Croup

Croup is an inflammation of the vocal cords (larynx) and windpipe (trachea). It causes difficulty breathing, a barking cough, and a hoarse voice. The cause is usually a virus, often parainfluenza virus. Other causes include allergies and reflux.

Croup often starts out like a cold. But then the vocal cords and windpipe become swollen, causing the hoarseness and the cough. There may also be a fever and high-pitched noisy sounds when breathing. The symptoms are usually worse at night, and last for about three to five days. Children between the ages of 6 months and 3 years have the highest risk of getting croup. They may also have more severe symptoms. Croup is more common in the fall and winter.

Most cases of viral croup are mild and can be treated at home. Rarely, croup can become serious and interfere with your child's breathing. If you are worried about your child's breathing, call your health care provider right away.

Dislocated Shoulder

What is a dislocated shoulder?

Your shoulder joint is made up of three bones: your collarbone, your shoulder blade, and your upper arm bone. The top of your upper arm bone is shaped like a ball. This ball fits into a cuplike socket in your shoulder blade. A shoulder dislocation is an injury that happens when the ball pops out of your socket. A dislocation may be partial, where the ball is only partially out of the socket. It can also be a full dislocation, where the ball is completely out of the socket.

What causes a dislocated shoulder?

Your shoulders are the most movable joints in your body. They are also the most commonly dislocated joints.

The most common causes of shoulder dislocations are:

• Sports injuries
• Accidents, including traffic accidents
• Falling on your shoulder or outstretched arm
• Seizures and electric shocks, which can cause muscle contractions that pull the arm out of place

Who is at risk for a dislocated shoulder?

A dislocated shoulder can happen to anyone, but they are more common in young men, who are more often involved in sports and other physical activities. Older adults, especially women, are also at higher risk because they are more likely to fall.

What are the symptoms of a dislocated shoulder?

The symptoms of a dislocated shoulder include:

• Severe shoulder pain
• Swelling and bruising of your shoulder or upper arm
• Numbness and/or weakness in your arm, neck, hand, or fingers
• Trouble moving your arm
• Your arm seems to be out of place
• Muscle spasms in your shoulder

If you are having these symptoms, get medical treatment right away.

How is a dislocated shoulder diagnosed?

To make a diagnosis, your health care provider will take a medical history and examine your shoulder. Your provider may also ask you to get an x-ray to confirm the diagnosis.

What are the treatments for a dislocated shoulder?

The treatment for dislocated shoulder usually involves three steps:

• The first step is a closed reduction, a procedure in which your health care provider puts the ball of your upper arm back into the socket. You may first get medicine to relieve the pain and relax your shoulder muscles. Once the joint is back in place, the severe pain should end.
• The second step is wearing a sling or other device to keep your shoulder in place. You will wear it for a few days to several weeks.
• The third step is rehabilitation, once the pain and swelling have improved. You will do exercises to improve your range of motion and strengthen your muscles.

You may need surgery if you injure the tissues or nerves around the shoulder or if you get repeated dislocations.

A dislocation can make your shoulder unstable. When that happens, it takes less force to dislocate it. This means that there is a higher risk of it happening again. Your health care provider may ask you to continue doing some exercises to prevent another dislocation.

Dislocations

Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often are swollen, very painful and visibly out of place. You may not be able to move it.

A dislocated joint is an emergency. If you have one, seek medical attention. Treatment depends on which joint you dislocate and the severity of the injury. It might include manipulations to reposition your bones, medicine, a splint or sling, and rehabilitation. When properly repositioned, a joint will usually function and move normally again in a few weeks. Once you dislocate a shoulder or kneecap, you are more likely to dislocate it again. Wearing protective gear during sports may help prevent dislocations.

Encephalitis

What is encephalitis?

Encephalitis is inflammation (swelling) of the brain. It can happen when an infection or medical condition that affects the brain activates your immune system. The inflammation can cause a wide range of symptoms. In extreme cases, it can lead to brain damage, stroke, or even death.

What causes encephalitis?

There are different types of encephalitis, based on what the cause is. The two main types are infectious encephalitis and autoimmune encephalitis.

Infectious encephalitis is usually caused by a virus. In fact, viruses are the most common cause of encephalitis. Some of the different viruses that cause it include:

• Herpes viruses, including herpes simplex (HSV), the Epstein-Barr virus (which causes infectious mononucleosis) and the varicella-zoster virus (which causes chickenpox).
• Viruses you can get if you are bitten by an infected tick, such as tick-borne encephalitis (TBE virus) and Powassan virus.
• Viruses you can get if you are bitten by an infected mosquito, such as eastern equine encephalitis virus, West Nile virus, and La Crosse virus.
• Enteroviruses, which are a common group of viruses that mostly cause mild illness or respiratory infection. These infections usually happen in the summer and fall.

Bacteria, fungi, and parasites can also cause infectious encephalitis. But this is not common.

Autoimmune encephalitis happens when your immune system mistakenly attacks healthy brain cells. It can be triggered by conditions such as certain cancers, benign tumors, and infections. Sometimes the cause is not known.

Who is more likely to get encephalitis?

Anyone can get encephalitis, but you are more likely to get it if you:

• Have a weakened immune system, for example from having HIV or taking certain medicines. These could include medicines taken after an organ transplant, certain chemotherapy medicines, and specialized treatments for certain autoimmune diseases.
• Are a young child or older adult.
• Live in areas where there are ticks and mosquitoes that carry viruses that can cause encephalitis.

What are the symptoms of encephalitis?

The symptoms of encephalitis can vary a lot, depending on how severe it is. Many people do not have any symptoms. Others may have mild flu-like symptoms such as fever, fatigue, headache, or body aches. If encephalitis becomes more serious, it can cause:

• Severe headache
• Stiff neck
• Vomiting
• Seizures
• Behavior changes
• Drowsiness
• Muscle weakness
• Partial paralysis in your arms and legs
• Coma

Encephalitis can be dangerous in infants. Their symptoms may include:

• Fever
• Lethargy (weakness or drowsiness)
• Poor feeding
• Vomiting
• Body stiffness
• Unusual irritability or crying
• A full or bulging fontanel (the soft spot on the top of the head)

If you or your child is having symptoms of encephalitis, it's important to get medical care right away.

How is encephalitis diagnosed?

To find out if you have encephalitis, your health care provider:

• Will do a physical exam
• Will take your medical history, which includes asking about your symptoms
• May do a neurologic exam
• May order imaging tests, such as a brain CT scan or MRI
• May order an EEG (electroencephalography), which use small electric sensors to measure your brain activity
• May order blood and cerebrospinal fluid (CSF) tests

What are the treatments for encephalitis?

Most people with encephalitis will need treatment in the hospital. Depending on the cause, treatments may include antiviral medicines, antibiotics, corticosteroids, and other medicines.

For some types of encephalitis, there is no medicine to treat it. But rest, nutrition, and fluids can help your body fight the infection and relieve symptoms.

Some people may need physical, speech, and occupational therapy once the illness is under control.

Can encephalitis be prevented?

There are steps you can take to help prevent encephalitis that is caused by infections:

• Use good hygiene, including washing your hands often with soap and water.
• Don't share food, drinks, utensils, and glasses with other people.
• Get vaccines for viruses that can cause encephalitis.
• Avoid mosquito and tick bites, for example by:
  • Wearing insect repellent with DEET or another U.S. Environmental Protection Agency (EPA)-registered insect repellent. Make sure to follow the instructions for using the repellant.
  • Wearing clothes that cover your arms, legs and feet.
  • Treating your clothing and gear with products containing 0.5% permethrin before you go in grassy or woody areas.

NIH: National Institute of Neurological Disorders and Stroke

Exercise for Older Adults

Exercise and physical activity are good for just about everyone, including older adults. There are four main types and each type is different. Doing them all will give you more benefits.:

• Endurance, or aerobic, activities increase your breathing and heart rate. Brisk walking or jogging, dancing, swimming, and biking are examples.
• Strength exercises make your muscles stronger. Lifting weights or using a resistance band can build strength.
• Balance exercises help prevent falls
• Flexibility exercises stretch your muscles and can help your body stay limber

If you have not been active, you can start slowly and work up to your goal. How much exercise you need depends on your age and health. Check with your health care provider on what is right for you.

NIH: National Institute on Aging