Depending on your symptoms, your doctor may prescribe the following:

Antibiotics: metronidazole topical cream or gel (MetroCream, MetroGel) is the first-line therapy most commonly prescribed. Other topical antibiotics also may be effective. Tetracycline and tetracycline derivatives such as doxycycline, are prescription medicines you take by mouth once or twice a day. They sell several brands. The improvement is usually evident in the first two months after the start of treatment.

Azelaic acid (Finacea): The Food and Drug Administration (FDA, for its acronym in English) of the United States approved this drug in June 2003 for topical (applied to the skin). It is a dicarboxylic acid containing gel and used for inflamed pimples in cases of mild to moderate rosacea.

Beta-and alpha-antagonists, these drugs may reduce the redness through their effects on blood vessels. Propranolol (Inderal) and nadolol (Corgard) are beta blockers and clonidine (Catapres) is an alpha-antagonist. The use of these drugs for use rosacea is unofficial, meaning that the FDA has not approved its use for the treatment of rosacea. Beta blockers are generally used to treat high blood pressure and heart disease. Clonidine was developed to treat high blood pressure, but is also used to reduce hot flashes in menopause.

Estrogen: the female hormone used when rosacea is aggravated by hot flashes of menopause. You should use the lowest dose of estrogen to control menopausal symptoms and hormone should then be suspended when there are no more hot flashes.

Laser treatment: This is used to get rid of the dilated blood vessels or liminal excess tissue in the nose.

Surgical: surgery of scraping or dermabrasion can also help remove excess tissue in the nose in rhinophyma.

When To Call a Professional

Contact your doctor if you notice a persistent facial redness or pimples if your skin shows red, dry and scaly. Also call your doctor if you suspect your cheek erythema is caused by sunburn or by their tendency to blush easily. Remember, it is easy to diagnose incorrectly instead of acne rosacea also use the-counter medications for acne may worsen your rosacea to irritate the skin is dry and sensitive.

Forecast

The progress of rosacea varies from person to person, depending on factors such as genetics, skin sensitivity, skin, time exposed to sunlight without sunscreen, alcohol and spicy foods, and exposure to extreme heat and temperatures low. If you follow proper treatment and avoiding triggers, rosacea can usually be controlled well.

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Usually, a doctor could diagnose rosacea based on the history of redness and the appearance of the skin. In the early stages of rosacea, the rash can sometimes be mistaken for sunburn, acne, hot flashes of menopause or allergy to cosmetics.

Duration

The symptoms of rosacea often come and go in cycles, often triggered by substances and situations that make your face turn red. If you seek medical help and follow the medical treatment, you can improve the condition of the skin and may stop or reverse the progression of this condition.

Prevention

There is no way to prevent rosacea, but symptoms can be reduced by recognizing the following triggers: hot drinks, alcohol, spicy foods, stress, sunlight, heat or cold. These conditions increase blood flow and cause small blood vessels of the face get larger (dilate). If you have rosacea, try to identify specific triggers and modify them or avoid them altogether.

To clean or moisturize your face, facial products should be selected not to burn, irritate or cause erythema when they are applied. You should wash your face with warm water and mild soap, using the tip of your fingers to gently apply soap. You should also avoid toners, astringents, or exfoliating agents and products that contain alcohol or polish and acetone. The hydroxy acids and tretinoin (eg Retin A) may sensitize the skin to sun exposure and may worsen rosacea.

Sunscreens and sunblocks should be used regularly and without restrictions to protect the face. Use sunscreen with SPF 15 or higher. If chemical sunscreens cause itching, use sunscreen for the body, containing titanium oxide or zinc.

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Currently, rosacea affects 13 million people in the United States is more common in fair-skinned adults between 30 and 50 who have red hair and white skin and a history of blushing easily. Women develop rosacea more often than men, but men are more likely to have noses inflamed (swollen) and enlarged, a condition called rhinophyma. Rosacea is often mistaken for sunburn and are generally not diagnosed. There are many good treatment for this condition.

Symptoms

There are four progressive stages of rosacea:
- First stage: facial flushing and erythema intermittent.
- Second stage: persistent erythema on the cheeks, nose, chin and forehead.
- Third stage: small bumps, pus-colored or red with blood vessels that appear red fine lines.
- Fourth stage: lumps and thickening of the skin of the nose.

Below are the most common symptoms of rosacea:

Erythema: redness of the skin of the face like sunburn or blush. This is caused by flushing, which occurs when excess blood flowing quickly through the blood vessels in the skin and blood vessels enlarge to handle this flow. Gradually this redness becomes more evident and does not disappear. The skin of the face can also become very dry.

Blackheads and papules, may appear “bumps” small, red, hard or “pimples” full of pus in the face, similar to those seen in juvenile acne. In fact, rosacea has often been called adult acne or acne rosacea. The causes of acne rosacea are different, however, adults with rosacea do not have white spots or blackheads (called comedones) commonly seen in acne.

Red lines (telangiectasia), facial flushing or redness causes small blood vessels to expand and eventually show through the skin. These enlarged blood vessels appear as tiny red lines (telangiectasias) on the face, especially in the cheeks. First, telangiectasia may be hidden by erythema caused by flushing or blushing, but usually reappear after the rash disappears.

Nasal hump, if left untreated, rosacea can finally form small lumps and knots on the nose, giving it an appearance of being swollen. This condition is more common in men and is called rhinophyma.

Eye irritation: the eyes become red and dry in about half of people with rosacea. Involvement of the eyes is usually relatively mild. In rare cases, there is severe involvement of the eyes, which if not treated, it can affect vision.

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Call your doctor immediately if you notice blood in your urine or your urine is the color of cola. You should also call your health professional if you have fever or pain in the lower abdomen or side.

Forecast

Most people with hematuria related with exercise, medication, kidney stones, urinary tract infection or prostatitis has an excellent prognosis for recovery.

Children with hematuria due to glomerulonephritis usually recover completely if the disease is mild or if it develops after a strep infection. Adults with glomerulonephritis are less likely to recover by themselves, although the outlook depends on the specific type of glomerulonephritis. More severe forms of the disease can cause chronic kidney failure.

In people with bladder or kidney cancer, the outlook depends on the stage and type of tumor. In general, if the tumor in the bladder or kidney disease is diagnosed in its early stages, the cancer often be cured.

Although people with hemophilia may have frequent episodes of bleeding (including bleeding in the joints, internal organs and other body parts), recent advances in treatment have been a period of normal life in many patients.

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- Kidney stones, smaller stones can sometimes leave the urinary tract if you take plenty of fluids. Larger stones may require surgery or lithotripsy, a procedure that breaks the calculation.

- Trauma: the type and severity of injuries, in severe cases surgery may be needed.

- Tumor in the bladder or kidney, the treatment is determined according to cancer type and extent of spread (stage), as well as patient age, general health and preferences. The main types of treatment are surgery, chemotherapy, radiotherapy and immunotherapy, a treatment that stimulates the immune system to fight cancer.

- Glomerulonephritis: Treatment may include antibiotics to treat infection, medications called diuretics that help increase the amount of urine eliminated by the body, medications to control high blood pressure and changes in diet to reduce kidney function. However, children with this disease after streptococcal infection often recover without treatment. If glomerulonephritis is caused by an autoimmune treatment, such as lupus, may be prescribed medications to suppress the immune system, including corticosteroids or cyclophosphamide (Cytoxan, NEOs).

- Bleeding disorders: Treatment depends on the specific type of bleeding disorder. Patients with hemophilia can be treated with injections of clotting factors or fresh-frozen plasma, a type of transfusion that restores the missing factors.

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The duration of hematuria depends on the cause. For example, hematuria related to strenuous exercise usually goes away by itself within 24 to 48 hours. Hematuria due to a urinary tract infection will disappear when the infection is cured. Hematuria associated with a kidney stone will disappear once fired or removed.

Prevention

To prevent hematuria related to strenuous exercise, change to a program with lower intensity exercise. In general, you can help prevent other forms of hematuria by adopting a lifestyle that promotes a healthy urinary tract:

- stay hydrated, drink about eight glasses of fluid per day (more during hot seasons)
- Avoid smoking cigarettes because there are more chances of getting cancer in the urinary tract

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Once your doctor has confirmed that you have hematuria, ask about your medical history and family history, especially any history of kidney disease (in the kidneys), bladder problems or bleeding disorders. Your doctor will also ask about any cases of recent trauma or strenuous exercise, recent bacterial or viral infections, medications you take and your symptoms, including frequent urination, painful urination and pain in the side.

Your doctor will examine you, measure your temperature and blood pressure checked if you have pain or discomfort in your side or on the bladder area. The doctor may recommend that women perform a pelvic exam and men a prostate exam.

It will also prompt a fresh sample of urine for a urinalysis. The urine is tested in the laboratory to detect proteins, white cells and red blood cells to identify a bladder infection or kidney or kidney inflammation (glomerulonephritis).

Then, as the suspected cause of hematuria, other tests may include:

- Urine culture through analysis and testing a urine sample to see if bacteria grow. This analysis is used to confirm a bladder or kidney infection.

- CT of the kidneys, ureters and bladder, most commonly the first computed tomography (CT) is performed without contrast material placed intravenously (into a vein). If more information is still needed, the radiologist may want to inject a dye (also called contrast). The dye accumulates in the kidneys and excreted in the urine, which shows the outline of the entire urinary system. Tell the radiologist about your allergies, especially any previous reactions to contrast media.

- Ultrasound: This test uses sound waves to help determine whether the renal mass is not cancerous (benign), if a fluid-filled cyst or a solid mass, like a cancerous tumor. Ultrasound also can identify kidney stones.

- Cystoscopy through this examination, the doctor inserts a flexible endoscope into the urethra up into the bladder to examine the lining of the bladder for tumors or other problems. This test is usually done under local anesthesia and sedation.

- Blood tests can detect signs of urinary tract infection, kidney failure, anemia (often accompanied by kidney problems), bleeding disorders, or levels of chemicals in the blood that can increase the formation of kidney stones.

May recommend other tests to detect conditions causing kidney inflammation (such as lupus) based on results of routine tests of urine and blood.

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- Glomerulonephritis: If glomerulonephritis is not serious, it could cause any symptoms. If symptoms appear, may be inflammation (swelling), especially in the lower extremities, decreased urine and high blood pressure.

- Infection of the bladder or kidney, symptoms depend on where you located the infection, but can include severe pain in the middle region of the spine, fever, severe chills, nausea and vomiting, pain above the pubic bone or region bladder, foul-smelling urine, needing to urinate more often than normal, and pain or discomfort when urinating.

- Infection of the prostate may be pain in the lower spine or the area between the scrotum and anus, painful ejaculation, blood in semen, and sometimes fever and chills.

- Tumor in the kidney and bladder: the majority of bladder and kidney cancers grow without causing pain or discomfort. When symptoms develop, the most common are abdominal pain, more frequent urination and pain after urinating.

- Kidney stones: when a kidney stone gets stuck in a ureter (the narrow tubes connecting each kidney to the bladder) can cause severe pain in the spine, side, groin, nausea and vomiting or pain and urine frequent.

- Bleeding disorders (bleeding) tend to cause abnormal bleeding throughout the body, not just in the urine. Depending on the specific bleeding problem, symptoms can include unusual bruising, prolonged bleeding from cuts, bleeding into the skin, bleeding into joints or gastrointestinal tract (which gives stool tarry and black tone or bright red due to the blood in the stool), or even bleeding gums when flossing or brushing your teeth gently.

- Trauma: there are often signs of traumatic injury on the surface of the body, such as bruising, swelling, puncture holes or open wounds

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There are many possible causes of hematuria include:

- Urinary tract infection, hematuria may be caused by an infection anywhere in the urinary tract, most commonly the bladder (cystitis) or kidney (pyelonephritis).

- Kidney stones (stones in the kidney)

- Tumours in the kidney or bladder

- Physical exercise: the exercise hematuria is a harmless condition that causes blood in the urine after intense physical exercise. It is more common in men than in women.

- Trauma: Traumatic injuries anywhere in the urinary tract from the kidneys to the urethral opening (the connection between the bladder and the outside world) can cause hematuria.

- Medications: the Hematuria can be caused by medications such as anticoagulants, including heparin, warfarin (Coumadin) or medications such as aspirin, penicillin, sulfa-containing drugs and cyclophosphamide (Cytoxan).

- Glomerulonephritis: a group of diseases characterized by inflammation of the glomeruli, the kidney filtering units. Glomerulonephritis is a rare complication of certain bacterial and viral infections (including strep infection). It can also occur in people with certain autoimmune diseases, lupus erythematosus (also called lupus or SLE) and vasculitis, and sometimes there is no identifiable cause.
Bleeding disorders (bleeding): these include the family of hemophilia.

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Kidney failure can be the cause or the consequence of severe hypertension.
Treatment of hypertensive crisis should take into consideration the hemodynamics and consider that in the early hours of the drop in blood pressure may worsen renal function temporarily . The use of nitroprusside is elective, but must take into account the clearance to avoid thiocyanate toxicity.

Myocardial Ischemia

The basis of antihypertensive therapy is to reduce systemic vascular resistance and improve coronary perfusion. The decrease in coronary perfusion pressure
transform a potentially reversible ischemic zone infarcted area. In the presence of myocardial ischemia diastolic pressure should be less than 100 mm. of Hg. The drug of choice is labetalol EV.El nitroglycerin is a reasonable alternative. Avoid the hydralazine and diazoxide.

FORECAST

Mortality greater than 90% per year for those not tratadas.La hypertensive emergencies median survival is 144 months for those patients presenting in the emergency room with a hypertensive emergency. The 5-year survival of all patients presenting with a hypertensive crisis is 74%.

Patients without evidence of target organ damage may be discharged with emphasis on the monitoring service of Hypertension Arterial. There is a mistaken belief that a patient can be discharged from the guard with moderately high blood pressure. As a result of this belief is indicated for patients oral medication such as nifedipine, in an attempt to reduce tension quickly before high. This values ​​is formally contraindicated behavior and can result in harm to the patient.

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