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Gotthard Base Tunnel (GBT)
Gist
The Gotthard Base Tunnel (GBT) in Switzerland is the world's longest and deepest railway tunnel, measuring 57.1 km (35.5 miles) in length and up to 2,450 meters deep. Opened in 2016, it provides a high-speed flat route through the Alps, connecting Erstfeld and Bodio, significantly reducing travel time between Zurich and Milan.
Is the Gotthard Tunnel the longest tunnel in the world?
Switzerland's Gotthard Base Tunnel is the world's longest (and deepest) railway tunnel. Opened in 2016 after 17 years of construction, it consists of two 57.1km single-track tunnels for freight trains and passenger trains connecting Erstfeld in canton Uri with Bodio in canton Ticino.
Summary
The Gotthard Base Tunnel (GBT; German: Gotthard-Basistunnel, Italian: Galleria di base del San Gottardo, Romansh: Tunnel da basa dal Sogn Gottard) is a railway tunnel through the Alps in Switzerland. It opened in June 2016 and full service began the following December. With a route length of 57.09 km (35.47 mi), it is the world's longest railway and deepest traffic tunnel and the first flat, low-level route through the Alps. Located at the heart of the Gotthard axis, it is the third tunnel to connect the cantons of Uri and Ticino, after the Gotthard Tunnel and the Gotthard Road Tunnel.
The GBT consists of a large complex with, at its core, two single-track tunnels connecting Erstfeld (Uri) with Bodio (Ticino) and passing below Sedrun (Grisons). It is part of the New Railway Link through the Alps (NRLA) project, which also includes the Ceneri Base Tunnel further south (opened on 3 September 2020) and the Lötschberg Base Tunnel on the other main north–south axis. It is referred to as a "base tunnel" since it bypasses most of the existing vertex line, the Gotthard railway line, a winding mountain route opened in 1882 across the Saint-Gotthard Massif, which was operating at its capacity before the opening of the GBT. The new base tunnel establishes a direct route usable by high-speed rail and heavy freight trains.
The main purpose of the Gotthard Base Tunnel is to increase local transport capacity through the Alpine barrier, especially for freight on the Rotterdam–Basel–Genoa corridor. The tunnel is specifically meant to shift freight to trains from trucks, and thereby to reduce environmental damage and deadly road crashes. The tunnel also provides a faster connection between the canton of Ticino and the rest of Switzerland, as well as between northern and southern Europe, cutting the Basel/Zürich–Lugano–Milan journey time for passenger trains by one hour (and from Lucerne to Bellinzona by 45 minutes).
After 64 percent of Swiss voters accepted the NRLA project in a 1992 referendum, the first preparatory and exploratory work began in 1996. Construction began in November 1999 at Amsteg. Drilling operations were completed in March 2011. Completed in 2016, the final cost was reported to be CHF 12.2 billion (US$12 billion). A freight train derailment in August 2023 forced the tunnel's closure for over a year before reopening in September 2024.
Details
Gotthard Base Tunnel, railway tunnel under the Saint-Gotthard Massif in the Lepontine Alps in southern Switzerland, the world’s longest and deepest railway tunnel. Opened in June 2016, the tunnel provided a high-speed rail link between northern and southern Europe, forming a mainline rail connection between Rotterdam in the Netherlands and Genoa in Italy. Comprising two single-track tunnels, the Gotthard Base Tunnel (GBT) is 57 km (35 miles) in length and has a maximum depth of 2,300 metres (7,546 feet). It runs from Erstfeld, in Uri canton, to Bodio, in Ticino canton, and is a division of the New Railway Link through the Alps (NRLA) project.
Importance
Largely flat and straight, the GBT is a “base tunnel” because it passes through the base of the mountains rather than traversing the difficult terrain. The tunnel significantly increased local transport capacity through the Swiss Alpine barrier, providing a faster, more efficient route than the St. Gotthard Pass, the old St. Gotthard Tunnel (constructed 1872–80), or the St. Gotthard Road Tunnel (opened 1980). The GBT is used for both passenger and freight trains and helped shift freight volume from trucks to rail, with both safety and environmental benefits. With practically no gradient, the GBT can bear heavier and longer trains than the old line and has increased the freight train capacity from about 180 to about 260 trains per day. Passenger trains within the GBT travel at a speed of 200 km (124 miles) per hour and can complete the journey from Erstfeld to Bodio in 20 minutes. Freight trains travel at a minimum speed of 100 km (62 miles) per hour. Four to six freight trains and up to two passenger trains often run per hour in each direction through the tunnel every day.
History and construction
The first visionary idea for the GBT was sketched by engineer Carl Eduard Gruner in 1947. The Swiss government established a committee to evaluate various base tunnel ideas in the 1960s and formally recommended the construction of a Gotthard base tunnel in 1970. In 1992 the Swiss electorate passed the government’s resolution to construct the Swiss Rail Link through the Alps, providing the formal start to the project. Over the next few years, exploratory bores and other investigations were carried out to determine the most geotechnically favourable route for the tunnel, finally landing on the Erstfeld-Bodio route. AlpTransit Gotthard AG, a subsidiary of Swiss Federal Railways, was responsible for construction of the GBT, which officially began on November 4, 1999.
The construction of the GBT was a remarkable feat of modern engineering. The unpredictable quality of the rock, coupled with the intense weight of the mountain above and the resultant extreme temperatures and humidity (without ventilation, the temperature inside the mountain system can reach 46 °C, or 115 °F), posed serious challenges. Tunneling was done from each direction in each of the two bores, with four access tunnels built to facilitate the simultaneous construction. The four construction sites, Erstfeld, Amsteg, Sedrun, and Faido, each had its own base camp with living quarters, cafeterias, and worker transit as well as water treatment facilities and concrete factories that were fed excavated rock from the tunnel construction; a fifth site at Bodio was added later. The tunnels were primarily constructed with four massive tunnel boring machines, Herrenknecht Gripper TBMs, each of which was more than 441 metres (1,446 feet) long; blasting was used for only about 25 percent of the project. After nearly 11 years the final breakthrough in the east tube took place, in October 2010. The breakthrough was one of the most precise breakthroughs in the history of tunnel construction, with a horizontal deviation of just 8 cm (3 inches) and a vertical deviation of a remarkable 1 cm (0.4 inch).The final breakthrough in the west tube was completed in March 2011. From first blast to the extravagant opening ceremony, the tunnel took 17 years to complete and finished both on time and within its $12 billion (12.2 billion Swiss francs) budget. Nine workers died in accidents while the tunnel was under construction.
Additional Information
The Gotthard Base Tunnel (GBT) was inaugurated in 2016. The 57-km long railway tunnel connects northern to southern Europe, enabling passenger and goods transport to reduce travelling time by one hour between Zurich and Milan. It is the world’s longest railway and deepest traffic tunnel and the first flat, low-level route through the Alps.
The primary purpose of the Gotthard Base Tunnel is to increase transport capacity through the Alps, especially for freight, notably on the Rotterdam–Basel–Genoa corridor. A more specific objective is to shift freight volumes from heavy goods vehicles (HGV) to freight trains to reduce the environmental damage caused by HGV significantly.
The Gotthard Base Tunnel mainly consists of two single-track tunnels connecting Erstfeld with Bodio. It is part of the New Railway Link through the Alps (NRLA) project, which also includes the Ceneri Base Tunnel further south (opened in 2020) and the Lötschberg Base Tunnel (opened in 2007) on the other main north-south axis.
Two interesting figures about the Gotthard Base Tunnel construction are outlined below:
* Impact of tunnelling on arch dams of hydraulic power plant
In the central part of the GBT (section Sedrun), three arch dams and hydropower reservoirs are located almost directly above the new GBT, approximately in the middle of the tunnel. The height of the concrete arch dams varies between 117 m for Santa Maria, 127 m for Nalps and 153 m for Curnera.
In 1978, the driving of an exploratory tunnelling gallery for a planned highway tunnel had adverse effects on the arch dam of the Zeuzier reservoir in the Alps, causing significant settlements of up to 13 cm. Well aware of this, tunnelling engineers already started surveying the area four years before the tunnelling works began in the region and developed coupled numerical models for a forecast of the surface deformations.
* Tunnelling challenges in squeezing rocks
Engineers had to face challenging tunnelling conditions in squeezing rock, in the Sedrun section, in the geological section of Tavetsch Intermediate Massif North (TZM North), due to poor rock quality with low strength, squeezing properties and an 800 m thick overburden, and additionally in the Faido section, northern part, with the contact zone between the Leventina and the Lucomagno gneiss formations, under an extremely thick overburden exceeding 2,000 m.

Diabetic Neuropathy
Gist
Diabetic neuropathy is a common, often disabling form of nerve damage caused by long-term high blood sugar and fat levels, affecting up to 50% of people with diabetes. It most frequently causes pain, burning, and numbness in the legs and feet, but can also impair digestion, bladder function, and cardiovascular systems. While it can lead to serious ulcers or amputations, it is often managed by tight glucose control, pain medications, and lifestyle changes.
What is the best cure for diabetic neuropathy?
While keeping blood glucose levels in goal range can prevent peripheral neuropathy and keep it from getting worse, there aren't any treatments that can reverse nerve disease once it's established. Once neuropathy is detected, the focus is on keeping the feet and legs healthy and on managing pain.
Summary
Diabetic neuropathy includes various types of nerve damage associated with diabetes mellitus. The most common form, diabetic peripheral neuropathy, affects 30% of all diabetic patients. Studies suggests that cutaneous nerve branches, such as the sural nerve, are involved in more than half of patients with diabetes 10 years after the diagnosis and can be detected with high-resolution magnetic resonance imaging. Symptoms depend on the site of nerve damage and can include motor changes such as weakness; sensory symptoms such as numbness, tingling, or pain; or autonomic changes such as urinary symptoms. These changes are thought to result from a microvascular injury involving small blood vessels that supply nerves (vasa nervorum). Relatively common conditions which may be associated with diabetic neuropathy include distal symmetric polyneuropathy; third, fourth, or sixth cranial nerve palsy; mononeuropathy; mononeuropathy multiplex; diabetic amyotrophy; and autonomic neuropathy.
Diabetic neuropathy is the most common complication of diabetes mellitus (DM), affecting as many as 50% of patients with type 1 and type 2 DM. Diabetic peripheral neuropathy involves the presence of symptoms or signs of peripheral nerve dysfunction in people with diabetes after other possible causes have been excluded. In some cases, patients are symptomatic long before routinely performed clinical examination reveals abnormalities. Of all treatments, tight and stable glycemic control is probably the most important for slowing the progression of neuropathy.
Signs and symptoms of diabetic neuropathy
In type 1 DM, distal polyneuropathy typically becomes symptomatic after many years of chronic prolonged hyperglycemia, whereas in type 2, it may be apparent after only a few years of known poor glycemic control or even at diagnosis. Symptoms include the following:
Sensory – Negative or positive, diffuse or focal; usually insidious in onset and showing a stocking-and-glove distribution in the distal extremities
Motor – Distal, proximal, or more focal weakness, sometimes occurring along with sensory neuropathy (sensorimotor neuropathy)
Autonomic – Neuropathy that may involve the cardiovascular, gastrointestinal, and genitourinary systems and the sweat glands.
Details:
Overview
Diabetic neuropathy is a type of nerve damage that can happen with diabetes. Blood sugar, also called glucose, becomes high because of diabetes. Over time, high blood sugar can injure nerves throughout the body. Diabetic neuropathy most often damages nerves in the legs and feet.
Depending on the affected nerves, diabetic neuropathy symptoms may include pain and numbness in the legs, feet and hands. It also can cause problems with the digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be painful and disabling.
Diabetic neuropathy is a serious health concern. It may affect up to half of people who have diabetes. But diabetic neuropathy often can be prevented. And people who have it can take steps to keep it from getting worse. The key is to tightly manage blood sugar and lead a healthy lifestyle.
Symptoms
There are four main types of diabetic neuropathy. You can have one type or more than one type of neuropathy.
The symptoms depend on the type of diabetic neuropathy you have and which nerves are affected. Usually, symptoms appear slowly over time. You may not notice anything is wrong until a lot of nerve damage has happened.
Peripheral sensorimotor neuropathy
This type of neuropathy also may be called distal symmetric peripheral neuropathy. It's the most common type of diabetic neuropathy. It affects the feet and legs first, followed by the hands and arms. Symptoms often are worse at night. They may include:
* Loss of feeling, also called numbness, or less ability to feel pain or temperature changes.
* A tingling or burning feeling.
* Sharp pains or cramps.
* Muscle weakness.
* Being very sensitive to touch. For some people, even a bedsheet's weight can be painful.
* Serious foot problems, such as ulcers, infections, and bone and joint damage.
Autonomic neuropathy
The autonomic nervous system controls blood pressure, heart rate, sweating, pupils, bladder, digestive system and sex organs. Diabetes can affect nerves in any of these areas. That can cause symptoms including:
* A lack of the usual warning symptoms that let you know when blood sugar levels are low. This is called hypoglycemia unawareness.
* Drops in blood pressure when rising from sitting or lying down. This is called orthostatic hypotension. It can cause dizziness or fainting.
* A fast-beating heart while at rest.
* Bladder or bowel problems.
* Slow stomach emptying, also called gastroparesis. This can cause upset stomach, vomiting, a feeling of fullness and loss of appetite.
* Trouble swallowing.
* Changes in the way the eyes adjust from light to dark or far to near.
* More or less sweating than usual.
* Problems with sexual response. For instance, some people may have vaginal dryness or trouble feeling aroused. Others may have trouble getting or keeping an erection.
Proximal neuropathy
This type of neuropathy also is called diabetic polyradiculopathy. It often affects nerves in the thighs, hips, buttocks or legs. It can affect the stomach area and chest area. Symptoms often are on one side of the body. Rarely, they spread to the other side. Proximal neuropathy may include:
* Serious pain in the buttock, hip or thigh.
* Weak and shrinking thigh muscles.
* Trouble rising from a sitting position.
* Pain in the chest or the walls of the stomach area.
Mononeuropathy
This type of neuropathy also is called focal neuropathy. It damages a single, specific nerve. That nerve may be in the face, torso, arm or leg. It’s possible for mononeuropathy to affect single nerves in different parts of the body at the same time. Mononeuropathy may lead to:
* Trouble focusing or seeing two images of the same object, also called double vision.
* Not being able to move one side of the face. This is called paralysis.
* Numbness or tingling in the hand or fingers.
* Weakness in the hand that may result in dropping things.
* Pain in the shin or foot.
* Weakness that makes it hard to lift the front part of the foot. This condition is known as foot drop.
* Pain in the front of the thigh.
When to see a doctor
Call your healthcare professional for a checkup if you have:
* A cut or sore on your foot that is infected or won't heal.
* Burning, tingling, weakness or pain in your hands or feet that makes it hard to do daily activities or sleep.
* Changes in digestion, urination or sexual function.
* Dizziness and fainting.
Tests can check for diabetic neuropathy before a person has symptoms of it. These are called screening tests. Screening tests can find diseases early when they're easier to treat. The American Diabetes Association recommends that screening for diabetic neuropathy start:
* Right after you learn you have type 2 diabetes.
* Or five years after you're found to have type 1 diabetes.
After that, screening is recommended once a year.
Causes
The exact cause of each type of neuropathy is unknown. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals. This process may lead to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels called capillaries that supply the nerves with oxygen and nutrients.
Risk factors
Anyone who has diabetes can get diabetic neuropathy. But these risk factors make nerve damage more likely:
* Poor blood sugar control. Uncontrolled high blood sugar raises the risk of every medical complication that can happen with diabetes, including nerve damage.
* Diabetes history. The risk of diabetic neuropathy rises the longer you have diabetes, especially if your blood sugar isn't well controlled.
* Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage.
* Being overweight. Having a body mass index (BMI) of 25 or more may raise the risk of diabetic neuropathy.
* Smoking. Smoking narrows and hardens the arteries, lowering blood flow to the legs and feet. This makes it harder for wounds to heal. It also damages the peripheral nerves.
* High blood pressure and high cholesterol. Both are linked with a higher risk of diabetic neuropathy.
Complications
Diabetic neuropathy can cause serious medical conditions, including:
* Hypoglycemia unawareness. Most often, blood sugar levels below 70 milligrams per deciliter (mg/dL) — 3.9 millimoles per liter (mmol/L) — cause shakiness, sweating and a fast heartbeat in people living with diabetes. But people who have autonomic neuropathy may not feel these warning signs.
* Loss of a toe, foot or leg. Nerve damage can cause a loss of feeling in the feet. That means even minor cuts can turn into sores or ulcers without being noticed. Sometimes, an infection can spread to the bone or lead to tissue death. Without fast treatment, a toe, foot or even part of the leg may need to be removed with surgery. This is called amputation.
* Urinary problems. If the nerves that control the bladder are damaged, the bladder may not empty fully when urinating. Bacteria can build up in the bladder and kidneys, causing urinary tract infections. Nerve damage also can affect the ability to feel the need to urinate or to control the muscles that release urine. This can lead to leakage, also called incontinence.
* Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect the body's ability to adjust blood pressure. This can cause a sharp drop in pressure when standing after sitting or lying down. That may lead to lightheadedness and fainting.
* Digestive problems. If nerve damage happens in the digestive tract, you may get constipation or diarrhea, or both. Diabetes-related nerve damage can lead to a condition in which the stomach empties too slowly or not at all. This is called gastroparesis. It can cause bloating and an upset stomach.
* Sexual conditions. Diabetic neuropathy often damages the nerves that affect the sex organs. Symptoms may include vaginal dryness, having trouble becoming aroused, and difficulty getting or keeping an erection. This is called erectile dysfunction.
* More or less sweating than usual. Nerve damage can disrupt how the sweat glands work. That makes it hard for the body to control its temperature properly.
Prevention
You may be able to prevent or delay diabetic neuropathy and the medical problems that can happen with it. To do so, closely manage your blood sugar and take good care of your feet.
Blood sugar control
A blood test called the A1C test looks at your average blood sugar level for the past 2 to 3 months. The American Diabetes Association recommends that people with diabetes have an A1C test at least twice a year. You also might hear it called the glycosylated hemoglobin, hemoglobin A1C or HbA1c test.
A1C goals may need to be tailored to each person. But for most adults, the American Diabetes Association recommends an A1C of less than 7.0%. The goal may be higher for older adults or those with other medical conditions. If your blood sugar levels are higher than your goal, you may need to change how you manage your diabetes. Your healthcare professional might change your medicine or add medicine to your treatment plan. Or you might be told to change your diet or physical activity.
Foot care
Foot problems are common with diabetic neuropathy. Examples include sores that don't heal and ulcers. But you can prevent many of these problems. The key is to take good care of your feet at home. And have a thorough foot exam at least once a year. Also have your healthcare professional check your feet at each office visit.
Follow your healthcare professional's advice for good foot care. To protect the health of your feet:
* Check your feet every day. Look for blisters, cuts, bruises, cracked and peeling skin, redness, and swelling. Use a mirror to look at parts of your feet that are hard to see. Or ask a friend or family member to help check.
* Keep your feet clean and dry. Wash your feet every day with lukewarm water and mild soap. Don't soak your feet. Dry your feet and between your toes thoroughly.
* Moisturize your feet. This helps prevent cracking. But don't get lotion between your toes. It might make fungus more likely to grow.
* Trim your toenails carefully. Cut your toenails straight across. File the edges gently so they are smooth. If you can't do this yourself, see a specialist in foot problems, called a podiatrist, for help.
* Wear clean, dry socks. Look for socks made of cotton or moisture-wicking fibers. The socks should not have tight bands or thick seams.
* Wear cushioned shoes that fit well. Wear closed-toed shoes or slippers to protect your feet. Make sure your shoes fit properly, and give your toes space to move. A foot specialist can teach you how to buy properly fitted shoes. The specialist also can show you how to prevent problems such as corns and calluses. If you have Medicare, your plan may cover the cost of at least one pair of shoes each year.
* Protect your feet from the heat. Wear shoes if you walk on hot pavement or go to the beach. If you go barefoot outdoors, put sunscreen on the tops of your feet so they don't get sunburned.
* Boost blood flow to your feet. If you can, put your feet up while you sit. And throughout the day, wiggle your toes around for a few minutes. It also helps to move your ankles in and out as well as up and down.
Additional Information
Diabetes-related neuropathy is nerve damage that affects people with diabetes. The most common type is peripheral neuropathy, which often affects your feet. There’s no cure for diabetes-related neuropathy. But you can manage it with medication, therapies and tighter blood sugar management.
Overview:
What is diabetes-related neuropathy?
Diabetes-related neuropathy happens when you experience nerve damage due to high blood sugar (hyperglycemia) that lasts a long time. It can affect people with long-term diabetes, like Type 1 diabetes and Type 2 diabetes. But not everyone with diabetes develops it.
Neuropathy can develop from other causes, too, like pinched nerves, inflammation, nutrient deficiencies and injuries affecting your nerves. Healthcare providers diagnose neuropathy as diabetes-related if you have diabetes and they can’t find another cause for it.
Types of diabetes-related neuropathy
Diabetes-related neuropathy can damage different nerves throughout your body. Types of diabetes-related neuropathy include:
* Peripheral neuropathy: This is the most common type of neuropathy. “Peripheral” refers to any of the nerves outside of your spinal cord. It often affects your feet and legs and sometimes your hands.
* Autonomic neuropathy: This type of neuropathy happens when you have damage to autonomic nerves, which control your involuntary body processes. They control things like your bladder, intestinal tract, blood pressure, heart and sex organs. Another name for autonomic neuropathy is dysautonomia.
* Proximal neuropathy: This is a rare type of neuropathy that affects nerves in your hip, thigh or buttock. It typically only affects one side of your body.
How common is diabetes-related neuropathy?
Overall, diabetes-related neuropathy is fairly common. Studies show that up to 50% of people with diabetes have peripheral neuropathy. More than 30% of people with diabetes have autonomic neuropathy.
Symptoms and Causes:
What are the symptoms of diabetes-related neuropathy?
Your symptoms will depend on which type of diabetes-related neuropathy you have.
Symptoms of diabetes-related peripheral neuropathy
Diabetes-related peripheral neuropathy commonly affects your feet. Symptoms include:
* Numbness, tingling and/or pins and needles sensations (paresthesia).
* Pain, which may be burning, stabbing or shooting.
* Unusual touch-based sensations (dysesthesia).
* Muscle weakness.
* Slow-healing leg or foot sores (ulcers).
* Total loss of sensation in your feet, like not feeling pain from foot injuries.
* Nerve damage that causes peripheral neuropathy typically develops over many years. You may not notice symptoms of mild nerve damage for a long time.
Symptoms of diabetes-related autonomic neuropathy
Autonomic neuropathy can have many different symptoms because it can affect several body systems. Examples include:
* Digestive system: Indigestion, heartburn, nausea and vomiting, gas, diarrhea and constipation. Gastroparesis is a type of digestive system neuropathy.
* Urinary system: Urinary incontinence, urinary retention and frequent UTIs.
* sex organs: Sexual dysfunction, erectile dysfunction, retrograde ejaculation, vaginal dryness and anorgasmia.
* Cardiovascular system: Low blood pressure, irregular heart rate, dizziness and fainting.
* Sweat glands: Excessive sweating or a lack of sweat.
* Eyes: Difficult for your pupils to adjust to changes in light.
Autonomic neuropathy can also cause hypoglycemia unawareness. This means you don’t experience the typical warning signs of low blood sugar, like shakiness, confusion and intense hunger.
Symptoms of diabetes-related proximal neuropathy
Symptoms of proximal neuropathy include:
* Sudden and severe pain in your hip, buttock or thigh.
* Weakness in your leg that makes it difficult to stand up.
* Loss of reflexes, like the knee-jerk reflex.
* Loss of muscle tissue (atrophy) in the affected area.
* Unexplained weight loss.
What causes diabetes-related neuropathy?
Perpetually high blood sugar levels can damage small blood vessels that provide oxygen and nutrients to your nerves. Without enough oxygen and nutrients, nerve cells can die, affecting the function of your nerve. This causes neuropathy.
Each person is different, so it’s almost impossible to predict how high blood sugar levels have to be — and for how long — to cause neuropathy. One study of people with Type 2 diabetes shows that having an A1C over 7% for at least three years increases your risk of diabetes-related neuropathy. An A1C of 7% means your blood sugar is 154 mg/dL on average.
What are the risk factors for diabetes-related neuropathy?
If you have diabetes, your chance of developing diabetes-related neuropathy increases the older you get and the longer you’ve had diabetes.
Studies show that peripheral neuropathy affects at least 20% of people with Type 1 diabetes who’ve had diabetes for at least 20 years. It affects 15% to 50% of people with Type 2 diabetes who’ve had diabetes for at least 10 years.
You’re also more likely to develop neuropathy if you have diabetes along with:
* High blood pressure (hypertension).
* High body mass index (BMI).
* High cholesterol.
* Kidney disease.
* Alcohol use disorder.
* Smoking.
Studies show that genetics may also increase your risk of diabetes-related neuropathy.
Diagnosis and Tests:
How is diabetes-related neuropathy diagnosed?
To start, a healthcare provider will ask detailed questions about your medical history and diabetes management. They’ll ask about your symptoms and do a physical exam. Tests that help confirm a diabetes-related neuropathy diagnosis include:
* Diabetes foot exam: Your provider will visually assess your feet for any injuries or issues. They’ll then touch your toes and feet with various tools to check if you have numbness. This exam helps diagnose peripheral neuropathy.
* NCS (nerve conduction studies): This test checks how fast electrical signals move through your peripheral nerves in different parts of your body. It helps diagnose peripheral and proximal neuropathies.
* EMG (electromyography): This test evaluates the health and function of your skeletal muscles and the nerves that control them. It helps diagnose peripheral and proximal neuropathies.
Tests to diagnose autonomic neuropathy vary depending on which body system is affected. For example, an ultrasound can show how well your bladder empties when you pee. Tests like gastric emptying scintigraphy (GES) can help diagnose digestive system issues.
It may take more time to get an autonomic neuropathy diagnosis, as many other conditions can cause the same symptoms.

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2517) Hyperglycemia
Gist
Hyperglycemia is high blood sugar, commonly affecting diabetics when glucose exceeds 125 mg/dL (fasting) or 180 mg/dL (postprandial) due to low insulin, skipped medication, or stress. Symptoms include increased thirst, frequent urination, fatigue, and blurred vision. Long-term effects include severe nerve, kidney, heart, and eye damage.
Hyperglycemia treatment focuses on lifestyle changes (diet, exercise, hydration), monitoring blood sugar, and taking prescribed medications like insulin or oral agents (e.g., metformin), with emergency care for severe cases like Diabetic Ketoacidosis (DKA) involving IV fluids and insulin, aiming to prevent long-term complications like kidney or eye disease.
Summary
Hyperglycemia is an unusually high amount of glucose in the blood. It is defined as blood glucose level exceeding 6.9 mmol/L (125 mg/dL) after fasting for 8 hours or 10 mmol/L (180 mg/dL) 2 hours after eating.
Signs and symptoms
Hyperglycemia may be asymptomatic. Blood glucose levels can rise above normal and cause pathological and functional changes for significant periods without producing any permanent effects or symptoms. During this asymptomatic period, an abnormality in carbohydrate metabolism can occur, which can be tested by measuring plasma glucose.
The degree of hyperglycemia can change over time depending on the metabolic cause, for example, impaired glucose tolerance or fasting glucose, and it can depend on treatment.
Details:
Overview
High blood sugar, also called hyperglycemia, affects people who have diabetes. Several factors can play a role in hyperglycemia in people with diabetes. They include food and physical activity, illness, and medications not related to diabetes. Skipping doses or not taking enough insulin or other medication to lower blood sugar also can lead to hyperglycemia.
It's important to treat hyperglycemia. If it's not treated, hyperglycemia can become severe and cause serious health problems that require emergency care, including a diabetic coma. Hyperglycemia that lasts, even if it's not severe, can lead to health problems that affect the eyes, kidneys, nerves and heart.
Symptoms
Hyperglycemia usually doesn't cause symptoms until blood sugar (glucose) levels are high — above 180 to 200 milligrams per deciliter (mg/dL), or 10 to 11.1 millimoles per liter (mmol/L).
Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious symptoms may become. But some people who've had type 2 diabetes for a long time may not show any symptoms despite high blood sugar levels.
Early signs and symptoms
Recognizing early symptoms of hyperglycemia can help identify and treat it right away. Watch for:
* Frequent urination
* Increased thirst
* Blurred vision
* Feeling weak or unusually tired
Later signs and symptoms
If hyperglycemia isn't treated, it can cause toxic acids, called ketones, to build up in the blood and urine. This condition is called ketoacidosis. Symptoms include:
* Fruity-smelling breath
* Dry mouth
* Abdominal pain
* Nausea and vomiting
* Shortness of breath
* Confusion
* Loss of consciousness
When to see a doctor
Seek immediate help from your care provider if:
* You have ongoing diarrhea or vomiting, and you can't keep any food or fluids down
* Your blood glucose levels stay above 240 milligrams per deciliter (mg/dL) (13.3 millimoles per liter (mmol/L)) and you have symptoms of ketones in your urine
Causes
During digestion, the body breaks down carbohydrates from foods — such as bread, rice and pasta — into sugar molecules. One of the sugar molecules is called glucose. It's one of the body's main energy sources. Glucose is absorbed and goes directly into your bloodstream after you eat, but it can't enter the cells of most of the body's tissues without the help of insulin. Insulin is a hormone made by the pancreas.
When the glucose level in the blood rises, the pancreas releases insulin. The insulin unlocks the cells so that glucose can enter. This provides the fuel the cells need to work properly. Extra glucose is stored in the liver and muscles.
This process lowers the amount of glucose in the bloodstream and prevents it from reaching dangerously high levels. As the blood sugar level returns to normal, so does the amount of insulin the pancreas makes.
Diabetes drastically reduces insulin's effects on the body. This may be because your pancreas is unable to produce insulin, as in type 1 diabetes. Or it may be because your body is resistant to the effects of insulin, or it doesn't make enough insulin to keep a normal glucose level, as in type 2 diabetes.
In people who have diabetes, glucose tends to build up in the bloodstream. This condition is called hyperglycemia. It may reach dangerously high levels if it is not treated properly. Insulin and other drugs are used to lower blood sugar levels.
Risk factors
Many factors can contribute to hyperglycemia, including:
* Not using enough insulin or other diabetes medication
* Not injecting insulin properly or using expired insulin
* Not following your diabetes eating plan
* Being inactive
* Having an illness or infection
* Using certain medications, such as steroids or immunosuppressants
* Being injured or having surgery
* Experiencing emotional stress, such as family problems or workplace issues
Illness or stress can trigger hyperglycemia. That's because hormones your body makes to fight illness or stress can also cause blood sugar to rise. You may need to take extra diabetes medication to keep blood glucose in your target range during illness or stress.
Complications:
Long-term complications
Keeping blood sugar in a healthy range can help prevent many diabetes-related complications. Long-term complications of hyperglycemia that isn't treated include:
* Cardiovascular disease
* Nerve damage (neuropathy)
* Kidney damage (diabetic nephropathy) or kidney failure
* Damage to the blood vessels of the retina (diabetic retinopathy) that could lead to blindness
* Feet problems caused by damaged nerves or poor blood flow that can lead to serious skin infections, ulcerations and, in some severe cases, amputation
* Bone and joint problems
* Teeth and gum infections
Emergency complications
If blood sugar rises very high or if high blood sugar levels are not treated, it can lead to two serious conditions.
* Diabetic ketoacidosis. This condition develops when you don't have enough insulin in your body. When this happens, glucose can't enter your cells for energy. Your blood sugar level rises, and your body begins to break down fat for energy.
When fat is broken down for energy in the body, it produces toxic acids called ketones. Ketones accumulate in the blood and eventually spill into the urine. If it isn't treated, diabetic ketoacidosis can lead to a diabetic coma that can be life-threatening.
* Hyperosmolar hyperglycemic state. This condition occurs when the body makes insulin, but the insulin doesn't work properly. Blood glucose levels may become very high — greater than 600 milligrams per deciliter (mg/dL), (33.3 millimoles per liter (mmol/L)) without ketoacidosis. If you develop this condition, your body can't use either glucose or fat for energy.
Glucose then goes into the urine, causing increased urination. If it isn't treated, diabetic hyperosmolar hyperglycemic state can lead to life-threatening dehydration and coma. It's very important to get medical care for it right away.
Prevention
To help keep your blood sugar within a healthy range:
* Follow your diabetes meal plan. If you take insulin or oral diabetes medication, be consistent about the amount and timing of your meals and snacks. The food you eat must be in balance with the insulin working in your body.
* Monitor your blood sugar. Depending on your treatment plan, you may check and record your blood sugar level several times a week or several times a day. Careful monitoring is the only way to make sure that your blood sugar level stays within your target range. Note when your glucose readings are above or below your target range.
* Carefully follow your health care provider's directions for how to take your medication.
* Adjust your medication if you change your physical activity. The adjustment depends on blood sugar test results and on the type and length of the activity. If you have questions about this, talk to your health care provider.
Additional Information
Hyperglycemia (high blood sugar) is common in people who have diabetes. If it’s left untreated, chronic hyperglycemia can lead to diabetes complications, such as nerve damage, eye disease and kidney damage.
Overview:
What is hyperglycemia (high blood sugar)?
Hyperglycemia happens when there’s too much sugar (glucose) in your blood. It’s also called high blood sugar or high blood glucose. This happens when your body has too little insulin (a hormone) or if your body can’t use insulin properly (insulin resistance).
Hyperglycemia usually means you have diabetes, and people with diabetes can experience hyperglycemia episodes frequently.
If you have hyperglycemia that’s untreated for long periods of time, it can damage your nerves, blood vessels, tissues and organs.
Severe hyperglycemia can also lead to an acute (sudden and severe) life-threatening complication called diabetes-related ketoacidosis (DKA), especially in people with diabetes who take insulin or people with undiagnosed Type 1 diabetes. This requires immediate medical treatment.
What blood sugar level is hyperglycemia?
For people undiagnosed with diabetes, hyperglycemia is blood glucose greater than 125 mg/dL (milligrams per deciliter) while fasting (not eating for at least eight hours).
A person has prediabetes if their fasting blood glucose is 100 mg/dL to 125 mg/dL.
A person with a fasting blood glucose greater than 125 mg/dL on more than one occasion usually receives a diabetes diagnosis — typically Type 2 diabetes. People with Type 1 diabetes usually have very high blood sugar (above 250 mg/dL) upon diagnosis.
For a person with diabetes, hyperglycemia is usually considered to be a blood glucose level greater than 180 mg/dL one to two hours after eating. But this can vary depending on what your target blood sugar goals are.
What is blood sugar?
Glucose (sugar) mainly comes from carbohydrates in the food and drinks you consume. It’s your body’s main source of energy. Your blood carries glucose to all of your body’s cells to use for energy.
If you don’t have diabetes, several bodily processes naturally help keep your blood glucose in a healthy range. Insulin, a hormone your pancreas makes, is the most significant contributor to maintaining healthy blood sugar.
High blood sugar most often happens due to a lack of insulin or insulin resistance. This leads to diabetes. People who have diabetes must use medication, like oral diabetes medications or synthetic insulin, and/or lifestyle changes to help keep their blood sugar levels in range.
How common is hyperglycemia?
Hyperglycemia and diabetes are very common — about 1 in 10 people in the United States has diabetes. Hyperglycemia episodes are also very common in people with diabetes.
Symptoms and Causes
Symptoms of hyperglycemia include increased thirst, frequent urination, headache, blurred vision, fatigue and more.
If you have these symptoms, you should see a healthcare provider. If you have these symptoms in addition to vomiting and/or labored breathing, seek immediate medical help.
What are the signs and symptoms of hyperglycemia?
Early symptoms of hyperglycemia include:
* Increased thirst (polydipsia) and/or hunger.
* Frequent urination (peeing).
* Headache.
* Blurred vision.
Symptoms of long-term hyperglycemia include:
* Fatigue.
* Weight loss.
* Vaginal yeast infections.
* Skin infections.
* Slow-healing cuts and sores.
You should see your healthcare provider if you or your child is experiencing these symptoms.
The glucose level at which people with diabetes start to experience symptoms varies. Many people don’t experience symptoms until their blood sugar is 250 mg/dL or higher. People who haven’t yet been diagnosed with diabetes typically experience these symptoms at lower levels.
It’s especially important to know the early signs of hyperglycemia and to monitor your blood sugar regularly if you take insulin or other medications for diabetes. If hyperglycemia is left untreated, it can develop into diabetes-related ketoacidosis (DKA), in which a lack of insulin and a high amount of ketones cause your blood to become acidic. DKA can also affect people who have undiagnosed Type 1 diabetes. This condition is an emergency situation that can lead to coma or death.
Symptoms of ketoacidosis include:
* Nausea and vomiting.
* Dehydration.
* Abdominal pain.
* Fruity-smelling breath.
* Deep labored breathing or hyperventilation (Kussmaul breathing).
* Rapid heartbeat.
* Confusion and disorientation.
* Loss of consciousness.
What causes hyperglycemia?
Hyperglycemia most often results from a lack of insulin. This can happen due to insulin resistance and/or issues with your pancreas — the organ that makes insulin.
Other hormones can contribute to the development of hyperglycemia as well. Excess cortisol (the “stress hormone”) or growth hormone, for example, can lead to high blood sugar:
Insulin resistance
A common cause of hyperglycemia is insulin resistance. Insulin resistance, also known as impaired insulin sensitivity, happens when cells in your muscles, fat and liver don’t respond as they should to insulin.
When your cells don’t properly respond to insulin, your body requires more and more insulin to regulate your blood sugar. If your body is unable to produce enough insulin (or you don’t inject enough insulin), it results in hyperglycemia.
Insulin resistance is the main cause of Type 2 diabetes, but anyone can experience it, including people without diabetes and people with other types of diabetes. It can be temporary or chronic.
Common causes of insulin resistance include:
* Obesity. Scientists believe obesity, especially excess fat tissue in your belly and around your organs (visceral fat), is a primary cause of insulin resistance.
* Physical inactivity.
* A diet of highly processed, high-carbohydrate foods and saturated fats.
* Certain medications, including corticosteroids, some blood pressure medications, certain HIV treatments and some psychiatric medications. These may cause temporary or long-term insulin resistance depending on how long you take them.
Certain hormonal conditions can lead to insulin resistance, such as:
* Cushing syndrome (excess cortisol).
* Acromegaly (excess growth hormone).
* Pregnancy. During pregnancy, the placenta releases hormones that cause insulin resistance. For some people, this leads to gestational diabetes.
Certain inherited genetic conditions are also associated with insulin resistance, including:
* Rabson-Mendenhall syndrome.
* Donohue syndrome.
* Myotonic dystrophy.
* Alström syndrome.
* Werner syndrome.
Pancreas issues
Damage to your pancreas can lead to a lack of insulin production and hyperglycemia. Pancreatic conditions that can cause hyperglycemia and diabetes include:
* Autoimmune disease: In Type 1 diabetes, your immune system attacks the insulin-producing cells in your pancreas for unknown reasons. This means your pancreas can no longer make insulin, resulting in hyperglycemia. Latent autoimmune diabetes in adults (LADA) also results from an autoimmune reaction, but it develops much more slowly than Type 1.
* Chronic pancreatitis: This condition causes prolonged inflammation of your pancreas, which can damage the cells that produce insulin. This can result in a lack of insulin and hyperglycemia. Pancreatitis is a known cause of Type 3c diabetes.
* Pancreatic cancer: Cancer in your pancreas can damage the cells that produce insulin, resulting in a lack of insulin and hyperglycemia. About 25% of people with pancreatic cancer are diagnosed with diabetes 6 months to 36 months before the diagnosis of pancreatic cancer.
* Cystic fibrosis: People who have cystic fibrosis develop excessive mucus, which can scar their pancreas. This can cause their pancreas to produce less insulin, resulting in hyperglycemia and cystic fibrosis-related diabetes (CFRD).
Temporary causes of hyperglycemia
Certain situations can temporarily increase your blood sugar levels and cause hyperglycemia in people with and without diabetes.
Physical stress, such as from an illness, surgery or injury, can temporarily raise your blood sugar. Acute emotional stress, such as experiencing trauma or work-related stress, can increase your blood sugar as well. This is because your body releases cortisol and/or epinephrine (adrenaline).
Causes of hyperglycemia in people with diabetes
Several factors can contribute to hyperglycemia in people with diabetes. It can develop if things like food and diabetes medications are out of balance.
Common situations that can lead to hyperglycemia for people with diabetes include:
* Not taking enough insulin, injecting the wrong insulin or expired insulin, or an issue with the injection (such as from a site issue in insulin pump therapy).
* Not timing insulin and carb intake correctly.
* The amount of carbohydrates you’re consuming isn’t balanced with the amount of insulin your body can make or the amount of insulin you inject.
* The dose of oral diabetes medication you’re taking is too low for your needs.
* Being less active than usual.
* Dawn phenomenon.
What are the complications of hyperglycemia?
Prolonged (chronic) hyperglycemia over the years can damage blood vessels and tissues in your body. This can lead to a variety of complications, including the following:
* Retinopathy.
* Nephropathy.
* Neuropathy.
* Gastroparesis.
* Heart disease.
* Stroke.
It’s important to remember that other factors can contribute to the development of diabetes complications, such as genetics and how long you’ve had diabetes.
Acute (sudden and severe) hyperglycemia can lead to DKA, which is life-threatening.
Diagnosis and Tests:
How is hyperglycemia diagnosed?
Healthcare providers order bloodwork to screen for hyperglycemia and diagnose diabetes. These tests may include:
* Fasting glucose tests.
* Glucose tolerance tests.
* A1c test.
People with diabetes use at-home blood sugar testing (using a glucose meter) to monitor their blood sugar and check for hyperglycemia. If you use continuous glucose monitoring (CGM), your device may alert you to high blood sugar. As this technology can sometimes be inaccurate, it’s important to check your blood sugar with a glucose meter if the CGM reading doesn’t match how you feel.

2454) Frits Zernike
Gist:
Work
When light passes through a transparent object, there is a change in the phase of the light waves, the position of the wave crests’ in relation to one another. Our eye does not perceive this, but in the beginning of the 1930s, Frits Zernike developed a way to make it visible. A light beam is passed through an object while a reference beam goes by it. When the beams are brought together, they are strengthened or canceled out because of phase displacement, and the object is outlined more clearly in contrast to its surroundings. The phase contrast microscope became particularly important in the study of living cells.
Summary
Frits Zernike (born July 16, 1888, Amsterdam, Neth.—died March 10, 1966, Groningen) was a Dutch physicist, winner of the Nobel Prize for Physics in 1953 for his invention of the phase-contrast microscope, an instrument that permits the study of internal cell structure without the need to stain and thus kill the cells.
Zernike obtained a doctorate from the University of Amsterdam in 1915. He became an assistant at the State University of Groningen in 1913 and served as a full professor there from 1920 to 1958. His earliest work in optics was concerned with astronomical telescopes. While studying the flaws that occur in some diffraction gratings because of the imperfect spacing of engraved lines, he discovered the phase-contrast principle. He noted that he could distinguish the light rays that passed through different transparent materials. He built a microscope using that principle in 1938. In 1952 Zernike was awarded the Rumford Medal of the Royal Society of London.
Details
Frits Zernike (16 July 1888 – 10 March 1966) was a Dutch physicist who received the Nobel Prize in Physics in 1953 for his invention of the phase-contrast microscope.
Early life and education
Frederick Zernike was born on 16 July 1888 in Amsterdam, Netherlands to Carl Friedrich August Zernike and Antje Dieperink. Both parents were teachers of mathematics, and he especially shared his father's passion for physics. In 1905 he enrolled at the University of Amsterdam, studying chemistry (his major), mathematics and physics.
Academic career
In 1912, he was awarded a prize for his work on opalescence in gases. In 1913, he became assistant to Jacobus Kapteyn at the astronomical laboratory of Groningen University. In 1914, Zernike and Leonard Ornstein were jointly responsible for the derivation of the Ornstein–Zernike equation in critical-point theory. In 1915, he became lector in theoretical mechanics and mathematical physics at the same university and in 1920 he was promoted to professor of mathematical physics.
In 1930, Zernike was conducting research into spectral lines when he discovered that the so-called ghost lines that occur to the left and right of each primary line in spectra created by means of a diffraction grating, have their phase shifted from that of the primary line by 90 degrees. It was at a Physical and Medical Congress in Wageningen in 1933, that Zernike first described his phase contrast technique in microscopy. He extended his method to test the figure of concave mirrors. His discovery lay at the base of the first phase contrast microscope, built during World War II.
He also made another contribution in the field of optics, relating to the efficient description of the imaging defects or aberrations of optical imaging systems like microscopes and telescopes. The representation of aberrations was originally based on the theory developed by Ludwig Seidel in the middle of the nineteenth century. Seidel's representation was based on power series expansions and did not allow a clear separation between various types and orders of aberrations. Zernike's orthogonal circle polynomials provided a solution to the long-standing problem of the optimum 'balancing' of the various aberrations of an optical instrument. Since the 1960s, Zernike's circle polynomials are widely used in optical design, optical metrology and image analysis.
Zernike's work helped awaken interest in coherence theory, the study of partially coherent light sources. In 1938 he published a simpler derivation of Van Cittert's 1934 theorem on the coherence of radiation from distant sources, now known as the Van Cittert–Zernike theorem.
Death
He died in hospital in Amersfoort in 1966 after suffering illness the last years of his life. His granddaughter is the journalist Kate Zernike.
Honours and awards
In 1946, Zernike became member of the Royal Netherlands Academy of Arts and Sciences.
In 1953, Zernike won the Nobel Prize in Physics, for his invention of the phase-contrast microscope, an instrument that permits the study of internal cell structure without the need to stain and thus kill the cells.
In 1954, Zernike became an Honorary Member of The Optical Society (OSA). Zernike was elected a Foreign Member of the Royal Society.
The university complex (Zernike Campus) to the north of the city of Groningen is named after him, as is the crater Zernike on the Moon and the minor planet 11779 Zernike.
Zernike's great-nephew Gerard 't Hooft won the Nobel Prize in Physics in 1999.
The Oz Enterprise, a Linux distribution, was named after Leonard Ornstein and Frederik Zernike.

Q: What room has no doors, no walls, no floor and no ceiling?
A: A mushroom.
* * *
Q: What room can be eaten?
A: A mushroom!
* * *
Q: What's an airplanes favorite mushroom?
A: Air-portabela.
* * *
Q: Why does Ms. Mushroom go out with Mr. Mushroom?
A: Because he is a fungi (fun guy)!
* * *
Q: What did the fungi say when he was offered seconds at dinner?
A: "No thanks, I don't have mushroom left in my stomach."
* * *
Comedies Quotes - I
1. Even actresses that you really admire, like Reese Witherspoon, you think, 'Another romantic comedy?' You see her in something like 'Walk the Line' and think, 'God, you're so great!' And then you think, 'Why is she doing these stupid romantic comedies?' But of course, it's for money and status. - Gwyneth Paltrow
2. I don't have any favourites, but I like situational comedies, not forced ones. - Sushmita Sen
3. Julia Roberts and Sandra Bullock do romantic comedies. I do dark dramas. I do these movies well. - Jodie Foster
4. It has nothing to do with the emotional demands of a role; I've done comedies that are as draining to me as any drama. - Sean Penn
5. I'd like to do 'My Best Friend's Wedding,' 'Pretty Woman,' Meg Ryan type stuff. Romantic comedies. I'd love to do some action stuff as well. - Jennifer Love Hewitt
6. I love romantic comedies. I like to watch them and I like to be in them. It's something that's increasingly difficult to find that spark of originality that makes if different than the ones that come before. - Julia Roberts
7. I think in general, romantic comedies tend to take one person's point of view, but every once in a while you get something that is balanced for two people. - Sandra Bullock
8. I don't want to be typecast as a heroine who does a certain kind of cinema, which is why I experiment with the types of films that I do. But yes, I won't deny that romantic love stories or romantic comedies are what I enjoy doing the most, because as an audience those are the kind of films that I like watching. - Deepika Padukone.
Asthma
Gist
Asthma is a chronic respiratory disease involving inflammation, mucus production, and muscle tightening that narrows airways, causing wheezing, coughing, chest tightness, and shortness of breath. It is caused by genetic and environmental factors. While often a lifelong condition, it is manageable with medication. Common triggers include allergies, smoke, infections, exercise, and, in severe cases, untreated, it can lead to permanent airway structural changes.
Asthma is caused by a combination of genetic predisposition and environmental factors, leading to chronic airway inflammation and hyperresponsiveness, where airways tighten, swell, and produce excess mucus when exposed to triggers like allergens (pollen, dust mites), irritants (smoke, pollution), exercise, cold air, respiratory infections, and strong emotions. While genetics increases susceptibility, environmental exposures often trigger symptoms in those predisposed to the condition, creating a complex interplay.
Summary
Asthma is a common long-term inflammatory disease of the airways. It is characterized by variable and recurring symptoms and reduced lung function. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. A sudden worsening of asthma symptoms sometimes called an 'asthma attack' or an 'asthma exacerbation' can occur when allergens, pollen, dust, or other particles, are inhaled into the lungs, causing the bronchioles to constrict and produce mucus, which then restricts oxygen flow to the alveoli. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.
Asthma is thought to be caused by a combination of genetic and environmental factors. Environmental factors include exposure to air pollution and allergens. Other potential triggers include medications such as aspirin and beta blockers. Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry lung function testing. Asthma is classified according to the amount of medication required to control symptoms or mechanisms underlying the condition.
There is no known cure for asthma, but it can be controlled. Symptoms can be prevented by avoiding triggers, such as allergens and respiratory irritants, and suppressed with the use of inhaled corticosteroids. Long-acting beta agonists (LABA) or antileukotriene agents may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled. Treatment of rapidly worsening symptoms is usually with an inhaled short-acting beta2 agonist such as salbutamol and corticosteroids taken by mouth. In very severe cases, intravenous corticosteroids, magnesium sulfate, and hospitalization may be required.
In 2019, asthma affected approximately 262 million people and caused approximately 461,000 deaths. Most of the deaths occurred in the developing world. Asthma often begins in childhood, and the rates have increased significantly since the 1960s. Asthma was recognized as early as Ancient Egypt. The word asthma is from the Greek ἆσθμα (âsthma), which means 'panting'.
Details
Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.
For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.
Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust your treatment as needed.
Symptoms
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.
Asthma signs and symptoms include:
* Shortness of breath
* Chest tightness or pain
* Wheezing when exhaling, which is a common sign of asthma in children
* Trouble sleeping caused by shortness of breath, coughing or wheezing
* Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:
* Asthma signs and symptoms that are more frequent and bothersome
* Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)
* The need to use a quick-relief inhaler more often
For some people, asthma signs and symptoms flare up in certain situations:
* Exercise-induced asthma, which may be worse when the air is cold and dry
* Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
* Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, math waste, or particles of skin and dried saliva shed by pets (pet dander)
When to see a doctor:
Seek emergency treatment
Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:
* Rapid worsening of shortness of breath or wheezing
* No improvement even after using a quick-relief inhaler
* Shortness of breath when you are doing minimal physical activity
Contact your doctor
See your doctor:
* If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from getting worse over time.
* To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack.
* If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often.
Don't take more medication than prescribed without consulting your doctor first. Overusing asthma medication can cause side effects and may make your asthma worse.
* To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.
Causes
It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and inherited (genetic) factors.
Asthma triggers
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:
* Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of math waste
* Respiratory infections, such as the common cold
* Physical activity
* Cold air
* Air pollutants and irritants, such as smoke
* Certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
* Strong emotions and stress
* Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
* Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
Risk factors
A number of factors are thought to increase your chances of developing asthma. They include:
* Having a blood relative with asthma, such as a parent or sibling
* Having another allergic condition, such as atopic dermatitis — which causes red, itchy skin — or hay fever — which causes a runny nose, congestion and itchy eyes
* Being overweight
* Being a smoker
* Exposure to secondhand smoke
* Exposure to exhaust fumes or other types of pollution
* Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
Complications
Asthma complications include:
* Signs and symptoms that interfere with sleep, work and other activities
* Sick days from work or school during asthma flare-ups
* A permanent narrowing of the tubes that carry air to and from your lungs (bronchial tubes), which affects how well you can breathe
* Emergency room visits and hospitalizations for severe asthma attacks
* Side effects from long-term use of some medications used to stabilize severe asthma
Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.
Prevention
While there's no way to prevent asthma, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.
* Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.
Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life.
* Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.
* Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.
* Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath.
But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter. A peak flow meter measures how hard you can breathe out. Your doctor can show you how to monitor your peak flow at home.
* Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.
When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed. Also, immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.
* Take your medication as prescribed. Don't change your medications without first talking to your doctor, even if your asthma seems to be improving. It's a good idea to bring your medications with you to each doctor visit. Your doctor can make sure you're using your medications correctly and taking the right dose.
Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.
Additional Information
Asthma is a condition that causes your airways to swell, narrow and fill with mucus. This can make it hard to breathe or cause other symptoms, like chest tightness, cough and wheezing. Common asthma triggers include allergies (like pets or pollen), smoke, cold weather, exercise, strong smells and stress. Asthma attacks can be fatal if not treated.
What Is Asthma?
Asthma is a condition that causes long-term (chronic) inflammation in your airways. The inflammation makes them react to certain triggers, like pollen, exercise or cold air. During these attacks, your airways narrow (bronchospasm), swell up and fill with mucus. This makes it hard to breathe or causes you to cough or wheeze. Without treatment, these flare-ups can be fatal.
Millions of people in the U.S. and around the world have asthma. It can start in childhood or develop when you’re an adult. It’s sometimes called bronchial asthma.
Types of asthma
Types of asthma include:
* Allergic asthma: when allergies trigger asthma symptoms
* Cough-variant asthma: when your only asthma symptom is a cough
* Exercise-induced asthma: when exercise triggers asthma symptoms
* Occupational asthma: when substances you breathe in at work cause you to develop asthma or trigger asthma attacks
* Asthma-COPD overlap syndrome (ACOS): when you have both asthma and COPD (chronic obstructive pulmonary disease)
Symptoms and Causes:
Symptoms of asthma
Symptoms of asthma include:
* Shortness of breath
* Wheezing
* Chest tightness, pain or pressure
* Cough
You might have asthma most of the time (persistent asthma). Or you might feel fine in between asthma attacks (intermittent asthma).
Asthma causes
Experts aren’t sure what causes asthma. But you might be at a higher risk if you:
* Live with allergies or eczema (atopy)
* Were exposed to toxins, fumes or secondhand or thirdhand smoke (residue left behind after smoking), especially early in life
* Have a biological parent with allergies or asthma
* Experienced repeated respiratory infections (like RSV) as a child
Asthma triggers
Asthma triggers are anything that causes asthma symptoms or makes them worse. You might have one specific trigger or many. Common triggers include:
* Allergies: pollen, dust mites, pet dander, other airborne allergens
* Cold air: especially in winter
* Exercise: especially intense physical activity and cold-weather sports
* Mold: even if you’re not allergic
* Occupational exposures: sawdust, flour, glues, latex, building materials
* Respiratory infections: colds, flu and other respiratory illnesses
* Smoke: smoking, secondhand smoke, thirdhand smoke
* Stress: physical or emotional
* Strong chemicals or smells: perfumes, nail polish, household cleaners, air fresheners
* Toxins in the air: factory emissions, car exhaust, wildfire smoke
Asthma triggers can bring on an attack right away. Or it might take hours or days for an attack to start after you’re exposure to a trigger.
Complications of asthma
Asthma can cause severe flare-ups that don’t get better with treatment (status asthmaticus). This can be fatal if you can’t get enough oxygen to your organs and tissues.
Diagnosis and Tests:
How doctors diagnose asthma
An allergist or pulmonologist diagnoses asthma by asking about your symptoms and performing lung function tests. They’ll ask about your personal and family medical history. It can be helpful to let them know what makes asthma symptoms worse and if anything helps you feel better.
Tests
Your provider might determine how well your lungs are working and rule out other conditions with:
* Allergy blood tests or skin tests: These can determine if an allergy is triggering your asthma symptoms.
* Blood count: Providers can look at eosinophil and immunoglobulin E (IgE) levels and target them for treatment if they’re elevated. Eosinophils and IgE can be elevated in certain types of asthma.
* Spirometry: This is a common lung function test that measures how well air flows through your lungs.
* Chest X-rays or CT scans: These can help your provider look for causes of your symptoms.
Management and Treatment:
What is the best way to manage asthma?
The best way to manage asthma is to avoid any known triggers and use medications to keep your airways open. Your provider might prescribe:
* Maintenance inhalers: These usually contain inhaled steroids that reduce inflammation. Sometimes, they’re combined with different types of bronchodilators (medicines that open your airways).
* A rescue inhaler: Fast-acting “rescue” inhalers can help during an asthma attack. They contain a bronchodilator that quickly opens your airways, like albuterol.
* A nebulizer: Nebulizers spray a fine mist of medication through a mask on your face. You might use a nebulizer instead of an inhaler for some medications.
* Leukotriene modifiers: Your provider might prescribe a daily pill to help reduce asthma symptoms and your risk of an asthma attack.
* Oral steroids: Your provider might prescribe a short course of oral steroids for a flare-up.
* Antihistamines: Your provider might recommend cetirizine (Zyrtec®), loratadine (Claritin®), fexofenadine (Allegra®) or other allergy medications if you have allergic asthma.
* Biologic therapy: Treatments like monoclonal antibodies might help severe asthma.
* Bronchial thermoplasty: If other treatments don’t work, your provider may suggest bronchial thermoplasty. In this procedure, a pulmonologist uses heat to thin the muscles around your airways.
Asthma action plan
Your healthcare provider will work with you to develop an asthma action plan. This plan tells you how and when to use your medicines. It also tells you what to do when you have certain symptoms and when to seek emergency care. Ask your healthcare provider to walk you through it.
When should I see my healthcare provider?
Talk to your healthcare provider if you’re having frequent asthma attacks or feel like your symptoms aren’t manageable. Make sure you understand your asthma action plan and when to go to the emergency room.
Use your rescue inhaler, then call your local emergency number if you’re having a severe asthma attack or are experiencing these symptoms:
* Anxiety or panic
* Bluish, whitish or grayish fingernails, lips or gums
* Chest pain or pressure
* Coughing that won’t stop
* Severe wheezing when you breathe
* Difficulty talking or swallowing
* Pale, sweaty face
* Rapid breathing
Outlook / Prognosis:
What can I expect if I have asthma?
Most people with asthma can manage their symptoms. Asthma management means you:
* Can do the things you want to do at work and home
* Have no (or minimal) asthma symptoms
* Rarely need to use your rescue inhaler
* Can sleep without asthma symptoms waking you up
* Don’t need oral steroids for flare-ups more than twice a year
Some people are able to avoid triggers and have no symptoms most of the time. Others need to use a maintenance inhaler or other medications in addition to avoiding triggers. Kids may have fewer or no symptoms as they get older and their airways get bigger.
What can I do to feel better?
You might be able to reduce or avoid asthma symptoms with a few everyday habits. These include:
* Avoid triggers whenever possible. It might be helpful to keep a symptoms journal to figure out what makes your symptoms worse.
* Be physically active to a level that’s right for you. Ask your provider what they recommend. A pulmonary rehabilitation program might help.
* Don’t smoke or vape.
* Let your provider know if you’re unable to use inhalers or take medication as prescribed.
* A peak flow meter: This can measure how much your airways are restricted during certain activities.

Humerus (Bone)
Gist
The humerus is the longest and largest bone of the upper arm, extending from the shoulder to the elbow. It connects the scapula (shoulder blade) to the radius and ulna of the forearm, forming the glenohumeral and elbow joints. It facilitates movement, provides structural support, and serves as an attachment point for major muscles like the deltoid and rotator cuff.
The humerus is the single long bone of the upper arm, running from the shoulder to the elbow, connecting the scapula (shoulder blade) with the radius and ulna (forearm bones). It's crucial for arm movement, supporting major muscles, and housing important nerves and vessels, featuring distinct parts like the head (ball for the shoulder joint), shaft, and lower end with articular surfaces for the elbow.
Summary
The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes (tubercles, sometimes called tuberosities). The shaft is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes (trochlea and capitulum), and 3 fossae (radial fossa, coronoid fossa, and olecranon fossa). As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.
Function:
Muscular attachment
The deltoid originates on the lateral third of the clavicle, acromion and the crest of the spine of the scapula. It is inserted on the deltoid tuberosity of the humerus and has several actions including abduction, extension, and circumduction of the shoulder. The supraspinatus also originates on the spine of the scapula. It inserts on the greater tubercle of the humerus, and assists in abduction of the shoulder.
The pectoralis major, teres major, and latissimus dorsi insert at the intertubercular groove of the humerus. They work to adduct and medially, or internally, rotate the humerus.
The infraspinatus and teres minor insert on the greater tubercle, and work to laterally, or externally, rotate the humerus. In contrast, the subscapularis muscle inserts onto the lesser tubercle and works to medially, or internally, rotate the humerus.
The biceps brachii, brachialis, and brachioradialis (which attaches distally) act to flex the elbow. (The biceps do not attach to the humerus.) The triceps brachii and anconeus extend the elbow, and attach to the posterior side of the humerus.
The four muscles of supraspinatus, infraspinatus, teres minor and subscapularis form a musculo-ligamentous girdle called the rotator cuff. This cuff stabilizes the very mobile but inherently unstable glenohumeral joint. The other muscles are used as counterbalances for the actions of lifting/pulling and pressing/pushing.
Details
The humerus is your upper arm bone. It’s connected to 13 muscles and helps you move your arm. When you injure your humerus, it’s likely the muscles and nerves attached to it will be damaged, too. If your bones are weakened by osteoporosis, you have an increased risk for fractures you might not even know about.
Overview:
What is the humerus?
The humerus is your upper arm bone. Other than the bones in your leg, it’s the longest bone in your body. It’s a critical part of your ability to move your arm. Your humerus also supports lots of important muscles, tendons, ligaments and parts of your circulatory system.
If you experience a fractured (broken) humerus, you might need surgery to repair your bone and physical therapy to help you regain your strength and ability to move.
Your humerus — like all bones — can be affected by osteoporosis.
Because your humerus is connected to so many muscles and nerves, injuries to one can often affect the others.
Function:
What does the humerus do?
Your humerus has several important jobs, including:
* Helping your arm move, flex and rotate.
* Holding 13 muscles in place.
* Stabilizing the rest of your arm, including your elbow and hand.
Anatomy:
Where is the humerus located?
The humerus is the only bone in your upper arm. It runs from your shoulder to your elbow.
What does the humerus look like?
The humerus has a rounded end where it meets your shoulder, a long shaft in the middle and a flatter end that forms your elbow joint. The upper end has a ball shape that fits into your shoulder socket.
Even though it’s one long bone, your humerus is made up of several parts. These include:
Humerus proximal aspect
The upper (proximal) end of your humerus connects to your shoulder joint. The proximal end (aspect) contains the:
* Head (sometimes called the humeral head or humeral ball).
* Greater tuberosity.
* Lesser tuberosity.
* Intertubercular sulcus (biceps groove).
Humerus shaft
The shaft is the long middle portion of the humerus that supports the weight of your upper arm and gives it its shape. It’s slightly rounded at the top near your shoulder and flatter at the bottom near your elbow. The shaft of your humerus includes the:
* Deltoid tuberosity.
* Radial groove.
Humerus distal aspect
The lower (distal) end of your humerus forms the top of your elbow joint. It meets your forearm bones (radius and ulna). It includes the:
* Supracondylar ridges.
* Epicondyles.
* Trochlea.
* Capitulum.
* Coronoid, radial and olecranon fossae.
All these parts and labels are usually more for your healthcare provider to use as they describe where you’re having pain or issues. If you ever break your humerus — a humeral fracture — your provider might use some of these terms to describe where your bone was damaged.
How big is the humerus?
Other than the bones in your legs, your humerus is the largest bone in your body. Most adults’ humerus bones are around a foot long.
Conditions and Disorders:
What are the common conditions and disorders that affect the humerus?
The most common issues that affect the humerus are fractures, osteoporosis and damage to nerves or muscles attached to it.
Humerus fractures
A bone fracture is the medical term for breaking a bone. You can break your humerus during trauma, like a fall or car accident. Some people also experience humerus fractures playing sports. Symptoms of a fracture include:
* Pain.
* Swelling.
* Tenderness.
* Inability to move your arm like you usually can.
* Bruising or discoloration.
* A deformity or bump that’s not usually on your body.
Go to the emergency room right away if you’ve experienced trauma or think you have a fracture.
Osteoporosis
Osteoporosis weakens bones, making them more susceptible to sudden and unexpected fractures. Many people don’t know they have osteoporosis until after it causes them to break a bone. There usually aren’t obvious symptoms.
Females and adults older than 50 have an increased risk for developing osteoporosis. Talk to your provider about a bone density test that can catch osteoporosis before it causes a fracture.
Nerve and muscle damage
When you injure your humerus, it’s likely the muscles and nerves attached to it will be damaged, too. Some of the most common nerve and muscle damage includes:
* Rotator cuff injuries: The rotator cuff is a group of muscles and tendons that keep your shoulder joint stable and help it move. Sports injuries and traumas (like falls and car accidents) are the most common causes of rotator cuff injuries.
* Dislocated shoulders: A dislocated shoulder happens when the head of your humerus is pushed out of the socket in your shoulder. Any hard push or pull on your shoulder can cause a dislocation.
* Radial nerve damage: Your radial nerve helps you move your elbow, wrist, hand and fingers. It runs down the back of your arm from your armpit to your hand. People who experience a humerus fracture often damage their radial nerve during that injury.
Talk to your provider if you’re experiencing new pain in your arm or shoulder.
What tests are done on the humerus?
The most common test done to check the health of your humerus is a bone density test. It’s sometimes called a DEXA or DXA scan. A bone density test measures how strong your bones are with low levels of X-rays. It’s a way to measure bone loss as you age.
If you’ve experienced a humeral fracture, your provider or surgeon might need imaging tests, including:
* X-rays.
* Magnetic Resonance Imaging (MRI).
* CT scan.
What are common treatments for the humerus?
Usually, your humerus won’t need treatment unless you’ve experienced a fracture or other injury to your arm. You might need treatment if you’ve been diagnosed with osteoporosis.
Humerus fracture treatment
How your fracture is treated depends on what caused it and where the break is in your humerus. You’ll need some form of immobilization — like a splint or cast — and might need surgery to realign (set) your bone to its correct position and secure it in place so it can heal.
Osteoporosis treatment
Treatments for osteoporosis can include vitamin and mineral supplements, exercise and medications.
Exercise and taking supplements are usually all you’ll need to prevent osteoporosis. Your provider will help you develop a treatment plan that’s customized for you and your bone health.
Rotator cuff and shoulder dislocation treatment
A healthcare provider will diagnose and treat shoulder dislocations and rotator cuff injuries. Most people who experience a shoulder dislocation need to wear a sling for a few weeks. You’ll need surgery to repair a torn rotator cuff.
Care:
Keeping your humerus healthy
Following a good diet and exercise plan and seeing your healthcare provider for regular checkups will help you maintain your bone (and overall) health. If you’re older than 50 or have a family history of osteoporosis, talk to you provider about a bone density scan.
Follow these general safety tips to reduce your risk of an injury:
* Always wear your seatbelt.
* Wear the right protective equipment for all activities and sports.
* Make sure your home and workspace are free from clutter that could trip you or others.
* Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
* Follow a diet and exercise plan that will help you maintain good bone health.
* Use a cane or walker if you have difficulty walking or have an increased risk for falls.
Additional Information
Humerus is a long bone of the upper limb or forelimb of land vertebrates that forms the shoulder joint above, where it articulates with a lateral depression of the shoulder blade (glenoid cavity of scapula), and the elbow joint below, where it articulates with projections of the ulna and the radius.
In humans the articular surface of the head of the humerus is hemispherical; two rounded projections below and to one side receive, from the scapula, muscles that rotate the arm. The shaft is triangular in cross section and roughened where muscles attach. The lower end of the humerus includes two smooth articular surfaces (capitulum and trochlea), two depressions (fossae) that form part of the elbow joint, and two projections (epicondyles). The capitulum laterally articulates with the radius; the trochlea, a spool-shaped surface, articulates with the ulna. The two depressions—the olecranon fossa, behind and above the trochlea, and the coronoid fossa, in front and above—receive projections of the ulna as the elbow is alternately straightened and flexed. The epicondyles, one on either side of the bone, provide attachment for muscles concerned with movements of the forearm and fingers.
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Q: Why did the Fungi leave the party?
A: There wasn't mushroom.
* * *
Q: Why did the Mushroom get invited to all the parties?
A: 'Cuz he's a fungi!
* * *
Q: Why do Toadstools grow so close together?
A: They don't need Mushroom.
* * *
Q: What would a mushroom car say?
A: Shroom shroom!
* * *
Q: Which vegetable goes best with jacket potatoes?
A: Button Mushrooms.
* * *
2516) Sodium Phosphate
Gist
Sodium phosphate is a versatile salt (H3PO4) used as a food additive (emulsifier, buffer, leavening agent), cleaning agent, and saline laxative for colonoscopies. It exists in mono-, di-, and tribasic forms, often used in processed foods and medical treatments. While generally safe, excessive consumption can cause serious side effects.
Consuming small amounts of foods that contain sodium phosphate is "most likely" not harmful to your health. However, since many people consume fast food, processed meats and packaged foods on a daily basis, there is concern that high levels of sodium phosphate can harm the body.
Summary
A sodium phosphate is a generic variety of salts of sodium (Na+) and phosphate. Phosphate also forms families or condensed anions including di-, tri-, tetra-, and polyphosphates. Most of these salts are known in both anhydrous (water-free) and hydrated forms. The hydrates are more common than the anhydrous forms.
Uses
Sodium phosphates have many applications in food and for water treatment. Sodium phosphates are often used as water-retaining agents for frozen food, thickening agents for processed food, and leavening agents for baked goods. It is also a source of the phosphate ion (an emulsifying agent) for processed cheese, where it chelates calcium, thereby allowing the casein in cheese to remain suspended and preventing separation during heating. They are also used to control pH of processed foods.
They are also used in medicine for constipation and to prepare the bowel for medical procedures, by acting as an osmotic laxative that draws water into the bowel.
Like other phosphate salts they are used in detergents to increase their activity in hard water. They are also used in water softeners in addition to regular sodium chloride.
They are also useful corrosion inhibitors for preventing rusting of metal pipes.
Adverse effects
Sodium phosphates are popular in commerce in part because they are inexpensive and because they are nontoxic at normal levels of consumption. However, oral sodium phosphates when taken at high doses for bowel preparation for colonoscopy may in some individuals carry a risk of kidney injury under the form of phosphate nephropathy. There are several oral phosphate formulations which are prepared extemporaneously. Oral phosphate prep drugs have been withdrawn in the United States, although evidence of causality is equivocal. Since safe and effective replacements for phosphate purgatives are available, several medical authorities have recommended general disuse of oral phosphates.
Details:
Description
Sodium phosphate is a colorless to white crystalline powder or granules. It is prepared by neutralization of phosphoric acid under controlled conditions with sodium hydroxide or sodium carbonate .
We are committed to bringing you Greener Alternative Products, which belong to one of the four categories of greener alternatives. Sodium phosphate supports cleaner technologies as a versatile buffering and stabilizing agent that helps control pH, mitigate corrosion and side reactions, and extend equipment/component lifetimes—reducing waste, chemical use, and energy demand across processes.
Application
Sodium phosphate is used as a:
* component in the preparation of solid crystals of calcium hydroxyapatite substituted by strontium
* block buffer to study segmental and subcellular distribution of CFTR in the kidney
(CFTR: The Cystic Fibrosis Transmembrane Conductance Regulator is a protein-coding gene and ion channel that transports chloride and bicarbonate ions across epithelial cell membranes, crucial for regulating fluid balance in the lungs and pancreas. Mutations in the CFTR gene cause cystic fibrosis, leading to thick, sticky mucus, chronic infections, and organ damage.)
Additional Information:
What is Sodium Phosphate?
Sodium phosphate also known as phospho soda with the formula Na3PO4 is a saline cathartic that is familiar to radiologists since it is often used as a cleansing agent prior to double contrast barium enema.
It is prepared by neutralization of phosphoric acid under controlled conditions with sodium hydroxide or sodium carbonate. Sodium phosphate cradles are the most widely recognized, yet there is broad utilization of potassium phosphate buffer and blends of sodium and potassium. Many compounds of pharmaceutical interest are formulated in sodium phosphate buffers.
Uses of Sodium Phosphate – Na3PO4
* Short-term, local treatment of inflammation with neomycin as bacterial prophylaxis.
* Used after glaucoma surgery or after cataract surgery.
* Used as a mild laxative, stimulates the emptying of the gall bladder.
* One of the most palatable of the saline laxatives. It is also used in the form of an oral solution as an antihypercalcemia.
* Used to control the pH of water hardness precipitation and control agent in mildly acidic solutions.
Frequently Asked Questions
Q1. Is sodium phosphate an acid or a base?
A1. Sodium phosphate is a salt obtained by the reaction of phosphoric acid and sodium hydroxide.
Q2. What is sodium phosphate used for in medicine?
A2. Sodium biphosphate and sodium phosphate are sources of phosphorus which is a material that occurs naturally and is essential in every cell in the body. Sodium biphosphate and sodium phosphate is a combination drug used in adults before a colonoscopy to relieve constipation and cleanse the intestines.
Q3. What happens if your phosphate levels are low?
A3. High phosphate levels seldom contribute to hypophosphatemia symptoms; rather symptoms generally arise from the underlying disorder that causes hypophosphatemia. Ultra low levels of phosphate can cause difficulty breathing, agitation, altered mental state, muscle weakness and muscle damage called rhabdomyolysis.
Q4. What is sodium phosphate monobasic monohydrate?
A4. Sodium Phosphate, monobasic (monohydrate) is a reagent commonly used in molecular biology, biochemistry, and chromatography with a very high buffering capacity. Monobasic sodium phosphate is extremely hygroscopic and soluble in water.
Q5. What is the difference between sodium phosphate monobasic and dibasic?
A5. Sodium phosphate monobasic has the chemical formula of NaH2PO4, and the chemical formula of Na2HPO4 has sodium phosphate dibasic. As sodium phosphate dibasic dissolves in water, the basicity in the medium is higher than when monobasic sodium phosphate dissolves in water.

2453) Thomas Huckle Weller
Gist:
Work
Many infectious diseases are caused by viruses—very small biological particles. A virus lacks metabolism of its own and cannot multiply without infecting a living cell. For a long time the prevailing opinion was that viruses could not be cultured in a laboratory. However, in 1949 Frederick Robbins, John Enders, and Thomas Weller succeeded in culturing the virus that causes polio in human muscle and tissue in a laboratory setting. This became an important step on the road toward a vaccine against polio.
Summary
Thomas H. Weller (born June 15, 1915, Ann Arbor, Mich., U.S.—died Aug. 23, 2008, Needham, Mass.) was an American physician and virologist who was the corecipient (with John Enders and Frederick Robbins) of the Nobel Prize for Physiology or Medicine in 1954 for the successful cultivation of poliomyelitis virus in tissue cultures. This made it possible to study the virus “in the test tube”—a procedure that led to the development of polio vaccines.
After his education at the University of Michigan at Ann Arbor (A.B., 1936; M.S., 1937) and Harvard University (M.D., 1940), Weller became a teaching fellow at the Harvard Medical School (1940–42) and served in the U.S. Army Medical Corps during World War II. He was appointed assistant director of Enders’ infectious diseases laboratory at the Children’s Medical Center, Boston (1949–55), and, working with Enders and Robbins, soon achieved the propagation of poliomyelitis virus in laboratory suspensions of human embryonic skin and muscle tissue. He was also the first (with the American physician Franklin Neva) to achieve the laboratory propagation of rubella (German measles) virus and to isolate chicken pox virus from human cell cultures. Weller became professor of tropical public health at Harvard University in 1954 and from 1966 to 1981 served also as director of the Center for the Prevention of Infectious Diseases at the Harvard University School of Public Health. Weller’s autobiography, Growing Pathogens in Tissue Cultures: Fifty Years in Academic Tropical Medicine, Pediatrics, and Virology, was published in 2004.
Details
Thomas Huckle Weller (June 15, 1915 – August 23, 2008) was an American virologist. He, John Franklin Enders and Frederick Chapman Robbins were awarded a Nobel Prize in Physiology or Medicine in 1954 for showing how to cultivate poliomyelitis viruses in a test tube, using a combination of human embryonic skin and muscle tissue.
Biography
Weller was born and grew up in Ann Arbor, Michigan, where he graduated from Ann Arbor High School. He then went to the University of Michigan, where his father Carl Vernon Weller was a professor in the Department of Pathology. At Michigan, he studied medical zoology and received a B.S. and an M.S., with his masters thesis on fish parasites.
In 1936, Weller entered Harvard Medical School, and in 1939 began working under John Franklin Enders, with whom he would later (along with Frederick Chapman Robbins) share the Nobel Prize. It was Enders who got Weller involved in researching viruses and tissue-culture techniques for determining infectious disease causes. Weller received his MD in 1940, and went to work at Children's Hospital in Boston.
In 1942, during World War II, he entered the Army Medical Corps and was stationed at the Antilles Medical Laboratory in Puerto Rico, earning the rank of Major and heading the facility's Departments of Bacteriology, Virology and Parasitology. After the War, he returned to Children's Hospital in Boston, and it was there in 1947, that he rejoined Enders in the newly created Research Division of Infectious Diseases. After several leading positions, in July 1954, he was appointed head of the Tropical Public Health Department at the Harvard School of Public Health. Weller also served from 1953 to 1959 as director of the Commission on Parasitic Diseases of the American Armed Forces Epidemiological Board.
In addition to his work on polio, Weller also contributed to treating schistosomiasis, and Coxsackie viruses. He was also the first to isolate the virus responsible for chickenpox.
Awards
In 1954, Weller was awarded the George Ledlie prize in recognition of his research on rubella, polio and cytomegalovirus(CMV) viruses.
He was awarded the Nobel Prize in Physiology or Medicine in 1954 for his research on polio.
In 1996 he was awarded the Walter Reed Medal from the American Society of Tropical Medicine and Hygiene.
Personal life
In 1945, Weller married Kathleen Fahey, who died in 2011 aged 95. They had two sons and two daughters.

Comeback Quotes
1. I don't know, I am lucky. I always make a good comeback. - Hardik Pandya
2. When you are injured, you need to strengthen yourself very well to make a comeback very confidently. - P. V. Sindhu
3. Comebacks are not at all easy. After a major surgery, the difficult part is to conquer the inner demons. It's all in the mind. Only an individual can overcome his fears. - Rohit Sharma
4. I would like to thank all my tennis fans who were there from Day One when I was No. 1, through my stabbing, and my comeback. - Monica Seles
5. At one point, when I didn't make the 2007 World Cup squad, I was very, very frustrated. Then I became very hard on myself. Whenever I used to go to the nets, or when I trained in the gym, I was very hard on myself. I couldn't sleep; I used to think a lot. Very, very desperate to make a comeback. - Gautam Gambhir
6. For some reason, every time I peak in my career, I injure myself. So, I'm constantly on the comeback trail. - Sania Mirza
7. I am pleased about making a comeback in Bollywood, but then I really cannot think about leaving South Indian cinema. Whatever I am today is because of South films, and I cannot give up on that. - Tamannaah
8. I have never played cricket for selfish reasons like scoring 800-900 runs on flat tracks to make a comeback. - Gautam Gambhir
9. By making a comeback, I'm changing the attitude of people toward me. If I'd known that people would react so enthusiastically, I'd have done it years ago. - Mark Spitz
10. Looking back, yes, I made too many comebacks. But each comeback I was 100 percent sure that I would win. I never came back for the money, because I didn't need it. The adulation I was getting anyway in other spheres. But I'm a guy who likes to see how close he can get to the edge of the mountain - that's what makes me tick. - Sugar Ray Leonard
11. In the single group format, where each team plays against the other, it gives a chance to the established outfits to make a comeback if they falter in the early games. - Inzamam-ul-Haq
12. Wimbledon is not the easiest tournament in which to make a comeback. - Mats Wilander
Mount Kilimanjaro
Gist
Mount Kilimanjaro, located in Tanzania, is Africa's highest peak (5,895 meters/19,341 feet) and the world's tallest free-standing mountain. It is a dormant stratovolcano with three volcanic cones—Kibo, Mawenzi, and Shira—and is famous for its snow-capped peak and five diverse ecological zones. Climbing is a popular non-technical trek, typically taking 5-9 days.
Kilimanjaro is famous as Africa's highest peak, the world's highest free-standing mountain, and a bucket-list destination for trekkers, known for its iconic snow-capped summit, diverse ecosystems, and status as one of the Seven Summits challenge. Its fame comes from being an accessible yet challenging climb, offering a unique journey through five distinct climate zones, making it a symbol of adventure and a visible indicator of climate change due to its shrinking glaciers.
Summary
Mount Kilimanjaro is a large dormant volcano in Tanzania. It is the highest mountain in Africa and the highest free-standing mountain above sea level in the world, at 5,895 m (19,341 ft) above sea level and 4,900 m (16,100 ft) above its plateau base. It is also the highest volcano in the Eastern Hemisphere and the fourth most prominent peak on Earth.
Kilimanjaro's southern and eastern slopes served as the home of the Chagga Kingdoms until their abolition in 1963 by Julius Nyerere. The origin and meaning of the name Kilimanjaro is unknown, but may mean "mountain of greatness" or "unclimbable". Although described in classical sources, German missionary Johannes Rebmann is credited as the first European to report the mountain's existence, in 1848. After several European attempts, Hans Meyer reached Kilimanjaro's highest summit in 1899.
The mountain was incorporated into Kilimanjaro National Park in 1973. As one of the Seven Summits, Kilimanjaro is a major hiking and climbing destination. There are seven established routes to Uhuru Peak, the mountain's highest point. Although not as technically challenging as similar mountains, the prominence of Kilimanjaro poses a serious risk of altitude sickness.
One of several mountains arising from the East African Rift, Kilimanjaro was formed from volcanic activity over 2 million years ago. Its slopes host montane forests and cloud forests. Multiple species are endemic to Mount Kilimanjaro, including the giant groundsel Dendrosenecio kilimanjari. The mountain possesses a large ice cap and the largest glaciers in Africa, including Credner Glacier, Furtwängler Glacier, and the Rebmann Glacier. This ice cap is rapidly shrinking, with over 80% lost in the 20th century. The cap is projected to disappear entirely by the mid-21st century.
Details
Mount Kilimanjaro is Africa’s tallest mountain and the world’s largest free-standing mountain.
Located in Tanzania, Mount Kilimanjaro is Africa’s tallest mountain at about 5,895 meters (19,340 feet). It is the largest free-standing mountain rise in the world, meaning it is not part of a mountain range.
Also called a stratovolcano (a term for a very large volcano made of ash, lava and rock), Kilimanjaro is made up of three cones: Kibo, Mawenzi and Shira. Kibo is the summit of the mountain and the tallest of the three volcanic formations. While Mawenzi and Shira are extinct, Kibo is considered dormant and could possibly erupt again. Scientists estimate that the last time it erupted was 360,000 years ago. The highest point on Kibo’s crater rim is called Uhuru, the Swahili word for “freedom.”
No one knows how Kilimanjaro got its name. It may come from the Swahili word Kilima (meaning “mountain”) and the KiChagga word Njaro (meaning “shining” or “whiteness”); the mountain is known for its snow-capped peak. Some local people living in the foothills of the mountain, including the Chagga and the Maasai, view it as the seat of God.
Unfortunately, the white snow that the mountain is named for may soon disappear. Over the last hundred years, all of Kilimanjaro’s glaciers have begun to retreat. Some have vanished altogether. Scientists have studied satellite images and learned that Kilimanjaro has lost more than 90 percent of its ice since 1900. Many experts are studying the causes of this catastrophic melt.
The people who live in the vicinity of Kilimanjaro are an important part of the mountain’s history. In 1889, local climber Yohani Kinyala Lauwo (also known as Mzee Lauwo) guided German geographer Hans Meyer and Austrian mountaineer Ludwig Purtscheller to the Kilimanjaro summit. Lauwo then became the first Tanzanian to reach the peak at the age of 18. Purtscheller and Meyer were the first Europeans to summit. Lauwo was a member of the Chagga tribe. The Chagga have lived on Kilimanjaro’s slopes for centuries. Lauwo went on to guide climbers to Kilimanjaro’s summit for more than 50 years, dying at the age of 125.
Kilimanjaro continues to be a popular hiking spot. This is partly because the hiking routes do not require as much equipment or experience as mountains of similar heights. Tens of thousands of climbers ascend the mountain each year. The climb is still dangerous, however, because of the risk of altitude sickness. Climbers can experience altitude sickness if they ascend too quickly, and it can be deadly if not treated right away.
In 1973, the mountain and its six surrounding forest corridors were named Kilimanjaro National Park. The park was named a United Nations Educational, Scientific and Cultural Organization (UNESCO) World Heritage site in 1987. These measures can help protect the area’s unique environment. A variety of animals live in the area surrounding the mountain, including the blue monkey (Cercopithecus mitis).
Additional Information
Kilimanjaro is a volcanic massif in northeastern Tanzania, near the Kenya border. Its central cone, Kibo, rises to 19,340 feet (5,895 metres) and is the highest point in Africa. Kilimanjaro lies about 100 miles (160 km) east of the East African Rift System and about 140 miles (225 km) south of Nairobi, Kenya. The massif extends approximately east-west for 50 miles (80 km) and consists of three principal extinct volcanoes: Kibo (centre), Mawensi (east), and Shira (west). Kibo, the youngest and highest, retains the form of a typical volcanic cone and crater and is linked by a 7-mile (11-km) saddle at about 15,000 feet (4,500 metres) with Mawensi (16,893 feet [5,149 metres]), which is the older core of a former summit. Shira ridge (13,000 feet [3,962 metres]) is a remnant of an earlier crater. Below the saddle, Kilimanjaro slopes in a typical volcanic curve to the plains below, which lie at an elevation of about 3,300 feet (1,000 metres). The breathtaking snow-clad dome of Kibo contains a caldera (crater) on its southern side that is 1.2 miles (2 km) across and some 980 feet (300 metres) deep, with an inner cone that displays residual volcanic activity. Mawensi’s cone is highly eroded, jagged, and precipitous and is cleft east and west by gorges. Only Kibo retains a permanent ice cap. Mawensi has semipermanent ice patches and substantial seasonal snow.
The mountain and its surrounding forests were designated a game reserve in the early part of the 20th century. In 1973 Mount Kilimanjaro National Park was established to protect the mountain above the tree line as well as the six forest corridors that extend downslope through the montane forest belt. The park was designated a UNESCO World Heritage site in 1987.
Kilimanjaro has a succession of vegetation zones consisting of (from base to summit) the semiarid scrub of the surrounding plateau; the massif’s cultivated, well-watered southern slopes; dense cloud forest; open moorland; alpine desert; and moss and lichen communities. Two notable species that grow in the moorlands are the giant lobelia (Lobelia deckenii) and the giant groundsel (Senecio johnstonii cottonii). The forests of the southern slopes and surrounding areas are home to elephants, buffalo, and eland (oxlike antelopes). Smaller mammals inhabiting the forests include black and white colobus monkeys, blue monkeys, and bushbuck and duikers (small African antelopes). The forests also host a rich variety of birdlife, including the rare Abbot’s starling.
The Kilimanjaro formations became known to Europeans when they were reached in 1848 by the German missionaries Johannes Rebmann and Johann Ludwig Krapf, although the news that there were snow-capped mountains so close to the Equator was not believed until more than a decade later. The Kibo summit was first reached in 1889 by the German geographer Hans Meyer and the Austrian mountaineer Ludwig Purtscheller. The Kilimanjaro region is one of Tanzania’s leading producers of mild coffee, barley, wheat, and sugar; other crops include sisal, corn (maize), beans, bananas, wattle bark (Acacia), cotton, pyrethrum, and potatoes. The region is populated by the Chaga (Chagga), Pare, Kahe, and Mbugu peoples. The town of Moshi, at the southern foot of Kilimanjaro, is the chief trading centre and base for ascent. As Kibo’s peak can be reached without the aid of mountaineering equipment, thousands of hikers attempt the ascent each year.
