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There are 4 major ligaments in the knee. Ligaments are elastic bands of tissue that connect bones to each other and provide stability and strength to the joint. The four main ligaments in the knee connect the femur (thighbone) to the tibia (shin bone), and include the following:

• Anterior cruciate ligament (ACL). The ligament, located in the center of the knee, that controls rotation and forward movement of the tibia (shin bone).
• Posterior cruciate ligament (PCL). The ligament, located in the back of the knee, that controls backward movement of the tibia (shin bone).
• Medial collateral ligament (MCL). The ligament that gives stability to the inner knee.
• Lateral collateral ligament (LCL). The ligament that gives stability to the outer knee.

What are the symptoms of a cruciate ligament injury?

Often, a cruciate ligament injury does not cause pain. Instead, the person may hear a popping sound as the injury occurs, followed by the leg buckling when trying to stand on it, and swelling. However, each individual may experience symptoms differently.

The symptoms of a cruciate ligament injury may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How are collateral ligaments injured?

The medial collateral ligament is injured more often than the lateral collateral ligament. Stretch and tear injuries to the collateral ligaments are usually caused by a blow to the outer side of the knee, such as when playing hockey or football.

What are the symptoms of a collateral ligament injury?

Similar to cruciate ligament injuries, an injury to the collateral ligament causes the knee to pop and buckle, causing pain and swelling.

The symptoms of a collateral ligament injury may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is a knee ligament injury diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for a knee ligament injury may include X-ray, Magnetic resonance imaging (MRI), and Arthroscopy.

Source: Johns Hopkins Medicine

People infected with the hepatitis C virus are at risk for liver damage, but the results of a new Johns Hopkins study now show the infection may also spell heart trouble.

The findings, described online July 27 in The Journal of Infectious Diseases, emerged from a larger ongoing study of men who have sex with men, many but not all of whom were infected with HIV and followed over time to track risk of infection and disease progression. A subset of the participants had both HIV and hepatitis C, two infections that often occur together.

Even though people infected with HIV are already known to have an elevated risk for heart disease, researchers emphasize their results offer strong evidence that hepatitis C can spark cardiovascular damage independent of HIV.

Specifically, the research found that study participants chronically infected with hepatitis C were more likely to harbor abnormal fat-and-calcium plaques inside their arteries, a condition known as atherosclerosis and a common forerunner of heart attacks and strokes.

“We have strong reason to believe that infection with hepatitis C fuels cardiovascular disease, independent of HIV and sets the stage for subsequent cardiovascular trouble,” says study principal investigator Eric Seaberg, Ph.D., assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “We believe our findings are relevant to anyone infected with hepatitis C regardless of HIV status.”

Investigators emphasize they don’t know exactly how infection with the hepatitis C virus precipitates the growth of artery-clogging plaque but that their evidence is strong enough to warrant vigilant monitoring for cardiac symptoms among people infected with the virus.

“People infected with hepatitis C are already followed regularly for signs of liver disease, but our findings suggest clinicians who care for them should also assess their overall cardiac risk profile regularly,” says study author Wendy Post, M.D., M.S., professor of medicine at the Johns Hopkins University School of Medicine and a cardiologist at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

Source: Johns Hopkins Bloomberg School of Public Health

The Presidential Healthcare Center provides Hepatitis Screening and Vaccinations.

West Nile virus (WNV) is most commonly transmitted to humans by mosquitoes. You can reduce your risk of being infected with WNV by using insect repellent and wearing protective clothing to prevent mosquito bites. There are no medications to treat or vaccines to prevent WNV infection. Fortunately, most people infected with WNV will have no symptoms. About 1 in 5 people who are infected will develop a fever with other symptoms. Less than 1% of infected people develop a serious, sometimes fatal, neurologic illness.

The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.

Serious illness can occur in people of any age. However, people over 60 years of age are at the greatest risk for severe disease. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk for serious illness.

Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent.  About 10 percent of people who develop neurologic infection due to West Nile virus will die.

Currently, no vaccine or specific antiviral treatments for West Nile virus infection are available.  Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms.  And in severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.

Source: CDC

National Institutes of Health researchers have shown that women’s cholesterol levels correspond with monthly changes in estrogen levels. This natural variation, they suggest, might indicate a need to take into account the phases of a woman’s monthly cycle before evaluating her cholesterol measures. On average, the total cholesterol level of the women in the study varied 19 percent over the course of the menstrual cycle.

In a typical cycle, estrogen levels steadily increase as the egg cell matures, peaking just before ovulation. Previous studies have shown that taking formulations which contain estrogen — oral contraceptives or menopausal hormone therapy — can affect cholesterol levels. However, the results of studies examining the effects of naturally occurring hormone levels on cholesterol have not been conclusive. According to the NIH’s National Heart, Lung and Blood Institute, high blood cholesterol levels raise the risk for heart disease.

The researchers found that as the level of estrogen rises, high-density lipoprotein (HDL) cholesterol also rises, peaking at the time of ovulation. HDL cholesterol is believed to be protective against heart disease.

In contrast, total cholesterol and low-density lipoprotein (LDL) cholesterol levels — as well as another form of blood fat known as triglycerides — declined as estrogen levels rose. The decline was not immediate, beginning a couple of days after the estrogen peak at ovulation. Total cholesterol, LDL cholesterol and triglyceride levels reached their lowest just before menstruation began.

Source: NIH News

The number of US counties experiencing high incidence of Lyme disease has grown considerably from 1993 through 2012, according to a study published online July 15 and in the August issue of Emerging Infectious Diseases.

“Despite the substantial increase in the number of counties with high incidence, the limited movement of the geographic centers suggests relatively constant rates of geographic expansion in all accessible directions,” write Kiersten J. Kugeler, from the Centers for Disease Control and Prevention, Fort Collins, Colorado, and colleagues.

“Our results show that geographic expansion of high-risk areas is ongoing, emphasizing the need to identify broadly implementable and acceptable public health interventions to prevent human Lyme disease.”

Lyme disease develops when an infected tick bites a person and transmits the Borrelia burgdorferi bacteria to the person. Historically high-risk regions for Lyme disease include the northeastern, mid-Atlantic, and north-central states in the United States, but officials have noted increasing cases during the past 2 decades.

The researchers grouped all confirmed Lyme disease cases during the study period into four intervals of 5 years each. Using census data, the researchers calculated the incidence of the disease at the county level and then mapped the incidence, identifying counties that fell wholly or partly “within a defined, statistically significant high-risk spatial cluster.”

In the earliest period, from 1993 to 1997, there were 69 counties with high incidence of Lyme disease; this number climbed to 130 counties for the period from 1998 to 2002, 197 counties in 2003 to 2007, and 260 counties in 2008 to 2012.

In contrast, just four counties in the southeastern United States identified as high incidence in the 1993 to 1997 period dropped off the list during the following period, most likely because the early cases were misdiagnosed cases of another tick-associated illness, southern tick-associated rash illness, which has similar symptoms to those of Lyme but does not involve B burgdorferi.

The region with the greatest incidence, the northeastern states, saw a more than 320% jump in countries with high incidence, from 43 counties in the first period to 182 in the most recent. A similar jump in the north-central states, going from 22 to 78 during the time studied, resulted in approximately a 250% increase.

Source: Medscape

Women who exercised during their teen years were less likely to die from cancer and all other causes during middle-age and later in life, according to a new study by investigators at Vanderbilt University Medical Center and the Shanghai Cancer Institute in China.

The study was published online July 31 in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association of Cancer Research.

Lead author Sarah Nechuta, Ph.D., MPH, assistant professor of Medicine in the Vanderbilt Epidemiology Center, said understanding the long-term impact of modifiable lifestyle factors such as exercise in adolescence can have important public health implications for disease prevention over the course of a woman’s life.

“Our results support the importance of promoting exercise participation in adolescence to reduce mortality in later life and highlight the critical need for the initiation of disease prevention early in life,” said Nechuta.

The study was designed to ascertain potential associations between adolescent exercise and cancer, cardiovascular disease or other causes of death among women in middle age and later life. The investigators used data from the Shanghai Women’s Health Study, a large ongoing prospective cohort study of 74,941 Chinese women between the ages of 40 and 70. The women enrolled in the study between 1996 and 2000. Each participant was interviewed at enrollment about exercise during adolescence, including participation in team sports, as well as other adolescent lifestyle factors. They were also asked about exercise during adulthood and other adult lifestyle factors and socioeconomic status, and participants were interviewed again every two to three years.

Regular exercise was defined as occurring at least once a week for at least three continuous months. Women who reported regular adolescent exercise were also asked how many hours a week they participated and for how many years they had exercised regularly.

“In women, adolescent exercise participation, regardless of adult exercise, was associated with reduced risk of cancer and all-cause mortality,” explained Nechuta.

Participation in team sports during the teen years was associated with a reduced risk of cancer death later in life.

Source: American Association for the Advancement of Science (AAAS)

Irregular sleeping patterns have been “unequivocally” shown to lead to cancer in tests on mice, a study suggests.

The report, in Current Biology, lends weight to concerns about the damaging impact of shift work on health.

The researchers said women with a family risk of breast cancer should never work shifts, but cautioned that further tests in people were needed.

The data also indicated the animals were 20% heavier despite eating the same amount of food.

Studies in people have often suggested a higher risk of diseases such as breast cancer in shift workers and flight attendants.

One argument is disrupting the body’s internal rhythm – or body clock – increases the risk of disease.

However, the link is uncertain because the type of person who works shifts may also be more likely to develop cancer due to factors such as social class, activity levels or the amount of vitamin D they get.

Mice prone to developing breast cancer had their body clock delayed by 12 hours every week for a year.

Normally they had tumors after 50 weeks – but with regular disruption to their sleeping patterns, the tumors appeared eight weeks earlier.

The report said: “This is the first study that unequivocally shows a link between chronic light-dark inversions and breast cancer development.”

Interpreting the consequences for humans is fraught with difficulty, but the researchers guesstimated the equivalent effect could be an extra 10kg (1st 8lb) of body weight or for at-risk women getting cancer about five years earlier.

“If you had a situation where a family is at risk for breast cancer, I would certainly advise those people not to work as a flight attendant or to do shift work,” one of the researchers, Gijsbetus van der Horst, from the Erasmus University Medical Centre, in the Netherlands, said.

Dr Michael Hastings, from the UK’s Medical Research Council, told the BBC: “I consider this study to give the definitive experimental proof, in mouse models, that circadian [body clock] disruption can accelerate the development of breast cancer.

“The general public health message coming out of my area of work is shift work, particularly rotational shift work is a stress and therefore it has consequences.

“There are things people should be looking out for – pay more attention to your body weight, pay more attention to inspecting breasts, and employers should offer more in-work health checks.

“If we’re going to do it, then let’s keep an eye on people and inform them.”

Source: BBC

Contaminated food and water is the leading source of illness and diarrhea that occurs during travel. Fortunately, there are some choices you can make to reduce your chance of becoming ill. Here are some suggestions:

Ask the concierge at your hotel or on your cruise ship for recommendations for well-established, reliable dining locations. International hotels and better restaurants that normally cater to travelers in big cities are generally a safer option when dining out. Yet, careful, informed choices remains important everywhere

When selecting foods, know that foods and beverages served steaming hot are considered safe. Street vendors should be avoided. Order all meat and seafood well done. Beware of anything cold, especially meat, even if it has been cooked. The following chart provides a short list of food products considered safe as well as foods to avoid.

Foods Considered Safe

• Hot coffee, tea, and soup (if served steaming)
• Any food served steaming
• Undiluted fresh grapefruit or orange juice
• Bottled/canned noncarbonated water
• Bottled/canned carbonated beverages: soft drinks, beer, or mineral water
• Packaged butter
• Packaged processed cheese
• Dry bread

Foods to Avoid

• Tap water and ice
• Fresh salads and leafy green vegetables
• Desserts, especially those containing custard, cream, or whipped cream
• Fresh cheese
• Cold meats and foods, including previously boiled seafood
• Reheated foods
• Spicy sauces in open containers on tables
• Milk and other dairy products from questionable sources
• Any food product from a street vendor that you have not seen boiling for at least 5 minutes
• Fruit that has been peeled by someone else

Bottled or canned beverages are usually considered safe, especially if carbonated. Beverages that are boiled, such as tea, coffee, hot chocolate, are also considered safe. Before opening a bottled or canned beverage, be sure to wipe the container opening and drinking edge with a clean tissue. It is wise to use clean straws for drinking cold beverages. Experienced travelers often bring their own supply.

Source: Cleveland Clinic

Symptoms of heat stroke may be eased by applying cold packs to the cheeks, hands and feet, a study suggests, potentially offering a new way to help lower body temperatures in overheated athletes.

“The cheeks, palms, and soles of the feet are special areas,” with blood vessels that don’t contract when cold packs are applied, helping to remove heat from the skin surface and cool body temperatures, said study co-author Dr. Grant Lipman, a researcher in emergency medicine at Stanford University in California.

 Heat-related illness is common, and can often be prevented by proper hydration and limited exertion outside during the hottest parts of the day. But left untreated, heat stroke can develop and be fatal. The condition kills thousands of people every year, most during the hottest months, and is a leading cause of death among young athletes, the authors write in Wilderness & Environmental Medicine.

Warning signs for heat exhaustion, a precursor to heat stroke, can include heavy sweating, clammy skin, weakness, nausea or vomiting, and fainting, according to the U.S. Centers for Disease Control and Prevention.

Heat stroke develops when the body temperature exceeds 39.44 degrees Celsius (103 degrees Fahrenheit), requiring rapid cooling with cold packs or an icy bath and then hospitalization.

Lipman and colleagues tested a new method for applying cold packs to overheated athletes to see if their alternative might be more effective than the traditional placement of cold packs on the skin over large blood vessels in the neck, groin and armpits.

They dressed ten healthy men in insulated military clothes designed to trap body heat, then asked the men to walk on a treadmill for 30 to 40 minutes in a room heated to about 40 C (104 F).

Each man did the treadmill test three times, with at least one day between trials to allow for rest and recovery. First, they finished with no treatment to help lower their body temperature. Then they got cold packs the traditional way, applied at the neck, groin and armpits. Last, they received cold packs using the new method, placed on the cheeks, hands and feet.

The average body temperature after the treadmill test was 39.2 C (102.6 F).

Without any treatment, the men cooled by an average of 0.3 degrees Celsius after five minutes and by a total of 0.42 degrees (to 101.8 F) after 10 minutes.

Ice packs on the usual spots cooled the men by an average of 0.4 degrees after five minutes and 0.57 degrees after 10 minutes (to 101.5 F). With ice packs on the hands, feet and cheeks, the decline in body temperature was steeper: 0.6 degrees after five minutes and 0.9 degrees after 10 minutes (to 100.9 F).

Source: Reuters

Every year on July 28th, World Hepatitis Day aims to increase the awareness and understanding of viral hepatitis as a major global health threat. All types of viral hepatitis can cause inflammation of the liver; however, hepatitis B and C infection can result in a lifelong, chronic infection.

The World Health Organization (WHO) estimates that nearly 400 million people have chronic viral hepatitis worldwide and most of them do not know they are infected. More than 1 million people die each year from causes related to viral hepatitis, commonly cirrhosis and liver cancer.

Hepatitis A:

• Hepatitis A is a liver disease caused by the hepatitis A virus that can cause mild to severe illness but does not lead to chronic infection.
• Globally, there are an estimated 1.4 million cases of hepatitis A every year.
• The hepatitis A virus is spread by ingestion of contaminated food and water, or through direct contact with an infectious person.

Hepatitis B:

• Hepatitis B is a serious liver disease caused by the hepatitis B virus that can cause both acute and chronic disease.
• Globally, there are an estimated 240 million people living with chronic Hepatitis B.
• The hepatitis B virus is spread through contact with the blood or other body fluids of an infected person.
• There is a safe and effective vaccine available to prevent Hepatitis B.
• The best way to prevent getting infected with Hepatitis B is to get vaccinated.  In the United States, the Hepatitis B vaccine is recommended for all babies at birth and adults at risk of infection.  

Hepatitis C:

• Hepatitis C is a serious liver disease caused by the hepatitis C virus that can cause both acute and chronic disease.
• Globally, there are an estimated 130–150 million people living with chronic Hepatitis C.
• The hepatitis C virus is a bloodborne virus.
• There is currently no vaccine for hepatitis C.

Source: CDC