Chronic obstructive pulmonary disease, or COPD, is really a progressive (gets worse over time) lung disorder of adults that includes emphysema and chronic (long-term) bronchitis. COPD is also known as chronic obstructive airway illness (COAD) or chronic obstructive lung disease (COLD). COPD is characterized by a narrowing of the patient's airway that limits the flow of air to the lungs and causes shortness of breath, coughing, and tiredness. Unlike asthma, nevertheless, the partial closure of the airway in COPD is not usually reversible.
COPD is the sixth leading trigger of death worldwide, according to the World Health Organization. It is expected to become the third leading trigger of death by 2020 simply because of an increase in the number of smokers in most countries. Smoking accounts for 80-90 percent of cases in the United States, where COPD is the fourth leading cause of death as of 2008. Most of the remaining instances are caused by occupational exposure to dust produced in cotton weaving, gold mining, or coal mining, or by air pollution in large cities. Anyone over forty who has trouble breathing, chronic coughing, sputum production, and a history of smoking or other risk factors should be examined by their doctor for COPD.
Cleft lip and palate are birth defects that affect the shape and function of the upper lip and the roof of the mouth. A cleft is basically an abnormal split or division. A child may have either a cleft lip (CL), a cleft palate (CP), or both (CL/P).
Cleft lip is really a birth defect that affects only skin tissue rather than underlying bone or cartilage. It could be categorized as either partial (a little gap or indentation in the baby's upper lip) or complete (the split runs from the upper lip up into the nose). It may also be defined as either unilateral, occurring on only one side of the mouth, or bilateral, occurring on both sides of the mouth. Cleft palate is a defect in which the two plates of bone that ordinarily join to form the hard palate in the front of the roof of the mouth fail to fuse completely during the baby's development before birth.
Cleft palate may be either incomplete, a defect in which only the soft palate at the back of the roof of the mouth is split; or it may be complete, when the tough palate as well as the soft palate is divided. In addition to complete and incomplete cleft palate, there is a third kind of defect affecting the roof of the mouth known as a submucous cleft. This is really a condition in which a cleft in either the hard or the soft palate is hidden by a layer of tissue. As a result, the cleft might not be discovered until some months after the baby's birth.
In the United States, between one in 500 and one in 550 babies in the general population are born with cleft lip, cleft palate, or both. You will find considerable differences among racial and ethnic groups, nevertheless. The highest rates of these birth defects are among Native Americans and the lowest rates among African Americans:
Cleft lip and cleft palate are caused by the failure of two or more lobes of tissue failing to join correctly during the baby's development during pregnancy. There are five lobes of tissue involved in the formation of the baby's face and upper lip: one that grows downward from the top of the head; two that grow inward from the cheeks; and two that grow inward just below the cheeks to form the chin and lower lip.
If two or more of these five lobes of tissue fail to join totally, a cleft lip or even complete facial deformity might result. The palate is formed later than the upper lip; it's composed of two bony plates that grow together as the last step in joining the five lobes of tissue described earlier. The whole complex process of facial and oral formation can be interrupted by a number of genetic and environmental elements. A few of the causes of cleft lip and palate that have been identified as of 2008 include:
Cleft lip and palate could be determined by the doctor at the time of the baby's birth by a careful physical examination of the newborn. Cleft lip may also be diagnosed before birth by ultrasound. In addition to a physical examination of the baby, the physician might suggest genetic testing to rule out a genetic cause of the defect or to evaluate the possibility that the parents will have another child with cleft lip or palate.
Surgery is the primary treatment for cleft lip and palate. In most instances the baby will probably be evaluated and treated by a team of doctors along with other health care experts in order to assess his or her need for speech therapy, dental surgery, and other treatments in addition to repair of the upper lip and palate. The treatment of cleft lip and palate is highly individualized. Surgical repair of the child's facial abnormalities is frequently carried out in the following order:
Speech therapy is included in the child's educational program as needed. Numerous kids with cleft lip or palate also need some form of counseling or psychotherapy, particularly when they reach adolescence. Even though preschoolers with a cleft lip or palate don't appear to feel worse about themselves than other children, by the early school years numerous children begin to withdraw socially or turn out to be fearful of being teased or rejected by classmates.
In the teen years, many youngsters with speech problems or facial abnormalities related to cleft lip or palate become depressed because their peers usually rate appearance more highly than such personal qualities as humor or intelligence. Strong parental support can make an important distinction in a child's capability to cope with social difficulties, as can counseling by a therapist.
Cleft lip and cleft palate are extremely treatable conditions. Most of the physical problems associated with cleft lip and palate, like crooked teeth, speech difficulties, and an increased risk of ear infections can be treated surgically with a high degree of success. The psychological and social difficulties of children with these birth defects, however, are much less simple to resolve.
Some causes of cleft lip and cleft palate can't be entirely eliminated. Mothers can, however, lower the risk of having a child with these birth defects by quitting smoking, avoiding the use of alcohol and illegal drugs during pregnancy, and taking vitamin supplements during pregnancy.
One exciting new development in the field of cleft lip and palate repair is the possibility of operating on the baby before it's born. Advances in surgery that would allow correction of these facial and oral defects before birth would have numerous advantages. One benefit is that there would be less scarring; surgery performed on a fetus in the womb is recognized to leave much less noticeable scars than surgery performed after birth. In addition, correction of cleft lip and palate before birth might lower the number of orthodontic along with other procedures needed after birth.
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