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Pain in the ear. This can occur because of conditions within the ear itself, the ear canal, or the visible external portion of the ear. Acute infection of the middle ear, medically called acute otitis media (AOM), is inflammation of the middle ear and is the most frequent diagnosis in sick children in the US. The eustachian tube is shorter in children than adults which allows easy entry of bacteria and viruses into the middle ear, resulting in acute otitis media in childhood. Infection of the ear canal (otitis externa) is also called swimmer's ear. Otitis externa is typically caused by bacterial infection. Earache can also be due to pain and inflammation of the outer portion of the ear

An ear infection, or otitis media, is the most common cause of earaches. Although this condition is a frequent cause of infant distress and is often associated with children, it can also affect adults.

The infection in the middle ear (the space behind the eardrum where tiny bones pick up vibrations and pass them along to the inner ear) very often accompanies a common cold, the flu, or other types of respiratory infections. This is because the middle ear is connected to the upper respiratory tract by a tiny channel known as the Eustachian tube. Germs that are growing in the nose or sinus cavities can climb up the Eustachian tube and enter the middle ear to start growing.

Most parents are frustratingly familiar with ear infections. Except for wellness baby visits, ear infections are the most common reason for trips to the pediatrician, accounting for approximately 30 million doctor visits a year in the U.S.
 
 
 

A natural wax-like substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps material such as dust and sand particles. Usually a small amount of wax accumulates, and then dries up and falls out of the ear canal carrying with it unwanted particles. Ear wax is helpful in normal amounts and serves to coat the skin of the ear canal where it acts as a temporary water repellent. The absence of ear wax may result in dry, itchy ears, and even infection.

Pica is the persistent eating of substances such as dirt or paint that have no nutritional value.

The Handbook of Clinical Child Psychologycurrently estimates that prevalence rates of pica range from 4%-26% among institutionalized populations. Research among non-institutionalized populations takes the form of individual case studies, making prevalence rates difficult to estimate.
 
 
 

Eczema is a common skin condition marked by itchy and inflamed patches of skin. It’s also known as atopic dermatitis. It is more common in babies and young children, and often occurs on the faces of infants. It also often appears inside the elbows and behind the knees of children, teenagers, and adults.
In rare cases, atopic dermatitis can first appear during puberty or adulthood. It affects males and females equally.

Eczema is a condition where patches of skin become inflamed, itchy, red, cracked, and rough. Blisters may sometimes occur.Different stages and types of eczema affect 31.6 percent of people in the United States.The word "eczema" is also used specifically to talk about atopic dermatitis, the most common type of eczema.

Atopic" refers to a collection of diseases involving the immune system, including atopic dermatitis, asthma, and hay fever. Dermatitis is an inflammation of the skin.Some people outgrow the condition, while others will continue to have it throughout adulthood.This MNT Knowledge Center article will explain what eczema is and discuss the symptoms, causes, treatments, and types.

Fast facts on eczema

Here are some key points about eczema. More detail and supporting information is in the main article.

Certain foods can trigger symptoms, such as nuts and dairy.

Symptoms vary according to the age of the person with eczema, but they often include scaly, itchy patches of skin.

Eczema can also be triggered by environmental factors like smoke and pollen. However, eczema is not a curable condition.

Treatment focuses on healing damaged skin and alleviating symptoms. There is not yet a full cure for eczema, but symptoms can be managed.

Eczema is not a contagious condition.

ifferent stages and types of eczema affect 31.6 percent of people in the United States.

The word "eczema" is also used specifically to talk about atopic dermatitis, the most common type of eczema.

"Atopic" refers to a collection of diseases involving the immune system, including atopic dermatitis, asthma, and hay fever. Dermatitis is an inflammation of the skin.

Some people outgrow the condition, while others will continue to have it throughout adulthood.

This MNT Knowledge Center article will explain what eczema is and discuss the symptoms, causes, treatments, and types.

Eczema is a skin condition in which the skin of a person becomes dry, itchy, cracked and reddened. This chronic condition affects both males and females and mainly affects children. It is also known as atopic eczema or atopic dermatitis.  About 30 % of the skin diseases diagnosed will be eczema. Atopic eczema means inherited eczema.  It can occur in any part of the body and it is a long term disease. The intensity of the disease increases at some stages in the life and it needs intense treatment. Eczema can be triggered as an allergic response to various substances and situations.

Emphysema is a chronic lung disease caused by damage to the alveoli, the tiny air sacs in the lung where the exchange of oxygen and carbon dioxide takes place. With emphysema, damage to the alveoli results in air becoming trapped, causing them to expand and rupture.

Damage to alveoli, and the resultant compromise in air exchange results in a decreased level of oxygen in the blood (hypoxemia) combined with an increased level of carbon dioxide in the blood (hypercapnia).

Pertaining to hormones and the glands that make and secrete them into the bloodstream through which they travel to affect distant organs. The endocrine sites include the hypothalamus, pituitary gland, pineal gland, thyroid, parathyroids, heart (which makes atrial-natriuretic peptide), the stomach and intestines, islets of Langerhans in the pancreas, the adrenal glands, the kidney (which makes renin, erythropoietin, and calcitriol), fat cells (which make leptin). the testes, the ovarian follicle (estrogens) and the corpus luteum in the ovary). Endocrine is as opposed to exocrine. (The exocrine glands include the salivary glands, sweat glands and glands within the gastrointestinal tract.)

The presence of tissue that normally grows inside the uterus (womb) in an abnormal anatomical location. Endometriosis is very common and may not produce symptoms, or it may lead to painful menstruation. It has also been associated with infertility. Endometriosis occurs most commonly within the Fallopian tubes and on the outside of the tubes and ovaries, the outer surface of the uterus and intestines, and anywhere on the surface of the pelvic cavity. It can also be found, less often, on the surface of the liver, in old surgery scars or, very rarely, in the lung or brain.

Endometriosis occurs in the reproductive years. The average age at diagnosis is 25-30.Endometriosis may be suspected by during a physical examination; it is confirmed by surgery, usually laparoscopy; available treatments include medication for pain, hormone therapy, and surgery.

When nerve cells in the brain fire electrical impulses at a rate of up to four times higher than normal, this causes a sort of electrical storm in the brain, known as a seizure. A pattern of repeated seizures is referred to as epilepsy. Known causes include head injuries, brain tumors, lead poisoning, maldevelopment of the brain, genetic and infectious illnesses. But in fully half of cases, no cause can be found. Medication controls seizures for the majority of patients.

 A consistent inability to sustain an erection sufficient for sexual intercourse. Commonly known as impotence. Medically, the term erectile dysfunction is used to properly differentiate this form of impotence from other problems that interfere with sexual intercourse, such as disease, injury, drug side effects, or a disorder that impairs the nerve supply or the blood flow to the penis. Other forms of impotence include lack of sexual desire and problems with ejaculation and orgasm. Erectile dysfunction is treatable in all age groups, and treatment includes using medication (notably Viagra) and penile implants. Abbreviated ED.

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence.

Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.

Not all male sexual problems are caused by ED. Other types of male sexual dysfunction include:

premature ejaculation

delayed or absent ejaculation

lack of interest in sex

A chalazion usually appears as a painless lump or swelling on your upper or lower eyelid. Chalazia may affect both upper and lower lids and can occur in both eyes at the same time. Depending on the size and location of the chalazion, it may blur or block vision.

Although not as common, a chalazion may be red, swollen, and painful if an infection is present.

Eyestrain is a common condition that occurs when your eyes get tired from intense use, such as while driving long distances or staring at computer screens and other digital devices.

Eyestrain can be annoying. But it usually isn't serious and goes away once you rest your eyes or take other steps to reduce your eye discomfort. In some cases, signs and symptoms of eyestrain can indicate an underlying eye condition that needs treatment.

A sty is a red, painful lump near the edge of your eyelid that may look like a boil or a pimple. Sties are often filled with pus. A sty usually forms on the outside of your eyelid. But sometimes it can form on the inner part of your eyelid.

In most cases, a sty will begin to disappear on its own in a couple days. In the meantime, you may be able to relieve the pain or discomfort of a sty by applying a warm washcloth to your eyelid.

ENT physicians must complete about 15 years of education and training, including a 4-year undergraduate program, 4-year medical program, at least 5 years of specialty training and a 1- to 2-year residency program (e.g., General Surgery). Then, physicians must undergo peer evaluations and pass oral and written examinations administered by the American Board of Otolaryngology.

After attaining board certification, otolaryngologists may pursue a one- or two- year fellowship for extensive training and examinations in a subspecialty area. Otolaryngology subspecialties include:

Allergy
Facial Plastic and Reconstructive Surgery
Head and Neck Surgery
Laryngology
Otology/Audiology
Pediatric Otolaryngology
Rhinology
Neurotology
Sleep Medicine
Board certification is valid for 10 years. To revalidate their certification, ENTs must meet guidelines established by the American Board of Medical Specialties and complete a Maintenance of Certification Program. This process emphasizes professional standing, lifelong learning and self-assessment, cognitive expertise and evaluation of performance in practice.

Valid certificate issued by the American Board of Otolaryngology
Valid, unrestricted medical license
Privileges to practice otolaryngology-head and neck surgery in accredited hospital or surgical center
Completion of required CME credits
Successful completion of the American Board of Otolaryngology self-assessment module
Maintenance of Certification Examination

Are you in search of how to make your eyelashes grow?  Like the hair on your scalp. eyelashes naturally grow in cycles and have a genetically determined growth phase which determines the full potential your lashes can reach.  However, only about 24% of your eyelashes ever reach full length? That’s because your lashes will sustain damage from curling, cleansing, wearing makeup and encountering environmental elements over time. So, while you may not be able to reverse damage to your eyelashes. You can learn how to protect and condition them so they can reach their full fluttery potential.

Infinite Lash has a revolutionary formula infused with a blend of vitamins, minerals, polypeptides, and botanicals that nourish and rejuvenate your natural lashes. It also contains natural antioxidants that protect against dryness and damage.

Not all of us are blessed with long, thick, luscious lashes but here are some essential tips you could try – if you ever wanted to know how to make your eyelashes grow.

t can reduce your risk of major illnesses, such as heart disease, stroke, type 2 diabetes and cancer by up to 50% and lower your risk of early death by up to 30%.It’s free, easy to take, has an immediate effect and you don’t need a GP to get some. Its name? Exercise.Click on the links below to find out if you're doing enough for your age:early childhood (under five years old)young people (five to 18 years old)

adults (19 to 64 years old)

older adults (65 and over)

Exercise is the miracle cure we’ve always had, but for too long we’ve neglected to take our recommended dose. Our health is now suffering as a consequence.This is no snake oil. Whatever your age, there's strong scientific evidence that being physically active can help you lead a healthier and even happier life.People who do regular activity have a lower risk of many chronic diseases, such as heart disease, type 2 diabetes, stroke, and some cancers.Research shows that physical activity can also boost self-esteem, mood, sleep quality and energy, as well as reducing your risk of stress, depression, dementia and Alzheimer’s disease.“If exercise were a pill, it would be one of the most cost-effective drugs ever invented,” says Dr Nick Cavill, a health promotion consultant

An epithelial cells line the surfaces of organs and tissues throughout the body, including the urinary tract. In a urine sample, the presence of epithelial cells can be an indication of various conditions that affect the urinary tract and kidneys, such as urinary tract infections, kidney disease, and bladder cancer.

An epithelial cell in urine test is a routine and non-invasive test that involves collecting a urine sample and analyzing it for the presence of epithelial cells. The interpretation of the results of epithelial cells in urine tests can be complex and requires the expertise of a healthcare professional. Depending on the results of the test, your healthcare provider may recommend further testing or follow-up to diagnose or monitor your condition.

An erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood sample. Normally, red blood cells settle relatively slowly. A faster-than-normal rate may indicate inflammation in the body. Inflammation is part of your immune response system. It can be a reaction to an infection or injury. Inflammation may also be a sign of a chronic disease, an immune disorder, or other medical condition.

Other names: ESR, SED rate sedimentation rate; Westergren sedimentation rate

In India, we have an estimated 4.6 million people with corneal blindness that is curable through corneal transplantation made possible by eye donation.

The cornea is the clear surface at the front of the eye and is the main focusing element. When the cornea becomes cloudy from disease, injury, infection or any other cause, vision will be drastically reduced. Cornea transplant is the surgical procedure which replaces a disc-shaped segment of an impaired cornea with a similarly shaped piece of a healthy donor cornea. More than 90% of the corneal transplantation is carried out successfully and helps restore vision in people with corneal blindness. Corneal transplantation in infants born with cloudy cornea can make a big difference to their lives.

Encephalitis is a rare condition that is most often caused by viruses.

It can also be caused by noninfectious diseases, such as systemic lupus erythematosus and Behçet's disease.

The leading cause of severe encephalitis is the herpes simplex virus.

Other causes include enterovirus infections or mosquito-borne viruses.

The very young and the elderly are more likely to have more severe encephalitis.

Exposure to viruses can occur through breathing in respiratory droplets from infected people, certain insect bites, and direct skin contact.

Meningitis is inflammation of the membranes (meninges) that surround the brain and spinal cord.

Eustachian tubes are small tubes that run between your middle ears and the upper throat. They are responsible for equalizing ear pressure and draining fluid from the middle ear, the part of the ear behind the eardrum. The eustachian tubes are usually closed except for when you chew, swallow, or yawn.

These passageways are small in size and can get plugged for a variety of reasons. Blocked eustachian tubes can cause pain, hearing difficulties, and a feeling of fullness in the ears. Such a phenomenon is referred to as eustachian tube dysfunction (ETD).

ETD is a relatively common condition. Depending on the cause, it may resolve on its own or through simple at-home treatment measures. Severe or recurring cases may require a visit to the doctor.

Cryoglobulinemia is a medical condition that is caused by proteins called cryoglobulins, which are present in the blood. Cryoglobulins are abnormal proteins that by definition have the unusual property of precipitating from the serum when it is chilled in the laboratory and then dissolves back into the serum upon rewarming.

Cryoglobulins may or may not cause disease. Cryoglobulins can accompany another condition (such as dermatomyositis, multiple myeloma, viral infections, or lymphoma) or be an isolated condition themselves, called cryoglobulinemia.

Earwax blockage occurs when earwax (cerumen) accumulates in your ear or becomes too hard to wash away naturally.

Earwax is a helpful and natural part of your body's defenses. It cleans, lubricates and protects your ear canal by trapping dirt and slowing the growth of bacteria.

If earwax blockage becomes a problem, you or your doctor can take simple steps to remove the wax safely.

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact your health, your emotions and your ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

Most eating disorders involve focusing too much on your weight, body shape and food, leading to dangerous eating behaviors. These behaviors can significantly impact your body's ability to get adequate nutrition. Eating disorders can harm the heart, digestive system, bones, and teeth and mouth, and lead to other diseases.

Eating disorders often develop in the teen and young adult years, although they can develop at other ages. With treatment, you can return to healthier eating habits and sometimes reverse serious complications caused by the eating disorder.

An ectopic pregnancy is an early pregnancy that occurs outside of the normal location (uterine lining) for a developing pregnancy. Most ectopic pregnancies occur in the Fallopian tubes. An ectopic pregnancy cannot progress normally and typically results in the death of the embryo or fetus.

Ectropion (ek-TROH-pee-on) is a condition in which your eyelid turns outward. This leaves the inner eyelid surface exposed and prone to irritation.

Ectropion is more common in older adults, and it generally affects only the lower eyelid. In severe ectropion, the entire length of the eyelid is turned out. In less severe ectropion, only one segment of the eyelid sags away from the eye.

Artificial tears and lubricating ointments can help relieve symptoms of ectropion. But usually surgery is needed to fully correct the condition.

Eggs are one of the most common allergy-causing foods for children.

Egg allergy symptoms usually occur a few minutes to a few hours after eating eggs or foods containing eggs. Signs and symptoms range from mild to severe and can include skin rashes, hives, nasal congestion, and vomiting or other digestive problems. Rarely, egg allergy can cause anaphylaxis — a life-threatening reaction.

Egg allergy can occur as early as infancy. Most children, but not all, outgrow their egg allergy before adolescence.

Ehrlichiosis is a bacterial illness transmitted by ticks that causes flu-like symptoms. The signs and symptoms of ehrlichiosis range from mild body aches to severe fever and usually appear within a week or two of a tick bite. If treated quickly with appropriate antibiotics, ehrlichiosis generally improves within a few days.

Another tick-borne infection — anaplasmosis — is closely related to ehrlichiosis. But the two have distinct differences and are caused by different microorganisms.

The best way to prevent these infections is to avoid tick bites. Tick repellents, thorough body checks after being outside and proper removal of ticks give you the best chance of avoiding ehrlichiosis.

Eisenmenger (I-sun-meng-uhr) syndrome is a complication of a heart defect that you're born with (congenital).

A heart defect that causes a hole (shunt) to develop between two chambers of your heart is the most common cause of Eisenmenger syndrome. This hole causes blood to circulate abnormally in your heart and lungs. Increased blood flow returns to your lungs instead of going to the rest of your body. The blood vessels in your lung arteries become stiff and narrow, increasing the pressure in your lungs' arteries. This permanently damages the blood vessels in your lungs.

Eisenmenger syndrome occurs when the increased pressure of the blood flow in the lung becomes so great that the direction of blood flow through the shunt reverses. Oxygen-poor (blue) blood from the right side of the heart flows into the left ventricle and is pumped to your body so you don't receive enough oxygen to all your organs and tissues.

Eisenmenger syndrome is a life-threatening condition requiring careful medical monitoring. Medications can improve symptoms and prognosis.

 Central nervous system (CNS) embryonal tumors form in embryonic cells that remain in the brain after birth. CNS embryonal tumors tend to spread through the cerebrospinal fluid (CSF) to other parts of the brain and spinal cord.

The tumors may be malignant (cancer) or benign (not cancer). Most CNS embryonal tumors in children are malignant. Malignant brain tumors are likely to grow quickly and spread into other parts of the brain. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Benign brain tumors grow and press on nearby areas of the brain. They rarely spread to other parts of the brain. Both benign and malignant brain tumors can cause signs or symptoms and need treatment.

Although cancer is rare in children, brain tumors are the third most common type of childhood cancer, after leukemia and lymphoma. This summary is about the treatment of primary brain tumors (tumors that begin in the brain). The treatment of metastatic brain tumors, which begin in other parts of the body and spread to the brain, is not discussed in this summary. For information about the different types of brain and spinal cord tumors, see the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview.

Brain tumors occur in both children and adults. Treatment for adults may be different from treatment for children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults.

Encopresis (en-ko-PREE-sis), sometimes called fecal incontinence or soiling, is the repeated passing of stool (usually involuntarily) into clothing. Typically it happens when impacted stool collects in the colon and rectum: the colon becomes too full and liquid stool leaks around the retained stool, staining underwear. Eventually, stool retention can cause swelling (distention) of the bowels and loss of control over bowel movements.

Encopresis usually occurs after age 4, when the child has already learned to use a toilet. In most cases, soiling is a symptom of chronic constipation. Far less frequently it occurs without constipation and may be the result of emotional issues.

Encopresis can be frustrating for parents — and embarrassing for the child. However, with patience and positive reinforcement, treatment for encopresis is usually successful

Endocarditis generally occurs when bacteria, fungi or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart. If it's not treated quickly, endocarditis can damage or destroy your heart valves and can lead to life-threatening complications. Treatments for endocarditis include antibiotics and, in certain cases, surgery.

Since there are many ways to develop endocarditis, your doctor might not be able to pinpoint the exact cause of your condition. However, people at greatest risk of endocarditis usually have damaged heart valves, artificial heart valves or other heart defects.

Endometrial cancer is a type of cancer that begins in the uterus. The uterus is the hollow, pear-shaped pelvic organ in women where fetal development occurs.

Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer.

Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer.

An enlarged heart (cardiomegaly) isn't a disease, but rather a sign of another condition.

The term "cardiomegaly" refers to an enlarged heart seen on any imaging test, including a chest X-ray. Other tests are then needed to diagnose the condition causing your enlarged heart.

You may develop an enlarged heart temporarily because of a stress on your body, such as pregnancy, or because of a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms.

Certain conditions may cause the heart muscle to thicken or one of the chambers of the heart to dilate, making the heart larger. Depending on the condition, an enlarged heart may be temporary or permanent.

An enlarged heart may be treatable by correcting the cause. Treatment for an enlarged heart can include medications, medical procedures or surgery.

If your doctor tells you that you've got an enlarged liver, it means it's swollen beyond its normal size. There's usually another condition that's causing it, such as hepatitis. You have a lot of treatment choices, but you first need to find out the source of the problem.

Getting treated is important. Your liver has a lot of big jobs to do. Just to name a few key ones, it helps clean your blood by getting rid of harmful chemicals that your body makes. It makes a liquid called bile, which helps you break down fat from food. And it also stores sugar, called glucose, which gives you a quick back-up energy boost when you need it.

Depending on what's causing your liver to swell, you could end up with long-term damage if you don't get treated.

Entropion (en-TROH-pee-on) is a condition in which your eyelid turns inward so that your eyelashes and skin rub against the eye surface. This causes irritation and discomfort.

When you have entropion, your eyelid may be turned in all the time or only when you blink hard or squeeze your eyelids shut. Entropion is more common in older adults, and it generally affects only the lower eyelid.

Artificial tears and lubricating ointments can help relieve symptoms of entropion. But usually surgery is needed to fully correct the condition. Left untreated, entropion can cause damage to the transparent covering in the front part of your eye (cornea), eye infections and vision loss.

In eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), a type of white blood cell (eosinophil) builds up in the lining of the tube that connects your mouth to your stomach (esophagus). This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow.

Eosinophilic esophagitis is a chronic immune system disease. It has been identified only in the past two decades, but is now considered a major cause of digestive system (gastrointestinal) illness. Research is ongoing and will likely lead to revisions in the diagnosis and treatment of eosinophilic esophagitis.

If you learn that you or your child has a type of spine and brain cancer called an ependymoma, there's a lot to take in. You'll have lots of questions about how to treat the disease and manage the swirl of emotions you may feel.

Depending on where the cancer is, your doctor may recommend surgery, chemotherapy, or radiation. But make sure you take care of your mental health, too. Turn to family, friends, and support groups to get the emotional backing you need.

Epidermoid (ep-ih-DUR-moid) cysts are noncancerous small bumps beneath the skin. They can appear anywhere on the skin, but are most common on the face, neck and trunk.

Epidermoid cysts are slow growing and often painless, so they rarely cause problems or need treatment. You might choose to have a cyst removed by a doctor if its appearance bothers you or if it's painful, ruptured or infected.

Many people refer to epidermoid cysts as sebaceous cysts, but they're different. True sebaceous cysts are less common. They arise from the glands that secrete oily matter that lubricates hair and skin (sebaceous glands).

Epidermolysis bullosa (ep-ih-dur-MOL-uh-sis buhl-LOE-sah) is a group of rare diseases that cause fragile, blistering skin. The blisters may appear in response to minor injury, even from heat, rubbing, scratching or adhesive tape. In severe cases, the blisters may occur inside the body, such as the lining of the mouth or the stomach.

Most types of epidermolysis bullosa are inherited. The condition usually shows up in infancy or early childhood. Some people don't develop signs and symptoms until adolescence or early adulthood.

Epidermolysis bullosa has no cure, though mild forms may improve with age. Treatment focuses on caring for blisters and preventing new ones.

Epididymitis (ep-ih-did-uh-MY-tis) is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Males of any age can get epididymitis.

Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed — a condition called epididymo-orchitis.

Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis — a small cartilage "lid" that covers your windpipe — swells, blocking the flow of air into your lungs.

A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to your throat and various infections. The most common cause of epiglottitis in children in the past was infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia, meningitis and infections in the bloodstream. Epiglottitis can occur at any age.

Routine Hib vaccination for infants has made epiglottitis rare, but epiglottitis remains a concern. If you suspect that you or someone in your family has epiglottitis, seek emergency help immediately. Prompt treatment can prevent life-threatening complications.

Esophageal cancer is cancer that occurs in the esophagus — a long, hollow tube that runs from your throat to your stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.

Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.

Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic locations. In some regions, higher rates of esophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.

Normally, contractions of the esophagus camera.gif (the tube that connects the mouth and the stomach) move food from the mouth to the stomach with a regular, coordinated rhythm.

Esophageal spasm means that contractions of the esophagus are irregular, uncoordinated, and sometimes powerful. This condition may be called diffuse esophageal spasm, or DES. These spasms can prevent food from reaching the stomach. When this happens, the food gets stuck in the esophagus.

Sometimes the squeezing moves down the esophagus in a coordinated way, but it is very strong. This can be called nutcracker esophagus. These contractions move food through the esophagus but can cause severe pain.

Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases.

Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver. To go around the blockages, blood flows into smaller blood vessels that aren't designed to carry large volumes of blood. The vessels can leak blood or even rupture, causing life-threatening bleeding.

A number of drugs and medical procedures can help prevent and stop bleeding from esophageal varices.

Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you do simple tasks, such as drinking from a glass or tying shoelaces.

It's usually not a dangerous condition, but essential tremor typically worsens over time and can be severe in some people. Other conditions don't cause essential tremor, although it's sometimes confused with Parkinson's disease.

Esthesioneuroblastoma (es-THEE-zee-o-NOO-row-blas-TOE-muh) is a rare type of cancer that begins in the upper portion of the nasal cavity.

The area where esthesioneuroblastoma begins is separated from the brain by a bone that contains tiny holes that allow the nerves that control smell (olfactory nerves) to pass through. Esthesioneuroblastoma is also called olfactory neuroblastoma.

Esthesioneuroblastoma, which can occur at any age in adults, generally begins as a tumor in the nasal cavity and may grow or extend into the sinus, eyes and brain. People with esthesioneuroblastoma can lose their sense of smell, have frequent nosebleeds and experience difficulty breathing through their nostrils as the tumor grows.

Esthesioneuroblastoma can also spread to the lymph nodes in the neck and the parotid glands. In advanced cases, esthesioneuroblastoma can spread to other parts of the brain and other parts of the body, such as the lungs, liver and bones.

Esthesioneuroblastoma treatment usually includes surgery. Often, radiation and chemotherapy are recommended, as well.

Exercise headaches occur during or after sustained, strenuous exercise. Some activities associated with exercise headaches include running, rowing, tennis, swimming and weightlifting.

Doctors divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren't connected to any underlying problems and can often be prevented with medication.

Secondary exercise headaches are caused by an underlying, often serious problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.

Eye floaters appear as small spots that drift through your field of vision. They may stand out when you look at something bright, like white paper or a blue sky. They might annoy you, but they shouldn’t interfere with your sight.

If you have a large floater, it can cast a slight shadow over your vision. But this tends to happen only in certain types of light.

You can learn to live with floaters and ignore them. You may notice them less as time passes. Only rarely do they get bad enough to require treatment.

The term eye strain is frequently used by people to describe a group of vague symptoms that are related to use of the eyes. Eye strain is a symptom, not an eye disease. Eye strain occurs when your eyes get tired from intense use, such as driving a car for extended periods, reading, or working at the computer. If you have any eye discomfort caused by looking at something for a long time, you can call it eye strain.

Although eye strain can be annoying, it usually is not serious and goes away once you rest your eyes. In some cases, signs and symptoms of eye strain are a sign of an underlying eye condition that needs treatment. Although you may not be able to change the nature of your job or all the factors that can cause eye strain, you can take steps to reduce eye strain.

An ECG (electrocardiogram) records the electrical activity of your heart at rest. It provides information about your heart rate and rhythm, and shows if there is enlargement of the heart due to high blood pressure (hypertension) or evidence of a previous heart attack (myocardial infarction). However, it does not show whether you have asymptomatic blockages in your heart arteries or predict your risk of a future heart attack. The resting ECG is different from a stress or exercise ECG or cardiac imaging test. You may need an ECG test if you have risk factors for heart disease such as high blood pressure, or symptoms such as palpitations or chest pain. Or you may need it if you already have heart disease. But in other cases, you may think twice about having this test.

An echocardiogram (echo) is a graphic outline of the heart's movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

Fetal echocardiography is a test similar to an ultrasound. This exam allows your doctor to better see the structure and function of your unborn child’s heart. It’s typically done in the second trimester, between weeks 18 to 24.

The exam uses sound waves that “echo” off of the structures of the fetus’ heart. A machine analyzes these sound waves and creates a picture, or echocardiogram, of their heart’s interior. This image provides information on how your baby’s heart has formed and whether it’s working properly.

It also allows your doctor to see the blood flow through their heart. This in-depth look allows your doctor to find any defects or abnormalities in the baby’s blood flow or heartbeat.

The child will lie down tilted slightly on his / her side on a hospital bed in our child-friendly examination room, not an operating room. Many exam rooms are equipped with a television to keep a child entertained and alleviate boredom. The child must be undressed from the waist up and can choose to wear a short gown.

To improve the quality of the pictures, a colorless, warm gel is applied to the skin on the area of the chest where the heart is located. A transducer, a small microphone-like device, is placed on top of the gel and against the skin. The transducer uses sound waves, which bounce off the different parts of a child's heart, creating a picture.

The transducer is moved over the chest, abdominal area, and neck in order to obtain the images.

The sounds you may hear from the echo machine are the sounds of the blood flowing from one chamber to another and the valves opening or closing as the blood moves through the heart.

The colors you see on the screen are not the colors of the blood. The colors tell us what direction the blood is flowing. The red color shows the blood is flowing towards the transducer and the blue color shows blood is flowing away. A child may feel some discomfort from the pressure of the transducer. Pediatric echosonographers are trained to complete scans in as pain-free and patient-sensitive manner as possible. 

A computer interprets the information from the transducer to make an image of the heart appear on the screen. This image is recorded into a digital storage system for the cardiologist to measure and review. 

A stress echocardiography, also called an echocardiography stress test or stress echo, is a procedure that determines how well your heart and blood vessels are working.

During a stress echocardiography, you’ll exercise on a treadmill or stationary bike while your doctor monitors your blood pressure and heart rhythm. When your heart rate reaches peak levels, your doctor will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.

Your doctor may order a stress echocardiography test if you have chest pain that they think is due to coronary artery disease or a myocardial infarction, which is a heart attack. This test also determines how much exercise you can safely tolerate if you’re in cardiac rehabilitation. The test can also tell your doctor how well treatments such as bypass grafting, angioplasty, and anti-anginal or antiarrhythmic medications are working.

An electromyogram (EMG) measures the electrical activity of muscles when they're at rest and when they're being used. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.

Nerves control the muscles in the body with electrical signals called impulses. These impulses make the muscles react in certain ways. Nerve and muscle problems cause the muscles to react in ways that aren't normal.

If you have leg pain or numbness, you may have these tests to find out which nerves are being affected and how much they are affected. These tests check how well your spinal nerves are working. They also check the nerves in your arms and legs.

We reviewed the records of 52 amyotrophic lateral sclerosis (ALS) patients examined between 1995 and 2000 who had needle electromyography (EMG) of their respiratory muscles, including the diaphragm, at or near the time of their diagnosis. With respiratory function testing, patients with abnormal diaphragmatic EMG at diagnosis (Group 1, n=23) had significantly lower forced vital capacity (FVC), lower daytime arterial PO(2) and higher PCO(2) measurements (p<0.05) than patients with normal diaphragmatic EMG (Group 2, n=29). Twenty-eight percent of the patients without symptoms or signs of respiratory insufficiency at the time they were examined had an abnormal diaphragm EMG. Mean survival of Groups 1 and 2 were similar. However, sub-analysis of patients within each group, comparing those treated with non-invasive positive pressure ventilation (NIPPV) with those not treated, showed that treated patients in Group 1 (abnormal diaphragm EMG) survived significantly longer (p<0.05) than untreated patients. They also started NIPPV earlier than treated patients in Group 2. We conclude that respiratory muscle EMG was simply and safely performed on ALS patients at or around the time of diagnosis. The procedure can detect sub-clinical respiratory muscle dysfunction. The technique used for EMG of the respiratory muscles, its pitfalls and contraindications are also reviewed.

Electromyography (EMG) is a diagnostic procedure that evaluates the health condition of muscles and the nerve cells that control them. These nerve cells are known as motor neurons. They transmit electrical signals that cause muscles to contract and relax. An EMG translates these signals into graphs or numbers, helping doctors to make a diagnosis.

A doctor will usually order an EMG when someone is showing symptoms of a muscle or nerve disorder. These symptoms may include tingling, numbness, or unexplained weakness in the limbs. EMG results can help the doctor diagnose muscle disorders, nerve disorders, and disorders affecting the connection between nerves and muscles.

There are two components to an EMG test: the nerve conduction study and needle EMG. The nerve conduction study is the first part of the procedure. It involves placing small sensors called surface electrodes on the skin to assess the ability of the motor neurons to send electrical signals. The second part of the EMG procedure, known as needle EMG, also uses sensors to evaluate electrical signals. The sensors are called needle electrodes, and they are directly inserted into muscle tissue to evaluate muscle activity when at rest and when contracted.

During each part of the EMG procedure, one electrode releases a very mild electrical signal while the other electrodes measure how long it takes for the signal to reach them. This mimics the natural electrical signals sent by the nerves to the muscles. The distance between the electrodes and time it takes for a signal to reach them is used to determine the speed at which the nerves are able to send and receive signals. An abnormal speed usually indicates a muscle or nerve disorder.

This course shows you videos of the commonly studied muscles in the upper extremity, insertional activity and muscle activation and motor unit analysis techniques to help you gain a working understanding of the technical skills you need to perform needle EMG examinations. The video will focus on muscle localization and needle insertion techniques, what results you should expect, how to study the shape, amplitude and duration of motor unit waveforms, pitfalls and common errors you should watch for. Muscles studied include the First Dorsal Interosseous (FDI), the Abductor Pollicis Brevis (APB), the Flexor Carpi Radialis (FCR) the Brachio-Radialis (BR), the Triceps (TRI), the Deltoid (DEL) and the Cervical Paraspinals.

This test measures the integrity of nerve tracts which conduct the electric impulses. It is used to assess the nature, severity and duration of the nerve lesion and in combination with EMG helps in predicting the chances of recovery after a nerve lesion.The nerves of interest are stimulated with a very low voltage electric current which causes mild tingling over the area stimulated. The test takes 20 min to 1 hour depending upon the number of nerves to be tested. It is very useful, in cases of carpal tunnel syndrome, diabetic neuropathy, traumatic neuropathy, plexopathy, varius vitamin deficiencies.

This test is used to test the nerves and muscles in your entire lower extremity. Your doctor will usually order this test when he suspects that there may be some type of problem with the nerve supply to your foot and leg. Commonly the EMG/NCV test is used to diagnosis one of the following: Tarsal Tunnel Syndrome, Peripheral Neuropathy, Neuromuscular disorders, Nerve palsy or Paralysis, and Radioculopathy. Your doctor typically will refer you to either a hospital or a neurologist to have the test preformed.

The EMG portion of the test is used to record the electrical activity in your muscles. It can diagnose diseases of the nerves and muscles. It can detect conditions such as tarsal tunnel syndrome, inflamed muscles and pinched nerves. A tiny needle, called an electrode, is inserted directly into a specific muscle belly. The electrode then records the activity during the insertion, while the muscle is at rest, and while the muscle contracts. Nerve and muscle diseases alter the pattern of electrical activity in these muscles, which is record both audibly and on a computer screen. After the first muscle is tested, the electrode may be inserted into another muscle. Muscles chosen for the testing vary with the patient's symptoms and may be modified, depending on the results from the first muscles tested. Total testing time may range from just a few minutes to more than an hour, depending upon how many muscles are tested. After the exam, you may feel tenderness in the tested muscles. There is a slight risk of minor, localized inflammation in muscles during the test. This usually lasts only a few hours. Other common patient complaints are pain with insertion of the electrode.

Most of the time the Nerve Conduction Velocity Test will accompany the EMG Test. The NCV evaluates the health of the peripheral nerve by recording how fast electrical impulse travels through it. A peripheral nerve transmits information between the spinal cord and the muscles. You will be resting on a cart or bed and electrodes will be taped to your skin. A stimulator will be held against your skin, which sends out a small electrical charge along the nerve. You may feel a tingle or your muscles may twitch but this shock is not harmful. Each test will take only a few minutes. After the exam the electrodes will be removed and your skin cleaned. The time between the stimulation and response will be recorded to determine how quickly and thoroughly that the impulse is sent. A number of nervous system diseases may reduce the speed of this impulse. Each nerve test takes just a few minutes to an hour, depending upon how many nerves are being tested.

While the hospital or neurologist's office will give you instructions for the day of the examination, a few general preparations will help. Eat normally and take medication as you usually would. If you are taking a blood thinner, make sure you inform the testing facility and ask the ordering physician about the use of the medication and the timing of the test. Bath or shower the morning of the examination. Avoid bath oils or any skin lotions or emollients the day of the examination.

A typical EMG/NCV of the lower extremity takes approximately 45 minutes. This test is an important tool for diagnosing diseases of the nervous system, you can help ensure the best results if you relax and cooperate with the technicians. Make sure that you ask any questions that you have about the test before it is performed. Your physician will discuss the results with you. If you have any further questions regarding why this test was ordered for you, please ask your physician.

Culture and Sensitivity Aerobic test is performed on a sample of ear swab to measure the level of Culture of the pathogenic organism in the ear swab.It is performed to confirm Ear infection and also during the treatment and after the treatment of Ear infection.

Electrolytes are minerals that are found in body tissues and blood in the form of dissolved salts. As electrically charged particles, electrolytes help move nutrients into and wastes out of the body's cells, maintain a healthy water balance, and help stabilize the body's acid/base (pH) level.

The electrolyte panel measures the blood levels of the main electrolytes in the body: sodium (Na+), potassium (K+), chloride (Cl-), and bicarbonate (HCO3-; sometimes reported as total CO2).

A person's diet provides sodium, potassium, and chloride. The kidneys help maintain proper levels by reabsorption or by elimination into the urine. The lungs provide oxygen and regulate CO2. The CO2 is produced by the body and is in balance with bicarbonate. The overall balance of these chemicals is an indication of the functional well-being of several basic body functions. They are important in maintaining a wide range of body functions, including cardiac and skeletal muscle contraction and nerve impulse conduction.

Any disease or condition that affects the amount of fluid in the body, such as dehydration, or affects the lungs, kidneys, metabolism, or breathing has the potential to cause a fluid, electrolyte, or pH imbalance (acidosis or alkalosis). Normal pH must be maintained within a narrow range of 7.35-7.45 and electrolytes must be in balance to ensure the proper functioning of metabolic processes and the delivery of the right amount of oxygen to tissues. (For more on this, see the condition article on Acidosis and Alkalosis and also on Dehydration.)

Circulating IgA endomysial antibodies are present in 70% to 80% of patients with dermatitis herpetiformis or celiac disease, and in nearly all such patients who have high grade gluten-sensitive enteropathy and are not adhering to a gluten-free diet.

For your convenience, we recommend utilizing cascade testing for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate one for your specific patient situation. Algorithms for the cascade tests are available in Special Instructions.

-CDCOM / Celiac Disease Comprehensive Cascade: complete testing including HLA DQ

-CDSP / Celiac Disease Serology Cascade: complete testing excluding HLA DQ

-CDGF / Celiac Disease Gluten-Free Cascade: for patients already adhering to a gluten-free diet

Endothelin-1 (ET-1), a peptide of 21 amino acid residues, is the most potent vasoconstrictor substance known. Originally isolated from porcine aortic endothelial cells1, ET-1 is now known to be one of a family of three mammalian vasoactive peptides that also includes endothelin-2 (ET-2) and endothelin-3 (ET-3).2 These related peptides differ from ET-1 at the two and six amino acid residue positions, respectively. A fourth peptide, vasoactive intestinal contractor (VIC), is sometimes classified as rat ET-2.3

The pemphigus   Pemphigus foliaceus  and pemphigoid   Skin: bullous pemphigoid  autoimmune skin diseases   Immune-mediated disease: overview   are mediated by autoantibodies that target antigens within the interkeratinocyte desmosomes (pemphigus) or the basement membrane zone hemidesmosomes (pemphigoid).

A range of laboratory methods may be used to demonstrate the presence of these autoantibodies. These tests have not been used widely in equine pemphigus or pemphigoid diseases and, in those report available, have shown variable sensitivity and specifity.

Autoantibodies may be detected either in situ(within lesional skin biopsies), or circulating with the serum of affected animals.

Epstein-Barr virus (EBV) is a virus that typically causes a mild to moderate illness. Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection.

Epstein-Barr virus causes an infection that is very common. According to the Centers for Disease Control and Prevention (CDC), most people in the United States are infected by EBV at some point in their lives. The virus is very contagious and easily passed from person to person. It is present in the saliva of infected individuals and can be spread through close contact such as kissing and through sharing utensils or cups.

After initial exposure to EBV, there is a period of several weeks before associated symptoms may appear, called the incubation period. During the acute primary infection, the virus multiplies in number. This is followed by a decrease in viral numbers and resolution of symptoms, but the virus never completely goes away. Latent EBV remains in the person's body for the rest of that person's life and may reactivate but usually causes few problems unless the person's immune system is significantly weakened.

Most people are infected by EBV in childhood and experience few or no symptoms. However, when the initial infection occurs in adolescence, it can cause infectious mononucleosis, commonly called mono, a condition associated with fatigue, fever, sore throat, swollen lymph nodes, an enlarged spleen, and sometimes an enlarged liver. These symptoms occur in about 25% of infected teens and young adults and usually resolve within a month or two.

People with mono are typically diagnosed by their symptoms and the findings from a complete blood count (CBC) and a mono test (which tests for a heterophile antibody). About 25% of those with mono do not produce heterophile antibodies and will have a negative mono test; this is especially true with children. Tests for EBV antibodies can be used to determine whether or not the symptoms these people are experiencing are due to a current infection with the EBV virus.

EBV is the most common cause of mono. According to the CDC, examples of other causes of mono include cytomegalovirus (CMV), hepatitis A, hepatitis B or hepatitis C, rubella, and toxoplasmosis. Sometimes, it can be important to distinguish EBV from these other illnesses. For instance, it may be important to diagnose the cause of symptoms of a viral illness in a pregnant woman. Testing can help to distinguish a primary EBV infection, which has not been shown to affect a developing baby, from a CMV, herpes simplex virus, or toxoplasmosis infection, as these illnesses can cause complications during the pregnancy and may harm the fetus.

It can also be important to rule out EBV infection and to look for other causes of the symptoms. Those with strep throat, an infection caused by group A streptococcus, for instance, need to be identified and treated with antibiotics. A person may have strep throat instead of mono or may have both conditions at the same time.

Several tests for different types and classes of EBV antibodies are available. The antibodies are proteins produced by the body in an immune response to several different Epstein-Barr virus antigens. During a primary EBV infection, the level of each of these EBV antibodies rises and falls at various times as the infection progresses. Measurement of these antibodies in the blood can aid in diagnosis and typically provides the healthcare practitioner with information about the stage of infection and whether it is a current, recent, or past infection.

Receptors are specialized proteins on the surface of or within cells that recognize and bind to other substances. The binding typically has a specific effect on the cells. Many, but not all, breast cancer cells have receptors that bind to the hormones estrogen and progesterone. Breast cancer tumors with estrogen receptors (ER) and progesterone receptors (PR) depend on the hormones to grow and divide. ER and PR testing of breast tumor tissue determines if one or both types of receptors are present.

Knowing if a tumor depends on hormones to grow helps a health practitioner determine a person's risk of breast cancer recurrence and whether it can be treated with hormone therapy to block estrogen and progesterone. About two-thirds of breast cancer tissues are positive for both ER and PR.

In 2010, the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) jointly published guidelines that recommend that all tumors from individuals with newly diagnosed invasive breast cancer be evaluated for estrogen and progesterone receptors. The guidelines also state that all recurrent breast cancers should be tested and that the option of testing should be provided for patients who have non-invasive breast cancer.

Erythropoietin (EPO) is a hormone produced primarily by the kidneys. It plays a key role in the production of red blood cells (RBCs), which carry oxygen from the lungs to the rest of the body. This test measures the amount of erythropoietin in the blood.

Erythropoietin is produced and released into the blood by the kidneys in response to low blood oxygen levels (hypoxemia). EPO is carried to the bone marrow, where it stimulates production of red blood cells. The hormone is active for a short period of time and then eliminated from the body in the urine.

The amount of erythropoietin released depends upon how low the oxygen level is and the ability of the kidneys to produce erythropoietin. Increased production and release of erythropoietin continues to occur until oxygen levels in the blood rise to normal or near normal concentrations, then production falls. The body uses this dynamic feedback system to help maintain sufficient oxygen levels and a relatively stable number of RBCs in the blood.

However, if a person's kidneys are damaged and do not produce sufficient erythropoietin, then too few RBCs are produced and the person typically becomes anemic. Similarly, if a person's bone marrow is unable to respond to the stimulation from EPO, then the person may become anemic. This can occur with some bone marrow disorders or with chronic diseases, such as rheumatoid arthritis. (Read Anemia of Chronic Diseases to learn more.)

Individuals who have conditions that affect the amount of oxygen they breathe in, such as lung diseases, may produce more EPO to try to compensate for the low oxygen level. People who live at high altitudes may also have higher levels of EPO and so do chronic tobacco smokers.

If too much erythropoietin is produced, as occurs with some benign or malignant kidney tumors and with a variety of other cancers, too many RBCs may be produced (polycythemia or erythrocytosis). This can lead to an increase in the blood's thickness (viscosity) and sometimes to high blood pressure (hypertension), blood clots (thrombosis), heart attack, or stroke. Rarely, polycythemia is caused by a bone marrow disorder called polycythemia vera, not by increased erythropoietin.

Erythrocyte sedimentation rate (ESR or sed rate) is a test that indirectly measures the degree of inflammation present in the body. The test actually measures the rate of fall (sedimentation) of erythrocytes (red blood cells) in a sample of blood that has been placed into a tall, thin, vertical tube. Results are reported as the millimeters of clear fluid (plasma) that are present at the top portion of the tube after one hour.

When a sample of blood is placed in a tube, the red blood cells normally settle out relatively slowly, leaving little clear plasma. The red cells settle at a faster rate in the presence of an increased level of proteins, particularly proteins called acute phase reactants. The level of acute phase reactants such as C-reactive protein (CRP) and fibrinogen increases in the blood in response to inflammation.

Inflammation is part of the body's immune response. It can be acute, developing rapidly after trauma, injury or infection, for example, or can occur over an extended time (chronic) with conditions such as autoimmune diseases or cancer.

The ESR is not diagnostic; it is a non-specific test that may be elevated in a number of these different conditions. It provides general information about the presence or absence of an inflammatory condition.

There have been questions about the usefulness of the ESR in light of newer tests that have come into use that are more specific. However, ESR test is typically indicated for the diagnosis and monitoring of temporal arteritis, systemic vasculitis and polymyalgia rheumatica. Extremely elevated ESR is useful in developing a rheumatic disease differential diagnosis. In addition, ESR may still be a good option in some situations, when, for example, the newer tests are not available in areas with limited resources or when monitoring the course of a disease.

An estradiol test measures the amount of the hormone estradiol in your blood. It’s also called an E2 test.

Estradiol is a form of the hormone estrogen. It’s also called 17 beta-estradiol. The ovaries, breasts, and adrenal glands make estradiol. During pregnancy, the placenta also makes estradiol.

Estradiol helps with the growth and development of female sex organs, including the:

uterus

fallopian tubes

vagina

breasts

Estradiol helps to control the way fat is distributed in the female body. It’s also essential for bone and joint health in females.

Males also have estradiol in their bodies. Their levels of estradiol are lower than the levels in females. In males, the adrenal glands and testes make estradiol. Estradiol has been shown in vitro to prevent destruction of sperm cells, but its clinical importance in sexual function and development in men is likely less significant than in women.

The estrogen test measures the total amounts of the estrogen in the blood. Estrogens are the hormones responsible for female sexual development and function. Estrogens are secreted by the gonads, adrenal glands, and placenta.

Normal estrogen results depend upon the sex and age of the person being tested. With women, it also depends upon their menstrual cycle or whether they are pregnant.

Estrone (E1) is one of the three estrogens, which also includes estradiol (E2) and estriol (E3). Estrone is the least abundant of the three and is relevant to health and disease because it is considered the stronger acting estrogen.

In post-menopausal women, higher levels of E1 when compared to the other estrogens have been implicated in cardiovascular disease, stroke, and certain types of cancer.

If you are taking estrogen replacement therapy, it is important to follow the balance of the three main estrogens in your body. Imbalances in the relationship between E1 and the other two major estrogens are thought to increase the risk for many age-related diseases.

Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. A lipid profile measures the level of specific lipids in the blood.

Two important lipids, cholesterol and triglycerides, are transported in the blood by lipoprotein particles. Each particle contains a combination of protein, cholesterol, triglyceride, and phospholipid molecules. The particles measured with a lipid profile are classified by their density into high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL).

Monitoring and maintaining healthy levels of these lipids is important in staying healthy. While the body produces the cholesterol needed to function properly, the source for some cholesterol is the diet. Eating too much of foods that are high in saturated fats and trans unsaturated fats (trans fats) or having an inherited predisposition can result in a high level of cholesterol in the blood. The extra cholesterol may be deposited in plaques on the walls of blood vessels. Plaques can narrow or eventually block the opening of blood vessels, leading to hardening of the arteries (atherosclerosis) and increasing the risk of numerous health problems, including heart disease and stroke. A high level of triglycerides in the blood is also associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood.

Histopathology (or histology) involves the examination of sampled whole tissues under the microscope. Three main types of specimen are received by the pathology laboratory.

Specimens received by the pathology laboratory require tissue preparation then are treated and analysed using techniques appropriate to the type of tissue and the investigation required. For immediate diagnosis during a surgical procedure a frozen section is performed

Larger specimens include whole organs or parts thereof, which are removed during surgical operations. Examples include a uterus after a hysterectomy, the large bowel after a colectomy or tonsils after a tonsillectomy.

Pieces of tissue rather than whole organs are removed as biopsies, which often require smaller surgical procedures that can be performed whilst the patient is still awake but sedated. Biopsies include excision biopsies, in which tissue is removed with a scalpel (e.g. a skin excision for a suspicious mole) or a core biopsy, in which a needle is inserted into a suspicious mass to remove a slither or core of tissue that can be examined under the microscope (e.g. to investigate a breast lump).

Fluid and very small pieces of tissue (individual cells rather than groups of cells, e.g. within fluid from around the lung) can be obtained via a fine needle aspiration (FNA). This is performed using a thinner needle than that used in a core biopsy, but with a similar technique. This type of material is usually liquid rather than solid, and is submitted for cytology rather than histology (see Cytopathology).