelet anomaly characterized by hemolysis, elevated liver enzymes and thrombocytopenia that affects pregnant or post-partum women, and is frequently associated with severe preeclampsia. Symptoms are variable, typically including right upper quadrant or epigastric abdominal pain, nausea, vomiting, excessive weight gain, generalized edema, hypertension, general malaise, right shoulder pain, backache, and/or headache. Hepatic hemorrhage and rupture, renal failure, and pulmonary edema can result in maternal and/or fetal death.
HELLP syndrome is a life-threatening condition that can potentially complicate pregnancy. It is named for 3 features of the condition: H emolysis, E levated L iver enzyme levels, and L ow P latelet levels. It typically occurs in the last 3 months of pregnancy (the third trimester) but can also start soon after delivery. A wide range of non-specific symptoms may be present in women with HELLP syndrome. Symptoms may include fatigue; malaise; fluid retention and excess weight gain; headache; nausea and vomiting; pain in the upper right or middle of the abdomen; blurry vision; and rarely, nosebleed or seizures.
They commonly present with skin lesions, less commonly symptoms due to central nervous system involvement, and in a minority of cases symptoms due to the involvement of the bone marrow, liver, kidneys, ovaries, and/or cervix . [1] They often show signs of an disseminated disease such as fever, weight loss, night sweats , arthralgias , jaundice , decreased numbers of circulating red blood cells , white blood cells , and/or platelets , bone marrow involvement as determined by biopsy , and signs/symptoms of multiple organ involvement. [8] Diagnosis [ edit ] The diagnosis of IVNK/TL depends upon obtaining histology findings in the skin and/or other involved tissue that resembles that seen in IVBCL except that the malignant lymphocytes are not B-cells but rather: 1) NK-cells as evidenced by their expression of NK-cell selective marker proteins (e.g.
Intravascular large B-cell lymphoma (IVLBCL) is a very rare form of diffuse large B-cell lymphoma (see this term) characterized by the selective growth of lymphoma cells within the lumina of small blood vessels (especially the capillaries) that most often presents with a wide range of clinical manifestations (as potentially any tissue can be involved), with patients from Western countries more frequently manifesting with neurological and cutaneous symptoms while patients from Asian countries more frequently displaying hepatosplenomegaly and thrombocytopenia. IVLBCL is characterized by an absence of lymphadenopathy, an aggressive clinical course and a poor prognosis.
Catholic membership in Britain continues to grow, thanks to the immigration of Irish and more recently Polish workers. [23] Conflict and rivalry between Catholicism and Protestantism since the 1920s, and especially since the 1960s, has centred on the Troubles in Northern Ireland . [24] Anti-Catholicism in Britain was long represented by the burning of an effigy of the Catholic conspirator Guy Fawkes at widespread celebrations on Guy Fawkes Night every 5 November. [25] However, this celebration has lost most of its anti-Catholic connotations. ... Clergy, nuns and lay leaders began to be targeted, leading to thousands of arrests over the ensuing years, often on trumped up charges of currency smuggling or "immorality". [87] In Hitler's Night of the Long Knives purge, Erich Klausener , the head of Catholic Action , was assassinated. [88] Adalbert Probst , national director of the Catholic Youth Sports Association, Fritz Gerlich , editor of Munich's Catholic weekly and Edgar Jung , one of the authors of the Marburg speech , were among the other Catholic opposition figures killed in the purge. [89] By 1937, the Church hierarchy in Germany, which had initially attempted to co-operate with the new government, had become highly disillusioned.
The main symptoms which occur in nearly all dogs with diabetes mellitus are: [48] excessive water consumption, excessive water consumption due to too much thirstiness, this condition is often called polydipsia. [48] frequent and/or excessive urination, known as polyuria , often requiring the dog to be let outside to urinate during the night, [49] greater than average appetite, increased appetite to abnormal levels, which is too greater than the average appetite, a condition known as polyphagai. , [47] [48] weight loss, dogs with diabetes may also suffer from severe weight loss, weakness , anorexia and blindness. [48] Sometimes, the first sign of diabetes noticed by the owner may be that their dog either has become blind (due to the formation of cataracts in the eyes), or has vomiting, anorexia, lethargy and weakness (due to ketoacidosis). [49] Diabetes mellitus can be a threat to the health of the dog since it may cause urinary tract infections.
They recommended starting therapy in patients with constitutional symptoms such as recurrent fever , night sweats , fatigue due to anemia , weight loss , progressive symptomatic lymphadenopathy or spleen enlargement , and anemia due to bone marrow infiltration.
In these cases, there is relatively little involvement of lymph nodes except as a result of direct invasion from non-nodal sites. [12] Thirty-five to forty-five percent of patients present with a history of malaise , fever , night sweats , and/or weight loss . Most (70-75%) patients are diagnosed with early stage I or II disease while the rest have far more serious stage III or IV disease.
Recommended Surveillance for Individuals with Bloom Syndrome (BSyn) View in own window Manifestation Evaluation Frequency Wilms tumor Abdominal ultrasound Screen for signs/symptoms incl hematuria & a painless abdominal mass Every 3 mos from time of diagnosis to age 8 yrs Leukemia Screening & family education on signs/symptoms incl pallor, abnormal bleeding, petechiae, fatigue, unintentional weight loss Every health visit Lymphoma Screening & family education on signs/symptoms incl enlarged lymph nodes, unexplained fevers, drenching night sweats, fatigue, unintentional weight loss Every health visit Whole-body MRI Every 1-2 yrs from age 12-13 yrs Colorectal cancer Colonoscopy Annually from age 10-12 yrs Fecal immunochemical testing Every 6 mos from age 10-12 yrs Breast cancer Breast MRI in females Annually from age 18 yrs Skin cancer Skin examination w/dermatologist for any suspicious skin lesions On recognition of suspicious lesions & annually thereafter Diabetes mellitus Fasting blood glucose & hemoglobin A1C Screening & family education on signs/symptoms of polyuria, polydipsia, weight loss Annually from age 10 yrs Hypothyroidism Serum TSH w/reflex to T4 Screening & family education on signs/symptoms incl fatigue, constipation, cold sensitivity, weight gain Annually from age 10 yrs Dyslipidemia Lipid profile Annually from age 10 yrs Agents/Circumstances to Avoid Sun exposure to the face and other exposed areas, particularly in infancy and early childhood, should be avoided.
Bloom syndrome Crystal structure of the Bloom's syndrome helicase BLM in complex with DNA (PDB ID: 4CGZ). Specialty Medical genetics Bloom syndrome (often abbreviated as BS in literature) [1] is a rare autosomal recessive genetic disorder characterized by short stature, predisposition to the development of cancer, and genomic instability. BS is caused by mutations in the BLM gene which is a member of the RecQ DNA helicase family. Mutations in other members of this family, namely WRN and RECQL4, are associated with the clinical entities Werner syndrome and Rothmund–Thomson syndrome , respectively. More broadly, Bloom syndrome is a member of a class of clinical entities that are characterized by chromosomal instability, genomic instability, or both and by cancer predisposition.
Bloom syndrome affects many different body systems and is characterized by slow growth, sun sensitivity, and an increased risk of cancer. Symptoms include short stature, sun-sensitive skin rash, and an immune system that doesn't work correctly. Some people with Bloom syndrome have learning disabilities, type 2 diabetes, and chronic obstructive pulmonary disease (COPD). Most people with Bloom syndrome develop some type of cancer by age 40. Bloom syndrome is caused by genetic variants in the BLM gene and is inherited in an autosomal recessive pattern.
Bloom syndrome is an inherited disorder characterized by short stature, a skin rash that develops after exposure to the sun, and a greatly increased risk of cancer. People with Bloom syndrome are usually smaller than 97 percent of the population in both height and weight from birth, and they rarely exceed 5 feet tall in adulthood. Affected individuals have skin that is sensitive to sun exposure, and they usually develop a butterfly-shaped patch of reddened skin across the nose and cheeks. A skin rash can also appear on other areas that are typically exposed to the sun, such as the back of the hands and the forearms. Small clusters of enlarged blood vessels (telangiectases) often appear in the rash; telangiectases can also occur in the eyes.
A number sign (#) is used with this entry because Bloom syndrome (BLM), also referred to here as microcephaly, growth restriction, and increased sister chromatid exchange-1 (MGRISCE1), is caused by homozygous or compound heterozygous mutation in the gene encoding DNA helicase RecQ protein-like-3 (RECQL3; 604610) on chromosome 15q26. Description Bloom syndrome is an autosomal recessive disorder characterized by proportionate pre- and postnatal growth deficiency; sun-sensitive, telangiectatic, hypo- and hyperpigmented skin; predisposition to malignancy; and chromosomal instability. Genetic Heterogeneity of Microcephaly, Growth Restriction, and Increased Sister Chromatid Exchange See also MGRISCE2 (618097), caused by mutation in the TOP3A gene (601243) on chromosome 17p12. Clinical Features Landau et al. (1966) described a patient whose parents were second cousins and who showed low gamma-A and gamma-M serum proteins. German et al. (1984) collected information on 103 patients. German and Takebe (1989) suggested that differences in skin pigmentation in various ethnic groups may confer a degree of protection against actinic radiation and thus obscure one of the characteristic facial signs of Bloom syndrome, i.e., telangiectasia.
Bloom syndrome is a rare disorder associated with pre- and postnatal growth deficiency, a telangiectatic erythematous rash of the face and other sun-exposed areas, insulin resistance and predisposition to early onset and recurrent cancer of multiple organ systems. Epidemiology Bloom syndrome (BSyn) overall prevalence is unknown, but in the Ashkenazi Jewish population it is estimated at approximately 1/ 48,000 births. A founder mutation, known as BLM ash is present in approximately 1 in 100 persons of Ashkenazi Jewish background. There are also founder mutations in the Slavic and Hispanic populations. Clinical description Individuals with BSyn show proportionate growth deficiency of prenatal onset (average birth weight 1757 g) and continuing throughout life (average adult height of 149 cm for men and 138 cm for women).
Bronchial carcinoid can cause airway obstruction, pneumonia , pleurisy , difficulty with breathing, cough, and hemoptysis , or may be associated with weakness, nausea, weight loss, night sweats, neuralgia, and Cushing's syndrome.
Overview Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine tumors are rare and can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas. There are many types of neuroendocrine tumors. Some grow slowly and some grow very quickly. Some neuroendocrine tumors produce excess hormones (functional neuroendocrine tumors).
Other approaches include spinal cord stimulators, adenosine receptor blockade, and psychiatric intervention. [42] [43] [44] [45] [46] [47] Suspected angina [ edit ] Hospital admission for people with the following symptoms is recommended, as they may have unstable angina: pain at rest (which may occur at night), pain on minimal exertion, angina that seems to progress rapidly despite increasing medical treatment.
Overview Angina (an-JIE-nuh or AN-juh-nuh) is a type of chest pain caused by reduced blood flow to the heart. Angina is a symptom of coronary artery disease. Angina is also called angina pectoris. Angina pain is often described as squeezing, pressure, heaviness, tightness or pain in the chest. It may feel like a heavy weight lying on the chest. Angina may be a new pain that needs to be checked by a health care provider, or recurring pain that goes away with treatment. Although angina is relatively common, it can still be hard to distinguish from other types of chest pain, such as the discomfort of indigestion.