Health News. Lots of resources and information

A number of complications have been associated with acute and chronic cholecystitis:• Empyema – occurs when super-infection of stagnant bile leads to pus filling the gallbladder. This complication carries a high risk of gram-negative sepsis.• Gangrene – results from chronic ischemia of the gallbladder wall leading to complete tissue necrosis. There is a high risk of perforation associated with this complication.• Perforation (with or without peritonitis) – may be either localized (contained by the omentum and serosa of contiguous organs) or free (frank rupture of the gallbladder into the peritoneal cavity). Fever and a palpable RUQ mass may be present when a localized perforation has occurred. A free perforation produces the clinical findings of diffuse peritonitis.• Emphysematous cholecystitis – occurs when gas-producing bacteria invade a gangrenous gallbladder wall. The clinical manifestations are usually more severe but may be indistinguishable from nongaseous cholecystitis. An abdominal plain radiograph may reveal gas within the gallbladder lumen, gas in a ring along the contours of the gallbladder wall, or a gas-fluid level in the gallbladder.• Cholecystenteric fistulas – can form with chronic inflammation and can connect areas of bowel adjacent to the gallbladder wall. Fistulas from the gallbladder to the duodenum are the most common.• Gallstone ileus – refers to the mechanical intestinal obstruction resulting from passage of a large gallstone through the bowel lumen. If a significantly sized gallstone (>2.5 cm in diameter) passes through a fistula into the intestines, it can cause obstruction, typically at the ileocecal valve. An abdominal plain radiograph reveals intestinal obstruction, gas in the biliary tree, and a calcified gallstone in the bowel lumen.• Porcelain gallbladder – can occur in the setting of chronic cholecystitis when calcium salts deposit within the chronically inflamed gallbladder wall. Cholecystectomy is recommended in these cases because of the association of carcinoma of the gallbladder.• Pericholecystic abscess – consists of a localized pus collection adjacent to the gallbladder.• Intra-abdominal abscess – can occur following a perforation of the gallbladder (usually a free perforation).• Bacteremia – results from translocation of bacteria from the gallbladder into the bloodstream.*105/348/5*

Stress is something that we generate inside ourselves in response to ‘stressors’. Stressors can be major events such as crumbling relationships, a dead-end job or delinquent children – but they can also be simply the accumulating daily hassles of constant deadlines and snatched meals. In other words, they can be anything that leads to stress.In fact not all stressors are nasty. Winning the lottery, or going on holiday can trigger as much of a stress response as having your handbag snatched on the way to work.Intense emotion such as excitement, anxiety, frustration and anger is the trigger for the body’s stress reaction.In primitive times the stress response was a vital part of our defence against danger such as being chased by wild animals. The stress response makes us ready for immediate physical action whether running as fast as we can to escape or stopping to fight. This is known as ‘the fight or flight response’.The body responds to a stressor in several ways:• adrenalin and glucose flood into the body• breathing becomes shallow and fast to take in more oxygen• muscles contract ready for use• blood pressure increases• the heart beats fosterStress can feel good. Adrenalin can give you a buzz and almost make you feel ‘high’. This is fine when you are racing to meet a deadline, for example, and you need that extra burst of energy to rise to the challenge.But stress becomes bad when the chemicals released during the stress reaction stay in the body. In prehistoric times the stress reaction would always have been followed by a burst of physical activity which would have broken down the chemicals allowing the body to relax afterwards.In modem times it appears that often the chemicals produced by the stress reaction are not broken down before we meet another stressor which starts the whole process again. This means our bodies never return to normal and we are in a permanent state of stress.For many of us the image of a stressed-out individual is a middle-aged company executive who works all hours, eats too many heavy business lunches, smokes like a chimney and is well on his way to his first coronary. But women are not immune to stress.In bet the dual pressures of home and work are purring women under extraordinary levels of stress. A recent survey of 20,000 British men and women found that 42 per cent of the women reported being under stress compared with 30 per cent of the men. Women today, it seems, may be more stressed than men.In the UK women now make up more than half the workforce but are still responsible for 80 per cent of the country’s housework, in addition to taking most of the burden of caring for children. And ifs not just working women who are under stress,Studies of stay-at-home mothers have consistently found that they are more depressed and have lower self-esteem than their working counterparts.*33\120\4*

Sometimes it’s hard to explain hope—just what is hope, anyway? The cutest illustration of hope I’ve found is about a little boy who was standing at the foot of the escalator in a big department store, intently watching the handrail. He never took his eyes off the handrail as the escalator kept going around and around. A salesperson saw him and finally asked him if he was lost. The little fellow replied, “Nope. I’m just waiting for my chewing gum to come back.”If your face is in the dust, if you are in a wringer situation, be like the little boy waiting for his chewing gum to come back. Stand firm, be patient, and trust God. Then get busy with your life . . . there is work to do.I like the note one mother sent me that simply said:Dear Barb (and Gopher Bill): Like the sundial, this year I am only going to count the sunny hours! I don’t know where we are—I don’t need to know. It’s all in His hands. How much safer could it be?Her words remind me that nothing touches me that has not passed through the hands of my heavenly Father, NOTHING. Whatever occurs, God has sovereignly surveyed and approved. We may not know why (we may never know why), but we do know our pain is no accident to Him who guides our lives. He is, in no way, surprised by it all. Before it ever touches us, it passes through Him.*17\316\2*