Slapped syn­drome a dan­ger in preg­nancy

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

I am­go­ing through menopause, but rather than hot flushes my main symp­tom is in­som­nia — in par­tic­u­lar I amhav­ing trou­ble get­ting to sleep. Is this com­mon? IN­SOM­NIA is quite a com­mon symp­tom of menopause. It used to be thought that it was a di­rect re­sult of sleep be­ing dis­turbed by hot flushes, but it is now known that it can oc­cur in­de­pen­dently of hot flushes, al­though the ex­act cause is yet to be de­ter­mined. Usu­ally menopause-as­so­ci­ated in­som­nia tends to re­solve af­ter a few years, as a wo­man’s hor­mones sta­bilise. How­ever, you should have a med­i­cal check-up to rule out any un­der­ly­ing con­di­tion. If no cause is found, try the stan­dard mea­sures to im­prove your sleep in­clud­ing cut­ting out caf­feine, go­ing to bed and get­ting up at the same time each day, en­sur­ing the bed­room is dark, de­vel­op­ing a ‘‘ wind-down’’ sleep rit­ual and per­haps prac­tis­ing re­lax­ation tech­niques. Linda Cal­abresi is a GP and ed­i­tor of Med­i­calOb­server . Send your queries to linda.cal­abresi@medobs.com.au I have just been told that a child in my eight-year-old daugh­ter’s class has slapped-cheek syn­drome. How dan­ger­ous is this? I have a 10-month-old baby as well, is this likely to be a prob­lem for him? SLAPPED-CHEEK syn­drome is also known as par­vovirus B19 or Fifth Dis­ease. It usu­ally only af­fects school-aged chil­dren, and causes a mild rash (which re­sem­bles slapped cheeks — sur­pris­ingly enough). Usu­ally 60 to 70 per cent of adults have an­ti­bod­ies to the par­vovirus that in­di­cate they have pre­vi­ously had the dis­ease, and are there­fore im­mune. Chil­dren, even in­fants, who catch the dis­ease usu­ally only have mild symp­toms. It is more of a prob­lem in adults who might also ex­pe­ri­ence arthritic symp­toms and the real dan­ger is for preg­nant women, par­tic­u­larly those at fewer than 20 weeks. Should th­ese women con­tract the dis­ease they are at risk of mis­car­riage. If you have an af­fected child you should keep them at home to avoid po­ten­tial con­tact with preg­nant women, and if you are preg­nant and come into con­tact with the dis­ease see your doc­tor. I have re­cently been di­ag­nosed with the dry form of mac­u­lar de­gen­er­a­tion. I was told there was no treat­ment avail­able and I feel rather help­less. Have you any sug­ges­tions, as it is rather dis­tress­ing wait­ing for the slow de­gen­er­a­tion that may even­tu­ally lead to the loss of my sight? IN terms of treat­ment for dry mac­u­lar de­gen­er­a­tion, I’mafraid it is largely cor­rect that there are no recog­nised treat­ments for this form of the dis­ease. There has been some re­search that sug­gests tak­ing cer­tain an­tiox­i­dants and zinc sup­ple­ments can help re­duce the risk of mac­u­lar de­gen­er­a­tion and its progress, so that’s worth a try. Other mea­sures in­clude stop­ping smok­ing, mak­ing sure your blood pres­sure is nor­mal and eat­ing a bal­anced diet. It’s im­por­tant to un­der­stand the na­ture of this con­di­tion to get a per­spec­tive on your prog­no­sis. Mac­u­lar de­gen­er­a­tion causes le­gal blind­ness rather than true blind­ness be­cause it is the cen­tral vi­sion that is af­fected; gen­er­ally the pe­riph­eral vi­sion is pre­served. Also with the dry form of the dis­ease, which ac­counts for 90 per cent of cases, the progress tends to be very slow — ex­tend­ing over years — and is usu­ally asym­met­ri­cal, so one eye tends to re­main bet­ter than the other. This dif­fers from the more ag­gres­sive ‘‘ wet’’ mac­u­lar de­gen­er­a­tion, where fluid leaks into the retina caus­ing rapid de­te­ri­o­ra­tion of sight and for which there is now a treat­ment. Some­times a per­son with the dry form can de­velop fluid leak­age, wet mac­u­lar de­gen­er­a­tion, so it’s im­por­tant to get checked reg­u­larly by your eye spe­cial­ist.

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