“Yersiniosis refers to the illnesses caused by Y. enterocolitica and less often by Y. pseudotuberculosis infections. Infection occurs most often in young children. Common symptoms in children are fever, abdominal pain, and diarrhea, which is often bloody.

Most people become infected by eating contaminated food, especially raw or undercooked pork, or through contact with a person who has prepared a pork product, such as chitlins. For example, babies and infants can be infected if their caretakers handle contaminated food and then do not wash their hands properly before handling the child or the child’s toys, bottles, or pacifiers.  People occasionally become infected after drinking contaminated milk or untreated water, or after contact with infected animals or their feces.  On rare occasions, people become infected through person-to-person contact. For example, caretakers can become infected if they do not wash their hands properly after changing the diaper of a child with yersiniosis.”

CDC – Centers for Disease Control and Prevention  (https://www.cdc.gov/yersinia/faq.html)

“Agoraphobia is fear of and anxiety about being in situations or places without a way to escape easily or in which help might not be available if intense anxiety develops.  The situations are avoided, or they may be endured but with substantial anxiety. About 30 to 50% of people with agoraphobia also have panic disorder.  Agoraphobia without panic disorder affects about 2% of women and 1% of men during any 12-month period. Peak age at onset is the early 20s; first appearance after age 40 is unusual.”

Merck Manual Professional Version (https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/agoraphobia)

What is Agoraphobia:

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.

The anxiety is caused by fear that there’s no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again.

People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.

Agoraphobia treatment can be challenging because it usually means confronting your fears. But with psychotherapy and medications, you can escape the trap of agoraphobia and live a more enjoyable life.

How Agoraphobia is Diagnosed:

• Signs and symptoms
• In-depth interview with your doctor or a mental health professional
• Physical exam to rule out other conditions that could be causing your symptoms
• Criteria for agoraphobia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Treatments for  Agoraphobia :

Agoraphobia treatment usually includes both psychotherapy and medication. It may take some time, but treatment can help you get better.

1.) Psychotherapy

Psychotherapy involves working with a therapist to set goals and learn practical skills to reduce your anxiety symptoms. Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders, including agoraphobia.

Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to better tolerate anxiety, directly challenge your worries and gradually return to the activities you’ve avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.

You can learn:

• What factors may trigger a panic attack or panic-like symptoms and what makes them worse
• How to cope with and tolerate symptoms of anxiety
• Ways to directly challenge your worries, such as the likelihood of bad things happening in social situations
• That your anxiety gradually decreases if you remain in situations and that you can manage these symptoms until they do
• How to change unwanted or unhealthy behaviors through desensitization, also called exposure therapy, to safely face the places and situations that cause fear and anxiety

If you have trouble leaving your home, you may wonder how you could possibly go to a therapist’s office. Therapists who treat agoraphobia are well aware of this problem.

If you feel homebound due to agoraphobia, look for a therapist who can help you find alternatives to office appointments, at least in the early part of treatment. He or she may offer to see you first in your home or meet you in what you consider a safe place (safe zone). Some therapists may also offer some sessions over the phone, through email, or using computer programs or other media.

If the agoraphobia is so severe that you cannot access care, you might benefit from a more intensive hospital program that specializes in the treatment of anxiety.

You may want to take a trusted relative or friend to your appointment who can offer comfort, help and coaching, if needed.

2.) Medications

Certain types of antidepressants are often used to treat agoraphobia, and sometimes anti-anxiety drugs are used on a limited basis. Antidepressants are more effective than anti-anxiety medications in the treatment of agoraphobia.

• Antidepressants. Certain antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), are used for the treatment of panic disorder with agoraphobia. Other types of antidepressants may also effectively treat agoraphobia.
• Anti-anxiety medication. Anti-anxiety drugs called benzodiazepines are sedatives that, in limited circumstances, your doctor may prescribe to temporarily relieve anxiety symptoms. Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these drugs aren’t a good choice if you’ve had long-term problems with anxiety or problems with alcohol or drug abuse.

It may take weeks for medication to relieve symptoms. And you may have to try several different medications before you find one that works best for you.

Both starting and ending a course of antidepressants can cause side effects that create uncomfortable physical sensations or even panic attack symptoms. For this reason, your doctor likely will gradually increase your dose during treatment, and slowly decrease your dose when he or she feels you’re ready to stop taking medication.

3,) Alternative medicine

Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before you take any of these for agoraphobia, talk with your doctor. Although these supplements are available without a prescription, they still pose possible health risks.

For example, the herbal supplement kava, also called kava kava, appeared to be a promising treatment for anxiety, but there have been reports of serious liver damage, even with short-term use. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using any product that contains kava until more-rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.

“Nonalcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis). The more severe form of NAFLD is called nonalcoholic steatohepatitis (NASH). NASH causes the liver to swell and become damaged.”.

American Liver Foundation  (https://liverfoundation.org/liver-diseases/fatty-liver-disease/nonalcoholic-fatty-liver-disease-nafld/)

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

The liver is a vital organ of vertebrates and in some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.

The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.  It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver^. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.

Nonalcoholic fatty liver disease is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol.

Nonalcoholic fatty liver disease is common and, for most people, causes no signs and symptoms and no complications.

But in some people with nonalcoholic fatty liver disease, the fat that accumulates can cause inflammation and scarring in the liver. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis.

At its most severe, nonalcoholic fatty liver disease can progress to liver failure.

Much of the American Liver Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

Much of the Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

But the Foundation is also tapping into the heightened awareness during Liver Awareness Month to draw attention to the alarming increase in the incidence of Non-Alcoholic Fatty Liver Disease (NAFLD), which, staggeringly, affects up to 25 percent of people in the United States.

As its name suggests, NAFLD is the buildup of extra fat in the liver that isn’t caused by alcohol. It’s normal for the liver to contain some fat. But if more than 5 to 10 percent of the liver’s weight is fat, then it is called a “fatty liver.”

Most often, NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. Sedentary behavior is another major contributing factor to the onset of NAFLD.

For these reasons, concern continues to grow as one in 10 children—that’s seven million children in the United States—is estimated to have fatty livers.

NALFD can become even more serious. It can progress to Non-Alcoholic Steatohepatitis (NASH), which means that along with the fat, there is inflammation and damage to the liver. A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.

“Do you know what foods are unhealthy? When examining your diet, it can be difficult to determine what foods are healthy or not.

The most common unhealthy foods include highly-processed items “such as fast foods and snack foods,” says Vilma Andari, M.S. “Highly-processed foods tend to be low in nutrients (vitamins, minerals and antioxidants) and high on empty calories due to the content of refined flours, sodium and sugar.  For optimal heart health, the American Heart Association recommends you consume:  No more than 1,500 milligrams of sodium per day.  No more than 6 teaspoons or 100 calories of sugar a day for women. Unfortunately, the average American eats more than double their recommended sodium and sugar intake, consuming 3,600 milligrams of sodium and 22 teaspoons of sugar daily.”

American Heart Association (https://www.heart.org/en/healthy-living/go-red-get-fit/unhealthy-foods)

“If you haven’t thought about whether or not the foods that you consume are truly nourishing you, take time to examine your eating habits to ensure that you’re meeting your nutritional goals.

“It’s unreasonable to expect you to eat healthy foods 100 percent of the time, but for better health, aim to eat nutritious foods at least 80 percent of the time. That means sweets, snacks and other junk food should only be occasional treats, rather than the bulk of your diet,” says Jason Sayanlar, M.D., FACC, a cardiologist at Hackensack University Medical Center.

The American Heart Association recommends that adults should limit their sodium intake to 1,500 mg per day, but the average person consumes more than twice that amount. Too much salt may lead to high blood pressure and increase the risk of heart disease.  To cut back on daily salt intake, eat fewer processed, pre-packaged foods, including canned foods and frozen meals. At mealtime, reach for the pepper mill instead of the salt shaker when you want more flavor. And in the supermarket, read labels and choose low-sodium soup, salt-free nuts and more.  Foods containing refined carbohydrates are stripped of fiber and other nutrients during the manufacturing process.  This strips you from good nutrients; pick whole-grain varieties of breads, pastas, rice, crackers, breakfast cereals and other foods.”.

Hackensack Meridian Health (https://www.hackensackmeridianhealth.org/en/healthu/2021/11/18/worst-foods-to-eat-for-your-health)

“It is now the standard of care in several countries for all pregnant women to be routinely tested for GBS with a vaginal/rectal swab test during the 36th or 37th week during each pregnancy unless their urine already cultured positive in the current pregnancy.  GBS colonization is transient which means that a woman could test negative, but be colonized later in pregnancy and vice versa.  GBS is a fast-acting type of bacteria so it is imperative that everyone who takes care of your baby knows the symptoms of possible GBS infection in babies and how to respond.  GBS is a leading cause of sepsis and meningitis in newborns according to the U.S Centers for Disease Control and Prevention (CDC).”.

Group B Strep International (https://www.groupbstrepinternational.org/july_gbs_awareness_month.html)

“Your appendix is a thin tube in your lower right abdomen. It sits where your small intestine meets your large intestine.

Your appendix is a 4-inch-long tube. It’s attached to the first part of your large intestine. Its exact function is unclear. Some people believe that it’s an evolutionary holdover that provides no benefits to your health.

This conventional wisdom has led to the widespread use of appendectomies to prevent and treat disease.”

Healthline

“A risk factor is anything that affects your chance of getting a disease such as cancer.