Diverticulitis

Diverticula are small outpockets of the bowel that have formed as a result of weaknesses in the bowel wall muscles. These pockets, called diverticula, are generally asymptomatic and go unnoticed. Having these pockets in the bowel is referred to as diverticulosis, and affects 50% of North Americans over age 60. In advanced cases the diverticula can be so profuse that they start to cause problems with stool motility. This can lead to abnormal defecation, bloating, and abdominal pain. Occasionally, a diverticulum becomes infected, which is referred to as diverticulitis. This condition varies from fairly benign to being an emergency. The least serious cases don’t require treatment, while the most severe require emergency surgical removal of the affected part of the bowel.

Photo of Diverticula

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Prostate Cancer

The prostate is a gland found in the male reproductive system that contributes about 25% of semen volume. Cancer of this organ is extremely common, being the most common cancer affecting North American men. It tends to be one of the less aggressive cancers, usually progressing over several decades. It is, however, still the second leading cause of cancer deaths in men (after lung cancer). Symptoms of prostate cancer include frequent urination, trouble urinating, blood in the urine, and pain with urination. Because prostate cancer is so common it is screened for in older men using digital rectal exams and sometimes PSA antigen tests (controversial). Treatment for prostate cancer may include a combination of radiation therapy, chemotherapy, and radical surgery. The specific treatment depends on the stage of the cancer.

The prostate is located below the bladder, surrounding the urethra.

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Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White (WPW) Syndrome is an anatomical abnormality where there is an extra electrical conduction pathway found in the heart. This allows the ventricles (lower portion) of the heart to be excited prematurely. Early contraction means insufficient time for blood filling and can reduce overall cardiac output. Symptoms include palpitation, shortness of breath, and fainting.

Long QRS complex on electrocardiogram, typical of Wolff-Parkinson-White.

Further Reading:

ECG: On an electrocardiogram characteristic delta waves can be seen. Has a characteristically long QRS complex.

Terminology: The accessory conduction pathway is referred to as the Bundle of Kent.

Treatment: WPW Syndrome can be stabilized with drugs. The long term treatment is to destroy the extra conduction pathway with radio waves.

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Quadruple X Syndrome

Quadruple X syndrome is a genetic disorder where a female has 4 X chromosomes instead of 2. This disease is extremely rare, with only a few hundred diagnosed cases. The symptoms are variable but often include facial malformations, joint problems, developmental delays, and heart defects. Some girls are able to live relatively normal lives while others are required to be institutionalized. The only treatment that is available is supportive therapy.

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Williams Syndrome

Williams syndrome is a rare genetic condition where affected individuals are elf-like in appearance. The syndrome causes an unusual mixture of symptoms including intellectual disability, heart defects and unusual facial features. Individuals are often friendly and chatty but have a hard time understanding other people. There is no cure for williams syndrome although some treatments like physiotherapy are effective in making the condition more manageable.

Further Reading:

Genetics: The syndrome is caused by a deletion on chromosome 7 that results in loss of the elastin gene. This causes problems in connective tissue, which accounts for the majority of the symptoms.

Incidence: Williams syndrome occurs at approximately 1 in every 5000-20,000 live births, making it a very rare condition.

Pop Culture: This disease has been featured in Season 9 of Law and Order as well as season 4 of House, M.D.

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Strep Throat

Strep throat, also known as Streptococcal pharyngitis, is an infection of the throat by the group A Streptococcus family of bacteria. Strep throat is responsible for around 5-30% of throat infections. The symptoms of strep throat are sore throat, fever, and pus on the tonsils. Strep throat is easily treated by antibiotics like penicillin and bacterial resistance isn’t often a problem. If strep throat isn’t treated quickly it can cause some very severe disorders (see below). Throat infections are taken seriously because of these potential complications.

An individual with strep throat. Photo by James Heilman, MD.

Further Reading:

Naming: The term strep throat is often misused to describe any throat infection. Caution must be taken when people use the term.

Complications: In some cases untreated strep throat can lead to glomerulonephritis (can cause kidney failure), rheumatic fever, or rheumatoid arthritis.

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Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is the general term for long term narrowing of airways that causes shortness of breath. COPD is caused by particles entering the airways, most often cigarette smoke. COPD has a very high prevalence in our society because of the high rates of smoking. It is one of the leading causes of death towards the end of life.

Affected Lung

Further Reading:

Other diseases (co-morbid) : COPD is often the result of emphysema, bronchitis, or both. COPD is not the same thing as asthma.

Some Symptoms: Chronic (long term) cough, troubled breathing, and tiredness.

Treatment: Patients can be given oxygen and proper nutrition. Over time the disease worsens and can eventually cause death. The best treatment is to remove the cause (ex. Quit smoking).

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Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome is a form of drug withdrawal in newborns. This syndrome has multiple causes but the most common situation occurs when the mother is taking narcotics during pregnancy. The drugs get transferred through the placenta to the baby and the baby’s body becomes relient on that chemical. The newborn essentially becomes addicted to the same substance as the mother. Common substances that cause this syndrome include heroin, oxycodone, morphine, marijuana, and even caffeine.

Further Reading:

Symptoms: Some examples include sweating, fever, tremors, poor feeding, poor sleeping and an elevated respiratory rate.

Treatment: Infants are just given supportive treatment (treat the symptoms). The syndrome usually passes after a few days, although it can take as long as a few weeks, depending on the narcotic used.

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Pancreatic Cancer

Pancreatic cancer is an uncommon but extremely deadly type of cancer. It is cancer of the pancreas, which normally secretes enzymes into the intestine. Affected individuals usually have few symptoms during the first stages of this cancer and as a result it is often too late for treatment by the time it is discovered. Approximately 5% of individuals diagnosed with pancreatic cancer survive for 5 more years.

Prevalence of Pancreatic Cancer by the WHO. The United States has a rate of 8 per 100,000 individuals.

Further Reading:

Symptoms: Back pain, abdominal pain, weight loss, diabetes and jaundice are all common symptoms of pancreatic cancer.

Treatment: Chemotherapy and surgery can be used to treat patients with pancreatic cancer. The most common surgical technique is called the Whipple procedure and involves removing part of the pancreas and intestine.

Hormones: The pancreas produces insulin for the body. So in some cases of pancreatic cancer patients can develop diabetes.

Risk Factors: An individual is more likely to be diagnosed with pancreatic cancer if they are male, smoke, older (>60), are obese, or have diabetes.

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Necrotizing Fasciitis

Necrotizing fasciitis is a rare skin disease that is also known as flesh-eating disease. In this disease the connective tissue of an individual is eaten away by a bacteria-secreted toxin. Several different bacteria are able to enter via wounds and secrete the dangerous toxin. Necrotizing fasciitis is characterized by its speed of progression. It can take as little as a day to require amputation of a limb.

An affected leg. Image by Piotr Smuszkiewicz, Iwona Trojanowska and Hanna Tomczak

Further Reading:

Symptoms: Intense pain that is disproportionate to the visible wound, redness, blisters, swelling, and fever.

Treatment: The infection can often be treated by antibiotics. In many cases antibiotics aren’t effective fast enough and amputation of the affected limb is required.

Culprits: Common examples of the bacteria who secrete this exotoxin include Staphylococcus aureus and Streptococcus pyogenes.

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