Cat-scratch disease - an infection with bartonella bacteria. It may be transmitted by:
cat scratches,
cat bites, or
flea bites.
Symptoms
A person who has had contact with an infected cat may show symptoms, including:
Bump (papule) or bump with pus inside (pustule) at site of injury (usually the first sign)
Fatigue
Fever (in some people)
Headache
Lymph node swelling (lymphadenopathy) near the site of the scratch or bite
Overall discomfort (malaise)
Less common symptoms may include:
Loss of appetite
Sore throat
Weight loss
Causes
Cat-scratch disease is caused by the bacteria Bartonella henselae.
The disease is spread through contact with an infected cat (a bite or scratch) or exposure to cat fleas.
It also can be spread through contact with cat saliva on broken skin or mucosal surfaces like those in the nose, mouth, and eyes.
Treatment
Most often, cat-scratch disease is not serious. Medical treatment may not be needed. In some cases, treatment with antibiotics such as azithromycin can be helpful. Other antibiotics may be used, including:
Clarithromycin
Rifampin
Trimethoprim-sulfamethoxazole
Ciprofloxacin
In people with HIV/AIDS and others who have a weak immune system, cat-scratch disease can be more serious. Treatment with antibiotics may be needed.
People who have a healthy immune system should recover fully without treatment.
People with a weak immune system need antibiotic treatment to recover.
People with weak immune systems may develop complications such as:
Encephalopathy (loss of brain function)
Neuroretinitis (inflammation of the retina and optic nerve of the eye)
Osteomyelitis (bone infection)
Parinaud syndrome (red, irritated, and painful eye)
Prevention
To prevent cat-scratch disease:
Wash your hands thoroughly with soap and water after playing with your cat. Wash any bites or scratches thoroughly.
Play gently with cats so they don't scratch and bite.
Don't allow a cat to lick your skin, eyes, mouth, or open wounds or scratches.
Use flea control measures to lower the risk that your cat will develop the disease.
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Delirium - sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness.
It involves a quick change between mental states.
E.g., from lethargy to agitation and back to lethargy.
Symptoms
Changes in alertness (usually more alert in the morning, less alert at night)
Changes in feeling (sensation) and perception
Changes in level of consciousness or awareness
Changes in movement (for example, may be slow moving or hyperactive)
Changes in sleep patterns, drowsiness
Confusion (disorientation) about time or place
Decrease in short-term memory and recall
Disorganized thinking, such as talking in a way that doesn't make sense
Emotional or personality changes, such as anger, agitation, depression, irritability, and overly happy
Incontinence
Movements triggered by changes in the nervous system
Problem concentrating
Causes
Delirium is most often caused by physical or mental illness and is usually temporary and reversible. Many disorders may cause delirium. Often, these disorders do not allow the brain to get oxygen or other substances. They may also cause dangerous chemicals (toxins) to build up in the brain. Delirium is common in the intensive care unit (ICU), especially in older adults.
Causes include:
Alcohol or medicine overdose or withdrawal
Drug use or overdose, including being sedated in the ICU
Electrolyte or other body chemical disturbances
Infections such as urinary tract infections, pneumonia, or meningitis
Certain medicines such as pain medicines, sedatives, or anticholinergic medicines
Severe lack of sleep
Poisons
General anesthesia and surgery
Autoimmune disease
Treatment
The goal of treatment is to control or reverse the cause of the symptoms.
Treatment depends on the condition causing delirium.
The person may need to stay in the hospital for a short time.
Stopping or changing medicines that may worsen confusion, or that are no longer needed, may improve mental function.
Disorders that contribute to confusion should be treated. These may include:
Anemia
Decreased oxygen (hypoxia)
Heart failure
High carbon dioxide levels (hypercapnia)
Infections
Kidney failure
Liver failure
Metabolic disorders
Nutritional disorders
Psychiatric conditions (such as depression or psychosis)
Thyroid disorders
Treating medical and mental disorders often greatly improves mental function.
Medicines may be needed to control aggressive or agitated behaviors.
These are usually started at very low dosages and adjusted as needed.
Some people with delirium may benefit from hearing aids, glasses, or cataract surgery.
Other treatments that may be helpful are:
Behavior modification to control unacceptable or dangerous behaviors.
Reality orientation to reduce disorientation.
Modifying the environment to help with orientation. This includes adjusting lights so one can keep track of day and night, clocks, and calendars.
Prognosis
Acute conditions that cause delirium may occur with long-term (chronic) disorders that cause dementia. Acute brain syndromes may be reversible by treating the cause.
Delirium often lasts about 1 week.
It may take several weeks for mental function to return to normal.
Full recovery is usually expected, but depends on the underlying cause of the delirium.
POSSIBLE COMPLICATIONS. Problems that may result from delirium include:
Loss of ability to function or care for self
Loss of ability to interact
Progression to stupor or coma
Side effects of medicines used to treat the disorder
PREVENTION. Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.
ALTERNATIVE NAMES. Acute confusional state. Acute brain syndrome.
A broken jaw is a break (fracture) in the jaw bone.
A dislocated jaw means the lower part of the jaw has moved out of its normal position at one or both joints where the jaw bone connects to the skull (temporomandibular joints).
A jaw bone joint is called the temporomandibular joint (TMJ).
Symptoms
Symptoms of a broken jaw include:
Pain in the face or jaw, located in front of the ear or on the affected side, that gets worse with movement
Bruising and swelling of the face, bleeding from the mouth
Difficulty chewing
Misaligned teeth or jaw
Jaw stiffness, difficulty opening the mouth widely, or problem closing the mouth
Jaw moving to one side when opening
Jaw tenderness or pain, worse with biting or chewing
Loose or damaged teeth
Lump or abnormal appearance of the cheek or jaw
Numbness of the face (particularly the lower lip)
Ear pain
Symptoms of a dislocated jaw include:
Pain in the face or jaw, located in front of the ear or on the affected side that gets worse with movement
Bite that feels "off" or crooked
Problems talking
Inability to close the mouth
Drooling because of inability to close the mouth
Locked jaw or jaw that protrudes forward
Teeth that do not line up properly
Causes
The most common cause of a broken or dislocated jaw is injury to the face. This may be due to:
Assault
Industrial accident
Motor vehicle accident
Recreational or sports injury
Trips and falls
After a dental or medical procedure
A broken or dislocated jaw usually heals well after treatment. But the jaw may become dislocated again in the future.
Complications may include:
Airway blockage
Bleeding
Breathing blood or food into the lungs
Difficulty eating (temporary)
Difficulty talking (temporary)
Infection of the jaw or face
Pain of the jaw joint (TMJ) pain and other problems
Numbness of part of the jaw or face
Problems aligning the teeth
Swelling
Do not try to correct the position of the jaw. A provider should do this.
A broken or dislocated jaw requires prompt medical attention.
Emergency symptoms include: (a) difficulty breathing or (b) heavy bleeding.
PREVENTION. During work, sports, and recreation activities, using safety equipment, such as a helmet when playing football, or using mouth guards can prevent or minimize some injuries to the face or jaw.
Decided I did in fact want a little floor plan of BACCHANALIA, the nightclub in Darkness Alters, but didn't want to draw it up in CAD or Dungeondraft, so here's a little sketch. If you happen to need a nightclub layout for your own work feel free to use it!
A floor plan of a large rectangular nightclub. There is a covered entry cut into the lower left corner with a slightly absurd switchback queue leading the bouncer and entry/exit doors. The entry dumps right into a narrow area of small standing-height tables with bar chairs.
A long bar with stools and a bar back area wraps in an 'L' along the front of the club and partway up the right side. It is long enough that is likely requires several bartenders. There are two lines of low banquette seating separating the bar and the utility areas from the dance floor, which is large and rectangular.
Stretching across most of the back wall is raised stage for live performances, which is flanked on one side by a DJ/AV booth and on the other by a backstage area and a greenroom, which extends a bit down the right side of the building. Backstage leads out to a loading dock and alley.
Along the right wall, past the end of the bar, is a vestibule for the restrooms and a set of stairs. The stairs lead up to an open mezzanine above the bar where the VIP lounge and the manager's office/apartment are. The upstairs is not shown, but is a loose groupings of lounge seats and tables, with swags of velvet on the ceiling and walls to absorb some of the sound. The lounge has several patio doors leading out to a balcony that overlooks the street. The manager's suite sits at the end farthest from the stairs, with large windows in the office that overlook the club. The apartment has a private balcony to the street.
If more pressure is put on a bone than it can stand, it will split or break.
A break of any size is called a fracture.
If the broken bone punctures the skin, it is called an open fracture (also sometimes called a compound fracture).
A stress fracture is a break in the bone that develops because of repeated or prolonged forces against the bone. The repeated stress weakens the bone until it finally breaks.
Symptoms
A visibly out-of-place or misshapen limb or joint
Swelling, bruising, or bleeding
Pain that may be severe
Numbness and tingling
Broken skin with bone protruding
Limited mobility or inability to move a limb or put weight on the leg
Common Causes
Fall from a height
Trauma
Motor vehicle accidents
Direct blow
Child abuse
Repetitive forces, such as those caused by running, can cause stress fractures of the foot, ankle, tibia, or hip
DO NOT
DO NOT move the person unless the broken bone is stable.
DO NOT move a person with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the person, pull the person to safety by their clothes (such as by the shoulders of a shirt, a belt, or pant legs).
DO NOT move a person who has a possible spine injury.
DO NOT attempt to straighten a bone or change its position unless blood circulation appears hampered and no medically trained personnel are nearby.
DO NOT try to reposition a suspected spine injury.
DO NOT test a bone's ability to move.
FRACTURES
A fracture is a partial or complete break in the bone. When a fracture happens, it’s classified as either open or closed:
Open fracture (compound fracture): The bone pokes through the skin and can be seen. Or a deep wound exposes the bone through the skin.
Closed fracture (simple fracture). The bone is broken, but the skin is intact.
Fractures have a variety of names. Here is a list of types that may happen:
Greenstick. This is an incomplete break. A part of the bone is broken, causing the other side to bend.
Transverse. The break is in a straight line across the bone.
Spiral. The break spirals around the bone. This is common in a twisting injury.
Oblique. The break is diagonal across the bone.
Compression. The bone is crushed. This causes the broken bone to be wider or flatter in appearance.
Comminuted. The bone has broken into 3 or more pieces. Fragments are present at the fracture site.
Segmental. The same bone is broken in 2 places, so there is a "floating" piece of bone.
Avulsion. The bone is broken near a tendon or ligament. A tendon or ligament pulls off a small piece of bone.
Symptoms may be a bit different for each person. Symptoms of a broken or fractured bone may include:
Sudden pain
Trouble using or moving the injured area or nearby joints
Unable to bear weight
Swelling
Obvious deformity
Warmth, bruising, or redness
The symptoms of a broken bone may seem like other health conditions or problems. Always see a healthcare provider for a diagnosis.
Treatment of Fractures
The goal of treatment is:
to put the pieces of bone back in place,
control the pain,
give the bone time to heal,
prevent complications, and
restore normal use of the fractured area.
Treatment may include:
Splint or cast. This immobilizes the injured area to keep the bone in alignment. It protects the injured area from motion or use while the bone heals.
Medicine. This may be needed to control pain.
Traction. This is the use of a steady pulling action to stretch certain parts of the body in a certain direction. Traction often uses pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone. This helps the bone ends to align and heal.
Surgery. Surgery may be needed to put certain types of broken bones back into place. Sometimes internal fixation devices (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place while they heal.
Fractures can take months to heal as broken bones “knit” back together when new bone is formed between the broken parts.
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There are a lot of medications in use today whose chemicals can be found in plants/minerals (or which were originally derived from plants/minerals). Note that most of these, while originally derived directly from plant material, are currently made in a lab.
Acetaminophen comes from chemically changing acetanilide, a chemical found in coal tar.
Aspirin comes from chemically changing salicin, a chemical found in a number of plants (willow, poplar, meadowsweet, black haw, cramp bark, among others).
Atropine (used in emergency medicine to increase heart rate and treat certain poisonings, among other things) is found in a number of plants in the nightshade family.
Caffeine is present in a lot of plants (it's a natural insecticide) including tea, coffee, cocoa, and yaupon holly.
Cocaine (both the local anesthetic and the illicit substance) is from the coca plant.
Colchicine is used to treat gout and comes from autumn crocus.
Digoxin (a medication used to treat heart failure) comes from the foxglove plant.
L-Dopa, used to treat Parkinson's disease, comes from Mucuna species (cowage, velvetbean).
Nicotine, a stimulant, comes from tobacco.
Opium is the dried sap of poppy pods. From it can be isolated morphine and codeine. Processing morphine further produces heroin.
Pseudoephedrine and ephedrine, medications used as decongestants (among other things), come from ma huang and ephedra.
Quinine is an antipyretic (fever reducer) that used to work against malaria (malaria is now resistant to quinine). it also comes from the cinchona tree.
Quinidine is an antiarrhythmic drug used to treat bad heart rhythms. it comes from the cinchona tree.
Reserpine is a drug used to treat high blood pressure (among other things). It comes from Indian snakeroot.
Scopolamine, used to treat nausea and motions sickness, comes from black henbane, stinking nightshade, and henpin.
Theophylline is a bronchodilator (treats asthma) that comes from the cacao plant and tea plant.
Ghost - usually considered to be the soul of a dead person that inhabits a different world or dimension than that of the living.
Have no physical body, just an illusion of a body.
Can appear in the form of a deceased person or take on different appearances.
People have claimed to have communicated with ghosts throughout history—although such communication is said to be difficult because ghosts are believed to dwell outside the living world.
People called mediums claim that they are capable of communicating with ghosts. Little evidence is available to validate their authenticity, however.
Ghost imagery has taken on many forms throughout history, but some attributes have consistently appeared in various folklore and fiction.
A common portrayal of a ghost is the vision of a white, cloudy mist.
Historians believe ancient peoples equated this image with ghosts because it resembled a person's breath in the cold air.
Shadows were also associated with ghostly visions. Some ancient cultures related shadows to a person's soul.
A disconnected shadowy figure was by extension considered a lost or dead soul, cut off from its physical body.
The science of parapsychology attempts to prove the existence of supernatural beings such as ghosts, but evidence is scarce in this field of inquiry.
Such belief in the supernatural is called supernaturalism.
Though many ghosts are perceived as angry and restless souls denied a peaceful afterlife, some folklore depicts good-natured ghosts who look out for people.
Perceptions of ghosts often vary from culture to culture.
Ghosts go by many names in different languages. Some English examples include spirits, apparitions, specters, phantoms, spooks, and poltergeists.
People have talked and prayed to the ghosts of their ancestors for thousands of years in an effort to appease them and keep them from interfering in their lives.
This practice of ancestor worship was common in many traditional African and traditional East Asian cultures.
The Ancient Egyptians had similar beliefs about the dead and buried corpses with various trinkets and offerings as an act of reverence.
Following in the footsteps of the Egyptians, the ancient Greek and Roman civilizations also believed that the souls of the dead could appear to the living.
References to apparitions of dead souls were later found in ancient Hebrew scripture.
When the Europeans began exploring the New World, they listened intently to the natives' accounts of ghosts.
The existence of ghosts came into question during the scientific revolution of the 17th and 18th centuries.
Many instances that had previously been termed "supernatural" could now be disproved by science.
Though some religions retained their belief in the supernatural and the afterlife, ghost stories were soon relegated to fictional narratives and were later manifested in the horror genre of film and literature.
Few people draw upon the ancient religious notion of ancestral spirits and a peaceful afterlife when referring to ghosts in modern times.
Though these spiritual beliefs influenced classic ghost stories, modern tales began ignoring the benevolent specter in favor of a more sorrowful or sinister presence.
Many popular ghost stories were scary tales involving violent ghosts with varying motives.
Interest in ghosts flourished as a result of sensational storytelling in literature.
Modern ghost stories were often filled with dark descriptions of shadowy figures with harmful intentions.
Most of these stories were rooted in ancient folk tales, however.
Ancient ghost stories continued to influence modern supernatural literature for centuries.
In Popular Culture
With origins in folklore and myth, ghosts have always been closely linked to popular culture.
They have been referenced in the art, theater, music, and literature of many peoples, serving to reinforce themes ranging from horror to comedy.
The modern Western conception of ghosts, while influenced by ancient folk tales and famous works by William Shakespeare and others, is most strongly influenced by Victorian-era literature.
It was in that period that authors solidified the themes that are recognizable as the traditional ghost story.
Notably, many depictions of ghosts from the mid-1800s onward included elements from the growing field of psychology.
Changing trends in religious belief further affected the way Western society viewed ghosts.
The evolution of mass media in the 20th century also significantly influenced popular images of ghosts, especially in the development of more child-friendly imagery.
One of the most famous examples is the character Casper the Friendly Ghost, developed in the 1930s for a children's book and soon turned into a popular cartoon.
Television and film exposed audiences to a wide variety of ghosts, both in the traditional horror format and in contexts such as comedy and romance.
The live-action comedy film Ghostbusters (1984) also helped popularize the notion of ghost hunting, which became a common subject of reality television programs in which crews attempt to document evidence of real ghosts.
Parapsychology
Though most scientific rationale denies the existence of ghosts, some sciences are aimed at discovering the presence of ghosts in the human world.
Established in the late 19th century, the field of parapsychology is dedicated to investigating paranormal, or supernatural, occurrences called parapsychological phenomena.
Parapsychologists refer to ghost encounters as apparitional experiences.
These experiences are not limited to visual events and can involve the observance of dead people or animals.
An apparition can also be a possessed inanimate object.
Parapsychologists often investigate claims of hauntings.
When a ghost is described as persistently appearing in the living world, it is haunting the place that it visits.
Hauntings can range from a simple nuisance to a violent presence.
Ghosts are often described as haunting the places that were important to them when they were alive, such as their homes.
Haunted houses have played an important role in popular horror culture for many centuries.
Many fictional horror tales are based on real-life accounts of house hauntings. The Whaley House in San Diego, California, is considered one of the most haunted houses in the nation, and many guests claim to have had ghostly experiences there.
A house in Amityville, New York, also claims to be haunted, and several books and films have been inspired by these claims.
Cemeteries are also cited as places that experience many hauntings.
To date, only inconclusive evidence exists supporting the presence of ghosts in the human world.
Many people remain convinced that ghosts are real, however.
