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2534) Primate
Gist
A primate is a member of the biological order Primates, which includes lemurs, lorises, tarsiers, monkeys, apes, and humans. These mammals are characterized by highly developed brains, forward-facing eyes for stereoscopic vision, and flexible hands/feet with opposable thumbs, adapted for life in trees.
Primates are an order of mammals that includes humans, apes, monkeys, tarsiers, lemurs, and lorises. They are characterized by large brains, forward-facing eyes for 3D vision, grasping hands with opposable thumbs, and high intelligence. Most species are social and arboreal (tree-dwelling), adapted for complex environments.
Summary
Primates is an order of mammals, which is further divided into the strepsirrhines, which include lemurs, galagos, and lorisids; and the haplorhines, which include tarsiers and simians (monkeys and apes). Primates arose 74–63 million years ago first from small terrestrial mammals, which adapted for life in tropical forests: many primate characteristics represent adaptations to the challenging environment among tree tops, including large brain sizes, binocular vision, color vision, vocalizations, shoulder girdles allowing a large degree of movement in the upper limbs, and opposable thumbs (in most but not all) that enable better grasping and dexterity. Primates range in size from Madame Berthe's mouse lemur, which weighs 30 g (1 oz), to the eastern gorilla, weighing over 200 kg (440 lb). There are 376–524 species of living primates, depending on which classification is used. New primate species continue to be discovered: over 25 species were described in the 2000s, 36 in the 2010s, and six in the 2020s.
Primates have large brains (relative to body size) compared to other mammals, as well as an increased reliance on visual acuity at the expense of the sense of smell, which is the dominant sensory system in most mammals. These features are more developed in monkeys and apes, and noticeably less so in lorises and lemurs. Some primates, including gorillas, humans and baboons, are primarily ground-dwelling rather than arboreal, but all species have adaptations for climbing trees. Arboreal locomotion techniques used include leaping from tree to tree and swinging between branches of trees (brachiation); terrestrial locomotion techniques include walking on two hindlimbs (bipedalism) and modified walking on four limbs (quadrupedalism) via knuckle-walking.
Primates are among the most social of all animals, forming pairs or family groups, uni-male harems, and multi-male/multi-female groups. Non-human primates have at least four types of social systems, many defined by the amount of movement by adolescent females between groups. Primates have slower rates of development than other similarly sized mammals, reach maturity later, and have longer lifespans. Primates are also the most cognitively advanced animals, with humans (genus Homo) capable of creating complex languages and sophisticated civilizations, while non-human primates have been recorded using tools. They may communicate using facial and hand gestures, smells and vocalizations.
Close interactions between humans and non-human primates (NHPs) can create opportunities for the transmission of zoonotic diseases, especially virus diseases including herpes, measles, ebola, rabies and hepatitis. Thousands of non-human primates are used in research around the world because of their psychological and physiological similarity to humans. About 60% of primate species are threatened with extinction. Common threats include deforestation, forest fragmentation, monkey drives, and primate hunting for use in medicines, as pets, and for food. Large-scale tropical forest clearing for agriculture most threatens primates.
Details
A primate, in zoology, is any mammal of the group that includes the lemurs, lorises, tarsiers, monkeys, apes, and humans. The order Primates, including more than 500 species, is the third most diverse order of mammals, after rodents (Rodentia) and bats (Chiroptera).
Although there are some notable variations between some primate groups, they share several anatomic and functional characteristics reflective of their common ancestry. When compared with body weight, the primate brain is larger than that of other terrestrial mammals, and it has a fissure unique to primates (the Calcarine sulcus) that separates the first and second visual areas on each side of the brain. Whereas all other mammals have claws or hooves on their digits, only primates have flat nails. Some primates do have claws, but even among these there is a flat nail on the big toe (hallux). In all primates except humans, the hallux diverges from the other toes and together with them forms a pincer capable of grasping objects such as branches. Not all primates have similarly dextrous hands; only the catarrhines (Old World monkeys, apes, and humans) and a few of the lemurs and lorises have an opposable thumb. Primates are not alone in having grasping feet, but as these occur in many other arboreal mammals (e.g., squirrels and opossums), and as most present-day primates are arboreal, this characteristic suggests that they evolved from an ancestor that was arboreal. So too does primates’ possession of specialized nerve endings (Meissner’s corpuscles) in the hands and feet that increase tactile sensitivity. As far as is known, no other placental mammal has them. Primates possess dermatoglyphics (the skin ridges responsible for fingerprints), but so do many other arboreal mammals.
The eyes face forward in all primates so that the eyes’ visual fields overlap. Again, this feature is not by any means restricted to primates, but it is a general feature seen among predators. It has been proposed, therefore, that the ancestor of the primates was a predator, perhaps insectivorous. The optic fibres in almost all mammals cross over (decussate) so that signals from one eye are interpreted on the opposite side of the brain, but, in some primate species, up to 40 percent of the nerve fibres do not cross over.
Primate teeth are distinguishable from those of other mammals by the low, rounded form of the molar and premolar cusps, which contrast with the high, pointed cusps or elaborate ridges of other placental mammals. This distinction makes fossilized primate teeth easy to recognize.
Fossils of the earliest primates date to the Early Eocene Epoch (56 million to 41.2 million years ago) or perhaps to the Late Paleocene Epoch (59.2 million to 56 million years ago). Though they began as an arboreal group, and many (especially the platyrrhines, or New World monkeys) have remained thoroughly arboreal, many have become at least partly terrestrial, and many have achieved high levels of intelligence. It is certainly no accident that the most intelligent of all forms of life, the only one capable of constructing the Encyclopædia Britannica, belongs to this order.
By the 21st century the populations of approximately 75 percent of all primate species were falling, and some 60 percent were considered either threatened or endangered species. Habitat loss and fragmentation from logging, mining, urban sprawl, and the conversion of natural areas to agriculture and livestock raising are the primary threats to many species. Other causes of widespread population declines include hunting and poaching, the pet trade, the illegal trade in primate body parts, and the susceptibility of some primates to infection with human diseases.
General considerations:
Size range and adaptive diversity
Members of the order Primates show a remarkable range of size and adaptive diversity. The smallest primate is Madame Berthe’s mouse lemur (Microcebus berthae) of Madagascar, which weighs some 35 grams (one ounce); the most massive is certainly the gorilla (Gorilla gorilla), whose weight may be more than 4,000 times as great, varying from 140 to 180 kg (about 300 to 400 pounds).
Primates occupy two major vegetational zones: tropical forest and woodland–grassland vegetational complexes. Each of these zones has produced in its resident primates the appropriate adaptations, but there is perhaps more diversity of bodily form among forest-living species than among savanna inhabitants. One of the explanations of this difference is that it is the precise pattern of locomotion rather than the simple matter of habitat that governs overt bodily adaptations. Within the forest there are a number of ways of moving about. An animal can live on the forest floor or in the canopy, for instance, and within the canopy it can move in three particular ways: (a) by leaping—a function principally dictated by the hind limbs; (b) by arm swinging (brachiation)—a function particularly of the forelimbs; (c) by quadrupedalism—a function equally divided between the forelimbs and the hind limbs. On the savanna, or in the woodland-savanna biome, which substantially demands adaptations for ground-living locomotion rather than those for tree-living, the possibilities are limited. If bipedal humans are discounted, there is a single pattern of ground-living locomotion, which is called quadrupedalism. Within this category there are at least two variations on the theme: (a) knuckle-walking quadrupedalism, and (b) digitigrade quadrupedalism. The former gait is characteristic of the African apes (chimpanzee and gorilla), and the latter of baboons and macaques, which walk on the flats of their fingers. After human beings, Old World monkeys of the subfamily Cercopithecinae are the most successful colonizers of nonarboreal habitats.
The structural adaptations of primates resulting from locomotor differences are considered in more detail in the section Locomotion, but they do not prove to be very extensive. Primates are a homogeneous group morphologically, and it is only in the realm of behaviour that differences between primate taxa are clearly discriminant. It can be said that the most successful primates (judged in terms of the usual criteria of population numbers and territorial spread) are those that have departed least from the ancestral pattern of structure but farthest from the ancestral pattern of behaviour. “Manners makyth man” is true in the widest sense of the word; in the same sense, manners delineate primate species.
Distribution and abundance
The nonhuman primates have a wide distribution throughout the tropical latitudes of Africa, India, Southeast Asia, and South America. Within this tropical belt, which lies between latitudes 25° N and 30° S, they have a considerable vertical range. In Ethiopia the gelada (genus Theropithecus) is found living at elevations up to 5,000 metres (16,000 feet). Gorillas of the Virunga Mountains are known to travel across mountain passes at altitudes of more than 4,200 metres when traveling from one high valley to another. The howler monkeys of Venezuela (Alouatta seniculus) live at 2,500 metres in the Cordillera de Merida, and in northern Colombia the durukuli (genus Aotus) is found in the tropical montane forests of the Cordillera Central.
In habitat, primates are predominantly tropical, but few species of nonhuman primates extend their ranges well outside the tropics. The Barbary “ape” (Macaca sylvanus) lives in the temperate forests of the Atlas and other mountain ranges of Morocco and Algeria. Some populations of rhesus monkey (M. mulatta) extended until the middle of the 20th century to the latitude of Beijing in northern China, and the Tibetan macaque (M. thibetana) is found from the warm coastal ranges of Fujian (Fukien) province to the cold mountains of Sichuan (Szechwan). One of the most remarkable, however, is the Japanese macaque (M. fuscata), which in the north of Honshu lives in mountains that are snow-covered for eight months of the year; some populations have learned to make life more tolerable for themselves by spending most of the day in the hot springs that bubble out and form pools in volcanic areas. Finally, two western Chinese species of snub-nosed monkey, the golden (Rhinopithecus roxellana) and black (R. bieti), are confined to high altitudes (up to 3,000 metres in the case of the former and to 4,500 metres in the latter), where the temperature drops below 0 °C (32 °F) every night and often barely rises above it by day.
Although many primates are still plentiful in the wild, the numbers of many species are declining steeply. According to the International Union for Conservation of Nature (IUCN), more than 70 percent of primates in Asia and roughly 40 percent of primates in South America, in mainland Africa, and on the island of Madagascar are listed as endangered. A number of species, particularly the orangutan, the gorilla, some of the Madagascan lemurs, and some South American species, are in serious danger of extinction unless their habitats can be preserved in perpetuity and human predation kept under control. The populations of several species number only in the hundreds, and in 2000 a subspecies of African red colobus monkey (Procolobus badius) became the first primate since 1800 to be declared extinct.
In the midst of these declines, the populations of some critically endangered primate species have increased. Concerted efforts to breed a type of marmoset, the golden lion marmoset (or golden lion tamarin; Leontopithecus rosalia), in captivity have been successful; reintroduction of that species into the wild continues in Brazil. The estimated number of western lowland gorillas (G. gorilla gorilla), a species thought to be critically endangered, increased when a population of more than 100,000 was discovered in 2008 in the swamps of the Lac Télé Community Reserve in the Republic of the Congo.
Natural history:
Reproduction and life cycle
The stages of the life cycle of primates vary considerably in duration. Among the most primitive members of the group, these stages are broadly comparable to those of other mammals of similar size. Higher in the phylogenetic scale, they are substantially extended. The greatest difference is in the duration of the infant and juvenile stages combined; the least is in the gestation period, which, despite the general belief, cannot be consistently correlated with adult body size. Gibbons, which weigh considerably less than macaques, have a 20 percent longer gestation period.
The clear trend toward prolongation of the period of juvenile and adolescent life is probably to be associated with the corresponding trend toward a progressive elaboration of the brain. The extended period of adolescence means that the young remain under adult (primarily maternal) surveillance for a long period, during which time the juvenile acquires, by example from its mother and peers, the knowledge that will allow it to become properly integrated as a fully adult member of a complicated social system. One might therefore expect a close correlation between the period of adolescence, the brain size, and the complexity of the social system; and, insofar as the latter factor can be assessed, this appears to be the case.
Breeding periods
The reproductive events in the primate calendar are copulation, gestation, birth, and lactation. Owing to the long duration of the gestation period, these phases occupy the female primate (among higher primates anyway) for a full year or more; then the cycle starts again. The female does not usually come into physiological receptivity until the infant of the previous pregnancy has been weaned.
Most lemurs and lorises show one or more discrete breeding seasons during the year, during which time they may undergo more than one reproductive estrous cycle (i.e., period of sexual activity). The breeding seasons are separated by periods of anestrus, which in bush babies and mouse lemurs are accompanied by changes in the skin of the external genitalia (vulva), which closes over, completely sealing the math. When living in the wild in the Sudan, the lesser bush baby (Galago senegalensis) has an estrus that occurs only twice yearly, during December and August. In captivity, however, breeding seasons may occur at any period in the year. In the wild, birth seasons are closely correlated with the prevailing climate, but in captivity under equable laboratory conditions, this consideration does not apply. For instance, in its native Madagascar, the ring-tailed lemur (Lemur catta) has only a single breeding season during the year, conception occurring in autumn (April) and births taking place in late winter (August and September). However, in zoos in the Northern Hemisphere, a seasonal inversion occurs in which the birth period shifts to late spring and early summer. These examples indicate the influence of environmental factors on the timing of the birth seasons.
Reproductive cycles in tarsiers, apes, and many monkeys continue uninterrupted throughout the year, though seasonality in births is characteristic mainly of monkey species living either outside the equatorial belt (5° north and south of the Equator) or at high elevations in equatorial regions, where dry seasons and seasonal food shortages occur. Seasonality of births in macaques (genus Macaca species) has been documented in Japan, on Cayo Santiago in the Caribbean (where an introduced population thrives under seminatural conditions), and in India. Observations of langurs in India and Sri Lanka, of geladas in Ethiopia, and of patas monkeys in Uganda have also demonstrated seasonality in areas with well-marked wet and dry seasons. Those within the equatorial belt tend to display birth peaks rather than birth seasons. A birth peak is a period of the year in which a high proportion of births, but not by any means all, are concentrated. Equatorial primates such as guenons, colobus monkeys, howlers, gibbons, chimpanzees, and gorillas might be expected to show a pattern of births uniformly distributed throughout the year, but population samples are as yet too small to make this assumption, and some equatorial monkeys, such as squirrel monkeys (genus Saimiri), are strictly seasonal breeders. Even in humans, there is evidence of high birth peaks. In Europe, the highest birth rates are reached in the first half of the year; in the United States, India, and countries in the Southern Hemisphere, in the second half. This may, however, be a cultural rather than an ecological phenomenon, for marriages in certain Western countries reach a peak in the closing weeks of the fiscal year, a fact that undoubtedly has some repercussions on the birth period.
Gestation period and parturition
The period during which the growing fetus is protected in the uterus is characterized by a considerable range of variation among primate species, but it shows a general trend toward prolongation as one ascends the evolutionary scale. Mouse lemurs, for example, have a gestation period of 54–68 days, lemurs 132–134 days, macaques 146–186 days, gibbons 210 days, chimpanzees 230 days, gorillas 255 days, and humans (on the average) 267 days. Even small primates such as bush babies have gestations considerably longer than those of nonprimate mammals of equivalent size, a reflection of the increased complexity and differentiation of primate structure compared with that of nonprimates. Although in primates there is a general trend toward evolutionary increase in body size, there is no absolute correlation between body size and the duration of the gestation period. Marmosets, for example, are considerably smaller than spider monkeys and howler monkeys but have a slightly longer pregnancy (howler monkeys 139 days, “true” marmosets 130–150 days).
An extraordinary and somewhat inexplicable difference exists between the dimensions of the pelvic cavity and the dimensions of the head of the infant at birth in monkeys and humans on the one hand, and apes on the other. The head of the infant ape is considerably smaller than the pelvic cavity, so birth occurs easily and without prolonged labour. When the head of the infant monkey engages in the pelvis, the fit is exact, and labour may be a prolonged and difficult affair, as it is generally with humans. Human parturition, however, is generally a much more extended process than that of monkeys. Like the human infant, the monkey is born head first. Twin births are rare in most monkeys and apes, but marmosets and some lemurs and lorises habitually produce twins.
Infancy
The degrees of maturation and mother dependency at birth are obviously closely related phenomena. Newborn primate infants are neither as helpless as kittens, puppies, or rats nor as developed as newborn gazelles, horses, and other savanna-living animals. With a few exceptions, primate young are born with their eyes open and are fully furred. Exceptions are mouse lemurs (Microcebus), gentle lemurs (Hapalemur), and ruffed lemurs (Varecia), which bear more helpless (altricial) infants and carry their young in their mouth. Primate life being peripatetic, it is axiomatic that the infants must be able to cling to the mother’s fur; just a few species (again, mouse lemurs and ruffed lemurs and a few others) leave their infants in nests while foraging, and lorises “park” their young, leaving them hanging under branches in tangles of vegetation. The young of most higher primates have grasping hands and feet at birth and are able to cling to the maternal fur without assistance; only humans, chimpanzees, and gorillas need to support their newborn infants, and humans do so longest.
It seems likely that the difference between the African apes and humans in respect to postnatal grasping ability is related to the acquisition in man of bipedal walking. One of the anatomic correlates of the human gait is the loss of the grasping function of the big toe, which is aligned in parallel with the remaining digits. Such an arrangement precludes the use of the foot as a grasping extremity. The human infant—and to a lesser degree the gorilla infant—must depend largely on its grasping hands to support itself unaided. The fact that humans are habitually bipedal and that, consequently, the hands are freed from locomotor chores may also be a contributory factor; the human mother can move about and at the same time continue to support her infant. Selection for postnatal grasping, therefore, has not had the high survival value in humans that it has in nonhuman primates, in which the survival of the infant depends on its ability to hold on tightly. On the other hand, it is well known that newborn human infants can support their own weight, for short periods, by means of their grasping hands. Clearly then, adaptations for survival are not wholly lacking in the human species. Perhaps cultural factors have had the effect of suppressing natural selection for early infant grasping ability. The first factor may be the social evolution of a division of labour between the sexes and a fixed home base, which has allowed the mother to park her infant with other members of the family as babysitters. A second factor may be more peripatetic communities, in which the invention of infant-carrying devices, such as the papoose technique of North American Indians, has made it unnecessary for the infant to support itself. Whatever the biological or cultural reasons, the human infant is more helpless than the young of all other primates.
Once the primate infant has learned to support itself by standing on its own two (or four) feet, the physical phase of dependency is over; the next phase, psychological dependency, lasts much longer. The human child is metaphorically tied to its mother’s apron strings for much longer periods than are the nonhuman primates. The reasons for this are discussed below. According to Adolph Schultz, the Swiss anthropologist whose comparative anatomic studies have illuminated knowledge of nonhuman primates since the mid-20th century, the juvenile period of psychological maternal dependency is 21/2 years in lemurs, 6 years in monkeys, 7–8 years in most apes (though it now appears to be even longer than this in chimpanzees), and 14 years in humans.
Growth and longevity
The prolongation of postnatal life among primates affects all life periods, including infantile, juvenile, adult, and senescent. Although humans are the longest-lived members of the order, the potential life span of the chimpanzee has been estimated at 60 years, and orangutans occasionally achieve this in captivity. The life span of a lemur, on the other hand, is about 15 years and a monkey’s 25–30 years.
The characteristic growth spurts of human infants in weight and height also occur in nonhuman primates but start earlier in the postnatal period and are of shorter duration. Primates differ from most nonprimate mammals by virtue of a delayed puberty in both sexes until growth is nearly complete; in humans, the peak of the growth spurt in boys comes slightly after the sexual maturity, whereas in girls the growth spurt precedes menarche. There is some controversy over the very existence of an adolescent growth spurt in nonhuman primates. In some species, males are very much larger than females; this extra growth occurs long after sexual maturity and rather rapidly, so it is possibly equivalent to the human growth spurt. The most remarkable case of such postmature growth is seen in orangutans. A male can mature physically in his early teens, or he can spend as much as 20 years as a subadult and then suddenly, within a year, almost double his weight and develop the cheek flanges characteristic of full maturity. It appears that this is related to social conditions; in proximity to a full-grown, dominant male, a subadult male’s development will remain suppressed, and when the dominant male moves away (or, in a zoo, is removed from the vicinity), the subadult undergoes a flush of testosterone and matures rapidly.
Locomotion
Primate locomotion, being an aspect of behaviour that arises out of anatomic structure, shows much of the conservativeness and opportunism that generally characterizes the order. Primates with remarkably few changes in their skeletons and musculature have adopted a bewildering variety of locomotor patterns. The “natural” habitat of primates—in the historical sense—is the canopy of the forest. Although many primates have adopted the ground as their principal foraging area during the day, given the opportunity they will return to the trees to sleep at night. Trees provide cover from the climate and protection from predators; they are of course also a source of food. Only the gelada, the hamadryas baboon of the mountainous regions of Ethiopia, and the chacma baboon, which lives on the rocky coast of the Cape of Good Hope, South Africa, are ground sleepers; yet even these animals seek the protection of the cliffs and rocky precipices of their habitats at night. No primate sleeps totally unprotected; as a consequence of their relative immunity from predation, primates are heavy sleepers.
Four types of locomotion
The essential arboreality of primates has guaranteed the relative uniformity of the locomotor apparatus. Even humans, who have long since abandoned the trees as their principal lodging place, have only partially lost the physical adaptations for tree climbing; their hands, in particular, remain in the arboreal mold. Only the feet have lost their primitive prehensility in adapting to bipedal walking. Primate locomotion can be classified on behavioral grounds into four major types: vertical clinging and leaping, quadrupedalism, brachiation, and bipedalism. Within these major categories, there are a number of subtypes, and within these subtypes, there are an infinite number of variations between species and, by virtue of individual variability, within species. The differences between the four major categories lie principally in the degree to which the forelimbs and hind limbs are used to climb, swing, jump, and run.
Vertical clinging and leaping, for instance, is primarily a function of the hind limbs, as is bipedalism, whereas brachiation is performed exclusively with the forelimbs. Quadrupedalism involves both forelimbs and hind limbs, of course, although not to an equal extent. Some quadrupeds are hind limb-dominated; in others, the forelimb and the hind limb are equally important. The hind limb-dominated primates, such as the langurs and colobus monkeys, employ a large element of leaping in their movements, a less-notable feature of the more generalized quadrupeds such as guenons. The quadrupedal category is inevitably somewhat of a grab bag, and the gaits included in it have not yet been studied critically. One subtype, here designated as slow climbing, differs profoundly from the other subtypes of the category, being somewhat ponderous and devoid of elements of leaping or jumping. The species in this category are lorises and pottos, all of which are arboreal and nocturnal.
As many authorities who have studied locomotion in free-ranging primate species have pointed out, the classifications of locomotion into categories is a somewhat artificial procedure. A chimpanzee shows a variety of different gaits according to the circumstances of the environment: quadrupedalism (knuckle walking), climbing, bipedalism, and brachiation. This holds true also for the langurs and colobus monkeys, which are designated semibrachiators, which means that they mainly move quadrupedally (usually with a “galloping gait” rather than walking) but also jump across gaps and occasionally swing by their arms. Although the categories are phrased in behavioral terms, their implications are also anatomic. Brachiation is the mode of locomotion for which the animal is specifically adapted; the anatomic correlates of brachiation are quite unmistakable and can be determined in fossil bones as much as in living animals. In some instances, it may well be that a particular anatomy is misleading. It has been argued that the anatomy of the great apes (including humans), for instance, is that of a brachiator, yet in fact they seldom brachiate (humans rarely and adult gorillas probably never). Watching gorillas, in particular, suggests that what appeared at first to be a locomotor adaptation may actually be a feeding one; the gorilla sits erect amid its food, reaching all around it to pull it in, and thereby saves an enormous amount of energy. The shortened lumbar spine (giving a lowered centre of gravity), broad chest, enhanced mobility of the shoulder joint, and flexible wrist may be related to this feeding style. The gibbons’ specializations for brachiation may be derived from these same traits, rather than the other way about.
Changes in climate and geography during the evolutionary history of primates may also have led to structural atavisms in the anatomy of living primates. Many chimpanzees now living in woodland-savanna conditions in Africa, where the trees are widely spaced and generally unsuitable for the classic climbing style of forest-living chimpanzees, have adopted a largely ground-living life. Gorillas and chimpanzees are first and foremost knuckle walkers, but, given an environment like that of a zoo with a cage specially designed with lots of overhead bars and ropes, they will brachiate fairly frequently.
When the subject of primate arboreal locomotion is studied in evolutionary terms by using fossils, it becomes clear that locomotor categories are not discrete but constitute a continuum of change from a hind limb-dominated gait to a forelimb-dominated one. The best single indicator of gait, one that has the added advantage of being strictly quantitative, is the intermembral index. Briefly, the index is a ratio expressed as percentage of arm length to leg length; an index over 100 indicates relatively long arms. This provides a model by means of which the locomotion of an early primate can be inferred by determination of the intermembral index of the fossil skeleton. Animals do not necessarily fall discretely into categories. Species with indexes lying between those of clearly recognizable locomotor types represent transitional types, whose style of locomotion really does manifest features of both of the bracketing categories. Some lemurs have indexes that fall between 65 and 75, and their gait is a combination of vertical clinging and quadrupedalism. The South American spider monkeys (genus Ateles), whose index lies between 100 and 108, show a type of locomotion that contains the elements of both quadrupedalism and brachiation.
When the intermembral index is applied to fossil primates, it appears that the earliest primates living in the Eocene Epoch (56 million to 33.9 million years ago) must have moved about somewhat in the manner of modern vertical clingers and leapers. Quadrupedal gaits were well established during the Miocene Epoch (23 million to 5.3 million years ago) when the two major environmental types of quadrupedal gait— terrestrial and the arboreal—were established, with indexes in the region of 85–100 and 75–85, respectively. Brachiation, associated with a high intermembral index, was established as a way of arboreal life at the end of the Miocene, with the small hominid Oreopithecus from Italy. There is direct evidence of bipedalism’s extending back four million years, and certain indirect evidence (see below Evolution and paleontology) suggests that bipedalism might have evolved in a modified form up to a million years before that.
Bipedalism
Some degree of bipedal ability, of course, is a basic possession of the order Primates. All primates sit upright. Many stand upright without supporting their body weight by their arms, and some, especially the apes, actually walk upright for short periods. The view that the possession of uprightness is a solely human attribute is untenable; humans are merely the one species of the order that has exploited the potential of this ancestry to its extreme.
Chimpanzees, gorillas and gibbons, macaques, spider monkeys, capuchins, and others are all frequent bipedal walkers. To define humans categorically as “bipedal” is not enough; to describe them as habitually bipedal is nearer the truth, but habit as such does not leave its mark on fossil bones. Some more precise definition is needed. The human walk has been described as striding, a mode of locomotion defining a special pattern of behaviour and a special morphology. Striding, in a sense, is the quintessence of bipedalism; it is a means of traveling during which the energy output of the body is reduced to a physiological minimum by the smooth, undulating flow of the progression. It is a complex activity involving the joints and muscles of the whole body, and it is likely that the evolution of the human gait took place gradually over a period of 10 million years or so.
The pattern of locomotion of human ancestors immediately preceding the acquisition of bipedalism has long been a matter of controversy, and the question has not yet been resolved. The evidence derived from anatomic, physiological, and biochemical studies for the close affinity of chimpanzees and humans, and the slightly less close affinity of gorillas, would suggest that humans evolved from a knuckle-walking ancestry. There have been claims that the wrist anatomy of australopithecines shows remnant knuckle-walking adaptations. The issue is still hotly debated, and some authorities continue to support a brachiation model for the ancestry of all the apes. Other authorities have proposed other solutions: semibrachiation, for example, and even a form of locomotion similar to that of tarsiers and other clingers and leapers. At the present time, there is insufficient information to elucidate the phylogeny of man’s bipedal gait, except that it can be assumed to have involved a large measure of truncal uprightness.
Diet
The diet of primates is a factor of their ecology that, during their evolution, has clearly played an important role in their dispersion and adaptive radiation as well as in the development of the teeth, jaws, and digestive system. Diet is also closely related to locomotor pattern and to body size.
The principal food substances taken by primates may be divided into vegetable (fruits, flowers, leaves, nuts, barks, pith, seeds, grasses, stems, roots, and tubers) and animal (birds, birds’ eggs, lizards, small rodents and bats, insects, frogs, and crustacea). The flesh of larger mammals (including primates) is not listed as an important item of nonhuman primate diet, with the sole exception of chimpanzees—it is taken by baboons in special circumstances that are not yet fully understood.
While diet is selective and specific to the order in many mammalian groups, among primates it is difficult to establish any hard and fast rules. Although there are decided preferences for certain food items, catholicity is more characteristic than specificity. Generally speaking, primates are omnivorous, as the physiology of their digestive system attests. Relatively few examples of dietary specialization are to be found. The so-called leaf-eating monkeys, a sobriquet that embraces the whole of the subfamily Colobinae, including colobus monkeys and langurs, are by no means exclusively leaf eaters and according to season include flowers, fruit, and (in some cases) seeds in their diet. The howler monkeys of the New World have a similar dietary preference.
Broadly, however, certain overall dietary preferences are discernible. The leaf-eating langurs have already been mentioned. The apes (other than the mountain gorilla) are substantially fruit eaters. Many of the smaller nocturnal primitive species such as galagos, dwarf lemurs, sportive lemurs, the aye-aye, and the slender loris are substantially insectivorous; the tarsier is probably the only primate that is exclusively carnivorous, feeding on insects, lizards, and snakes. The larger diurnal lemurs (e.g., typical lemurs, the sifaka, and the indri) are more vegetarian, including fruit, seeds, and leaves. It seems apparent that size, rather than activity rhythm, governs the nature of the primate diet. The small marmosets of the South American genus Callithrix have exclusively diurnal rhythms and are insectivorous and also eat gums, while the slightly larger, but equally diurnal, tamarins (genus Saguinus) are more omnivorous. An approximate cutoff point of 500 grams (Kay’s threshold, after the primatologist Richard Kay, who first drew attention to it) has been proposed as an upper limit for species subsisting mainly on insects and a lower limit for those relying on leaves. The reason is that insects are small and hard to catch, and a large animal simply would not be able to catch enough to sustain it during its waking hours. The cellulose and hemicellulose components of leaves, on the other hand, require complex digestive processes, and a small animal would be unable to maintain a constant throughput. Fruit, as a dietary component, suffers from neither of these constraints.
Size in evolutionary perspective
In evolutionary terms, increase in size has probably played a large part in determining the direction of primate evolution. Early primates of about 50 million years ago were small forest-living creatures whose molar teeth bore high, pointed cusps but were neither as tall nor as pointed as those of their insectivore-like ancestors, whose molars were ideally adapted for cracking the hard chitinous exoskeletons of insects. This fact suggests that the reduction of the molar cusps was associated with the adoption of a fruit-eating habit. Although this has some validity as a generalization, it should not be taken too literally, as most primates include some insects in their diet and of course there are many almost exclusively insectivorous forms, which have nonetheless reduced the height and acuity of their molar cusps. Increasing body size, a trend that is clearly apparent throughout primate evolution, would have been associated with the adoption of supplementary sources of food. An increase in size and the gradual addition of bulk foods to the diet would in turn have affected the habitat and the pattern of locomotion of primates. Suitable adaptations in this case would have been the facility to climb, leap, and balance in trees.
It is noteworthy that, during evolution, the development of a prehensile foot preceded that of a prehensile hand. Vertical-clinging primates such as the tarsiers or small, squirrel-like quadrupeds such as the marmosets—all of which have prehensile feet but not completely prehensile hands—by remaining or becoming small, have avoided the evolutionary pressures that have impinged on larger primates. A large arboreal primate without entirely prehensile hands is at a considerable disadvantage in moving about in the canopy of trees, but a small one suffers little disadvantage. Amid the large and firm branches, size is no particular hazard, but at the periphery of the crown, where the fruit is most abundant and the branches are slender and flexible, the risk of falling is increased. It is therefore likely that the combination of an increase in body size associated with the inevitable shift toward a bulk diet led first to the evolution of a grasping hand, then to the appearance of a prehensile hand, and finally to an opposable thumb. Four prehensile extremities are obviously more effective than two in defying gravity.
Such adaptations of the forelimbs would have had the effect of equalizing the role of the limbs. The limbs of vertical clingers are functionally disparate, the lower pair being dominantly propulsive and the upper secondary and purely supportive. The limbs of quadrupeds, however, are more homogeneous, both pairs having a propulsive function during running. Thus, it would seem that the transition in locomotor grade between vertical clinging and leaping and quadrupedalism came about as an adaptation to increased body size. Size, diet, ecology, locomotion, and anatomic structure provide a constellation of causes and effects that are critical factors in the evolution of the primates.
Forest and savanna
The chief physiognomic features of rainforests, the ancestral home of the order Primates and the principal habitat of nonhuman primates today, are the evergreen broad-leaved trees that collectively form a closed canopy, so opaque to sunlight that the forest floor is in perpetual twilight. Epiphytes and thick-stemmed lianas drape the trees, linking one crown to another and providing aerial pathways for monkeys to pass from tree to tree through a continuum of interlacing branches, a three-dimensional maze that provides home, restaurant, shopping districts, and highways for primates. Three strata of rainforests are broadly distinguishable: an understory, a middle story, and an upper story. The understory, consisting of shrubs and saplings, is often “closed,” the crowns of the constituent trees overlapping one another to form a dense continuous horizontal layer. The middle story is characterized by trees that are in lateral contact but do not overlap; the highest story, by tall trees, some 50 metres (about 165 feet) or more, that form a discontinuous layer of umbrella-shaped crowns. The occasional “emergent” forest giant may tower above the highest layer of the canopy. There is some evidence, much of it conflicting, that some zonation of forest primates occurs within the forest canopy. The stratification of forest is extremely variable; the number of layers tends to diminish from three to two in secondary forest, dry deciduous forest, and montane forest and from two to one as temperate zone, tropical woodland, or montane woodland supervenes.
Tropical grasslands, or savannas, are also the homes of primates in Africa and Asia; no savanna-living primates exist in South America. Tropical grasslands comprise a mixture of trees and grasses, the proportion of trees to grass varying directly with the rainfall. Areas of high seasonal rainfall support single-story woodlands of tall trees, while lush grasses form the ground vegetation; but, where rainfall is both seasonal and low, the trees consist of stubby xerophilous (dry-loving) shrubs and short, tussocky grasses. The principal primates of the savanna are the ground-living species: in Africa, the vervets, baboons, and patas monkey; and in Asia, the macaques and the Hanumān langur.
Tropical montane forests or tropical rainforests at high altitude also abound in primates in Africa, Asia, and South America. In equatorial Africa, certain primate species have colonized the montane-savanna regions, or moorlands, where the rugged mountainous terrain and seasonal food scarcity support herds of geladas and hamadryas baboons. These high mountaineers of Africa have no ecological counterparts in Asia or South America.
Additional Information
Primates are an order of mammals. It includes all lemurs, monkeys and apes, including humans. Most primates (but not humans) are mainly or entirely forest dwellers.
There are about 400 species of primates. All primates are similar to humans in many ways, but language is an important advantage which only humans have. Other primates have a pattern of calls and gestures, but not language as we know it.
Primates have hands with five fingers and flat fingernails (most other animals have claws or hooves). All primates are covered with fur (hair), but in humans the body hair is only noticeable in two places: on the head and around the genitals.
Primates are split into two groups: Strepsirrhini and Haplorhini. Haplorrhini includes larger monkeys such as, tarsiers and apes including humans. Strepsirrhini includes smaller monkeys such as lemurs, lorises, galagos (also called bush babies) and the aye-aye.
Primates are one of the few mammal groups which re-evolved full color vision. Even so, color vision in birds is better. Color vision was lost in mammals during the long period when dinosaurs ruled the Earth, and mammals were mainly small nocturnal animals.
Close contact between humans and non-human primates creates opportunities for zoonotic diseases to get to humans. Virus diseases transmitted to humans include herpes, measles, ebola, rabies, and hepatitis.

2471) Tadeusz Reichstein
Gist:
Work
Situated atop the kidneys are two small glands, the adrenal glands. Their function was unknown for a long time, but if they were injured, deficiency diseases ensued that ended in death. In the mid-1930s Edward Kendall and Tadeus Reichstein succeeded in isolating and analyzing the composition of a number of similar hormones derived from the adrenal cortex. These became the basis for cortisone preparations that, with input from Kendall and Philip Hench, were used at the end of the 1940s to treat rheumatoid arthritis and other inflammations.
Summary
Tadeus Reichstein (born July 20, 1897, Włocławek, Pol.—died Aug. 1, 1996, Basel, Switz.) was a Swiss chemist who, with Philip S. Hench and Edward C. Kendall, received the Nobel Prize for Physiology or Medicine in 1950 for his discoveries concerning hormones of the adrenal cortex.
Reichstein was educated in Zürich and held posts in the department of organic chemistry at the Federal Institute of Technology, Zürich, from 1930. From 1946 to 1967 he was professor of organic chemistry at the University of Basel. He received the Nobel Prize for research carried out independently on the steroid hormones produced by the adrenal cortex, the outer layer of the adrenal gland. Reichstein and his colleagues isolated about 29 hormones and determined their structure and chemical composition. One of the hormones they isolated, cortisone, was later discovered to be an anti-inflammatory agent useful in the treatment of arthritis. Reichstein was also involved in developing methods to synthesize the hormones he had discovered, among them cortisone and desoxycorticosterone, which was used for many years to treat Addison’s disease.
Apart from hormone research, Reichstein is also known for his synthesis of vitamin C, a feat achieved about the same time (1933) in England by Sir Walter N. Haworth and coworkers. In the latter part of his career, Reichstein studied plant glycosides, chemicals that can be used in the development of therapeutic drugs. He was awarded the Copley Medal of the British Royal Society in 1968.
Details
Tadeusz Reichstein (20 July 1897 – 1 August 1996), also known as Tadeus Reichstein, was a Polish-Swiss chemist and a Nobel Prize in Physiology or Medicine laureate (1950), which was awarded for his work on the isolation of cortisone.
((Cortisone is a naturally occurring, mostly inactive pregnene (21-carbon) steroid hormone. In the body, cortisone is produced as part of the Cortisol-Cortisone shunt, which protects vulnerable organs like the kidneys from cortisol.)
Early Life
Reichstein was born into a wealthy Polish-Jewish family with strong Polish patriotic traditions at Włocławek, Russian Empire (in the Russian Partition of Poland). His parents were Gastawa (Brockmann) and Izydor Reichstein. He was named after the 18th-century Polish national hero Tadeusz Kościuszko. He spent his early childhood at Kiev, where his father was an engineer. Due to the violent pogroms occurring all over the Russian Empire in 1905, his father began to explore emigration options for the family. Tadeus began his education at boarding-school in Jena, Germany and arrived in Zürich, Switzerland two years later (1907) at the age of 10.
Career
Reichstein studied under Hermann Staudinger during the latter's brief stint at the Technical University of Karlsruhe. It was here that he met Leopold Ruzicka, also a doctoral student.
In 1933, working in Zürich, Switzerland, at the ETHZ chemical laboratories of Ruzicka, Reichstein succeeded, independently of Sir Norman Haworth and his collaborators in the United Kingdom, in synthesizing vitamin C (ascorbic acid) in what is now called the Reichstein process. In 1937, he was appointed Associate Professor at ETHZ.
In 1937, Reichstein moved to the University of Basel where he became Professor of Pharmaceutical Chemistry, and then, from 1946 until his retirement in 1967, of Organic Chemistry.
Together with Edward Calvin Kendall and Philip Showalter Hench, he was awarded the Nobel Prize in Physiology or Medicine in 1950 for their work on hormones of the adrenal cortex which culminated in the isolation of cortisone. In 1951, he and Kendall were jointly awarded the Cameron Prize for Therapeutics of the University of Edinburgh.
In later years, Reichstein became interested in the phytochemistry and cytology of ferns, publishing at least 80 papers on these subjects in the last three decades of his life. He had a particular interest in the use of chromosome number and behavior in the interpretation of histories of hybridization and polyploidy, but also continued his earlier interest in the chemical constituents of the plants.
Retirement and death
Reichstein died at the age of 99 in Basel, Switzerland. The principal industrial process for the artificial synthesis of vitamin C still bears his name. Reichstein was the longest-lived Nobel laureate at the time of his death, but was surpassed in 2008 by Rita Levi-Montalcini.
The standard author abbreviation Reichst. is used to indicate this person as the author when citing a botanical name.

Q: How do elves eat their pancakes?
A: In short stacks.
* * *
Q: When the little boy was making pancakes why did the batter run away?
A: Because it said crack 2 eggs then beat it!
* * *
Did you know today is Pancake day, apparently it just creped up on us..
* * *
Q: Why did the pancake go to school?
A: To get a little batter education.
* * *
Q: What do pancakes say to each other?
A: “Flipping nice to see you!”
* * *
Comfortably Quotes
1. If society fits you comfortably enough, you call it freedom. - Robert Frost
2. From the very beginning, I always tried to make dialogue flow comfortably; I always did that to make it seem more authentic. - Eddie Murphy
3. I can sing very comfortably from my vantage point because a lot of the music was about a loss of innocence, there's innocence contained in you but there's also innocence in the process of being lost. - Bruce Springsteen
4. It's always good to win a Test match and if you win it comfortably, it can leave a few psychological marks on opposition sides. - Ricky Ponting
5. In all life one should comfort the afflicted, but verily, also, one should afflict the comfortable, and especially when they are comfortably, contentedly, even happily wrong. - John Kenneth Galbraith
6. I am lucky because my family are comfortably off. My father has his own glass business. - Rafael Nadal
7. I want to be successful, but I don't really have what it takes to do it comfortably. - Shania Twain
8. If my reel life character resembles me in real life, I can portray it comfortably. To me it's not acting, it's just about being you. That was the case with Khushi and Missamma. But to play a character that's unlike you is a different ball game. - Bhumika Chawla.
Salicylic Acid
Gist
Salicylic acid is a beta-hydroxy acid (BHA) widely used in skincare for its keratolytic (exfoliating) properties, effectively treating acne, blackheads, whiteheads, and dandruff by penetrating pores and dissolving dead skin cells. It is commonly found in 0.5%–2% concentrations for daily use but can also treat warts and psoriasis in higher concentrations.
Salicylic acid is a beta-hydroxy acid (BHA) that deeply exfoliates skin, penetrates pores to dissolve excess oil (sebum), and removes dead skin cells. It is highly effective at treating and preventing acne, including blackheads and whiteheads, while reducing inflammation and smoothing skin texture.
Summary
Salicylic acid is an organic compound with the formula C7H6O3. A colorless (or white), bitter-tasting solid, it is a precursor to and a metabolite of acetylsalicylic acid (aspirin). It is a plant hormone, and has been listed by the EPA (Environmental Protection Agency) Toxic Substances Control Act (TSCA) Chemical Substance Inventory as an experimental teratogen. The name is from Latin salix for willow tree, from which it was initially identified and derived. It is an ingredient in some anti-acne products. Salts and esters of salicylic acid are known as salicylates.
Safety
In excess, salicylates have toxic effects, which can be fatal. Toxicity is most often due to oral overdose.
Cosmetic applications of the drug pose no significant risk. Even in a worst-case use scenario in which one was using multiple salicylic acid-containing topical products, the aggregate plasma concentration of salicylic acid was well below what was permissible for acetylsalicylic acid (aspirin). Since oral aspirin (which produces much higher salicylic acid plasma concentrations than dermal salicylic acid applications) poses no significant adverse pregnancy outcomes in terms of frequency of stillbirth, birth defects or developmental delay, use of salicylic acid containing cosmetics is safe for pregnant women. Salicylic acid is present in most fruits and vegetables as for example in greatest quantities in berries and in beverages like tea.
In one documented case, a patient applied extreme levels of salicyate ointment topically (40% ointment, over 41% of the total skin surface), and subsequently received hemodialysis to reduce blood salicylate concentration.
Details
The compound treats treats many skin conditions, such as acne, psoriasis, dandruff, and warts. It works by decreasing inflammation. It also promotes skin cell turnover. This prevents clogged pores and loosens dry, scaly skin, making it easier to remove. It belongs to a group of medications called salicylates. Do not use this medication on sensitive areas of the body.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. What should I tell my care team before I take this medication?
They need to know if you have any of these conditions:
* Infection especially a viral infection such as chickenpox, cold sores, or herpes
* Kidney disease
* Liver disease
* An unusual or allergic reaction to salicylic acid, other medications, foods, dyes, or preservatives
* Pregnant or trying to get pregnant
* Breast-feeding
How should I use this medication?
This medication is for external use only. Do not take by mouth. Wash your hands before and after use. If you are treating your hands, only wash your hands before use. Do not get it in your eyes. If you do, rinse your eyes with plenty of cool tap water. Use it as directed on the prescription label at the same time every day. Do not use it more often than directed. Use the medication for the full course as directed by your care team, even if you think you are better. Do not stop using it unless your care team tells you to stop it early.
Apply a thin film of the medication to the affected area.
Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 2 years for selected conditions, precautions do apply.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What may interact with this medication?
* Medications that change urine pH, such as ammonium chloride, sodium bicarbonate, and others
* Medications that treat or prevent blood clots, such as warfarin
* Methotrexate
* Pyrazinamide
* Some medications for diabetes
* Some medications for gout
* Steroid medications, such as prednisone or cortisone
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medication?
Visit your care team for regular checks on your progress. It may be some time before you see the benefit from this medication. This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and sunscreen. Do not use sun lamps or tanning beds/booths.
What side effects may I notice from receiving this medication?
Side effects that you should report to your care team as soon as possible:
* Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
* Burning, itching, crusting, or peeling of treated skin
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
* Mild skin irritation, redness, or dryness
This list may not describe all possible side effects. Call your doctor for medical advice about side effects.
Where should I keep my medication?
Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Avoid exposure to extreme heat.
Get rid of medications that are no longer needed or have expired:
* Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
* If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.
Additional Information
Salicylic Acid is a type of beta hydroxy acid (BHA) and phenolic acid with a chemical formula C7H6O3. It is a BHA found as a natural compound in plants. It functions as a plant hormone. This lipophilic monohydroxybenzoic acid is a derivative of salicin metabolism. It is a crystalline organic carboxylic acid with keratolytic, bacteriostatic and fungicidal properties. It is poisonous when consumed in large. It can be used as an antiseptic and as a food preservative when consumed in small quantities. It consists of a carboxyl group COOH. It is odourless and has no colour.
Properties of Salicylic Acid – C7H6O3
C7H6O3 : Salicylic Acid
Molecular Weight/ Molar Mass : 138.121 g/mol
Density : 1.44 g/Cubic cm
Boiling Point : 211 °C
Melting Point : 158.6 °C
Uses (Salicylic Acid)
* It is used in toothpaste as an antiseptic.
* In the medical field, it is used to remove the outer layer of the skin.
* It is used in the treatment of acne, dandruff, and wrath.
* It is used as a preservative.
* It is used in the production of drugs like aspirin.
* It is used as a balm to reduce muscle and joint pain.
* It is used to relieve pain caused by mouth ulcers.
* It is used as a key additive in skin care products.
Frequently Asked Questions : FAQs
Q1. What are the uses of salicylic acid?
A1: Salicylic acid acts as a keratolytic (it serves as a peeling agent). Salicylic acid facilitates and makes the outer layer of the skin shed. The topical salicylic acid (for the skin) is used to treat acne, dandruff, seborrhea, or psoriasis and to remove cotton, calluses, and warts. Salicylic acid is found in many daily-use products.
Q2: What does salicylic acid do to your skin?
A2: Salicylic acid works by loosening and breaking apart desmosomes in the outer layers of the skin, which are attachments between cells. This action helps the skin to exfoliate and the pores to unclog. Salicylic acid is capable of reducing sebum secretion, which is another way to help reduce acne.
Q3: Is salicylic acid safe?
A3: Although the use of low-concentration household salicylic acid products is usually considered safe, salicylic acid can cause mild chemical burns at high concentrations. These chemicals can also cause dangerous intoxication if ingested.

Osteoporosis
Gist
Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes. This can lead to a decrease in bone strength that can increase the risk of fractures (broken bones).
Osteoporosis is a “silent” disease because you typically do not have symptoms, and you may not even know you have the disease until you break a bone. Osteoporosis is the major cause of fractures in postmenopausal women and in older men. Fractures can occur in any bone but happen most often in bones of the hip, vertebrae in the spine, and wrist.
Summary
Osteoporosis is a systemic skeletal disorder characterized by low bone mass (osteopenia), micro-architectural deterioration of bone tissue leading to more porous bone, and consequent increase in fracture risk. Bones undergo continuous remodeling: osteoclasts resorb old bone, and osteoblasts synthesize new bone. With advancing age, the rate of resorption exceeds that of bone formation, causing bones to lose density and become more susceptible to fractures.
It is the most common reason for a broken bone among the elderly. Bones that commonly break include the vertebrae in the spine, the bones of the forearm, the wrist, and the hip.
Until a broken bone occurs, there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. After the broken bone heals, some people may have chronic pain and a decreased ability to carry out normal activities.
Osteoporosis may be due to lower-than-normal maximum bone mass and greater-than-normal bone loss. Bone loss increases after menopause in women due to lower levels of estrogen, and after andropause in older men due to lower levels of testosterone. Osteoporosis may also occur due to several diseases or treatments, including alcoholism, anorexia or underweight, hyperparathyroidism, hyperthyroidism, kidney disease, and after oophorectomy (surgical removal of the ovaries). Certain medications increase the rate of bone loss, including some antiseizure medications, chemotherapy, proton pump inhibitors, selective serotonin reuptake inhibitors, glucocorticosteroids, and overzealous levothyroxine suppression therapy. Smoking and sedentary lifestyle are also recognized as major risk factors. Osteoporosis is defined as a bone density of 2.5 standard deviations below that of a young adult. This is typically measured by dual-energy X-ray absorptiometry (DXA or DEXA).
Prevention of osteoporosis includes a proper diet during childhood, hormone replacement therapy for menopausal women, and efforts to avoid medications that increase the rate of bone loss. Efforts to prevent broken bones in those with osteoporosis include a good diet, exercise, and fall prevention. Lifestyle changes such as stopping smoking and not drinking alcohol may help. Bisphosphonate medications are useful to decrease future broken bones in those with previous broken bones due to osteoporosis. In those with osteoporosis but no previous broken bones, they have been shown to be less effective. They do not appear to affect the risk of death.
Osteoporosis becomes more common with age. About 15% of Caucasians in their 50s and 70% of those over 80 are affected. It is more common in women than men. In the developed world, depending on the method of diagnosis, 2% to 8% of males and 9% to 38% of females are affected. Rates of disease in the developing world are unclear. About 22 million women and 5.5 million men in the European Union had osteoporosis in 2010. In the United States in 2010, about 8 million women and between 1 and 2 million men had osteoporosis. White and Asian people are at greater risk for low bone mineral density due to their lower serum vitamin D levels and less vitamin D synthesis at certain latitudes. The word "osteoporosis" is from the Greek terms for "porous bones".
Details
Osteoporosis silently weakens your bones. This increases your risk of broken bones without you knowing it. You can prevent bone density loss with treatments and exercise. Ask your healthcare provider about a bone density test if you’re over 65 or have a family history of osteoporosis.
What Is Osteoporosis?
Osteoporosis is a disease that weakens your bones and makes them much more likely to fracture. It makes your bones thinner and less dense than they should be.
Your bones are usually dense and strong enough to support your weight and absorb most kinds of impacts. As you age, your bones naturally lose some of their density and their ability to regrow themselves. If you have osteoporosis, your bones are much more fragile than they should be, and are much weaker.
You might not know you have osteoporosis until it causes you to break a bone. Osteoporosis can make any of your bones more likely to break, but the most commonly affected bones include your:
* Hips
* Wrists
* Spine
Symptoms and Causes:
Symptoms of osteoporosis
Osteoporosis doesn’t have symptoms the way that lots of other conditions do. That’s why healthcare providers sometimes call it a silent disease.
You won’t feel or notice anything that signals you might have it. You won’t have a headache, fever or stomachache that lets you know something in your body is wrong.
The most common “symptom” is suddenly breaking a bone. Especially after a small fall or minor accident that usually wouldn’t hurt you.
Even though osteoporosis doesn’t directly cause symptoms, you might notice a few changes in your body that can mean your bones are losing strength or density. These warning signs of osteoporosis can include:
* Losing an inch or more of your height
* Changes in your natural posture, like stooping or bending forward more
* Shortness of breath (if disks in your spine are compressed enough to reduce your lung capacity)
* Lower back pain
It might be hard to notice changes in your own physical appearance. A loved one may be more likely to see them, especially your height or posture. People sometimes joke about friends or family members “shrinking” as they age. But this can be a sign that you should visit a healthcare provider for a bone density test.
Around 1 in 3 adults over 50 who don’t have osteoporosis have osteopenia. This means your bone density is lower than it should be for your age. It’s an early sign of osteoporosis. Osteopenia can progress to become osteoporosis if it’s not treated.
Osteoporosis causes
Osteoporosis happens as you age and your bones lose their ability to regrow and reform themselves.
Your bones are living tissue like any other part of your body. They’re constantly replacing their own cells and tissue throughout your life. Up until about age 30, your body naturally builds more bone than you lose. After age 35, bone breakdown happens faster than your body can replace it. This causes a gradual loss of bone mass.
If you have osteoporosis, you lose bone mass faster than usual. People in postmenopause lose bone mass even faster.
Risk factors
Anyone can develop osteoporosis. You may have a higher risk if you:
* Are over 50
* Are female, especially if you’re in postmenopause
* Have a biological family history of osteoporosis
* Are naturally thin or have a “smaller frame”
* Smoke or use tobacco products
* Don’t get enough vitamin D
* Aren’t physically active
* Regularly drink alcohol (having more than two drinks per day)
Certain health conditions can make you more likely to develop osteoporosis, including:
* Endocrine disorders like thyroid disease, hyperthyroidism and diabetes
* Gastrointestinal diseases like celiac disease and inflammatory bowel disease
* Autoimmune diseases that affect your bones, like rheumatoid arthritis or ankylosing spondylitis
* Blood disorders or blood cancers like multiple myeloma
Some medications or surgical procedures can increase your osteoporosis risk as a side effect, including:
* Diuretics
* Corticosteroids
* Some medications used to treat seizures
* Bariatric surgery
* Hormone therapy for cancer
* Blood thinners
* Proton pump inhibitors
Diagnosis and Tests:
How doctors diagnose osteoporosis
A healthcare provider will diagnose osteoporosis with a bone density test. Providers sometimes refer to bone density tests as DEXA scans, DXA scans or bone density scans. All of these are different names for the same test.
A bone density test uses low levels of X-rays to measure how much calcium and other minerals are in your bones. It’s similar to a typical X-ray. There are no needles or injections.
Checking for changes in your bone density is the best way to catch osteoporosis before it causes a fracture. Your provider might suggest you get regular bone density tests if:
* You have a family history of osteoporosis
* You’re over 50
* You have osteopenia
* You’re in postmenopause
Management and Treatment:
Treatment for osteoporosis:
The most important part of treating osteoporosis is preventing broken bones. Your healthcare provider will suggest treatments to strengthen your existing bone tissue and slow down any bone density loss.
The most common osteoporosis treatments include:
Exercise
Staying active can strengthen your bones. It also helps all the tissue connected to them, like your muscles, tendons and ligaments. Your provider might suggest weight-bearing exercise to strengthen your muscles and train your balance. Exercises that make your body work against gravity can improve your strength and balance without putting too much stress on your bones. Some good options include:
* Walking
* Yoga
* Pilates
* Tai chi
You might need to work with a physical therapist to find exercises and movements that are right for you.
Vitamin and mineral supplements
You might need over-the-counter or prescription calcium or vitamin D supplements. Your provider will tell you:
* Which type is best
* How often you should take them
* Which dosage you’ll need
Medications for osteoporosis
Your provider may suggest prescription medications. Some of the most common osteoporosis medications include:
* Hormone therapies, like replacement estrogen or testosterone
* Bisphosphonates
If you have severe osteoporosis or a high risk of fractures, you might need other medications, like:
* Parathyroid hormone (PTH) analogs
* Denosumab
* Romosozumab
These medications are usually given as injections.
When should I see my healthcare provider?
Visit a healthcare provider if you notice any changes in your body that might be osteoporosis warning signs. Tell your provider about any other symptoms you’re experiencing, especially if you have bone pain or trouble moving.
Outlook / Prognosis:
What can I expect if I have this condition?
You’ll need regular appointments with a healthcare provider. They’ll tell you how often you’ll need follow-up bone density tests. Your provider will monitor any changes in your bone density and will adjust your treatments as needed.
Broken bones can always cause complications. And that’s especially true as you age. Some fractures, like broken hips, can have a big impact on your life. Talk to your healthcare provider if you’re worried about your risk of falls or bone fractures. They’ll help you stay safe and healthy.
Prevention:
Can this be prevented?
Staying physically active and making sure you get enough calcium and vitamin D are the best ways to support your bone health. But osteoporosis isn’t always preventable. Your provider will help you find a combination of treatments that’s best for your unique needs.
Additional Information:
Overview
Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can cause a break. Osteoporosis-related breaks most commonly occur in the hip, wrist or spine.
Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone.
Osteoporosis affects people of all races. But women who are white or of Asian descent, especially older women who are past menopause, are at highest risk. Medicines, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.
Symptoms
There often are no symptoms in the early stages of bone loss. But once osteoporosis weakens your bones, you might have symptoms of a fracture that include:
* Back pain caused by a broken or collapsed bone in the spine.
* Loss of height over time.
* A stooped posture.
* A bone that breaks much more easily than expected.
When to see a doctor
Talk with your healthcare professional about osteoporosis if you went through early menopause or took corticosteroids for several months at a time. Also see your care team if you have a parent or sibling with osteoporosis. This puts you at greater risk, especially if either of your parents had hip fractures.
Causes
Your bones are in a constant state of renewal — new bone is made and old bone is broken down. When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. After the early 20s this process slows, and most people reach their peak bone mass by age 30. As people age, bone mass is lost faster than it's created.
How likely you are to develop osteoporosis depends partly on how much bone mass you built in your youth. Peak bone mass is partly inherited and also varies by race. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age.
Risk factors
A number of factors can increase the likelihood that you'll develop osteoporosis. Risk factors include your age, race, lifestyle choices, and medical conditions and treatments.
Risks you can't change
Some risk factors for osteoporosis are out of your control, including:
* sex assigned at birth. Women are much more likely to develop osteoporosis than are men.
* Age. The older you get, the greater your risk of osteoporosis.
* Race. You're at greatest risk of osteoporosis if you're white or of Asian descent.
* Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.
* Body frame size. People who have small body frames tend to have a higher risk. This may be because they have less bone mass to draw from as they age.
Hormone levels
Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:
* sex hormones. Lowered sex hormone levels tend to weaken bone. The fall in estrogen levels at menopause is one of the strongest risk factors for developing osteoporosis. Treatments for prostate cancer that reduce testosterone levels and treatments for breast cancer that reduce estrogen levels are likely to speed up bone loss.
* Thyroid hormone. Too much thyroid hormone can cause bone loss. This can occur if your thyroid makes too much hormone or if you take too much thyroid hormone medicine to treat a thyroid that doesn't make enough hormone.
* Hormones from other glands. Osteoporosis also has been associated with having too much of the hormones from the parathyroid and adrenal glands.
Dietary factors
Osteoporosis is more likely to occur in people who have:
* Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to lower bone density, early bone loss and an increased risk of fractures.
* Eating disorders. Severely restricting food intake and being underweight weakens bone in all people.
* Gastrointestinal surgery. Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium. These surgeries include those to help you lose weight and those that treat other gastrointestinal conditions.
Steroids and other medicines
Long-term use of corticosteroid medicines, such as prednisone and cortisone, interferes with the bone-rebuilding process. These medicines are taken by mouth or shot. Osteoporosis also has been associated with medicines used to combat or prevent:
* Seizures.
* Gastric reflux.
* Cancer.
* Transplant rejection.
Medical conditions
The risk of osteoporosis is higher in people who have certain medical conditions, including:
* Celiac disease.
* Inflammatory bowel disease.
* Kidney or liver disease.
* Cancer.
* Multiple myeloma.
* Rheumatoid arthritis.
Lifestyle choices
Some habits can increase your risk of osteoporosis. Examples include:
* Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active. Weight-bearing exercise and activities that promote balance and good posture are good for your bones. Walking, running, jumping, dancing and weightlifting seem particularly helpful.
* Excessive alcohol use. Regular consumption of more than two alcoholic drinks a day increases the risk of osteoporosis.
* Tobacco use. The exact role tobacco plays in osteoporosis isn't clear, but tobacco use has been shown to contribute to weak bones.
Complications
Bone breaks, particularly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures often are caused by a fall. A hip fracture can result in disability and even an increased risk of death within the first year after the injury.
In some cases, broken bones in the spine can occur even if you haven't fallen. The bones that make up the spine, called vertebrae, can weaken to the point of collapsing. This can result in back pain, lost height and a hunched posture.
Prevention
Good nutrition, regular exercise and a healthy lifestyle are essential to keep your bones healthy throughout your life. In early stages of bone loss, many people can manage their bone health with supplements, diet and exercise.
There is a lot of misinformation about supplements for bone health. Not all products that claim to prevent or treat osteoporosis are safe or effective. Talk with your healthcare professional about which supplements can help improve bone health.
Steps you can take to help prevent bone loss include:
Calcium
People between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50 and men turn 70.
Good sources of calcium include:
* Low-fat dairy products.
* Dark green leafy vegetables.
* Canned salmon or sardines with bones.
* Soy products, such as tofu.
* Calcium-fortified cereals and orange juice.
If you find it hard to get enough calcium from your diet, consider taking calcium supplements. But too much calcium has been linked to kidney stones. Some experts suggest that too much calcium, especially in supplements, can increase the risk of heart disease. Research is ongoing.
The Food and Nutrition Board at the National Academies of Sciences, Engineering, and Medicine recommends that total calcium intake from supplements and diet combined should be no more than 2,000 milligrams daily for people older than 50.
Vitamin D
Vitamin D improves the body's ability to absorb calcium and improves bone health in other ways. People can get some of their vitamin D from sunlight. But this might not be a good source if you live in a high latitude, if you're housebound, or if you regularly use sunscreen or avoid the sun because of the risk of skin cancer.
Dietary sources of vitamin D include cod liver oil, trout and salmon. Many types of milk and cereal have been fortified with vitamin D.
Most people need at least 600 international units (IU) of vitamin D a day. That recommendation increases to 800 IU a day after age 70.
People without other sources of vitamin D and especially those with limited sun exposure might need a supplement. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for most people.
Exercise
Exercise can help you build strong bones and slow bone loss. Exercise can benefit your bones no matter when you start. But you gain the most benefits if you start exercising regularly when you're young and continue to exercise throughout your life.
Combine strength training exercises with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine. Weight-bearing exercises — such as walking, running, stair climbing, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling especially as you get older.
Healthy lifestyle
These healthy lifestyle suggestions might help reduce your risk of developing osteoporosis or breaking bones:
* Don't smoke. Smoking increases the rate of bone loss and the chance of fracture.
* Limit alcohol. Consuming more than two alcoholic drinks a day may decrease bone formation. Alcohol use also can increase your risk of falling.
* Prevent falls. Wear low-heeled shoes with nonslip soles. Check your house for electrical cords, area rugs and slippery surfaces that might cause you to fall. Keep rooms brightly lit. Install grab bars just inside and outside your shower door, and make sure you can get into and out of your bed easily.
Even when taking steps to prevent bone loss, some people continue to lose bone or have fractures. In these situations, treatment with medicines may become necessary. Even when medicines are used, diet, exercise and lifestyle choices still play an important role in bone health.

Hi,
#10815. What does the term in Biology Larva mean?
#10816. What does the term in Biology Leukocyte mean?
Hi,
#6021. What does the adjective puce mean?
#6022. What does the adjective puckish mean?
Hi,
#2607. What does the medical term Friedreich's ataxia mean?
Hi,
#9893.
Hi,
#6385.
Hi,
2747.
2533) Liechtenstein
Gist
Liechtenstein is a tiny, wealthy, doubly landlocked constitutional monarchy in the Central European Alps between Austria and Switzerland. With a population of roughly 40,000, this German-speaking country is known for its scenic mountains, medieval castles, strong industrial sector, and high GDP per capita. The capital is Vaduz.
Is Liechtenstein a wealthy country?
Yes, Liechtenstein is considered one of the richest countries in the world. It boasts one of the highest GDP per capita rates globally—estimated at over $200,000 — driven by a strong high-end manufacturing sector, financial services, and low taxes. The tiny Alpine nation has virtually no debt or unemployment.
Summary
Liechtenstein, officially the Principality of Liechtenstein is a doubly landlocked country in the Central European Alps. It is located between Austria to the east and north-east and Switzerland to the north-west, west and south. Formed in 1719, Liechtenstein became fully independent upon the dissolution of the German Confederation in 1866. Liechtenstein is a monarchy headed by the prince of Liechtenstein. Hans-Adam II, Prince of Liechtenstein has reigned over Liechtenstein since 1989. Liechtenstein is Europe's fourth-smallest country, with an area of just over 160 square kilometres (62 square miles) and a population of 41,389. It is the world's smallest country to border two countries, and is one of the few countries with no debt. The official language of Liechtenstein is German.
Liechtenstein is divided into 11 municipalities. Its capital is Vaduz, and its largest municipality is Schaan. It is a member of the United Nations, the European Free Trade Association, and the Council of Europe. It is not a member state of the European Union, but it participates in both the Schengen Area and the European Economic Area. It has a customs union and a monetary union with Switzerland, with its usage of the Swiss franc. A constitutional referendum in 2003 granted the monarch greater powers, including the power to dismiss the government, nominate judges and veto legislation.
Liechtenstein has a strong financial sector centred in Vaduz. It was once known as a billionaire tax haven, culminating in a tax affair in 2008, but the principality has since made significant efforts to shed this reputation. An Alpine country, Liechtenstein is mountainous, making it a winter sport destination.
Details
Liechtenstein, western European principality located between Switzerland and Austria. It is one of the smallest countries of Europe; its capital is Vaduz.
Geography
The eastern two-thirds of the country is composed of the rugged foothills of the Rhätikon Mountains, part of the central Alps. The highest peak is Grauspitz, which rises to 8,527 feet (2,599 metres), and much of the principality is at an elevation above 6,000 feet (1,800 metres). The lower slopes of the mountains are covered by evergreen forests and alpine flowers, while their bare peaks are blanketed by snow. The mountains contain three major valleys and are drained by the Samina River. The western section of the principality is occupied by the Rhine River floodplain, which, together with the valley of the Ill River, forms a triangular lowland widening northward. The river valley was once marshy, but a drainage channel built in the 1930s has made its rich soils highly suitable for agriculture.
The climate of Liechtenstein is mild and is greatly affected by the warm southerly wind known as the foehn. Annual precipitation ranges, according to location, from about 35 to 47 inches (900 to 1,200 mm), though some areas in the mountains can receive as much as 75 inches (1,900 mm). In winter the temperature rarely falls below 5 °F (−15 °C), while in summer the average daily maximum temperature varies from the high 60s to the low 80s F (about 20 to 28 °C). These conditions allow for the cultivation of grapes and corn (maize), which is unusual in a mountainous area.
Liechtenstein has a remarkable variety of vegetation. Water milfoil and mare’s-tail as well as reeds, bulrush, bird’s eye primrose, and orchids can be found. The forests comprise a mixed woodland with copper beeches, common and Norway maple, sycamore, linden, elm, and ash. Liechtenstein is also rich in wildlife, including red deer, roe deer, chamois, hares, marmots, blackcocks, pheasants, hazel grouse, partridges, foxes, badgers, martens, polecats, stoats, and weasels.
Liechtenstein is a constitutional monarchy. Its head of state is the prince, who succeeds to the throne by heredity through the male line as determined by the regulations of the princely house. The constitution of 1921 provides for a unicameral Landtag (Diet), which consists of 25 members elected to four-year terms. The traditional regions of Vaduz and Schellenberg are still recognized as unique regions—the Upper Country (Oberland) and the Lower Country (Unterland), respectively—and they form separate electoral districts. All citizens age 18 or older who live in the principality are eligible to vote in national elections.
The government consists of a prime minister and four other cabinet officials (with at least two officials from each of the two electoral districts), who are appointed by the prince on the recommendation of the Landtag. The 11 Gemeinden (communes) are governed autonomously—but under government supervision—by mayors and city councils, elected every three years. To the south, the more industrial Upper Country contains the communes of Vaduz, Balzers, Triesen, Triesenberg, Schaan, and Planken. The Lower Country, to the north, is divided into the communes of Eschen, Mauren, Gamprin, Ruggell, and Schellenberg. The government maintains a nominal police force, but the standing army was abolished and neutrality proclaimed in 1868 (defense of the principality is the responsibility of Switzerland).
Liechtenstein has no natural resources of commercial value, and virtually all raw materials, including wood, have to be imported. All of the principality’s forested areas are protected in order to maintain the ecology of the mountain slopes and to guard against erosion. There is no heavy industry, but small manufacturing concerns are spread throughout the principality. Production includes metalworking, pharmaceuticals, precision instruments, electronic equipment, food processing, and the manufacture of consumer goods. In 1921 Liechtenstein adopted the Swiss franc as its currency, and in 1923 it joined a customs union with Switzerland.
Few workers are employed in agriculture, but the average farming unit is fairly large, and the biggest concerns concentrate on livestock and dairying. Crops include corn, potatoes, and cereals. Vineyards are few and are split into small units. The Alpine slopes are used for grazing during the summer.
Tourism is a leading sector of Liechtenstein’s economy and is sponsored by the government. Most visitors come from the surrounding European countries and centre their activities on Vaduz. The registration of tens of thousands of foreign firms in Liechtenstein provides a source of tax income. The principality has also become a centre of banking because of its stable political situation and its laws providing absolute bank secrecy. In the late 20th century, however, Liechtenstein became a centre for money laundering, and its laws were subsequently altered to prohibit the opening of accounts anonymously. Pressure from the United States and the European Union (EU) led to the reform of the banking sector in the early 21st century, and the country worked to shed its image as a tax haven.
There is a network of excellent roads connecting Liechtenstein with its neighbours. The railway, part of the Paris-Vienna express route, passes through the northern sections of the country. There is no airport.
Ethnic Liechtensteiners, who compose about two-thirds of the population, are descended from the Alemanni tribe that came into the region after 500 ce. Although the official language is German, most of the population still speaks an Alemanni dialect containing local variations in pronunciation and vocabulary. Walsers, descendants of immigrants from the Swiss canton of Valais, settled in Triesenberg at the end of the 13th century and continue to speak a particularly distinctive form of the language. About four-fifths of the population is Christian (with about three-fourths of the total population identifying as Roman Catholic).
Post-World War II industrialization resulted in a shift of people to the larger communes. The most populous communes are Vaduz, the administrative and commercial centre, and Schaan, the principal industrial community. Nevertheless, almost nine-tenths of the population is classified as rural.
Matters of public health are the responsibility of a committee of public health, which is headed by a state medical officer. Liechtenstein’s small medical institutions are supplemented by the excellent neighbouring Swiss facilities, to which the principality contributes support. Social security is sustained by a variety of compulsory insurance schemes; the financing of these comprehensive plans is shared by employers, employees, and the government.
Education is supervised by the National Board of Education and is compulsory beginning at age 7. The school system consists of primary schools, secondary schools, a vocational school, grammar school, commercial high school, music school, and a technical college. The University of Liechtenstein offers degrees in architecture and business administration.
The world-famous art collections of the princes of Liechtenstein, exhibited in the Engländerhaus in the centre of Vaduz, include outstanding works of many 17th-century Dutch and Flemish painters. There is also a State Art Collection (1969). The Liechtenstein Treasure Chamber (2015) housed a collection that included the world’s largest Fabergé egg, the crown jewels of the royal family, and lunar rocks gifted to the principality by NASA. The Liechtenstein Postal Museum (founded in 1930) exhibits a large stock of stamps, including national issues since 1912. The Liechtenstein National Museum in Vaduz houses primarily early and Roman artifacts. The Hilti Art Foundation building (2015) served as a showcase for one of the most important privately held collections in Liechtenstein. The Liechtenstein National Library was established in 1961 as a public foundation. A large personal art collection of the Liechtenstein family also is displayed at the Liechtenstein Museum in Vienna (which reopened in 2004 after having been closed since 1938). The Liechtenstein Institute conducts research on topics relating to the country, especially in the sciences, economics, and history.
History of Liechtenstein
The Rhine plain has always been the focus of settlement. For centuries the valley was occupied by two independent lordships of the Holy Roman Empire, Vaduz and Schellenberg. The principality of Liechtenstein, consisting of these two lordships, was founded in 1719 and remained part of the Holy Roman Empire. It was included in the Confederation of the Rhine from 1806 to 1815 and in the German Confederation from 1815 to 1866. In 1866 Liechtenstein became independent. Throughout most of its history, Liechtenstein was a quiet, rural corner of the world that was largely unaffected by its European neighbours, maintaining its neutrality in both World Wars I and II. After World War II, however, the country underwent a remarkably rapid period of industrialization, led by Francis Joseph II, who served as prince from 1938 until his death in 1989.
Francis Joseph II was succeeded by his son Hans Adam II, under whom Liechtenstein joined the United Nations (1990), the European Free Trade Association (1991), the European Economic Area (1995), and the World Trade Organization (1995). Relations between the Landtag and the prince were often tense. The prince offered several constitutional amendments that would strengthen his role, and he frequently threatened to relocate to Austria if his wishes were not granted. In a constitutional referendum in 2003, voters endorsed wider powers for the prince, including the right to veto legislation and the ability to implement emergency powers and to dismiss the government (even if it retained majority support in the Landtag); the referendum also gave citizens the right to call a vote of confidence in the prince, which could result in his removal. In 2004 Hans Adam’s son, Crown Prince Alois, assumed the day-to-day responsibilities of royal governance, though his father officially remained head of state. In 2006 the principality celebrated its 200th anniversary.
A massive tax-evasion scheme involving Liechtenstein’s banks came to light in 2008, and the government moved quickly to reassure investors and foreign leaders. A transparency and reform package adopted in 2009 led the Organisation for Economic Co-operation and Development (OECD) to remove Liechtenstein from its “black list” of tax havens. In 2011 Liechtenstein acceded to the Schengen Agreement, one of the EU’s foundational documents. The treaty relaxed border controls between its signatories, enabling passport-free travel within the Schengen area. The powers of the monarchy were reaffirmed in July 2012 when voters overwhelmingly rejected a measure that would have stripped Alois of the right to veto referenda.
Additional Information
The Principality of Liechtenstein is a tiny, doubly-landlocked country tucked away between Switzerland and Austria and with mountain slopes rising above the Rhine valley.
It owes much of its wealth to its traditional status as a tax haven, though it has in recent years taken steps to shake off its image as a tax haven and to reposition itself as a legitimate financial centre.
Economically, it has one of the highest levels of gross domestic products (GDP) per person in the world.
The country has come through a lengthy political wrangle over the role and power of the hereditary monarchy.
After an often bitter campaign, the people voted in March 2003 in a constitutional referendum to give Prince Hans-Adam sweeping new political powers. The following year he handed over practical power to his son, Crown Prince Alois.
Capital: Vaduz
Area: 160 sq km
Population: 38,300
Language: German
Life expectancy: 80 years (men) 85 years (women).

2470) Edward Calvin Kendall
Gist:
Work
Situated atop the kidneys are two small glands, the adrenal glands. Their function was unknown for a long time, but if they were injured, deficiency diseases ensued that ended in death. In the mid-1930s Edward Kendall and Tadeus Reichstein succeeded in isolating and analyzing the composition of a number of similar hormones derived from the adrenal cortex. These became the basis for cortisone preparations that, with input from Kendall and Philip Hench, were used at the end of the 1940s to treat rheumatoid arthritis and other inflammations.
Summary
Edward Calvin Kendall (born March 8, 1886, South Norwalk, Conn., U.S.—died May 4, 1972, Princeton, N.J.) was an American chemist who, with Philip S. Hench and Tadeus Reichstein, won the Nobel Prize for Physiology or Medicine in 1950 for research on the structure and biological effects of adrenal cortex hormones.
A graduate of Columbia University (Ph.D. 1910), Kendall joined the staff of the Mayo Foundation, Rochester, Minn., in 1914. His early research concerned the isolation of the active constituent (thyroxine) of the thyroid hormone. He also crystallized and established the chemical nature of glutathione, a compound important to biological oxidation-reduction reactions.
Kendall’s most important research, however was the isolation from the adrenal cortex of the steroid hormone cortisone (which he originally called compound E; 1935). With Hench, he successfully applied the hormone in treatment of rheumatoid arthritis (1948). Kendall and Hench, along with Reichstein of Switzerland, received a Nobel Prize in 1950, and Kendall retired from his position as head of the biochemistry division of the Mayo Foundation in 1951. Kendall also acted as head of the biochemistry laboratory there from 1945 to 1951, and he was later visiting professor of chemistry at Princeton University.
Details
Edward Calvin Kendall (March 8, 1886 – May 4, 1972) was an American biochemist. In 1950, Kendall was awarded the Nobel Prize for Physiology or Medicine along with Swiss chemist Tadeusz Reichstein and Mayo Clinic physician Philip S. Hench, for their work with the hormones of the adrenal glands. Kendall not only researched the adrenal glands, he also isolated thyroxine, a hormone of the thyroid gland and worked with the team that crystallized glutathione and identified its chemical structure.
Kendall was a biochemist at the Graduate School of the Mayo Foundation at the time of the Nobel award. He received his education at Columbia University. After retiring from his job with the Mayo Foundation, Kendall joined the faculty at Princeton University, where he remained until his death in 1972. Kendall Elementary School, in Norwalk is named for him.
Early life and education
Kendall was born in South Norwalk, Connecticut in 1886. He attended Columbia University, earning a Bachelor of Science degree in 1908, a Master of Science degree in Chemistry in 1909, and a Ph.D. in Chemistry in 1910.
Research career
After obtaining his Ph.D., his first job was in research for Parke, Davis and Company, and his first task was to isolate the hormone associated with the thyroid gland. He continued this research at St. Luke's Hospital in New York until 1914. He was appointed Head of the Biochemistry Section in the Graduate School of the Mayo Foundation, and the following year he was appointed as the Director of the Division of Biochemistry.
Kendall made several significant contributions to biochemistry and medicine. His most important discovery was the isolation of thyroxine, although it was not the work for which he received the most accolades. Along with associates, Kendall was involved with the isolation of glutathione and determining its structure. He also isolated several steroids from the adrenal gland cortex, one of which was initially called Compound E. Working with Mayo Clinic physician Philip Showalter Hench, Compound E was used to treat rheumatoid arthritis. The compound was eventually named cortisone. In 1950, Kendall and Hench, along with Swiss chemist Tadeus Reichstein were awarded the 1950 Nobel Prize in Physiology or Medicine for "their discoveries relating to the hormones of the adrenal cortex, their structure and biological effects." His Nobel lecture focused on the basic research that led to his award, and was titled "The Development of Cortisone As a Therapeutic Agent." As of the 2010 awards, Kendall and Hench were the only Nobel Laureates to be affiliated with Mayo Clinic.
Kendall was elected to the United States National Academy of Sciences in 1950, and both the American Academy of Arts and Sciences and the American Philosophical Society in 1951.
Kendall's career at Mayo ended in 1951, when he reached mandatory retirement age. He moved on to Princeton University, where he was a visiting professor in the Department of Biochemistry. He remained affiliated with Princeton until his death in 1972. In addition to the Nobel Prize, Kendall received other major awards including the Lasker Award, the Passano Foundation Award and the Cameron Prize for Therapeutics of the University of Edinburgh. Kendall received the Golden Plate Award of the American Academy of Achievement in 1966. He was awarded honorary doctorates from the University of Cincinnati, Western Reserve University, Williams College, Yale University, Columbia University, National University of Ireland, and Gustavus Adolphus College.
Family life
Kendall married Rebecca Kennedy in 1915, and they had four children. He died in 1972 in Princeton, New Jersey. His wife died in 1973.

Comfortable Quotes - VI
1. I cannot tell a lie, and I'm very straightforward. Sometimes this hurts people. I've wondered if I should change, but I feel more comfortable about myself this way. - Sushma Swaraj
2. My whole life, I've wanted to feel comfortable in my skin. It's the most liberating thing in the world. - Drew Barrymore
3. As my primary language was English, I had to work on my Hindi. I wasn't so comfortable with it. - Mandira Bedi
4. Beauty, to me is about being comfortable in your own skin. - Gwyneth Paltrow
5. I'm a young woman, and I'm growing up and trying to do it in a way I feel comfortable with. - Selena Gomez
6. I think the interaction I had with Salman in 'London Dreams' kind of helped to have a comfortable relationship in 'Ready' because of the rapport created. He is always very supportive. - Asin
7. I have a tightly edited closet. I like what I like. And I repeat a lot. But I'm always comfortable in jeans - I feel like I can really do anything when I'm in them. - Katie Holmes
8. I feel that modelling has groomed my personality and made me a confident person, but even today, when I go on the ramp, I get nervous. I am more comfortable being in front of the camera than walking on the ramp. - Kriti Sanon
9. I dress according to what suits me and what I am comfortable in. - Kajal Aggarwal
10. I'm most comfortable with the Southern dialects, really. It's easy, for example, for me to do Irish because we've got Irish heritage where I come from. - Brad Pitt
11. Leaving my house and getting on to a red carpet is always crazy for me, because you have to find a way to be comfortable in the most uncomfortable situation imaginable. - Sandra Bullock
12. Money can't buy everything, but it can buy most of it. Because of money, I could give my parents a comfortable life. - Kangana Ranaut.
Q: Did you hear about the angry pancake?
A: He just flipped.
* * *
Q: What did the young pancake say to the old burnt pancake?
A: I don't like your flip side.
* * *
Q: What do the New York Yankees and pancakes have in common?
A: They both need a good batter!
* * *
Q: How do you make a pancake smile?
A: Butter him up.
* * *
Q: What's the best pancake topping?
A: More pancakes.
* * *
Carbon Tetrachloride
Gist
Carbon tetrachloride (CCl4) is a colorless, volatile liquid historically used as a cleaning agent, fire extinguisher component, and pesticide. Due to severe toxicity (liver/kidney damage) and ozone depletion, its use is heavily restricted. It is now largely limited to industrial applications as a chemical feedstock, solvent, and laboratory reagent.
Most industrial CCl4 is used in the synthesis of CFCs and chlorinated solvents. Production of CCl4 has been continuously declining in response to regulation.
Summary
Carbon tetrachloride, also known by many other names (such as carbon tet for short and tetrachloromethane, also recognised by the IUPAC), is a chemical compound with the chemical formula CCl4. It is a volatile, non-flammable, dense, colourless liquid with a chloroform-like sweet odour that can be detected at low levels. It was formerly widely used in fire extinguishers, as a precursor to refrigerants, an anthelmintic and a cleaning agent, but has since been phased out because of environmental and safety concerns. Exposure to high concentrations of carbon tetrachloride can affect the central nervous system and degenerate the liver and kidneys. Prolonged exposure can be fatal.
Properties
In the carbon tetrachloride molecule, four chlorine atoms are positioned symmetrically as corners in a tetrahedral configuration joined to a central carbon atom by single covalent bonds. Because of this symmetric geometry, CCl4 is non-polar. Methane gas has the same structure, making carbon tetrachloride a halomethane. As a solvent, it is well suited to dissolving other non-polar compounds such as fats and oils. It can also dissolve iodine. It is volatile, giving off vapors with an odor characteristic of other chlorinated solvents.
With a specific gravity greater than 1, carbon tetrachloride will be present as a dense nonaqueous phase liquid if sufficient quantities are spilt in the environment.
Details
Carbon tetrachloride, also known as tetrachloromethane, is an organic compound with the chemical formula CCl4. This compound is often classified as a polyhalogenated organic compound since it consists of a carbon atom which is attached to more than one halide functional group. Under standard conditions for temperature and pressure, CCl4 exists as a colourless liquid which emanates a very sweet odour.
In the past, this compound was widely used in cleaning agents. It was also used in fire extinguishers and was known to serve as a precursor to several refrigerants. However, the use of this compound has been phased out by several governments due to its toxicity. The inhalation of large quantities of carbon tetrachloride can cause serious damage to vital organs like the kidney and liver. It can also have negative effects on the central nervous system (CNS). Furthermore, prolonged human exposure to carbon tetrachloride often results in death.
Carbon tetrachloride was also widely used as a precursor to chlorofluorocarbons (CFCs). However, due to environmental concerns, the production of this compound has seen a sharp decline since the 1980s. Exposure to carbon tetrachloride is known to cause centrilobular hepatic necrosis. In the body, this compound is metabolized into the trichloromethyl radical, which is highly reactive. This trichloromethyl can go on to cause hepatocellular damage.
Structure of CCl4 Molecules
Carbon tetrachloride molecules have tetrahedral molecular geometries in which the central carbon atom is bonded to four chlorine atoms. The structure of CCl4 molecules is illustrated below.
It can be noted that the four chlorine atoms are positioned symmetrically at each corner around the central carbon atom in the CCl4 molecule. The bonds between the carbon atom and the chlorine atoms are covalent. As a consequence of the molecular geometry of this compound, it exhibits non-polar properties. It can be noted that the molecular structure of CCl4 is quite similar to that of CH4 (methane gas).
Properties of Carbon Tetrachloride:
Some important physical and chemical properties of CCl4 are listed below.
* The molar mass of carbon tetrachloride is 153.81 grams per mole.
* Under standard conditions, this compound exists in the liquid state. It has a colourless appearance and a sweet odour.
* The density of this compound (in its liquid state) corresponds to 1.5867 grams per cubic centimetre.
* The melting point of carbon tetrachloride is -22.93 degrees C whereas the boiling point of this compound corresponds to 76.72 degrees C.
* CCl4 is not very soluble in water. At a temperature of 25 degrees Celsius, the solubility of carbon tetrachloride in water is only 1 gram per litre (approx.). However, it can be noted that this compound is soluble in many organic solvents such as chloroform, benzene, alcohols, ethers, and formic acid.
* Carbon tetrachloride crystallizes in a monoclinic crystal lattice.
* The coordination geometry of this compound has a tetrahedral shape. The molecular shape of this compound is also tetrahedral. It can be noted that the central atom in this scenario is the carbon atom.
* The thermal capacity or the heat capacity of carbon tetrachloride is 132.6 Joules per mole Kelvin.
* The standard molar entropy associated with this organic compound is 214.42 Joules per mole Kelvin.
Key Applications of Tetrachloromethane
Before the 1980s, the primary application of carbon tetrachloride was in the production of chlorofluorocarbons for refrigeration. It was also used as a component of fire extinguishers and as a cleaning agent. However, despite the health hazards associated with this compound and the serious environmental damage caused by chlorofluorocarbons (see: ozone layer depletion), the use of this compound has been phased out by the governments of several countries. However, this compound is known to have other niche uses, some of which are listed below.
* Carbon tetrachloride is used as a chlorine source in a named reaction known as the Appel reaction.
* It is also used to reveal the watermarks that are placed on stamps without causing any damage to the stamp in the process.
* Carbon tetrachloride was also used as a component in the manufacture of lava lamps.
* Historically, CCl4 has been used in proton NMR spectroscopy.
Health Hazards Associated with CCl4
Carbon tetrachloride is a highly potent hepatotoxin which can cause serious damage to the liver. In high enough concentrations, this compound can also damage the central nervous system (CNS). Exposure to CCl4 for prolonged durations of time often leads to death or coma. Exposure to this compound has also been linked to cancer and kidney damage.
Frequently Asked Questions on Carbon Tetrachloride:
Q1: What are the uses of carbon tetrachloride?
A1: Carbon tetrachloride was commonly used in the past as a cleaning fluid (as a degreasing agent in dry cleaning institutions and other industries, and as a spot remover for clothes, furniture, and carpeting in households). Carbon tetrachloride has also been used in fire extinguishers and as a fumigant in grain in order to kill insects.
Q2: What happens when carbon tetrachloride is exposed to steam?
A2: In the presence of metals that can behave as catalysts (such as iron and aluminium), carbon tetrachloride is decomposed by water. If it is overheated steam, carbon tetrachloride can also be decomposed to create phosgene, even without the presence of a metal catalyst.
Q3: Comment on the structure of carbon tetrachloride.
A3: Four chlorine atoms are symmetrically arranged in the carbon tetrachloride molecule as corners in a tetrahedral structure, connected by single covalent bonds to a central carbon atom.
Q4: Why is carbon tetrachloride considered to be dangerous?
A4: Inhalation of carbon tetrachloride by human beings often lead to negative short term effects such as nausea, vomiting, lethargy, weakness, and headaches. Oral consumption of this compound can also contribute to these symptoms. Prolonged, long-term exposure to CCl4 is known to cause acute liver damage, acute kidney damage, and damage to the central nervous system. These health hazards associated with carbon tetrachloride are the reason why it is widely regarded as a dangerous substance.
Q5: What does carbon tetrachloride smell like?
A5: Carbon tetrachloride is known to have a strong, sweet odour. The smell associated with this chemical compound is quite similar to that of chloroform. CCl4 is a volatile organic compound that readily undergoes vaporization.
Additional Information
Carbon tetrachloride is a colourless, dense, highly toxic, volatile, nonflammable liquid possessing a characteristic odour and belonging to the family of organic halogen compounds, used principally in the manufacture of dichlorodifluoromethane (a refrigerant and propellant).
First prepared in 1839 by the reaction of chloroform with chlorine, carbon tetrachloride is manufactured by the reaction of chlorine with carbon disulfide or with methane. The process with methane became dominant in the United States in the 1950s, but the process with carbon disulfide remains important in countries where natural gas (the principal source of methane) is not plentiful. Carbon tetrachloride boils at 77° C (171° F) and freezes at -23° C (-9° F); it is much denser than water, in which it is practically insoluble.
Formerly used as a dry-cleaning solvent, carbon tetrachloride has been almost entirely displaced from this application by tetrachloroethylene, which is much more stable and less toxic.

Conjunctivitis
Gist
Conjunctivitis (pink eye), specifically bacterial and viral types, spreads rapidly through direct contact with an infected person's eye secretions, touching contaminated surfaces, or inhaling airborne droplets from coughs/sneezes. It is highly contagious, often spreading via unwashed hands touching the eyes. Contrary to myths, it does not spread by just looking at someone.
Inflammation of the conjunctiva is known as conjunctivitis and is characterized by dilation of the conjunctival vessels, resulting in hyperemia and edema of the conjunctiva, typically with associated discharge. The prevalence of conjunctivitis varies according to the underlying cause, which may be influenced by the patient’s age, as well as the season of the year.
Summary
Conjunctivitis, also known as pink eye, is inflammation of the conjunctiva, the thin and clear layer that covers the white surface of the eye and the inner eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be stuck shut in the morning. Swelling of the sclera may also occur. Itching is more common in cases that are due to allergies. Conjunctivitis can affect one or both eyes.
The most common infectious causes in adults are viral, whereas in children bacterial causes predominate. The viral infection may occur along with other symptoms of a common cold. Both viral and bacterial cases are easily spread among people. Allergies to pollen or animal hair are also a common cause. Diagnosis is often based on signs and symptoms. Occasionally a sample of the discharge is sent for culture.
Prevention is partly by handwashing. Treatment depends on the underlying cause. In the majority of viral cases, there is no specific treatment. Most cases that are due to a bacterial infection also resolve without treatment; however antibiotics can shorten the illness. People who wear contact lenses and those whose infection is caused by gonorrhea or chlamydia should be treated. Allergic cases can be treated with antihistamines or mast cell inhibitor drops.
Between three and six million people get acute conjunctivitis each year in the United States. Typically they get better in one or two weeks. If visual loss, significant pain, sensitivity to light or signs of herpes occur, or if symptoms do not improve after a week, further diagnosis and treatment may be required. Conjunctivitis in a newborn, known as neonatal conjunctivitis, may also require specific treatment.
Details
Pink eye (conjunctivitis) is inflammation in your eyes. It happens when the membrane that covers the white of your eye is irritated. Viral and bacterial infections are the most common causes. You may not need treatment. But visit a healthcare provider if you have symptoms that are getting worse after a few days.
What Is Pink Eye?
What does pink eye look like? The white of your eye will be light pink to reddish and you might have puffiness, crusting or fluid (discharge) coming from your eye.
Pink eye is inflammation in the conjunctiva in your eye. The conjunctiva is the clear membrane that covers part of your eye and the inside of your eyelid. The medical name for pink eye is conjunctivitis. It’s extremely common. It can affect one eye or both at the same time.
Pink eye can be short term (acute) or long term (chronic). Acute pink eye lasts for fewer than four weeks. Chronic pink lasts for more than four weeks.
Pink eye caused by an infection can easily spread. You can accidentally pass it to other people or spread it from one eye to the other.
What does conjunctivitis look like?
Just like it sounds, pink eye can make the white part of your eye look pink or reddish. It can also make your eyelids look puffy or droopy. You may notice discharge coming from your affected eyes.
Symptoms and Causes
The most common conjunctivitis symptoms include:
* Red eye
* Thick eye discharge (yellow, green or white)
* Crusting on your eyelashes or eyelids
* Feeling like something’s stuck in your eye
* Dry, watery, itchy, irritated eyes
* Burning eyes
* Blurred vision (may come and go)
* Light sensitivity
* Swollen eyelids
* Eye pain (usually mild)
Pink eye can share symptoms with lots of other eye conditions. An eye doctor can help you understand what’s affecting your eyes.
Pink eye causes
Lots of issues and conditions can cause pink eye. Healthcare providers usually divide conjunctivitis into two categories — infectious and noninfectious.
Infectious pink eye
This happens when an infection causes conjunctivitis. Any type of infection can cause pink eye, including:
* Viral infections: Infections from the adenovirus family are the most common cause of acute pink eye. Other viral infections that can cause viral conjunctivitis include measles, mumps, COVID-19, eye herpes, molluscum contagiosum and hand, foot and mouth disease. Some viruses that cause sexually transmitted infections (STIs) can lead to pink eye.
* Bacterial infections: Bacterial infections are the second most common cause of pink eye. The bacteria that cause staph infections, strep throat and some types of meningitis can all cause bacterial conjunctivitis. STIs like chlamydia, gonorrhea and syphilis can, too.
* Fungal and parasitic infections: It’s possible for a fungus or parasite to cause pink eye. But it’s much less common than pink eye from a viral or bacterial infection.
Noninfectious conjunctivitis
This happens when something other than an infection causes conjunctivitis. This is pink eye that doesn’t spread to you from other people, animals or contaminated objects.
Examples include:
* Allergens: Molds, pollen or other substances that cause allergies can irritate your conjunctiva. This is called allergic conjunctivitis.
* Irritants or toxic substances: Anything that gets in your eye can cause inflammation. This includes soap, cosmetics, dirt, smoke or pool chlorine. Your contact lenses or contact solution can irritate your eyes sometimes, too, even if they usually don’t. Some medications can cause pink eye as a side effect.
* Eye injuries: Anything that damages your conjunctiva can lead to conjunctivitis.
* Other health conditions: Autoimmune diseases can irritate your eyes. It’s much less common, but so can tumors or eye cancers.
What are the complications of pink eye?
Untreated conjunctivitis can cause permanent eye damage and even blindness. But this is rare. Complications that can lead to vision loss include:
* Trachoma
* Uveitis
* Corneal inflammation and cornea-conjunctiva inflammation
* More severe corneal diseases, especially corneal ulcers and recurrent corneal erosions
See an eye doctor or your primary care provider if symptoms are getting worse after more than a few days. That’s the best way to avoid complications.
Diagnosis and Tests:
How doctors diagnose pink eye
A healthcare provider will diagnose conjunctivitis with an eye exam. They’ll examine your eye and ask about the symptoms. Tell your provider when you first noticed symptoms and how they’ve changed or gotten worse.
Your provider may also test for bacterial infections. They’ll use a soft-tipped swab to collect some of the fluid oozing from your eye for lab testing. Your provider can use the results to guide your treatment.
You might need a follow-up appointment. Your provider will make sure your eyes are healing and check for signs of complications.
Management and Treatment:
How is conjunctivitis treated?
Most of the time, you can treat pink eye symptoms at home until they get better. Your healthcare provider will suggest ways to manage symptoms, including:
* NSAIDs like ibuprofen (Advil® or Motrin®)
* Corticosteroids
* Applying a warm or cool compress to your eye (don’t share washcloths or towels with others)
* Artificial tears
* Wearing your glasses instead of contact lenses while you have symptoms
If an irritant gets in your eye, you need to rinse it out. Flush your eyes with warm water for five minutes. If a strong acid or alkaline substance (like drain cleaner) gets in your eye, flush your eyes the same way. Then, get immediate emergency medical attention.
Your provider might give you medications to treat a specific cause, including:
* Antivirals: Many viruses that cause pink eye don’t need treatment. But your provider will treat herpes simplex, chickenpox/shingles or an STI. These infections have a higher risk of complications.
* Antibiotics: Eye drops, ointments and pills can all treat bacterial infections.
* Antifungals or antiparasitics: These medications treat infections from fungi or parasites.
* Allergy medications: Your provider will suggest prescription or over-the-counter antihistamines or decongestants to manage allergies.
* Immunosuppressants: These medications can treat autoimmune diseases. They calm your immune system and can prevent it from damaging your eyes.
How long does pink eye last?
How long conjunctivitis lasts depends on what caused it. Viral infections typically last up to two weeks. It’s rare, but some may last longer. Bacterial infections usually last up to 10 days. Allergy-related pink eye lasts as long as you’re around the allergen causing the reaction.
When should I see my healthcare provider?
Visit a healthcare provider if you think you have pink eye and the symptoms keep getting worse after a few days.
Some symptoms can be a sign of a serious problem, like an eye ulcer. Visit a healthcare provider right away if you experience:
* A severe sensitivity to light
* Blurred vision or a decrease in vision
* Severe eye pain
* Feeling like there’s something stuck in your eye
* A large amount of eye discharge
* Worsening symptoms
Outlook / Prognosis:
What can I expect if I have conjunctivitis?
The outlook for pink eye is good, especially with treatment. Milder cases often go away on their own.
Call your provider if it seems like treatments aren’t helping. They may be able to adjust your medications.
Can conjunctivitis come back?
Yes, pink eye can come back. Allergy-related pink eye is the most likely kind to happen again. Your eyes may react every time you’re exposed to an allergen.
If you have bacterial or viral pink eye, you can accidentally reinfect yourself. To avoid that, you should:
* Wash your bed linens, pillowcases, towels and washcloths in hot water and detergent. Change them frequently.
* Avoid wearing eye makeup until the infection goes away. Throw out old eye makeup, makeup tools and any makeup you used right before you got pink eye.
* Wear glasses instead of contact lenses while you have conjunctivitis. Clean your glasses often.
* Throw away the contacts and the case you were using right before you noticed symptoms. Only use sterile contact solution. Wash your hands before touching your eyes and contacts.
Prevention:
How can you prevent conjunctivitis?
You may not always be able to prevent pink eye. But you can lower your risk of some types by:
* Washing or sanitizing your hands frequently: Use soap and water if your hands look or feel dirty. If they don’t look or feel dirty, you can use an alcohol-based hand sanitizer (at least 60% alcohol).
* Wearing eye protection: Make sure you wear the right eyewear for any work or hobbies. If you wear glasses, don’t assume they’re enough to protect your eyes.
* Never sharing things that touch your eyes: Grooming and hygiene items can spread conjunctivitis very easily. Don’t share makeup tools, personal grooming items, washcloths or anything else that directly touches your eyes.
* Safely using eye drops: Wash your hands before picking up the bottle. Only touch your face with the hand that isn’t holding the bottle. Make sure the bottle tip doesn’t touch your eye. After you put the drops in, set the bottle down, wash your hands and then put it away.
Additional Information
Pink eye is an inflammation of the transparent membrane that lines the eyelid and eyeball. This membrane is called the conjunctiva. When small blood vessels in the conjunctiva become swollen and irritated, they're more visible. This is what causes the whites of the eyes to appear reddish or pink. Pink eye also is called conjunctivitis.
Pink eye is most often caused by a viral infection. It also can be caused by a bacterial infection, an allergic reaction or — in babies — an incompletely opened tear duct.
Though pink eye can be irritating, it rarely affects your vision. Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, getting an early diagnosis and taking certain precautions can help limit its spread.
Symptoms
The most common pink eye symptoms include:
* Redness in one or both eyes.
* Itchiness in one or both eyes.
* A gritty feeling in one or both eyes.
* A discharge in one or both eyes that forms a crust during the night that may prevent your eye or eyes from opening in the morning.
* Tearing.
* Sensitivity to light, called photophobia.
When to see a doctor
There are serious eye conditions that can cause eye redness. These conditions may cause eye pain, a feeling that something is stuck in your eye, blurred vision and light sensitivity. If you experience these symptoms, seek urgent care.
People who wear contact lenses need to stop wearing their contacts as soon as pink eye symptoms begin. If your symptoms don't start to get better within 12 to 24 hours, make an appointment with your eye healthcare professional to make sure you don't have a more serious eye infection related to contact lens use.
Causes
Causes of pink eye include:
* Viruses.
* Bacteria.
* Allergies.
* A chemical splash in the eye.
A foreign object in the eye.
* In newborns, a blocked tear duct.
Viral and bacterial conjunctivitis
Most cases of pink eye are caused by adenovirus. It also can be caused by other viruses, including herpes simplex virus and varicella-zoster virus.
Both viral and bacterial conjunctivitis can occur along with colds or symptoms of a respiratory infection, such as a sore throat. Wearing contact lenses that aren't cleaned properly or aren't your own can cause bacterial conjunctivitis.
Both types are very contagious. They are spread through direct or indirect contact with the liquid that drains from the eye of someone who's infected. One or both eyes may be affected.
Allergic conjunctivitis
Allergic conjunctivitis affects both eyes. It is a response to an allergy-causing substance such as pollen. In response to allergens, your body produces an antibody called immunoglobulin E (IgE). IgE triggers special cells in the mucous lining of your eyes and airways to release inflammatory substances, including histamines. Your body's release of histamine can produce a number of allergy symptoms, including red or pink eyes.
If you have allergic conjunctivitis, you may experience intense itching, tearing and inflammation of the eyes. You also could have sneezing and watery nasal discharge. Most allergic conjunctivitis can be controlled with allergy eye drops. Allergic conjunctivitis is not contagious.
Conjunctivitis resulting from irritation
Irritation from a chemical splash or foreign object in the eye also is associated with conjunctivitis. Sometimes flushing and cleaning the eye to wash out the chemical or object causes redness and irritation. Symptoms, which may include watery eyes and a mucous discharge, usually clear up on their own within about a day.
If flushing doesn't resolve the symptoms, or if the chemical is a caustic one such as lye, see your healthcare professional or eye specialist as soon as possible. A chemical splash into the eye can cause permanent eye damage. Ongoing symptoms could indicate that you still have the foreign body in your eye. Or you also could have a scratch on the cornea or the membrane covering the eyeball, called the conjunctiva.
Risk factors
Risk factors for pink eye include:
* Exposure to someone infected with the viral or bacterial form of conjunctivitis.
* Exposure to something you're allergic to, for allergic conjunctivitis.
* Using contact lenses, especially extended-wear lenses.
Complications
In both children and adults, pink eye can cause inflammation in the cornea that can affect vision. Prompt evaluation and treatment by your healthcare professional can reduce the risk of complications. See your professional if you have:
* Eye pain.
* A feeling that something is stuck in the eye.
* Blurred vision.
* Light sensitivity.
Prevention:
Preventing the spread of pink eye
Practice good hygiene to control the spread of pink eye. For instance:
* Don't touch your eyes with your hands.
* Wash your hands often.
* Use a clean towel and washcloth daily.
* Don't share towels or washcloths.
* Change your pillowcases often.
* Throw away old eye cosmetics, such as mascara.
* Don't share eye cosmetics or personal eye care items.
Keep in mind that pink eye is no more contagious than the common cold. It's okay to return to work, school or child care if you're able to practice good hygiene and avoid close contact. However, if work, school or child care involves close contact with others, it may be best to stay home until your or your child's symptoms clear up.
Preventing pink eye in newborns
Newborns' eyes are susceptible to bacteria present in the mother's birth canal. These bacteria often cause no symptoms in the mother. In some cases, these bacteria can cause infants to develop a serious form of conjunctivitis known as ophthalmia neonatorum. This condition needs immediate treatment to keep the baby's sight. That's why shortly after birth, an antibiotic ointment is applied to every newborn's eyes. The ointment helps prevent eye infection.

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Hyperthyroidism
Gist
Hyperthyroidism is caused by an overactive thyroid gland producing excessive thyroid hormones (T3 and T4), commonly driven by Graves' disease (an autoimmune disorder), toxic thyroid nodules, or thyroid inflammation (thyroiditis). Other causes include high iodine intake, overmedication for hypothyroidism, and rarely, pituitary tumors.
Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs.
Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. But there are treatments that can help.
Summary
Hyperthyroidism means that your thyroid gland is making too much thyroid hormone. You may also hear the term thyrotoxicosis. This also means there is too much thyroid hormone in your body.
What are the symptoms Hyperthyroidism?
If there is too much thyroid hormone, your body speeds up and this can cause symptoms such as:
* increased sweating and feeling hot
* feeling like your heart is racing or is beating irregularly
* hand tremors
* anxiety, nervousness, and irritability
* weight loss despite normal or even increased appetite
* frequent bowel movements or diarrhea
* difficulty sleeping
* hair loss
* changes in menstrual periods, often lighter and/or less frequent
* trouble swallowing or fullness in the neck
* increased or decreased energy level
* pain behind the eyes and/or swelling or bulging of eyes (for autoimmune thyroid dysfunction only)
Everyone is different and you may not have all the symptoms. Symptoms can start suddenly or come on slowly over time.
Hyperthyroidism can be caused by an autoimmune condition (Graves’ disease), inflammation of the thyroid (thyroiditis), or due to thyroid nodules making too much thyroid hormone (hot nodule or toxic multinodular goiter). We will briefly describe each of these but be sure to check out our other resource links.
Graves' Disease:
Graves’ disease is the most common cause of hyperthyroidism. It is an autoimmune thyroid condition caused by antibodies that stimulate all the cells in the thyroid gland to make too much thyroid hormone.
Details
Hyperthyroidism, also called overactive thyroid, happens when your thyroid makes and releases high levels of thyroid hormone. It speeds up several bodily functions, causing symptoms like rapid heart rate, weight loss, increased appetite and anxiety. Hyperthyroidism is treatable — typically with medications.
Overview:
What is hyperthyroidism?
Hyperthyroidism, also called overactive thyroid, is a condition where your thyroid makes and releases high levels of thyroid hormone. It has multiple possible causes. The main thyroid hormones are triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH).
Hyperthyroidism speeds up your metabolism, which can affect several aspects of your health. The condition can throw your whole well-being off balance. You may not feel like yourself or even feel out of control of your body. It’s important to get medical treatment if you develop signs of hyperthyroidism so you can get back to feeling like yourself.
How common is hyperthyroidism?
Hyperthyroidism is relatively rare. Approximately 1.3% of people in the United States have it.
Symptoms and Causes
What are the symptoms of hyperthyroidism?
Hyperthyroidism can impact your entire body, so there are many symptoms. You may experience some of these symptoms and not others, or many of them at the same time. Symptoms of hyperthyroidism can include:
* Rapid heart rate (tachycardia) and/or heart palpitations.
* Increased blood pressure.
* Shakiness, like hand tremors.
* Feeling anxious, nervous and/or irritable.
* Weight loss despite a regular or increased appetite.
* Diarrhea or more frequent pooping.
* Increased sweating and sensitivity to warm temperatures.
* Hair loss or brittle hair.
* Difficulty sleeping (insomnia).
* Menstrual period changes, like lighter or missed periods.
* Swelling and enlargement of your neck (goiter).
* Swelling or bulging of your eyes (thyroid eye disease).
These symptoms can start suddenly or develop slowly over time. It’s important to see your healthcare provider if you develop hyperthyroidism symptoms.
What causes hyperthyroidism?
Medical conditions and situations that can cause hyperthyroidism include:
* Graves’ disease: This is an autoimmune condition that makes your thyroid overactive. Graves’ disease is the most common cause of hyperthyroidism. Your chances of developing it increase if you have a biological family history of thyroid disease and/or another autoimmune condition.
* Thyroid nodules: These are lumps or growths of cells in your thyroid gland. They can sometimes produce excess thyroid hormone. Healthcare providers may call this toxic multinodular goiter (TMNG). Thyroid nodules are rarely cancerous.
* Thyroiditis: Thyroiditis is inflammation of your thyroid gland. It can cause hyperthyroidism temporarily. After this phase — the thyrotoxic phase — it may cause hypothyroidism (underactive thyroid). When the inflammation goes away, your hormone levels may stabilize.
* Consuming excess iodine: Consuming too much iodine (through foods or medications) can cause your thyroid to produce more thyroid hormone. Iodine is a mineral that your thyroid uses to create thyroid hormone. Receiving IV iodinated contrast (iodine “dye”) or taking amiodarone (a medication) may cause hyperthyroidism.
* TSH-releasing pituitary adenoma (thyrotropinoma): This is a growth in your pituitary gland that releases excess thyroid-stimulating hormone (TSH). Your pituitary gland normally releases TSH to trigger your thyroid to release thyroid hormone. Excess TSH can lead to excess thyroid hormone. This is a very rare cause of hyperthyroidism.
What are the risk factors for hyperthyroidism?
Factors that increase your risk of developing hyperthyroidism include:
* Biological family history of thyroid disease and/or autoimmune conditions.
* Smoking.
* Pregnancy (for postpartum thyroiditis).
Diagnosis and Tests:
How is hyperthyroidism diagnosed?
The diagnostic process for hyperthyroidism may involve multiple steps, including:
* A physical exam: To start, your healthcare provider will do a physical exam to check for signs of hyperthyroidism, like an enlarged thyroid, rapid heart rate and warm, moist skin.
* Thyroid blood tests: Blood tests can check your thyroid hormone levels. When you have hyperthyroidism, levels of the thyroid hormones T3 and T4 are above normal and thyroid-stimulating hormone (TSH) is often (but not always) lower than normal.
* Thyroid antibody blood test: This test can check if Graves’ disease is the cause.
* Imaging tests: Various imaging tests of your thyroid can help diagnose hyperthyroidism and its cause. They include a radioactive iodine uptake (RAIU) test and scan and a thyroid ultrasound. Your provider will go over the options and processes with you and recommend the test they think is best.
Management and Treatment:
What is the treatment for hyperthyroidism?
There are many treatment options for hyperthyroidism. Depending on the cause, some options may be better for you than others. Your healthcare provider will discuss each option with you and help you determine the best treatment plan.
Antithyroid medications
Methimazole (Tapazole®) and propylthiouracil (PTU) block the ability of your thyroid to make hormones. These medications are the most common treatment for hyperthyroidism. They can usually control thyroid function within two to three months. Your symptoms may get better within days to weeks.
Radioactive iodine (RAI) therapy
RAI therapy involves taking radioactive iodine by mouth in a single capsule or liquid dose. The radioactive iodine targets your thyroid cells specifically and destroys them. RAI usually leads to permanent destruction of your thyroid, which will cure hyperthyroidism. Most people who receive this treatment must take thyroid hormone medication (levothyroxine) for the rest of their lives to maintain normal thyroid hormone levels.
Surgery
A surgeon may remove all or part of your thyroid gland through surgery (thyroidectomy). This will correct hyperthyroidism but will usually cause hypothyroidism, requiring lifelong thyroid hormone medication.
Beta-blockers
Beta-blockers are medications that can help manage hyperthyroidism symptoms like rapid heartbeat, nervousness and shakiness. But they don’t change the level of hormones in your blood. Your provider may recommend beta-blockers alongside another treatment.
Each of these treatments has specific side effects and risks. Your provider will go over them with you. Don’t hesitate to ask questions.
Outlook / Prognosis:
What is the prognosis for someone with hyperthyroidism?
Hyperthyroidism is a treatable condition. Most people do well with treatment. While some forms of treatment require you to take medication for the rest of your life, this will help keep your thyroid hormone levels in a healthy range.
Untreated hyperthyroidism caused by Graves’ disease may get worse over time and cause complications, like Graves’ eye disease (Graves’ ophthalmopathy). If you have Graves’ disease, ask your healthcare provider how you can best manage the condition.
What happens if hyperthyroidism is left untreated?
Complications from untreated or undertreated hyperthyroidism include:
* Atrial fibrillation (Afib).
* Congestive heart failure.
* Infertility.
* Ischemic stroke.
* Osteoporosis.
A rare and life-threatening complication of hyperthyroidism is thyroid storm (thyroid crisis or thyrotoxic crisis). It happens when your thyroid makes and releases a large amount of thyroid hormone in a short amount of time. It’s an emergency that requires immediate medical attention.
Untreated or inadequately treated hyperthyroidism can cause thyroid storm. Stressors like infection, injury or surgery may trigger it.
Living With:
When should I see my healthcare provider?
* If you’re experiencing signs and symptoms of hyperthyroidism, it’s important to see your healthcare provider so they can assess your condition and recommend treatment.
* If you already have a diagnosis, you’ll likely need to see your provider regularly to make sure your treatment is working.
* If you’re experiencing signs of thyroid storm, like a high fever and very fast heart rate, get to the nearest hospital as soon as possible.
Additional Common Questions:
Does hyperthyroidism cause weight gain?
Hyperthyroidism doesn’t typically cause weight gain. In fact, some people experience weight loss — even with an increased appetite. This is because hyperthyroidism speeds up your metabolic rate, causing your body to use more calories for energy than usual.
Hypothyroidism (underactive thyroid) slows down your metabolism, which may lead to weight gain.
Can I develop hyperthyroidism during pregnancy?
During early pregnancy, your body needs to produce more thyroid hormones than normal to help the developing fetus. Having thyroid hormone levels that are a little higher than normal is OK, but if your levels increase dramatically, your healthcare provider may need to form a treatment plan. High levels of thyroid hormones can impact not only you but also the fetus.
It can be difficult to diagnose hyperthyroidism during pregnancy because your thyroid hormone levels naturally increase and the other symptoms of pregnancy can mask signs of the condition.
What foods should I avoid with hyperthyroidism?
Eating too many iodine-rich or iodine-fortified foods may cause hyperthyroidism or make it worse in some cases.
If you have hyperthyroidism, your healthcare provider may recommend certain changes to your diet. Always consult your provider or a registered dietitian before making drastic changes to your diet. Know that diet changes alone often can’t fix hyperthyroidism. You’ll likely need medical treatment.
If your provider recommends a low-iodine diet, try to avoid the following foods:
* Fish.
* Seaweed and kelp.
* Crab and lobster.
* Sushi.
* Prawns.
* Algae and alginate
* Milk and dairy products, like cheese.
* Egg yolks.
* Iodized salt.
Additional Information
Hyperthyroidism happens when the thyroid gland makes too much thyroid hormone. This condition also is called overactive thyroid. Hyperthyroidism speeds up the body's metabolism. That can cause many symptoms, such as weight loss, hand tremors, and rapid or irregular heartbeat.
Several treatments are available for hyperthyroidism. Anti-thyroid medicines and radioiodine can be used to slow the amount of hormones the thyroid gland makes. Sometimes, hyperthyroidism treatment includes surgery to remove all or part of the thyroid gland. In some cases, depending on what's causing it, hyperthyroidism may improve without medication or other treatment.
Symptoms
Hyperthyroidism sometimes looks like other health problems. That can make it hard to diagnose. It can cause many symptoms, including:
* Losing weight without trying.
* Fast heartbeat, a condition called tachycardia.
* Irregular heartbeat, also called arrhythmia.
* Pounding of the heart, sometimes called heart palpitations.
* Increased hunger.
* Nervousness, anxiety and irritability.
* Tremor, usually a small trembling in the hands and fingers.
* Sweating.
* Changes in menstrual cycles.
* Increased sensitivity to heat.
* Changes in bowel patterns, especially more-frequent bowel movements.
* Enlarged thyroid gland, sometimes called a goiter, which may appear as a swelling at the base of the neck.
* Tiredness.
* Muscle weakness.
* Sleep problems.
* Warm, moist skin.
* Thinning skin.
* Fine, brittle hair.
Older adults are more likely to have symptoms that are hard to notice. These symptoms may include an irregular heartbeat, weight loss, depression, and feeling weak or tired during ordinary activities.
When to see a doctor
If you lose weight without trying, or if you notice a rapid heartbeat, unusual sweating, swelling at the base of your neck or other symptoms of hyperthyroidism, make an appointment with your health care provider. Tell your provider about all the symptoms you've noticed even if they are minor.
After a diagnosis of hyperthyroidism, most people need regular follow-up visits with their health care provider to monitor the condition.
Causes
Hyperthyroidism can be caused by several medical conditions that affect the thyroid gland. The thyroid is a small, butterfly-shaped gland at the base of the neck. It has a big impact on the body. Every part of metabolism is controlled by hormones that the thyroid gland makes.
The thyroid gland produces two main hormones: thyroxine (T-4) and triiodothyronine (T-3). These hormones affect every cell in the body. They support the rate at which the body uses fats and carbohydrates. They help control body temperature. They have an effect on heart rate. And they help control how much protein the body makes.
Hyperthyroidism happens when the thyroid gland puts too much of those thyroid hormones into the bloodstream. Conditions that can lead to hyperthyroidism include:
* Graves' disease. Graves' disease is an autoimmune disorder that causes the immune system to attack the thyroid gland. That prompts the thyroid to make too much thyroid hormone. Graves' disease is the most common cause of hyperthyroidism.
* Overactive thyroid nodules. This condition also is called toxic adenoma, toxic multinodular goiter and Plummer disease. This form of hyperthyroidism happens when a thyroid adenoma makes too much thyroid hormone. An adenoma is a part of the gland that is walled off from the rest of the gland. It forms noncancerous lumps that can make the thyroid bigger than usual.
* Thyroiditis. This condition happens when the thyroid gland becomes inflamed. In some cases, it's due to an autoimmune disorder. In others, the reason for it is unclear. The inflammation can cause extra thyroid hormone stored in the thyroid gland to leak into the bloodstream and cause symptoms of hyperthyroidism.
Risk factors
Risk factors for hyperthyroidism include:
* A family history of thyroid disease, particularly Graves' disease.
* A personal history of certain chronic illnesses, including pernicious anemia and primary adrenal insufficiency.
* A recent pregnancy, which raises the risk of developing thyroiditis. This can lead to hyperthyroidism.
Complications
Hyperthyroidism can lead to the following complications.
* Heart problems
Some of the most serious complications of hyperthyroidism involve the heart, including:
* A heart rhythm disorder called atrial fibrillation that increases the risk of stroke.
* Congestive heart failure, a condition in which the heart can't circulate enough blood to meet the body's needs.
* Brittle bones
* Untreated hyperthyroidism can lead to weak, brittle bones. This condition is called osteoporosis. The strength of bones depends, in part, on the amount of calcium and other minerals in them. Too much thyroid hormone makes it hard for the body to get calcium into bones.
Vision problems
Some people with hyperthyroidism develop a problem called thyroid eye disease. It's more common in people who smoke. This disorder affects the muscles and other tissues around the eyes.
Symptoms of thyroid eye disease include:
* Bulging eyes.
* Gritty sensation in the eyes.
* Pressure or pain in the eyes.
* Puffy or retracted eyelids.
* Reddened or inflamed eyes.
* Light sensitivity.
* Double vision.
* Eye problems that go untreated may cause vision loss.
Discolored, swollen skin
In rare cases, people with Graves' disease develop Graves' dermopathy. This causes the skin to change colors and swell, often on the shins and feet.
Thyrotoxic crisis
This rare condition also is called thyroid storm. Hyperthyroidism raises the risk of thyrotoxic crisis. It causes severe, sometimes life-threatening symptoms. It requires emergency medical care. Symptoms may include:
* Fever.
* Fast heartbeat.
* Nausea.
* Vomiting.
* Diarrhea.
* Dehydration.
* Confusion.
* Delirium.
