The pain from nocturnal leg cramps vary in intensity and can last from a few seconds to 15 minutes or more. Cramps are more common in the calves, but may also occur in the feet and thighs.

The risk of nocturnal leg cramps increases with age, although it is usually difficult to pinpoint the exact cause. Possible causes include dehydration, the sitting for an extended period, not getting enough potassium, calcium and magnesium in the diet, and medications such as diuretics, beta blockers and others used to treat blood pressure. The nocturnal leg cramps can be linked to thyroid disorders, diabetes or cancer that spreads to the spine.

The Mayo Clinic Health Letter offers these suggestions to prevent them:

- Stay hydrated, drink fluids because sufficient that helps muscles contract and relax more easily. It is also extremely important to replace fluids when you participate in physical activities.
- Stretching before going to bed can help those who suffer from nighttime leg cramps.
- Light exercise, like riding a stationary bike for a few minutes before bedtime, may help to avoid suffering from cramps during sleep.
- Choose the right shoes, wearing shoes that provide good support.
- Loosen the sheets and blankets at the foot of the bed because there have more slack may reduce the incidence of nocturnal leg cramps.

When a cramp in the calf, recharge your weight on the affected leg and slightly bend the knee may provide relief. If it is too painful to recharge the weight on the leg, flex the foot can help. Gently massage the affected muscle could relax, and apply ice or a cold could reduce pain. Another alternative is to apply heat with a warm towel, heating pad or taking a bath or a hot shower.

The Mayo Clinic Health Letter covers the symptoms and treatment of polymyalgia rheumatica. Fortunately, with proper treatment can often improve symptoms within days and even overnight. However, keeping at bay the disorder usually involves carefully administer the drugs for a year or two.

Polymyalgia rheumatica is a disorder in which inflammation in the body for no apparent reason. The pain and stiffness resulting from inflammatory cells and proteins that are part of normal immune system to fight disease. Apart from the pain in muscles and joints, other symptoms are fatigue, mild fever at first, anemia, loss of appetite and depression.

Most people who develop polymyalgia rheumatica over 65 years. The disease is more common in women and rarely occurs among people under 50 years. Blood tests are used to establish the diagnosis.

The primary treatment is with oral corticosteroids such as prednisone, and this therapy usually relieves pain and stiffness in the first two or three days.

Corticosteroid treatment is generally necessary during one or two years. Patients should also frequently go to the doctor for follow-up to control the condition, adjust medications at the lowest effective dose and monitor side effects of medications. Possible side effects are osteoporosis and decreased bone density, also other side effects of prolonged use of corticosteroids may be hypertension, diabetes, cataracts and depression.

Treatment of thrombocytopenia depends on its cause and severity. If your thrombocytopenia is mild and is not caused by significant bleeding, your doctor may decide that you do not need treatment. This is often the standard strategy in children with acute ITP, because 80 to 90% of these children recover with treatment within 6 weeks.

If your thrombocytopenia is induced by drugs, your doctor may prescribe another medicine. Many people with drug-induced thrombocytopenia recover without additional treatment once the medication discontinued.

Patients with profuse bleeding require more aggressive treatments. Treatment options include:
Medications called glucocorticoids that are placed through a vein or by mouth or a medicine called immune globulin that is injected into a vein (intravenously). This is done to treat thrombocytopenia caused by an abnormal immune reaction.

Platelet transfusions: usually reserved for patients with thrombocytopenia and active bleeding or high risk of bleeding.

Splenectomy (surgical removal of the spleen) is often done to treat ITP that has not improved with other treatment. If the spleen is removed, thrombocytopenia goes away in 60% of patients with ITP. If the removal of the spleen does not solve the problem then may be prescribed immunosuppressant drugs such as azathioprine (Imuran), cyclophosphamide (Cytoxan, Neosar), vincristine (Oncovin and others) or vinblastine (Velban).

When To Call a Professional

Call your doctor if you develop any symptoms of thrombocytopenia, especially if you notice unusual bruising or if you experience heavy bleeding in the nose, mouth, vagina, rectum or urinary tract.

Forecast

The episodes of thrombocytopenia can be fatal, especially if the bleeding is severe or affects the brain. However, the prognosis is generally good, especially if the cause can be identified and eliminated. It is often successful long-term control of this disease.

The duration of thrombocytopenia depends on its cause. For example, some patients with ITP is easily bruised skin for years and have heavy vaginal bleeding with frequent bleeding episodes more severe. Others suffer from mild thrombocytopenia and almost never seen any problems. Many people with drug-induced thrombocytopenia recover within 7 to 10 days after stopping the medication. Most children with ITP recover within four to six weeks.

Prevention

Most cases of prostatitis are not preventable. You can avoid drinking large amounts of alcohol to reduce their risk of developing thrombocytopenia caused by alcoholism.

If you have had an episode of drug-induced thrombocytopenia, there is much probability that the problem manifested again if you take that medicine again. To help prevent the problem, be sure to keep the drug name that caused the thrombocytopenia. Tell each of the health professionals who visit on their sensitivity to the drug.

If your doctor determines that you are at risk of developing thrombocytopenia, it may ask you to not take aspirin because it affects the function of platelets.

People with severe thrombocytopenia may have abnormal bleeding elsewhere in the body. Symptoms may include:
- Reddish patches on the skin or purple, often concentrated at the bottom of the legs.
- Excessive bruising, up to minor trauma.
- Blood in the urine or feces (stool)
- Excessive bleeding or abnormal mouth or nose, especially nosebleeds or bleeding when you brush your teeth.
- Abnormal vaginal bleeding, especially heavy periods.
- Bleeding into the intestinal tract and rectum.
- Heavy bleeding after surgery or dental work.
- Headache and other neurological symptoms caused by bleeding within the brain (cerebral haemorrhage).

Diagnosis

Your doctor will begin by asking about your medical history. I was recently asked whether surgery or received blood transfusions and if you take medications (including non-prescription drugs or home remedies). Your doctor may also ask about how much alcohol you drink. Also asked to consider what risk has to be infected with AIDS, including questions about how and when they did blood transfusions, had sex, if you ever put drugs intravenously (into a vein) and whether it could have been exposed infections of the blood or body fluid in circulation. If you are pregnant, your doctor will want to know your date of birth. Your doctor will also ask if you have had recent infections or vaccinations if you have joint pain or rash, and if a relative has had a low platelet count.

Your doctor will check you for specific symptoms of abnormal bleeding, such as bruises or blood spots on your skin. Your doctor will feel your abdomen to see if your spleen is enlarged and examined for signs of liver disease such as jaundice (a yellowing of the skin and eyes).

To confirm the diagnosis of thrombocytopenia, your doctor will order blood tests to measure blood platelet count (platelets). Your doctor will also test your blood under a microscope.

Once your doctor has determined that you have thrombocytopenia, the next step is to discover the cause of this disease. If your doctor thinks there might be reacting to a drug, it may ask you to stop taking this medicine to see if your platelet count rises. If this happens, you have drug-induced thrombocytopenia (drugs).
In some sunsets, your doctor will need to bone marrow biopsy. This procedure removes a small amount of bone marrow with a needle and examined under a microscope. The appearance of the bone marrow and megakaryocytes (cells that produce platelets) will determine what is causing the problem.

Most people have more than 150,000 platelets per microliter of blood. A person with few platelets have some degree of thrombocytopenia. The risk of bleeding increases as the platelet count decreases, so people with less than 10,000 platelets per microliter of blood has a high risk of heavy bleeding.

Thrombocytopenia can occur alone or may manifest as a complication of another disease such as cancer or viral infection. In some cases, thrombocytopenia is a chronic (long) that lasts for years, while other times, the disease appears suddenly and drastically.

In general, thrombocytopenia develops due to one or more of the following reasons:

* The body’s bone marrow fails to produce enough platelets. That can happen because:
- A type of cancer such as leukemia or lymphoma, invades and destroys the bone marrow megakaryocytes, the cells that produce platelets.
- Aplastic anemia affect the production of platelets.
- Toxic chemicals, radiation or chemotherapy destroys megakaryocytes.
- Genetic problems, such as Wiskott-Aldrich syndrome or May-Hegglin anomaly, hinder production of platelets.
- Exposure to certain medications, especially thiazide diuretics or alcohol, decreases the production of megakaryocytes. Because drinking large amounts of alcohol can seriously diminish the production d platelets, transient thrombocytopenia is a common syndrome in alcoholics, especially if the drinkers diet is low in iron, vitamin B12 or folic acid.
- After suffering from a viral infection, varicella, parvovirus, mumps, rubella, Epstein-Barr virus, some patients have a decreased production of platelets. This problem usually takes little time and get better without treatment.

* The bone marrow makes enough platelets, but the body destroys them. Some common causes for this problem include:
- Inmunutaria thrombocytopenic purpura (ITP): This condition can be short term but may be extended
- Autoimmune Diseases: they include lupus erythematosus (SLE), polyarteritis and dermatomyositis.
- AIDS: People with AIDS often develop thrombocytopenia before other symptoms.
- Complications of pregnancy: approximately 5% of pregnant women develop mild thrombocytopenia when they are close to giving birth.
- Reaction to Drugs: thrombocytopenia can be caused by any medicine, but it happens quite often in those taking valproic acid (Depakote), gold salts, heparin (Calciparine, Liquaemin), and various other drugs. For example, up to 15% of hospitalized patients receiving heparin to prevent blood clots eventually develop thrombocytopenia. In most cases, thrombocytopenia develops two to five days after they started taking a new medication.
- Physical trauma, platelets may be damaged or destroyed as they pass through an artificial heart valve through a grafted blood vessel or through cannulas used machines and massive blood transfusion or surgery to bypass (deviation) cardiopulmonary.
- Infections: thrombocytopenia can develop after infections such as mononucleosis or cytomegalovirus.
- Inmunutaria thrombocytopenic purpura (ITP): This is a rare disease that lowers the levels of platelets, along with several other symptoms and complications.

* Too many platelets in the spleen. Usually, about a third of platelets in the spleen and the rest circulates in the blood. However, if the spleen is enlarged by a severe liver disease (especially cirrhosis), Gaucher disease or cancer, can accumulate too many platelets. This causes low platelets circulating in the bloodstream, causing thrombocytopenia.

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Once you have ruled out any serious problems, you can use simple remedies, but effective:
- Exercise. Swimming, walking, cycling, climbing stairs …, any exercise of this kind in which you have to move your legs, makes the kidneys work. If your activity requires you to work sitting for a long time, get up at least once an hour and gives a gentle stroll around the room. If you can, move your toes up and down, so that the muscles of the legs exert a pumping action.
- Get in the water. Once inside (in the sea, pool or bath), move your legs for the muscles to pump fluid into the bladder. The pressure of the water shall provide the expelled through the urine. - Rest your legs and feet. If fluid retention is accumulated in the lower limb, lie down and elevate your feet at least an hour in the afternoon. Do not wear shoes or socks are too tight.
- Drink plenty of water. The more water you drink, you can easily remove excess fluids. The minimum quantity is one quart and a half to two liters. Do not wait until thirsty to drink, do so continuously throughout the day, as this symptom is only indicative of dehydration has begun in the body. You can also drink juices and teas. One trick: a glass just to get up will help remove accumulated fluid overnight.
- The diuretic herbs and vegetables will help. The most effective are the infusions of parsley, juniper, olive leaves, horsetail, broth of leeks, asparagus and cucumber. They increase urine production.
- A diet rich in protein. Prevents water retention, and that after ingestion the liver produces albumin, which is the substance necessary for the fluid does not accumulate in tissues.
- Rest is essential. Eight hours a night and can be an hour after eating, if your lifestyle allows it.

Prohibitions
There are two fundamental prohibitions if you suffer from fluid retention:
- The use of diuretics. Be taken only on prescription, and that if eaten regularly can cause the rebound effect: just stimulating the action of hormones that will order the body to retain salt and water. Above all we must avoid if you are pregnant, especially during the first weeks of gestation. The foods you can substitute diuretic effect.
- The overuse of salt. We need to reduce salt intake at meals, and an excess of sodium in the body will cost more than 24 hours remove kidneys, causing fluid retention.

Who at some point in his life has not suffered fluid retention? It is a health problem that concerns many people, especially women. And for effective treatment is necessary to discover what causes motivate.

- When the level is above 75%
- Fluid retention occurs when there is an inability to remove any humor in the body (water and liquids of any kind) and are exceeded 75%.

Its main symptoms are cramps, weakness, palpitations, swelling and general discomfort. From an aesthetic point of view, can cause cellulite and a significant volume increase. In many cases, you get to confuse even overweight, so people who suffer are subjected to dieting wrong, compounding the problem.

Question of hormones … and more

There are many factors that can cause fluid retention:
- A poor diet with too much salt and alcohol, and lack of protein and nutrients.
- A very sedentary life.
- Hormonal fluctuations (pregnancy, menopause).
- Liver, heart or kidney, which make tip the balance and cause tissue fluid accumulation.
- Use of certain medications …
All these factors contribute to the heaviness and general malaise caused by this problem.

During pregnancy

It is very common in the gestation period retain more fluid than the body needs. At least 50% of women suffer at some time, especially during the third quarter. All this disarray is because of the dramatic hormonal changes that occur during pregnancy and is usually found with a slight swelling of the ankles and feet. In medicine, this problem is called ‘edema’ and it is very disturbing, but it is advisable to discuss with the gynecologist.

But if the swelling is too exaggerated and extends to the area of ??the hands and face, you must go to the doctor without delay. It could be a more serious condition such as preeclampsia, characterized not only by the presence of edema, because it contains protein in the urine and high blood pressure.
Mild edema corrected with simple measures, but in any case should not be taking any medication without consulting a specialist.

When to See a doctor

Although fluid retention is not usually a very annoying problem, it is necessary to go to the doctor, especially if it persists over time without obedience to hormonal changes (such as during menstruation or pregnancy), increasing weight suddenly significantly or if the pressure on the skin over the swollen area is marked for too long.

These are usually symptoms that indicate major problems such as hypertension, heart disease and some renal hypertrophy.

What are the causes of heart murmur?

Heart murmur can be caused by various factors or diseases, including the following:

- Defective heart valves.
- Holes in the walls of the heart (atrial septal defect or ventricular septal defect)
- Surgical repair of congenital heart defects (present at birth).
- Fever.
- Anemia (low red blood cells).

What are the different types of murmurs?

Your child’s doctor will evaluate a murmur based on several factors. Murmurs are analyzed for pitch, volume and duration. Also classified according to their intensity (on a scale of 1 to 6, in which one is the weakest and the strongest six).

Types of murmurs include the following:

- Systolic murmur – a heart murmur that occurs during heart muscle contraction. Systolic murmurs are divided into ejection murmurs (due to blood flow through a narrowed vessel or irregular valve) and regurgitant murmurs.
- Diastolic murmur – a heart murmur that occurs during heart muscle relaxation between beats. Diastolic murmurs are caused by a narrowing (stenosis) of the mitral or tricuspid regurgitation or aortic or pulmonary valves.
- Continuous murmur – a heart murmur that occurs throughout the cardiac cycle.

Murmurs related to a congenital (present at birth) or other problem involving the heart structures will be heard loudest in the area of ??the chest where the problem occurs. Some defects have almost no murmur in the newborn due to normally elevated pressures in the blood vessels of the lungs. Murmurs may be inconsistent and difficult to hear in an infant who is agitated or crying. Thus, murmurs may be overlooked or not detected.
Do all murmurs signify heart disease?

Not all heart murmurs are symptoms of heart disease. Sometimes, a murmur may be heard in a normal child who has fever or who is anemic; these murmurs disappear when treating the underlying problem.

Some children have what is known as an innocent murmur. These murmurs are not associated with congenital heart disease and usually resolve when the child reaches adulthood. If your child’s physician hears an innocent murmur, you may want to perform additional tests to ensure that no heart disease. A child with an innocent murmur can live a normal life and be as active as any healthy child.