Breast Development Stages: Tanner Stages, Puberty Changes, and Normal Growth in Girls

Breast Development Stages: Tanner Stages, Puberty Changes, and Normal Growth in Girls

pediagenosis    October 23, 2026    Comment   

THE BREAST  DEVELOPMENTAL STAGES

In a human new born at birth, in the female as well as in the male, the mammary glands have developed sufficiently so that they appear as distinct hemispheroidal elevations, palpable as movable soft masses. This is especially prominent in postterm infants. Histologically, a number of branching channels with layers of lining cells and plugs of basal cells at their ends, the future milk ducts and glandular lobules, respectively, can easily be recognized. In a great number of infants an everted nipple is observed, and in about 10% a greatly enlarged gland can be palpated, a condition that received the unfortunate name of mastitis neonatorum, though no signs of inflammation exist. These early glandular structures may produce a milk like secretion, the “witch’s milk,” starting 2 or 3 days after birth. All these neonatal phenomena in the breast are the result of the very intensive, maternal estrogen driven developmental processes in the last stages of intrauterine life. The changes subside within the first 2 to 3 weeks of life. It is during this period that the breast undergoes marked involutional changes leading to the quiescent stage, which is characteristic of infancy and childhood. During these periods, the male and the female glands consist of a few branching rudimentary ducts lined by flattened epithelium, surrounded by collagenous connective tissue.

Femoral Hernia: Causes, Symptoms, Diagnosis, and Treatment

Femoral Hernia: Causes, Symptoms, Diagnosis, and Treatment

pediagenosis    October 22, 2026    Comment   

FEMORAL HERNIA

A protrusion of parts of the abdominal viscus or of peritoneal fatty tissue through the femoral ring is termed a femoral hernia. Its incidence is far lower than that of the inguinal hernias. It is very seldom seen in children and is more common in women than in men (ratio 3:1). The right side is affected twice as frequently as is the left. Femoral hernias appear to be an acquired condition resulting from weakening or disruption of the fibromuscular tissue caused by an underlying connective tissue disorder or following injury or from increased intraabdominal pressure. The higher incidence in parous women suggests muscular weakening related to pregnancy or childbirth, but this finding has not been demonstrated in studies.

Vascular Dementia: Causes, Symptoms, Diagnosis and Treatment

Vascular Dementia: Causes, Symptoms, Diagnosis and Treatment

pediagenosis    October 21, 2026    Comment   

VASCULAR DEMENTIA

Vascular dementia is interesting in that many of those who do have a true vascular dementia are not diagnosed with it, while many who probably do not have a vascular dementia are diagnosed with it. The most straightfor-ward presentations are those in which an individual with normal cognition has a large stroke that causes a combination of cognitive signs, such as aphasia and a memory retrieval problem. If the patient cannot resume their prestroke day-to-day level of function because of these new cognitive deficits, the criteria for vascular dementia are met, but because the stroke so clearly caused the deficits, they are held to simply represent the consequences of a stroke (as opposed to a frank vascular dementia). On the other hand, some patients will present with a gradually progressive dementia, a retention-type memory deficit, no motor signs, no history of sensory or motor changes, and a neuroimaging study that shows subcortical changes that could be consistent with “small vessel cerebrovascular disease.” In the elderly, such patients almost always have the plaques and tangles that are expected in Alzheimer disease. In such cases, despite the neuroimaging changes, it is probably more appropriate to consider Alzheimer disease as the primary etiology. Still, the frequent association between Alzheimer disease and cerebrovascular pathology suggests these conditions may be linked in some way.

Treatable Dementias: Reversible Causes, Symptoms & Treatment

Treatable Dementias: Reversible Causes, Symptoms & Treatment

pediagenosis    October 21, 2026    Comment   

TREATABLE DEMENTIAS

Although in some ways cognitive performance abilities evolve throughout adulthood, many elderly people remain mentally sharp into their ninth and tenth decades. The emergence of uncharacteristic changes in an individual’s cognition that impacts their usual activities should, therefore, trigger an evaluation for possible etiologies.

Trichinosis: Symptoms, Diagnosis & Heart Complications

Trichinosis: Symptoms, Diagnosis & Heart Complications

pediagenosis    October 20, 2026    Comment   

TRICHINOSIS

Parasitic Heart Disease

Trichinosis

Trichinosis is caused by the roundworm Trichinella spiralis. When raw or incompletely cooked pork or a pork product containing living trichina larvae is eaten, the walls of the cysts are digested, liberating the microscopic larvae. Within the small intestine of the host, the freed larvae maturate during the next 2 days to adult male or female worms, and copulate. Beginning 5 days after ingestion of the infected meat and, in humans, continuing for as long as 12 weeks, the gravid adult female worms, which are partially embedded in the mucosal wall of the small bowel, give birth to larvae. The latter successively enter the lacteals of the intestinal villi, right ventricular cavity, pulmonary capillaries, and systemic circulation. By predilection the larvae penetrate skeletal muscle fibers, where they enlarge progressively, simultaneously causing degeneration of the fibers and provoking a local reaction characterized by edema, hyperemia, and granulomatous and eosinophilic inflammation. Approximately 30 days after invasion of the muscle fibers, the larvae, which now have assumed a characteristic coiled appearance, attain their maximal size and become encapsulated. In nature, the life cycle of the parasite is completed when a carnivorous mammal becomes infected with the parasite, as the result of ingesting the flesh of another animal containing living larvae (see Plate 6-146).

Scrotal Skin Diseases: Causes, Symptoms, Diagnosis, and Treatment

Scrotal Skin Diseases: Causes, Symptoms, Diagnosis, and Treatment

pediagenosis    October 15, 2026   

SCROTAL SKIN DISEASES I: CHEMICAL AND INFECTIOUS

Many skin diseases of infectious, allergic, or metabolic origin can involve the scrotum. Among many yeasts, molds, and fungi, only a few are infectious and are termed dermatophytes (“skin fungi”). Skin fungi live only on the dead layer of keratin protein on the skin surface. They rarely invade deeper and cannot live on mucous membranes. Infections by the fungus tinea cruris (ring-worm) are very common in the groin and scrotum. It involves desquamation of the scrotal skin and contiguous surfaces of the inner thighs and itches (“jock itch”). Tinea begins with fused, superficial, reddish-brown, well-defined scaly patches, which extend and coalesce into large, symmetrical, inflamed areas. The margins of the lesions are characteristically distinct. The initial lesion may become macerated and infected and is painful and itches. Sweating, tight clothing or obesity favor development and recurrence of this fungal infection, derived mainly from the genera Trichophyton and Microsporum. These same organisms cause tinea pedis or “athlete’s foot.”

Direct and Indirect Inguinal Hernias : Causes, Symptoms & Treatment

Direct and Indirect Inguinal Hernias : Causes, Symptoms & Treatment

pediagenosis    October 15, 2026    Comment   

INDIRECT AND DIRECT INGUINAL HERNIAS

Hernia (a word derived from the Greek, meaning “sprouting forth”) has been defined, from the time of A. Cornelius Celsus (second century AD), as a protrusion of an organ or tissue, through an abnormal opening, from the organ’s natural place in a cavity. Hernias are classified by the cause or the anatomic location of the defect.

Basal Cell Nevus Syndrome (Gorlin Syndrome): Symptoms & Treatment

Basal Cell Nevus Syndrome (Gorlin Syndrome): Symptoms & Treatment

pediagenosis    October 14, 2026    Comment   

MANIFESTATIONS OF BASAL CELL NEVUS SYNDROME

BASAL CELL NEVUS SYNDROME

Basal cell nevus syndrome (BCNS), also known as nevoid basal cell carcinoma syndrome or Gorlin syndrome, is an uncommon autosomal dominant genodermatosis caused by mutations in the patched-1 (PTCH1) gene on chromosome 9. Approximately 40% of cases represent new, spontaneous mutations. Affected individuals are predisposed to the development of multiple basal cell carcinomas (BCCs), often in the hundreds over their lifetime. The diagnosis of this syndrome is based on a number of established criteria.

Chagas Disease: Causes, Symptoms, Heart Damage & Complications

Chagas Disease: Causes, Symptoms, Heart Damage & Complications

pediagenosis    October 14, 2026    Comment   

CHAGAS DISEASE (TRYPANOSOMIASIS)

Chagas Disease

Chagas disease, also called South American (or American) trypanosomiasis, is a menace to millions of people in South-Central America. The parasite Trypanosoma cruzi enters the body, usually through the bite of a reduviid (assassin or kissing bug), or by the transfusion or inoculation of contaminated blood. The parasite circulates only in its trypanosomal form. It enters a body cell, transforms to a leishmania, and multiplies to form a leishmanial cyst, which ruptures the invaded cell. In this stage the parasites are released and transformed into trypanosomes, which circulate in the blood and invade other cells, thus continuing the cycle. The cardiac muscle cells are targeted in most cases, but with some strains in particular areas, there is equal or greater proclivity for the peripheral ganglion cells to be invaded or destroyed. In the rarer acute cases, all cells and tissues may be invaded, but in chronic cases, major damage is to the cardiac muscle cells and peripheral ganglion cells (see Plate 6-147).

Small Intestinal Bleeding: Causes, Symptoms, Diagnosis & Treatment

Small Intestinal Bleeding: Causes, Symptoms, Diagnosis & Treatment

pediagenosis    October 13, 2026    Comment   

VASCULAR MALFORMATION OF SMALL INTESTINE AND OTHER CAUSES OF SMALL INTESTINAL BLEEDING

Approximately 5% of cases of gastrointestinal bleeding occur in the small bowel, defined as the region between the ampulla of Vater and the ileocecal valve. Small intestinal vascular malformations are responsible for the majority of cases of small intestinal bleeding. They are more often seen in elderly patients, as is enteropathy induced by nonsteroidal antiinflammatory drugs (NSAIDs). Small intestinal tumors, Crohn disease, and nonspecific enteritis are more common in individuals under 40 years of age. Rarer causes include Meckel diverticulum, hemobilia, hemosuccus pancreaticus, and aortoenteric fistula.