10 COMMON DISEASES

CAUSES OF 10
COMMON SYMPTOMS

FAT

 
Subject Contents

Fat

 
Definition
Fats are organic compounds that are made up of carbon, hydrogen, and oxygen; they are the most concentrated source of energy in foods. Fats belong to a group of substances called lipids. Fats come in liquid or solid form. All fats are combinations of saturated and unsaturated fatty acids. Fats can be called very saturated or very unsaturated depending on their proportions.
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Alternative Names
Saturated fat; Diet - fat; Polyunsaturated fat; Monounsaturated fat; Lipids
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Function
Fat is one of the three nutrients (along with protein and carbohydrates ) that supply calories to the body. Fat provides 9 Calories per gram, more than twice the number provided by carbohydrates or protein. Fat is essential for the proper functioning of the body. Fats provide the "essential" fatty acids, which are not made by the body and must be obtained from food. Linoleic acid is the most important essential fatty acid, especially for the growth and development of infants. Fatty acids provide the raw materials that help in the control of blood pressure , blood clotting, inflammation, and other body functions. Fat serves as the storage substance for the body's extra calories. It fills the fat cells (adipose tissue) that help insulate the body. Fats are also an important energy source. When the body has used up the calories from carbohydrate , which occurs after the first 20 minutes of exercise , it begins to depend on the calories from fat. Healthy skin and hair are maintained by fat. Fat helps in the absorption, and transport through the bloodstream of the fat-soluble vitamins A, D, E, and K.
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Food Sources
  • Saturated fats:
  • These are the biggest dietary cause of high LDL levels ("bad cholesterol"). When looking at a food label, pay very close attention to the % of saturated fat and avoid or limit any foods that are high (for example, over 20% saturated fat). Saturated fats are found in animal products such as butter, cheese, whole milk, ice cream, cream, and fatty meats. They are also found in some vegetable oils -- coconut, palm, and palm kernel oils. (Note: most other vegetable oils contain unsaturated fat and are healthy.)
  • Unsaturated fats:
  • Fats that help to lower blood cholesterol if used in place of saturated fats. However, unsaturated fats have a lot of calories, so you still need to limit them. There are two types: mono-unsaturated and polyunsaturated. Most (but not all!) liquid vegetable oils are unsaturated. (The exceptions include coconut, palm, and palm kernel oils.)
  • Mono-unsaturated fats:
  • Fats that help to lower blood cholesterol if used in place of saturated fats. However, mono-unsaturated fats have a lot of calories, so you still need to limit them. Examples include olive and canola oils.
  • Polyunsaturated fats:
  • Fats that help to lower blood cholesterol if used in place of saturated fats. However, polyunsaturated fats have a lot of calories, so you still need to limit them. Examples include safflower, sunflower, corn, and soybean oils.
  • Trans fatty acids:
  • These fats form when vegetable oil hardens (a process called hydrogenation) and can raise LDL levels. They can also lower HDL levels ("good cholesterol"). Trans-fatty acids are found in fried foods, commercial baked goods (donuts, cookies, crackers), processed foods, and margarines.
  • Hydrogenated:
  • refers to oils that have become hardened (such as hard butter and margarine). Foods made with hydrogenated oils should be avoided because they contain high levels of trans fatty acids, which are linked to heart disease. (Look at the ingredients in the food label.) The terms "hydrogenated" and "saturated" are related; an oil becomes saturated when hydrogen is added (i.e., becomes hydrogenated).
  • Partially hydrogenated:
  • Refers to oils that have become partially hardened. Foods made with partially hydrogenated oils should be avoided because they contain high levels of trans fatty acids, which are linked to heart disease. (Look at the ingredients in the food label.)
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    Side Effects
    Eating too much saturated fat is one of the major risk factors for heart disease . A diet high in saturated fat causes a soft, waxy substance called cholesterol to build up in the arteries. Too much fat also increases the risk of heart disease because of its high calorie content, which increases the chance of becoming obese (another risk factor for heart disease and some types of cancer ). A large intake of polyunsaturated fat may increase the risk for some types of cancer. Reducing daily fat intake is not a guarantee against developing cancer or heart disease, but it does help reduce the risk factors.
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    Recommendations
  • Choose lean, protein-rich foods -- soy, fish, skinless chicken, very lean meat, and fat free or 1% dairy products.
  • Eat foods that are naturally low in fat -- like whole grains, fruits, and vegetables.
  • Get plenty of soluble fiber -- with oats, bran, dry peas, beans, cereal, and rice.
  • Limit your consumption of fried foods, processed foods, and commercially prepared baked goods (donuts, cookies, crackers).
  • Limit animal products like egg yolks, cheeses, whole milk, cream, ice cream, and fatty meats (and large portions of meats).
  • Look at food labels, especially for the level of saturated fat. Avoid or limit foods high in saturated fat (more than 20% on the label).
  • Look on food labels for words like "hydrogenated" or "partially hydrogenated" -- these foods are loaded with saturated fats and trans-fatty acids and should be avoided.
  • Liquid vegetable oil, soft margarine, and trans fatty acid-free margarine are preferable to butter, stick margarine, or shortening.
  • Children under two years of age should NOT be on a fat restricted diet because cholesterol and fat are thought to be important nutrients for brain development. It is important to read the nutrition labels and be aware of the amount of different types of fat contained in food. It is recommended that everyone over 20 have their cholesterol checked. Talk to your health care provider about how to cut down of your fat intake and to have your cholesterol checked.
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    Fat free diet and children

     
    Definition

     
    Alternative Names
    Children and fat free diets
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    Information
    Question: Should children eat fat-free and fat '>low-fat foods? Answer: There is no reason that children over the age of 2 can't eat fat '>low-fat and nonfat foods. Among the healthiest snack foods are fruits and vegetables. The key with children is to teach them healthy eating habits early, and hopefully those habits will continue throughout their life. A certain amount of fat is necessary to help absorb some of the vitamins , including vitamin A , vitamin D , vitamin E , and vitamin K .
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    Fat burning and exercise

     
    Definition

     
    Alternative Names
    Exercise and fat
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    Information
    Question: Which will burn more fat, walking or jogging? Answer: Walking a mile burns about the same number of calories as a mile of jogging.  The important thing is to try to exercise at a level of moderate-intensity.  This is equal to exercising at 60-85% of your maximum heart rate.  To determine your maximum heart rate, subtract your age from 220. Multiply that number by 0.6 or .85 in order to obtain the rate at 60-85%. Question: How long do I need work out before my body starts burning fat? Answer: An aerobic workout (like walking) for 30 to 45 minutes three times a week is enough to burn fat.
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    Fat removal - by suctioning

     
    Definition
    Removal of excess body fat by suction with specialized surgical equipment, typically performed by a plastic surgeon.
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    Alternative Names
    Liposuction
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    Description
    Liposuction (fat removal) has achieved the distinction of being the most popular cosmetic surgical procedure. By removing unwanted deposits of excess fat, liposuction improves body appearance and smoothes irregular or distorted body shapes. The procedure is sometimes referred to as body contouring. Liposuction may be useful for contouring under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas. However, liposuction is a serious surgical procedure and possibly may involve a painful recovery. It has the potential for rare but serious or occasionally fatal complications, so the decision to have liposuction should be well thought out. Before undergoing liposuction certain criteria must be met:
  • An initial patient consultation. This will include a history, a thorough physical examination, and a psychological health examination.
  • Your spouse's presence may be required during the visit and a second consultation is necessary to give you time to think over the surgery.
  • You should feel free to express the reasons for the consult, be free to ask as many questions as desired, and feel satisfied with the answers to those questions. A properly informed person makes a better patient.
  • You must understand fully the pre-operative preparations, the liposuction procedure, and the precise post-operative care.
  • You must have realistic expectations. Liposuction may help to enhance your appearance and also your self-confidence, but it will probably not give you your ideal body.
  • There are several different liposuction procedures.
  • Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed (sometimes, up to three times the volume of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution.
  • The lidocaine in the mixture helps to numb the area during and after surgery, and may be the only anesthesia needed for the procedure. The epinephrine in the solution helps to reduce the loss of blood, reduce the amount of bruising, and reduce the amount of swelling that accompanies the surgery. The IV solution helps to remove the fat more easily and is suctioned out along with the fat. This type of liposuction generally takes longer than other types.
  • The super-wet technique is similar to the tumescent liposuction stated above. The difference is that not as much fluid is used during the surgery--the amount of fluid injected is equal to the amount of fat to be removed. This technique takes less time; however it often requires sedation via an IV, or general anesthesia.
  • Ultrasound-assisted liposuction (UAL) is a fairly new technique, used in the US since 1996. During this technique ultrasonic vibrations are used to liquefy fat cells. After the cells are liquefied, they can be vacuumed out. UAL can be done in two ways, external (above the surface of the skin with a special emitter) or internal (below the surface of the skin with a small, heated cannula).
  • This technique may help to remove fat from dense, fibrous areas of the body such as the upper back or enlarged male breast tissue. UAL is often used in combination with the tumescent technique, in secondary (follow-up) procedures, or when precision must be enhanced. In general this procedure takes longer than the super-wet technique. Prior to the day of surgery you may have blood drawn and be asked to provide a urine sample. This allows the health care provider to rule out potential complications. If you are not hospitalized, you will need a ride home. A liposuction machine and specialized instruments are required for this surgery. The surgical team first preps the patient's operative site and administers either local or general anesthesia. Through a small skin incision, a suction tube with a sharp end is inserted into the fat pockets and swept through the area where fat is to be removed. The dislodged fat is literally "vacuumed" away through the suction tube. A vacuum pump or a large syringe provides the suction action. Several skin punctures may be necessary to treat large areas. After the appropriate amount of fat is removed, small drainage tubes may be inserted into the defatted areas to remove blood and fluid that accumulate during the first few days. If significant fluid or blood is lost during the surgery, the patient may require fluid replacement (intravenously) or even a blood transfusion. After the surgery, pressure bandages are applied to keep pressure and stop any bleeding, as well as help maintain shape. Bandages are kept in place usually for at least 2 weeks. Your doctor may call you from time to time to check on your health status and monitor your healing. A visit back to the surgeon after 5-7 days is often recommended. Occasionally liposuction is associated with weight gain. This is due to the increased fluid from surgery. Liposuction may or may not require hospitalization, depending on the location and extent of surgery. Liposuction can be done in an office-based facility, in a surgery center on an outpatient basis, or in a hospital. For reasons of cost and convenience, liposuction of smaller volumes is usually done as an outpatient. A stay in a hospital may be required if a larger volume of fat is being removed, or if you are having other procedures done at the same time. The cost of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Surgery charges can be separated into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges (assisting surgeon; treatment of complications; diagnostic procedures, such as blood or X-ray exams; medical supplies; or equipment use). Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.
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    Indications
    The following are some of the uses for liposuction:
  • Cosmetic reasons are the most common, including "love handles", unsightly fat bulges, or an abnormal chin line.
  • To improve sexual function by reducing abnormally placed fat deposits on the inner thighs, thus allowing easier access to the vagina.
  • Body shaping for people who are bothered by fatty bulges or irregularities that cannot be eliminated by diet and/or exercise.
  • However, liposuction is generally NOT appropriate for these uses:
  • Liposuction is not a substitute for exercise and diet, and it is not a cure for generalized obesity. However, it may be used in sequenced removal of fat from isolated areas at different points in time.
  • It is not an effective treatment for the uneven, dimpled appearance of skin in the condition of cellulite.
  • Certain areas should not have liposuction performed on them, such as the fat on the sides of the breasts. This is due to the fact that the breast is a common site for cancer.
  • Many alternatives to liposuction may be considered, including abdominoplasty (tummy tuck), excision of lipomas (fatty tumor), reduction mammaplasty (breast size reduction), or a combination of plastic surgery approaches.
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    Risks
    Certain pre-existing conditions should be thoroughly checked and brought under control before any surgery, including liposuction:
  • History of cardiac problems (heart attack)
  • Hypertension
  • Diabetes
  • Reactions to medications (allergies)
  • Pulmonary problems (shortness of breath, air pockets in blood stream)
  • Allergies (antibiotics, asthma, surgical prep)
  • Smoking, alcohol, or drug use
  • There are also inherent risks associated with receiving liposuction and these include:
  • Shock (usually from inadequate fluid replacement during the surgery)
  • Fluid overload -- usually from the procedure
  • Infections (strep, staph)
  • Bleeding, blood clot (thrombus)
  • Fat embolism (tiny globules of fat in the blood stream that block blood flow to tissue)
  • Nerve, skin, tissue, or organ damage or burns from the heat or instruments associated with liposuction
  • Asymmetry (uneven fat removal)
  • Drug reactions or overdose from the lidocaine used in the procedure
  • Scarring (skin surface may be irregular, asymmetric, or even "baggy," especially in the older patient)
  • Finally, make sure to review and sign any informed consent (legal) and permission for photographs.
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    Expectations after surgery
    Most patients, once correctly informed, are satisfied with the cosmetic result following their surgery. Informed patients understand that there are limitations to what liposuction can accomplish. If you are having a large amount of fat removed, such as having fat removed from your abdomen, or you are being put to sleep (general anesthesia) for the procedure, you should expect to be admitted to the hospital. If you are having a smaller amount of fat removed, such as from the thighs, and with the area numbed (local anesthesia) for the procedure, you may be able to have it done on an outpatient, same-day basis as long as the office has the proper equipment and oxygen on hand, should it be needed.
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    Convalescence
    The liposuctioned area may appear larger than before surgery because of swelling. A tight stocking, girdle, or snug elastic dressing must be worn over the treated area to reduce swelling and bleeding, and to help shrink the skin to fit the new contour. This garment should be worn continuously for 2 to 3 weeks. Patients should expect swelling, bruising, numbness, and pain that can be managed with medications. The stitches will be removed in 5 to 10 days. Antibiotics may be prescribed to prevent infection. Sensations such as numbness or tingling, as well as pain, may be felt for weeks after the surgery. Walking is recommended as soon after surgery as possible to help prevent blood clots from forming in the legs. More strenuous exercise is restricted for about a month after the surgery. You will start to feel better after about a week or two following liposuction surgery. You may return to work within a few days of the surgery. Bruising and swelling is usually subsides within three weeks; however, several months later you may still have some residual swelling. Your doctor will monitor your progress through follow-up visits. If you have any questions or problems between office visits you should call your doctor. Your new body shape begins to emerge in the first couple of weeks; however, it isn't until about 4 to 6 weeks that the improvement becomes more apparent. By exercising regularly and eating a healthy diet, you can help to maintain your new shape.
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    Fatigue

     
    Definition
    A feeling of lack of energy, weariness, or tiredness.
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    Alternative Names
    Tiredness; Weariness; Exhaustion; Lethargy
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    Considerations
    Fatigue is not the same as drowsiness , but the desire to sleep may accompany fatigue. Apathy is a feeling of indifference; this may accompany fatigue but may also exist independently. Fatigue represents a normal and important response to physical exertion, emotional stress , or lack of sleep. Fatigue can also be a nonspecific symptom of a psychological or physiologic disorder. Pathologic (illness-related) fatigue is not relieved by adequate rest, adequate sleep, or removal of stressful factors. Fatigue that is not relieved by normal means, or that occurs in the absence of a known cause or other symptoms should be medically evaluated. The pattern of fatigue may help delineate its underlying cause. Individuals who arise in the morning rested but, with activity, rapidly fatigue may have an ongoing condition or disease. Individuals who awaken fatigued and the level of fatigue remains constant throughout the day may be suffering from depression . However, these are not absolutes and chronic fatigue should be evaluated by a health care provider. In many cases, fatigue is related to boredom, unhappiness, disappointment, lack of sleep, or hard work. Because fatigue is such a common complaint and is often caused by psychological problems, its potential seriousness is often overlooked.
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    Common Causes
  • acromegaly
  • Addison's disease
  • AIDS
  • chronic
  • allergic-type disorders (such as
  • hay fever or asthma )
  • anemia
  • including
  • iron deficiency anemia
  • chronic boredom
  • chronic infection such as chronic
  • bacterial endocarditis
  • congestive heart failure
  • diabetes
  • drugs such as antihistamines, antihypertensives, sedatives, or diuretics
  • hypothyroidism
  • juvenile rheumatoid arthritis
  • kwashiorkor
  • malignancy
  • (
  • cancer )
  • excessive physical exertion
  • poor nutrition
  • rheumatoid arthritis
  • systemic lupus erythematosus
  • tuberculosis
  • viral infections such as
  • influenza and mononucleosis
  • anxiety
  • and
  • depression
  • grief
  • sleep disorders
  • such as
  • insomnia
  • stress
  • (prolonged and severe)
  • most types of surgery (temporary fatigue)
  • infectious diseases
  • congestive heart failure
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    Home Care
    There are no direct cures for the most common fatigue problems. Taking a vacation, changing jobs, undertaking new activities, and making marital adjustments can be helpful. A balanced diet , a program for regular exercise (within prescribed limits), and adequate rest are recommended. Set priorities, maintain a reasonable schedule, and develop good sleep habits. Chronic fatigue can often be reduced by alleviating pain, which may interfere with rest, and nausea (if present) which may lead to malnutrition . Taking stimulants does not work and can actually make the problem worse when the drugs are discontinued. Tranquilizers generally intensify fatigue. Vitamins may not solve the problem, but if taken in moderation probably won't hurt.
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    Call your health care provider if
  • there is prolonged, unexplained
  • weakness or fatigue particularly if accompanied by other unexplained symptoms.
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    What to expect at your health care provider's office
    The medical history will be obtained and a physical examination performed. The examiner may inquire into lifestyle and feelings. If fatigue is not caused by a physical disorder, the patient may be referred for psychological counseling. Medical history questions documenting fatigue may include:
  • sleep pattern
  • How much do you sleep?
  • What hours do you sleep?
  • Do you awake feeling rested or fatigued?
  • quality
  • Does the level of fatigue remain constant throughout the day?
  • Does fatigue get worse as the day goes on?
  • emotional state
  • Are you feeling boredom, unhappiness, or disappointment in your life?
  • other
  • Have you had unusual activity lately?
  • How are your relationships?
  • What is your diet like?
  • Do you get regular
  • exercise ?
  • What other symptoms are present? Is there pain?
  • nausea ?
  • What medications are being taken?
  • time pattern
  • Has fatigue only been developing recently?
  • Has it been lasting for weeks to months?
  • Does fatigue occur in regular cycles?
  • Physical examination will include special attention to the heart, lungs, and thyroid gland. Diagnostic tests that may be performed include:
  • tests for anemia
  • thyroid function tests
  • other blood studies such as
  • CBC '>CBC and blood differential
  • urinalysis
  • After seeing your health care provider:
  • You may want to add a diagnosis related to fatigue to your personal medical record.
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