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Appendicitis (inflammation of the appendix) requires immediate medical attention, so it's important to learn its symptoms — and how they differ from a run-of-the-mill stomachache — so you can seek medical care right away.

The first symptoms of appendicitis usually are a mild fever and pain around the bellybutton. The pain usually worsens and moves to the lower right side of the belly. Vomiting, diarrhea or constipation, and loss of appetite are other common symptoms.

Call your doctor immediately if you suspect that your child has appendicitis. The earlier it's caught, the easier it will be to treat.

About Appendicitis

The appendix is a small finger-like organ that's attached to the large intestine in the lower right side of the abdomen. The inside of the appendix forms a cul-de-sac that usually opens into the large intestine.

Blockage can be due to hard rock-like stool (called a fecolith), inflammation of lymph nodes in the intestines, or even parasites. Once the appendix is blocked, it becomes inflamed and bacteria can overgrow in it.

If the infected appendix isn't removed, it can burst and spread bacteria. The infection from a ruptured appendix is very serious — it can form an abscess (an infection of pus) or spread throughout the abdomen (this type of infection is called peritonitis).

Appendicitis mostly affects kids and teens between 11 and 20 years old, and is rare in infants. It's one of the most common reasons for emergency abdominal surgery in kids. Appendicitis is not contagious.

Symptoms

Call the doctor immediately if your child shows symptoms of appendicitis, including:

• significant abdominal pain, especially around the bellybutton or in the lower right part of the abdomen (perhaps coming and going and then becoming consistent and sharp)
• low-grade fever
• loss of appetite
• nausea and vomiting
• diarrhea (especially small amounts, with mucus)
• swollen or bloated abdomen, especially in infants

There is no way to prevent appendicitis, but with sophisticated diagnostic tests and antibiotics, most cases are identified and treated without complications.

If appendicitis goes untreated, the inflamed appendix can burst 24 to 72 hours after the symptoms begin. If the appendix has burst, the pain may spread across the whole abdomen, and the child's fever may be very high, reaching 104°F (40°C).

The symptoms of appendicitis can vary according to a child's age. In kids 2 years old or younger, the most common symptoms are vomiting and a bloated or swollen abdomen, accompanied by pain.

If you suspect that your child has appendicitis, call your doctor immediately and don't give your child any pain medication or anything to eat or drink unless instructed to by the doctor.

Diagnosis

Because the symptoms of appendicitis can be so similar to those of other medical conditions (like kidney stones, pneumonia, or even a urinary tract infection), it's often a challenge for doctors to diagnose it.

To confirm or rule out appendicitis, a doctor will examine the abdomen for signs of pain and tenderness, and order blood and urine tests. The doctor also might order other tests, like an X-ray of the abdomen and chest, ultrasound, or a CAT scan. If the doctor suspects appendicitis, you may be told to stop giving your child any food or liquids in order to prepare for surgery.

Treatment

Appendicitis is treated by removing the inflamed appendix through an appendectomy. Surgeons usually either make a traditional incision in the abdomen or use a small surgical device (a laparoscope) that creates a smaller opening. An appendectomy usually requires a 2- to 3-day hospital stay.

Before and after surgery, intravenous (IV) fluids and antibiotics will help prevent complications and decrease the risk for wound infections after surgery. If needed, your child will receive pain medication.

An infected appendix that bursts also will be removed surgically but might necessitate a longer hospital stay to allow antibiotics to kill any bacteria that have spread into the body.

Reviewed by: Yamini Durani, MD
Date reviewed: July 2012

Actividades:

1-    Observe el título y los subtítulos. ¿Conoce algunas palabras? ¿Puede predecir de qué se trata el texto? Escriba sus ideas.

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2-    Observe los dibujos y figuras. ¿Qué tipo de información le  proveen?

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3-    ¿Qué  información conoce sobre el tema?

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Actividades de Gramática

1-    Observe las siguientes palabras. Marque los sufijos y prefijos que encuentre. Diga a qué categoría gramatical pertenecen. Luego escriba las palabras en español.

a-    worsen : __________________________

b-    lower: ________________________

c-    stomachache: _________________________

d-    attached: ____________________________

e-    inflamed: _________________________

f-     overgrow: ________________________

g-    throughout: _________________________

h-    untreated: __________________________

i-      tenderness: _________________________

j-      antibiotic ; __________________________

2-    Busque en el texto 4 ejemplos de grupos verbales con:

¯  Futuro Simple

¯  Verbos Modales

¯  Condicional

¯  Escriba los equivalentes en español.

3-    Lea las siguientes oraciones extraídas del texto. Marque los conectores y decida su función.

Luego escriba la oración en español.

a- Appendicitis (inflammation of the appendix) requires immediate medical attention, so it's important to learn its symptoms

__________________________________________________________________________________________________________________________________________________________________________________________________________________

b- Blockage can be due to hard rock-like stool (called a fecolith), inflammation of lymph nodes in the intestines, or even parasites.

____________________________________________________________________________________________________________________________________________

c There is no way to prevent appendicitis, but with sophisticated diagnostic tests and antibiotics, most cases are identified and treated without complications ____________________________________________________________________________________________________________________________________________

d- Because the symptoms of appendicitis can be so similar to those of other medical conditions (like kidney stones, pneumonia, or even a urinary tract infection), it's often a challenge for doctors to diagnose it.

__________________________________________________________________________________________________________________________________________________________________________________________________________________

e. Surgeons usually either make a traditional incision in the abdomen or use a small surgical device (a laparoscope) that creates a smaller opening

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Actividades de Vocabulario:

1-    Observe las siguientes palabras extraídas del texto. Decida cuál es el significado de cada una de ellas de acuerdo al contexto en el cual se encuentra.

1-    DIFFER FROM : a) diferente

     b) diferir de

     c) diferencia

2-    CARE:                                   a) ocuparse de

b) cuidado

c) importar

3-    INFECTED:            a)contagiado

         b) infeccion

         c) inferir

4-    BLOCKED :               a) bloque

 b) obstruido

 c) congelado

5-    BELLYBUTTON:        a) boton

 b) cordon

 c) ombligo

6-    WORSEN:        a) empeorar

   b) agravado

   c) peor

7-    ATTACHED:             a) encariñarse

                                   b) apego

                                   c) cariño

8-    BLOCKAGE:                 a) obstrucción

               b) atasco

               c) oclusión

                             

Actividades de Comprensión

1-    Defina qué es apendicitis.

2-    ¿Qué síntomas puedes tener?

3-    Indique lo que sabe del apéndice.

4-    ¿Como se diagnostica?

5-    Hablar brevemente de su tratamiento.

About Marfan Syndrome

Marfan syndrome is a progressive genetic disorder that affects the body's connective tissue. Connective tissue is everywhere in the body, providing structure and support for cells. Think of it as a sort of "glue" that helps support every organ, blood vessel, bone, joint, and muscle.

In people with Marfan syndrome, this "glue" is weaker than normal because of a defect in the body's production of the protein fibrillin, a major component of connective tissue. Weakened connective tissue can lead to problems in many parts of the body, especially the heart, eyes, and bones.

Even though the disease has no cure, the good news is that doctors can successfully treat just about all of its symptoms. Just a few decades ago, most people with Marfan syndrome didn't live past 40. Now, thanks to new research and treatments, those who are diagnosed early and get good medical care have just about the same lifespan as everyone else.

Current research on a group of medications called ACE inhibitors appears extremely promising and is likely to further improve the health of people with Marfan syndrome.

Causes

Marfan syndrome is pretty rare, affecting about 1 in every 5,000 people. Researchers have traced the disorder to a defect in a gene found on chromosome 15. It's this mutation (change) that causes the abnormality in the production or the structure of fibrillin.

About 75% of the time, the gene for Marfan syndrome runs in families, getting passed down to kids from parents who have the disease. The gene is autosomal dominant, which means every child born to a parent who has Marfan syndrome has a 50% chance of having it too.

In the remaining 25% of cases, though, neither parent has the disease; the genetic mutation responsible for Marfan syndrome occurs spontaneously in either the egg or sperm cell at the time of conception. No one knows what causes this mutation, but those born with it have a 50% chance of passing it on to their kids.

Although people with Marfan syndrome often have similar physical features, the disease doesn't affect everyone in the same way. Some have very mild symptoms, while others have severe ones — even within the same family. This is known as "variable expression," and it makes it almost impossible to predict how the disease will progress in any affected individual.

Signs and Symptoms

People with Marfan syndrome are often (but not always) much taller than their family members and peers and have a lean, lanky build. Their fingers and toes are usually long and thin, and their joints are loose. Their arms and legs are often disproportionately long when compared with their torso, and their arm span is often a lot greater than their height.

They may share some facial characteristics, too, including a long, thin face; deep-set eyes; a small jaw; a high, arched roof of the mouth; and crowded teeth.

Complications

People with Marfan syndrome are also susceptible to complications in the following body systems:

Heart and Blood Vessels

The most serious complication of Marfan syndrome involves theheart. Over time, the disorder can cause the aorta — the large artery that carries blood away from the heart to the body — to stretch and dilate (widen).

If undetected or untreated, the wall of the aorta can eventually begin to tear and separate, allowing blood to leak through (this is known as an aortic dissection). A large, sudden rupture can be fatal.

Problems with the heart valves are common too. Instead of closing tightly, valves (usually the mitral and/or aortic valves) may become large and floppy, allowing blood to leak backwards through the heart. A minor leak may cause few symptoms, but a large one can cause shortness of breath and an irregular heartbeat, as well as a heart murmur. Leaky heart valves cause the heart to work harder and become enlarged, so they must be carefully monitored.

Eyes

More than half of all people with Marfan syndrome have a condition known as "dislocated lenses." That means the lenses of the eye, which are usually centered behind the pupil and held in place with connective tissue, may shift up, down, or to the side. Vision problems may occur depending on the position of the lens. The vision problems may require glasses at first, and later may require surgery.

People with Marfan syndrome also often have myopia (nearsightedness), and they are at greater risk for developing other problems — like detached retinas (when the light-sensing tissue at the back of the eye comes loose), glaucoma (high pressure in the eye), or cataracts (cloudy lenses) — earlier in life than other people. Young children are especially prone to developing amblyopia (lazy eye).

Skeletal Problems

In addition to excessive height and long limbs, Marfan syndrome may cause other skeletal problems, such as scoliosis (curvature of the spine) and chest wall abnormalities (the chest bone may either curve in or protrude out, giving the chest a sunken-in or a pigeon-breasted appearance). Overly loose joints and flat feet are common.

Other symptoms may affect the skin, nervous system, and lungs, but these tend to be less common and less serious, especially in kids and teens.

Diagnosing Marfan Syndrome

There's no single test for diagnosing Marfan syndrome. Diagnosis depends on detailed exams by a team of doctors, including a geneticist (a doctor who specializes in inherited disorders), a cardiologist (heart specialist), ophthalmologist (eye doctor), and an orthopedist (bone specialist). Molecular testing for a mutation in the FBN1 gene is part of the comprehensive evaluation.

First, a geneticist will ask about any family history of the disorder or whether any relatives died early from heart-related deaths. He or she may also take detailed skeletal measurements. The geneticist may order mutation testing on a small blood sample.

A cardiologist may listen for a heart murmur and will likely perform tests such as:

·         a chest X-ray

·         an electrocardiogram (EKG), which measures electrical activity in the heart

·         an echocardiogram, which uses sound waves to produce a picture of the heart to check the size of the aorta and the functioning of the valves

An ophthalmologist may perform a "slit lamp" test (a slit lamp allows the doctor to see the front of the eye under high magnification) while the eyes are dilated to check for lens dislocation and any other abnormalities.

An orthopedist will check for curvatures of the spine and chest bone, as well as joint problems and flat feet.