Bisphosphonates adhere to the surface of the bones and retard spoilage. That way they can avoid fractures (bone breaking) to preserve bone mass and even increase its density. Includes alendronate (Fosamax ®), ibandronate (Boniva ®), risedronate (Actonel ®) and zoledronic acid (Reclast ®). These medicines can have unwanted effects such as vomiting and stomach pain, consult your doctor if you feel you do not like them.

On the other hand, if you should get dental surgery, it is important to mention to your dentist you are taking this medicine. Ideally, medicine should be discontinued two weeks before dental treatment because there is something known as osteonecrosis of the jaw that happens very rarely, but whose risk is reduced if suspended before invasive dental procedures. Studies suggest that bisphosphonates be suspended after taking them for 5 consecutive years since its benefit may continue beyond that time.

Selective modulators of estrogen receptor (SERMs, for its acronym in English) such as raloxifene (Evista ®) delays the breakdown of old bone and, although they are not hormones have an effect on bone similar to estrogen but without the risks associated with the hormone, such as increased chance of having breast cancer or uterine cancer. You should avoid taking these medications if you have had deep vein thrombosis or a clot in a vein, because this medication can increase this risk.

Hormones: there are alternatives such as estrogen tablets (Premarin ®) and estrogen with progestin (Prempro ®, Premphase ®) reinforce the body’s natural hormones and slow the breakdown of old bone. Teriparatide (Forteo ®) helps the body form new bone faster than the old deteriorates. Calcitonin (Miacalcin ®, Fortical ®) also slows the breakdown of old bone.

RANK ligand inhibitor: This is the newest drug newly approved for use. It is applied subcutaneously twice a year. As above, delays the breakdown of old bone but its mechanism of action is different. In clinical studies to date tend to be fairly well tolerated, few cases have been mild back pain in the limbs or muscles transient urinary tract infection and elevated cholesterol. In rare cases, it is a skin reaction such as rash or eczema and osteonecrosis of the jaw, as bisphosphonates. Its trade name is Prolia ® (Denosumab).

As in most cases, osteoporosis can be detected by surprise and when there has been a fracture of one or more bones, affected individuals suggest that programs should be increased to prevent and detect the disease early.

Talk to your doctor about your bone health (your bones), review your risk factors with him or her and ask if you should get a bone density test. If necessary, may order medications to help prevent bone problems and reduce your chance of fractures due to osteoporosis. You can do many things to keep your bones healthy and strong, no matter how old you are. Cheer up, never too late to take care of your bones.

Remember what osteoporosis is and then talk of drugs that treat: it is a silent disease that affects the bones and occurs because the bones have less calcium deposits than they need, then weaken and become porous (for you can imagine, would look like a loofah).

It is said that osteoporosis is silent because they generally have no symptoms, unless you are very advanced. This means that you do not realize that you have and is usually detected when the problem already exists and there is a fracture (a broken) bone, typically in the hip, wrist or one or more vertebrae of the spine.

Currently, there are different types of medications that can help prevent and treat osteoporosis. Your doctor can tell you to take some if you perform a bone density test (which tells you how are your bones) and finds that your bones are weak and are likely to fracturarte.

By the way, before recommend these medicines, will determine that no other problems such as hyperparathyroidism, and so on. And it also should make sure that your vitamin D level in the blood is adequate and you are getting enough calcium (ideally in your food daily). When this is not possible, when calcium supplements are recommended. It’s harder to get vitamin D from food and is not recommended prolonged sun exposure, so it is often recommended vitamin D supplements (under medical supervision) when the level is below normal in the blood.

Also, do not forget about the importance of exercise, especially that includes weights. They have to be very heavy. In fact should never be more than 15 pounds or 6.8 kg. above your head if you already have osteoporosis. But the weight also strengthens your bones. Even activities like walking that puts the weight of your body, gardening are great.

It is an occasional seizure occurs in a child following a febrile process. It occurs in children between 6 months and 5 years.

It is very important constitutional predisposition, ie inheritance. Usually a family history of febrile seizures.

Types of febrile seizures

Simple febrile seizures

- Are the most frequent (85% -90%)

- They tend to be unique (only one in the same febrile illness)

- Are widespread, with symmetrical movements of arms and legs

- The postcrítico period is short.Complex febrile seizures, atypical or complicated

- Are partial

- It lasts longer than 15 minutes

- There is more of a fever in the same process (multiple)

- The postcrítico period is prolonged.

Factors that trigger febrile seizures

- Can be caused by any process that involves fever, infections such as the administration of vaccines. The fever is usually over 38 º C.

- They can appear as both a rise with a sudden drop in temperature. They are produced in the first 24 hours of febrile process.

- If it appears from Day 2 is required to rule out a central nervous system infection (meningitis mostly).

Interesting things about febrile seizures

Febrile seizures are the most common type of seizure in children.

After the first febrile seizure recurrence risk is 25% -30%. And this risk of recurrence increases in subsequent episodes.

Crisis if it lasts more than 30 minutes or there are several crisis followed for more than 30 minutes is called a “febrile status epilepticus seizure.”

Febrile seizures do not involve:

- Risk of death

- Neurological Complications

- Complications intellectuals.

Febrile seizures lead:

- Risk slightly higher than other children to have epilepsy in the future

- This risk does not decrease with preventive treatment.

credit to: Dra. Mª Cruz Llopis Garrido

Phenomena are caused by a sudden disruption of the normal function of neurons, ie our brain cells. You can say that this group of neurons begins to operate unchecked.

Although it can manifest in many different ways, most often they are presented as transient alterations of consciousness, sometimes associated with body movements (arms and legs).

Following the seizure there is a space of time the child is still a bit dazed until fully recovered: it is called postcrítico period. Then usually enter a deep sleep.

Types of seizures

Generally speaking, seizures are usually classified into two groups:

Generalized seizures

There is loss of consciousness. It is an emergency that requires the transfer of the patient to a healthcare facility, it can lead associated with various disorders (cerebral oxygen deficiency, lower blood glucose, etc..) That can cause brain damage if not treated early.Partial Seizures

They are produced by the activation of a limited group of neurons. They are not an emergency, but can sometimes be followed by a generalized seizure.

How can confuse a seizure in children?

There are a number of phenomena, like seizures, which can make us think that a child has a seizure, not being so in reality, such as:

Chills

Do not confuse the chills own temperature rising with seizures. In these there is no loss of consciousness.

Syncope

It is a sudden loss of consciousness, soon recovered, caused by a sudden decrease in cerebral blood flow. Is due to a sudden drop in blood pressure. It is usually caused by anxiety and / or pain (for example, to draw blood). Only recovers, usually in less than a minute.

Breath holding spell

These are children who cry uncontrollably until they suddenly go into spasm (what to throw into a jail colloquially called) may even momentarily lose consciousness. Also of spontaneous recovery, but create a large family anxiety.

Night terrors

Nightmares may seem at times to convulsions

Other less frequent

Hysterical crisis, tetany, twitching, dizziness and some headaches.

What attitude should follow the people who witness a seizure?

To respond correctly to a patient having a seizure you should transfer to hospital without delay. Meanwhile, place it in the ground or hard surface to prevent falls and check your pulse and breathing.

credit to: Dra. Mª Cruz Llopis Garrido

Epilepsy is a disease that manifests in attacks, also known as seizures. One of the most common neurological disorders, affecting 0.5% to 1% of the population. Epilepsy can occur at any age but is most common in childhood and old age. It is a disease that occurs under different symptoms with causes, treatments and prognoses.

Not all epileptic seizures are necessary. Sometimes, alcohol or some medications prescribed for other diseases can cause seizures in some circumstances.

Currently, most physicians do not interpret the isolated seizure and epilepsy. The prognosis of epilepsy is a clinical condition consisting of recurrent seizures in a patient.

The brain is composed of a large number of nerve cells called neurons that communicate with each other through electrical signals. For normal operation of the brain must be careful regulation of power flows that integrate the activity of these neurons.

An abnormal electrical discharge in the brain disrupts the normal functioning of neurons and can produce, among other things, an epileptic seizure. The type of seizure depends on the origin and extent in the brain of the shock in question. During an attack, these discharges can cause:

- Contraction of the muscles.

- Abnormal sensations (perception of odors or flavors, tingling or itching, burning on a side of the body).

- Emotional symptoms such as fear, perception of having lived before an event, a symptom known by the name of déjà vu, or the opposite sign, known by the name of jamais vu.

- Loss of consciousness.

Epileptic seizures are usually brief, it lasts a few seconds to few minutes. Once past the seizure, brain electrical activity to normal.

credit to: Dr. Jimmy Alfonso Schiemann Delgado

The evolution is progressive. The first and most important change is the loss of memory, especially for recent events, gradually evolving to a higher intensity, indicating the existence of a disease. This is often accompanied by difficulty performing everyday activities.

Initially, the patient feels that something is happening, and this is a very unpleasant and disturbing experience. However, with the progress of the disease concern disappears, becoming a problem for your family and friends.

What are the warning signs?

Many people in their daily lives suffer memory problems. If this condition is increasing, making your daily life can be a sign of dementia, requiring an evaluation by a physician, preferably a specialist as a clinical neurologist. Do not make judgments for himself and diagnoses, there may be disturbances of memory are not necessarily dementia.What can you do?

To prevent the onset of multi-infarct dementia, you can do the following:

- Eat less fatty foods.

- Stop smoking or at least reduce the number of cigarettes smoked.

- Maintain blood pressure control.

- If you have changes in heart function, especially in its rhythm (called arrhythmias), consult your doctor.

- If you have type I or type II, is very important to have a regular and permanent control.

- Because of its phenol content, a daily glass of red wine may decrease the risk of embolism (clots).

How does the doctor diagnose?

Some diseases, including treatable, have symptoms similar to multi-infarct dementia. Through history and some analysis, the doctor makes the diagnosis:

- Metabolic disorders

- Deficiency of vitamin B-12 (cobalamin)

- Dehydration

- Depression

You need a brain scan (CT) to confirm any suspicion of a multi-infarct dementia. The presence of other symptoms or clinical signs such as heart rhythm disorder (called arrhythmia) or other signs of occlusion of blood vessels, are indicative of this disease.

How is multi-infarct dementia?

Brain damage is irreversible, but to prevent disease progression may be used medications that should always be prescribed by your doctor.

- To prevent blood clots (called antiplatelet drugs), you can take acetylsalicylic acid (aspirin), ticlopidine or dipiradamol.

- If cardiac arrhythmias is necessary to use blood thinners such as heparin or warfarin.

The dementia itself is untreatable, with the symptomatic management, in advanced stages requiring care in a specialized unit, or supervised at home or in specialized residences.

credit to: Dr. Jimmy Alfonso Schiemann Delgado, Dr. Ole Davidsen, Dr. Dan Rutherford

Multi-infarct dementia is a form of dementia caused by a large number of small clots (emboli) in the brain. It is more common in people with abnormal heart function, especially an irregularity in the rhythm, or by occlusion of cerebral capillaries.

The consequence of emboli is a cerebral hypoxia (lack of oxygen to the brain), leading to the death of a large number of nerve cells. The disease is more common in elderly people with arteriosclerosis (hardening of the arteries). A stroke can be defined as an area of ??dead brain tissue.

The most severe disease, once diagnosed, is that you can not do anything about the damage that has already occurred. However, it is possible to prevent further brain damage. The causes of the disease are identical to those of stroke (thrombosis), produced by a large clot. The main difference is the only blood clots in the vessels of small diameter.Under what circumstances there is an increased risk of multi-infarct dementia?

All known risk factors that increase the chance of a stroke also increase the likelihood of developing multi-infarct dementia. These are:

- Smoking

- Increased blood pressure

- High cholesterol

- Diabetes Type 1 and Type 2 (particularly if poorly controlled)

- Alterations in cardiac function especially arrhythmias (irregular heartbeat)

- Occlusion (closure) of other blood vessels, leading to the brain clots

All these factors are associated with atherosclerosis, which is the main trigger of the disease. This means that if we limit the course and development of atherosclerosis, we may limit its impact and progress of multi-infarct dementia.

credit to: Dr. Jimmy Alfonso Schiemann Delgado, Dr. Ole Davidsen, Dr. Dan Rutherford

- Hypothyroidism, liver failure and/or renal

- Diabetes with falls of glucose levels

- epilepsy

- Parkinson’s disease

What can you do?

In the early stages of the disease, there are practical ways to refresh your memory, for example, keeping a journal or use a board to leave notes. Some seniors who have no family, to avoid missing out on the street, always carry with you (usually around the neck) a kind of card with their picture, name and address or telephone number.Not to be confused with dementia, other neurological or psychiatric diseases, although they may seem similar. For example, depression, states of agitation or drowsiness, or other type of pictures to produce forgetfulness, or similar symptoms. Before these cases, we must look first to our GP, who will know to harness the problem and differentiate it from true dementia.

When a new drug for dementia in the media should not think that this medicine is now available. Generally, they are studies still take years to yield results. However, there are some drugs that are being used in very early stages of the disease in some patients, but keep in mind that can only be given to a particular group of patients, controlled by the specialist.

credit to: Dra. Marion McMurdo, Dr. Jose Luis Monroy Anton

We can distinguish two main groups of causes:

Reversible dementias: may be caused by metabolic disease, poisoning by drugs, alcohol abuse, trauma, tumors, etc..

Irreversible dementia: as, for example, Alzheimer’s disease.

What types of dementia are there?

Alzheimer’s disease

This is the most common form of dementia, is due to a loss of brain cells (neurons) leading to brain atrophy. Seems to be related to a chemical imbalance in the brain. Over time, there are fewer neurons that function properly, and the patient’s mental state is deteriorating slowly but surely.Vascular dementia, among which include multi-infarct dementia

It is the second most common type of dementia, is due to poor cerebral blood flow. The most common causes are usually chronic hypertension and atherosclerosis of the vessels that carry blood to the brain. In this kind of dementia, there are many small strokes (infarcts), which cut the blood supply to parts of the brain. To get the disease progresses more slowly, it is important to maintain blood pressure and sugar in adequate numbers, and stop smoking.

alcoholic dementia

Excessive drinking causes brain damage, and one of these harms is the development of dementia. It is a type of dementia that stops progressing if the individual leaves the alcohol completely.

credit to: Dra. Marion McMurdo, Dr. Jose Luis Monroy Anton

The dementias are a type of brain disease. When a person has dementia, the brain cells deteriorate and lose their normal duties earlier than normal. This alteration in brain cells that the brain does not function properly, and slowly, patients lose their abilities and intellect.

The first symptoms usually consist of slight memory lapses and losses, the affected people forget things as common as the name of your husband or wife. Later, as the disease progresses, there are certain data such as date or place to meet, people do not recognize, forget conversations that have maintained, do not retain answers to questions about simple and even they are unable to fulfill orders that were made. We must pay special care when let out alone on the street, as it is often lost on routes that were previously known to themselves.Elderly patients with dementia may become apathetic or lose interest in activities that were important to them. In the later stages, patients are unable to care for themselves and need help with washing, dressing or eating. Their conversation becomes repetitive, and can ask the same question over and over again. Sometimes, they may become verbally or physically aggressive, and be agitated. In the final phase, the patient usually stays in bed, requiring constant attention by a caregiver.

Data on dementia

- It is a normal part of aging: it is normal for an elderly person not present insanity, but small oversights or lack of memory that can not be considered as a disease.

- It is caused by stress.

- It is not contagious.

- Not due to a poor or excessive mental activity.

credit to: Dra. Marion McMurdo, Dr. Jose Luis Monroy Anton