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1 – Myofascial pain involves discomfort or pain in the muscles that control jaw function. 2 – Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle. Rheumatic disease, such as arthritis, may also affect the temporomandibular joint as a secondary condition. Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend first using the most conservative, reversible treatments possible. Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment may be all that is necessary to relieve discomfort.
For many people with TMJ disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may provide temporary relief from jaw discomfort.
Your orthodontist may recommend an oral appliance, also called a stabilization splint or bite guard, which is a plastic guard that fits over the upper or lower teeth. The conservative, reversible treatments described are useful for temporary relief of pain – they are not cures for TMJ disorders. Botox® (botulinum toxin type A) is a neurotoxin protein that is used to relax facial muscles. By using this protein to target the muscles that cause TMJ, we are able to relax the musculature and provide relief in certain circumstances. Gallstones form in the gallbladder when cholesterol or bilirubin particles begin to cluster together into a solid lump. Gallstones can cause symptoms if they become caught in the narrow outlet of the gallbladder, or in the ducts that drain the gallbladder. More serious problems can develop if a gallstone gets into the drainage-duct system but does not make it all the way through to the intestines. Eighty percent of people with gallstones do not have any symptoms and do not need treatment.
Occasionally, gallstones cause more serious complications including pancreatitis or infections in the gallbladder or bile ducts.
Most gallstones do not show up on regular X-rays, but they are seen easily with an ultrasound. Smaller gallstones sometimes float out of the gallbladder on their own and are eliminated from the body in feces.
Nearly 90 percent of patients who want treatment for their gallstones undergo a type of surgery called laparoscopic cholecystectomy. Using small instruments that are placed through other small incisions, the surgeon is able to remove fluid and stones from the gallbladder to deflate it. Some patients have their gallbladders removed through a larger incision in a type of surgery called open cholecystectomy. This is a more practical surgery for people who have significant abdominal scarring from prior surgery or have a higher risk of complications during the surgery. For stones that are caught in the common bile duct, an additional treatment might be required. For an ERCP, your doctor uses miniature instruments attached to a camera at the end of a flexible tube (an endoscope). For people who cannot tolerate surgery, an oral medication known as ursodeoxycholic acid (Actigall) may be used to help dissolve stones.
Two other ways to break up gallstones are to use shockwaves (lithotripsy) or to dissolve the stones with solvents injected directly into the gallbladder with a needle. Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional.


The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The number of signs required by a business is dependent on certain factors, the size of the building, the use of the building and the type of occupants or visitors. Building plans, using plans and drawings of your premises can provide a systematic method of determining the signage you require; similarly an audit on foot through out all the possible routes of access and working spaces can identify problem areas. For complete peace of mind a reputable signage company may offer a site survey service, which will highlight and specific needs of your building and make sure you comply with the latest legislation.
Some people have other health problems that co-exist with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances or fibromyalgia, a painful condition that affects muscles and other soft tissues throughout the body.
Rheumatic diseases refer to a large group of disorders that cause pain, inflammation, and stiffness in the joints, muscles, and bone. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Your health care provider or a physical therapist can recommend exercises if appropriate for your particular condition. When necessary, your orthodontist can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or anti-depressants to help ease symptoms.
Used in small doses, Botox injections can actually help alleviate some health problems and have been approved by the Food and Drug Administration (FDA) for certain disorders.
The gallbladder is a pouch that collects bile as that liquid flows from the liver to the intestine through the bile ducts. The stone grows in size as the bile fluid washes over it, much like a pearl forms inside an oyster. Small gallstones can leave the gallbladder and its draining ducts, then pass out of the body through the intestines. After meals, especially meals high in fat, thin muscles in the wall of the gallbladder squeeze to help release bile into the intestines. In this case, the stone can cause a blockage with buildup of bile in the gallbladder or liver. If one of these problems occurs, you may experience fever, more severe abdominal pain or jaundice (a yellow color of the skin or whites of the eyes).
Gallstone attacks also can calm down on their own if the bothersome stones shift position within the gallbladder.
If you are a dieter, try to avoid diets that cause you to lose weight very quickly, such as diets restricted to fewer than 500 calories daily. In this procedure, a surgeon uses a small light and camera placed through a small incision into your abdomen.
In this surgery, a larger diagonal incision is made above the gallbladder, and the surgeon removes the gallbladder using a direct view instead of a camera. Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure done by a gastroenterology specialist or surgeon to view the opening of the bile duct where it empties into the intestine.
This treatment usually requires at least six months before results are seen and is only effective in about half of patients.
Surgery is strongly preferred over these other treatments because stones are likely to form again if the gallbladder is not removed. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Specialist signage needs to be incorporated to improve accessibility under the DDA (Disability Discrimination Act). Where ever a risk has been identified, ask yourself could a sign help reduce risk, or significantly raise awareness of that risk?


These disorders share some common symptoms, which suggests that they may share similar underlying mechanisms of disease.
Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. If a splint causes or increases pain, or affects your bite, stop using it and see your health care provider.
If the gallbladder squeezes against a gallstone, or if a gallstone blocks the fluid from draining easily, it can be very painful. Since the digestive tract is contaminated by bacteria, blocked fluid can lead to a very serious infection. Gallstones occur more commonly in older people, in people who are overweight, and in people who lose weight suddenly. If you have symptoms that aren't very typical for gallstones, even if you are found to have gallstones on an ultrasound or computed tomography (CT) scan, it may be difficult for your doctor to know if the stones are causing your symptoms. However, the majority of people whose gallstones cause symptoms will require surgery to cure the problem and will continue to have symptoms until the gallbladder is removed. Groups at high risk of gallstones include American Indians, Hispanics, people with sickle cell anemia and women who have had multiple pregnancies.
The camera, called a laparoscope, allows the surgeon to see what he or she is doing during the operation by watching a video screen. People recover very quickly from laparoscopic surgery because the surgical wounds are very small.
It is also important to know that in about 5 percent of cases, a surgeon may start a laparoscopic procedure, but choose to change to an open cholecystectomy for technical reasons. During ERCP the gastroenterologist can tug a stone out of the bile duct, or can widen the lower part of the duct so that the stones can pass out into the intestine on their own. The gallbladder is not a necessary organ and most people do not notice any digestive changes after it is removed. Certain businesses will have more hazards associated with them for example where there is heavy machinery such as a factory will require more safety signs.
Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment. If a gallstone lodges low down in the draining ducts, it can also block drainage of digestive enzymes from the pancreas. They also are more likely to occur in women who have been exposed to extra estrogen over their lifetime by having multiple pregnancies, by taking birth control pills, or by taking hormone replacement after menopause.
Even when a gallstone attack subsides on its own, the symptoms will return within two years in about two of three untreated people. In a few cases, abdominal pain or diarrhea develop after the gallbladder is removed, and additional treatment or changes in the diet are needed. Bile also contains some waste products including cholesterol and bilirubin (created when old red blood cells are destroyed). This will determine how many fire exit signs will be required for the emergency escape routes, fire exits etc.
Increased way-finding signage may be required to safely and efficiently guide visitor traffic through the building.



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