Medical News Today: What to expect from a bronchoscopy

A bronchoscopy is a procedure that allows a doctor to examine the inside of the lungs, including the bronchi, which are the main pathways into the lungs.

During a bronchoscopy, a doctor inserts a thin tube containing a light and camera into the lungs through the nose or mouth. The doctor can use the findings to diagnose infections, tumors, or diseases in the lungs.

It is a relatively quick and painless procedure, it requires little preparation, and people tend to recover quickly.

In this article, we describe what to expect before, during, and after a bronchoscopy. We also discuss the uses of this procedure and associated complications.

Why is it used?

3D render of lungs.
A bronchoscopy can diagnose lung problems.

Doctors use bronchoscopy to detect the cause of breathing difficulties and lung problems, such as tumors, infection, and bleeding.

During the procedure, a doctor may also insert stents in the airways or take a biopsy, which involves removing a small sample of tissue for testing.

A doctor may recommend a bronchoscopy to:

  • follow up on a scan that has indicated a lung infection or tumor, or a collapsed lung
  • determine why someone is coughing up blood
  • find the cause of a chronic cough
  • discover the reason for shortness of breath
  • look for blockages in the airways
  • check for lung rejection, following a transplant
  • assess damage after someone has inhaled chemicals or toxic gases
  • take a biopsy

Doctors also use bronchoscopies to treat certain conditions, for example, by:

  • removing fluid, mucus plugs, or foreign objects in the airways
  • widening a blocked or narrowed airway
  • treating cancer
  • draining an abscess


Most people are awake during a bronchoscopy. Before the procedure, a doctor sprays a local anesthetic into the nose and throat to numb the area. Many people also take a sedative to help them relax.

Doctors only recommend a general anesthetic in rare cases, when they will be using a rigid bronchoscope.

Once the anesthetic takes effect, the doctor will usually insert a flexible bronchoscope tube through the nose and throat and into the bronchi. As the tube moves into the lungs, a person may feel a pressing or tugging sensation.

Some people initially cough or gag, but this usually subsides quickly. A doctor may administer oxygen throughout the procedure may to aid breathing.

The bronchoscope’s light and camera help the doctor to see the airways clearly, even around bends.

If a doctor needs to insert a stent or take a biopsy, they can pass brushes, needles, and other instruments through a channel in the bronchoscope. A stent is a small tube that helps to keep blocked or narrow airways open.

A doctor sometimes sprays a saline solution through the airways, in a process called bronchial washing, or lavage, to collect cells and fluids. The doctor will later examine them under a microscope.

During the bronchoscopy, a doctor may take an ultrasound, to get a clearer picture of the lymph nodes and tissues in and around the bronchi.

Once they are finished checking the airways, the doctor will remove the bronchoscope. The procedure usually takes 20–30 minutes, although times can vary, depending on the number of examinations and the underlying issue.

Most people can return home on the day of the procedure.

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How to prepare for a bronchoscopy

Doctor explaining something to patient.
A doctor will provide advice on preparing for a bronchoscopy.

Follow the doctor’s advice. They will often recommend that a person avoids eating or drinking for a specified period.

Discuss any current medications with the doctor, especially blood thinners such as aspirin or warfarin. The doctor may advise against taking some medications shortly before the procedure.

It is important to follow specific instructions, especially concerning medication use.

Arrange a ride to and from the hospital, because it is not safe to drive after taking sedatives. To allow time for recovery, it may be a good idea to organize help with work and childcare.

Recovery time

A bronchoscopy is a relatively quick and painless procedure. Afterward, a person will need to remain at the hospital for a few hours until the medications wear off. Blood pressure and breathing are monitored during this time to check for complications.

The ability to cough, called the cough reflex, should return within 2 hours. After this, it is safe to eat and drink again. After taking a sedative, a person should avoid driving, operating machinery, and drinking alcohol for 24 hours.

Most people can return to regular activities after 24 hours, but it is normal to have a sore throat and hoarseness for a few days.

Results and diagnosis

Immediately after the medications wear off, the doctor may share what they saw during the procedure. Other results, including those of a biopsy, can take several days or weeks to arrive.

Normal results of a bronchoscopy mean that the doctor did not see any foreign materials, blockages, or unusual cells or fluids in the bronchi.

If results are abnormal, the doctor will recommend further tests or treatments, depending on the outcome.

Abnormal results can indicate one or more of the following issues:

  • bacterial infection
  • viral infection
  • fungi or parasites
  • inflammation of lung tissue
  • lung damage
  • cancer
  • narrowing of the trachea or bronchi
  • rejection of a transplanted lung

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Risks and complications

Woman with fever and flu in bed.
Complications from a bronchoscopy may include a fever.

Bronchoscopy is usually safe, but there are certain risks.

There is a small chance that a person may develop:

  • an abnormal heartbeat, which is called an arrhythmia
  • breathing difficulties
  • fever
  • infection
  • low blood oxygen levels during the procedure
  • minor bleeding, especially after a biopsy
  • pneumonia

Also, a person with a history of heart conditions may have an increased risk of heart attack.

Rarely, a bronchoscopy can cause a lung to collapse, which is called pneumothorax. This happens if the lung is punctured during the procedure. It is more likely if a doctor is using a rigid rather than a flexible scope.

Pneumothorax is serious and requires treatment. A doctor may perform a chest X-ray after a bronchoscopy to check the lungs for signs of collapse.

When a person has general anesthesia, additional risks include:

  • blood pressure changes
  • muscle pain
  • nausea
  • a slow heart rate
  • vomiting


A bronchoscopy is a safe procedure with a low risk of serious complications. Mortality rates for both flexible and rigid bronchoscopy procedures are less than 0.1 percent.

Doctors commonly use local anesthesia and sedatives to keep individuals comfortable and relaxed during the examination.

Contact a doctor if any of the following symptoms arise after a bronchoscopy:

  • breathing difficulties
  • chest pain
  • coughing up blood
  • fever
  • a rapid heart rate

These symptoms can suggest complications that require medical treatment.

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Medical News Today: Are gut bacteria to blame for anxiety, depression in obesity?

Obesity brought on by a high-fat diet might be accompanied by changes in gut bacteria that alter brain chemistry in such a way as to promote anxiety and depression.
gut bacteria in pink
Gut bacteria (depicted here) could cause anxiety and depression among people with obesity.

This was the conclusion that researchers from the Joslin Diabetes Center of Harvard Medical School in Boston, MA, and colleagues came to after studying the link between gut microbes and brain function in mice with diet-induced obesity.

They report their findings in a paper that is now published in the journal Molecular Psychiatry.

In the paper, they note how giving the animals antibiotics — which changed the composition of their gut bacteria — reduced inflammation, improved “insulin signaling in the brain,” and reduced “signs of anxiety and depression.”

“What this study says,” says senior study author C. Ronald Kahn, a professor of medicine at Harvard University and co-head of the Section on Integrative Physiology and Metabolism at Joslin Diabetes Center, “is that many things in your diet might affect the way your brain functions, but one of those things is the way diet changes the gut bacteria or microbes.”

Obesity, diabetes, and gut microbes

Obesity and diabetes are serious public health problems across the globe. Since 1975, worldwide prevalence has almost tripled. Global figures for 2016 estimate that around 650 million people, or 13 percent of the world’s population, are obese.

Much of this obesity epidemic is fuelled by diets that are high in fat and “energy-dense foods,” along with reductions in physical activity.

Global rates of diabetes have also risen significantly in the past 30 years. In 1980–2014, they rose from 108 to 422 million.

The vast majority of cases are type 2 diabetes, which is driven largely by excess weight and lack of physical activity.

Our guts contain vast and complex populations of microbes that exert a significant influence on our health, especially through their effects on metabolism and immune function.

Diet is recognized as the main driver of gut microbe composition, as it is in both obesity and type 2 diabetes. This effect occurs throughout our lives, during which an average of 66 tons of food will pass through our guts.

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Probing link to mood disorders

In their study paper, the researchers note that diabetes and obesity “are associated with increased rates of anxiety and depression.”

In addition, symptoms of these mood disorders can be replicated in mice by feeding them on a diet that makes them obese.

The team considered whether the gut microbiome might be a factor in this relationship because other studies have revealed that changing the composition of gut bacteria in mice “can improve neurobehavior.”

In previous work, they had found that changes in gut bacteria were partly responsible for mice fed on high-fat diets becoming obese and developing diabetes and “related metabolic diseases.”

They also found that giving the animals antibiotics, which changed their gut bacteria, reversed these conditions.

In this new study, the researchers added a new feature to the previous set of experiments. After developing obesity and diabetes from being fed a high-fat diet, the mice underwent behavioral tests for anxiety and depression.

These tests were the same as those used in screening drugs for mood disorders.

Gut microbes and insulin resistance

The additional tests showed that mice fed on a high-fat diet had behaviors that were “reflective of increased anxiety and depression,” compared with mice that were fed a normal diet.

But, when the mice were given antibiotics in their drinking water, the levels of raised anxiety and depression disappeared and the animals’ behavior “returned to normal.”

Can the changes to gut microbe composition wrought by the antibiotics be responsible for the reduction in anxiety and depression behaviors?

To test this idea, the scientists transferred fecal samples, which are laden with gut bacteria, from the diet-induced obese and diabetic mice into the guts of germ-free mice.

The previously germ-free mice began to show raised levels of anxiety and depression behavior. However, this was not the case when they received antibiotics in addition to the gut bacteria.

Finally, examination of brain tissue showed that the high-fat diet had induced insulin resistance in the brain. Insulin resistance is a condition in which cells lose their ability to use insulin to convert glucose into energy and is a hallmark of type 2 diabetes.

“We demonstrated,” Prof. Kahn explains, “that just like other tissues of the body, these areas of the brain become insulin resistant in mice on high-fat diets.”

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Insulin resistance given to germ-free mice

He and his team also found that “this response to the high fat is partly, and in some cases almost completely, reversed by putting the animals by antibiotics.”

In addition, the researchers found that the insulin resistance in the brain transferred to the germ-free mice when they introduced gut microbes from the high-fat diet mice.

This shows, Prof. Kahn says, that the “the insulin resistance in the brain is mediated at least in part” by influence from the gut microbes.

The scientists also managed to pinpoint some of the chemical messengers in the brain that were involved in the process.

They now want to identify which microbes are responsible for these changes and, in particular, which of the molecules that they produce exert the most influence.

The idea is that this could lead to supplements or medications that promote “metabolic profiles” that improve brain health.

Your diet isn’t always necessarily just making your blood sugar higher or lower; it’s also changing a lot of signals coming from gut microbes and these signals make it all the way to the brain.”

Prof. C. Ronald Kahn

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Medical News Today: Everything you need to know about facial tics

A facial tic is an involuntary, uncontrolled spasm in the facial muscles. The tic is unwanted and generally occurs regularly enough to be a nuisance to the person who experiences it.

A person can hold in a tic temporarily, in a similar way to holding in a sneeze, but doing so often makes the person increasingly uncomfortable.

A few different disorders can cause facial tics, but most of the time facial tics do not indicate a severe medical condition.

According to a report in Pediatric Neurology, facial tics occur more commonly in children than adults, and boys seem to be much more likely to experience facial tics than girls. Most children’s facial tics fade after a few months.

What are facial tics?

Woman with facial tics covering her face with her hands.
It is possible to temporarily suppress a facial tic.

Facial tics are involuntary muscle movements that can happen anywhere in the face. However, they usually occur in the same place each time and happen frequently enough to bother the person. Severe tics can affect a person’s quality of life.

Common types of facial tics include:

  • rapid eye blinking or winking
  • squinting
  • flaring the nostrils
  • clicking the tongue
  • sucking the teeth
  • raising the eyebrows
  • opening and closing the mouth
  • scrunching the nose
  • mouth twitching

As well as these muscular tics, some people may also experience vocal tics, such as clearing the throat or grunting.

A person may suppress a tic temporarily, but it will come out eventually.

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Types of tic disorders

Different types of disorders can cause facial tics. The severity of the tic, as well as the presence of other symptoms, can often help a doctor identify the underlying condition.

Transient tic disorder

Transient tics are temporary. Transient tic disorder may cause a regular facial or vocal tic, but the tic typically lasts for under a year.

Transient tic disorder usually only causes tics while a person is awake. People rarely have tics while they are sleeping.

Transient tic disorder is responsible for the majority of causes of tics in children. They usually resolve without any treatment.

Chronic motor tic disorder

Chronic motor tic disorder is a more persistent tic disorder. For a doctor to diagnose a person with chronic motor tic disorder, they must have experienced tics for over a year, for periods of at least 3 months at a time.

Unlike transient tic disorder, chronic motor tic disorder causes tics that can also occur during sleep.

Chronic motor tic disorder can occur in both children and adults. Young children who have chronic motor tic disorder may not need treatment, as symptoms may be more manageable or subside on their own over time.

Adults who have the disorder may need medication or other treatment to control the tics.

Tourette’s syndrome

Doctors can often diagnose Tourette’s syndrome in children.

Tourette’s syndrome, often shortened to Tourette’s, is a chronic condition that causes one or more motor or vocal tics.

Most people who have Tourette’s syndrome develop it during childhood, but the disorder can continue into adulthood. Tics usually become less severe as the person ages.

People with Tourette’s syndrome have both motor and verbal tics. They may make sounds or say words involuntarily.

Some people with Tourette’s syndrome have only small motor tics, such as rapid blinking or throat clearing. However, they may also have more involved motor tics, such as:

  • shrugging one or both shoulders
  • shaking the head uncontrollably
  • flapping the arms
  • saying inappropriate words
  • making inappropriate gestures
  • yelling out

People can often manage symptoms of Tourette’s syndrome by having behavioral therapy. However, people who have any additional underlying conditions may need medication.


Treatment for facial tics can vary depending on the type and severity of the tic. Many tics, such as those caused by transient tic disorder, may go away without treatment over time.

Tics that interfere with performance in school or at work may require treatment. Long-lasting, chronic tics, such as those caused by Tourette’s syndrome, may need more extensive treatment.

Treatment for tics may include:


Medication for tics include classes of drugs called alpha-adrenergic agonists, neuroleptic drugs, and dopamine blockers.

In cases of persistent facial twitches or tics, doctors may recommend Botox injections. Botox injections can paralyze the facial muscles for a few months, which may be enough to stop a tic from coming back.

Medications can also help treat any underlying conditions causing the tic, such as Tourette’s syndrome or ADHD.


Doctors may recommend a person has regular sessions with a psychotherapist who can help the person find ways to change or eliminate the tics.

Behavioral modification and habit reversal techniques may help some people get over their tics and improve their quality of life.

The process typically involves teaching the person to identify when the tic is about to happen. Once a person can do this, the therapist will then encourage them to try to replace the tic with a different behavior.

Over time, this may help replace the physical habit with one that is less distracting or does not affect a person’s daily functioning.


Some surgical methods may help in severe cases of facial tics, such as those caused by Tourette’s syndrome.

One surgical therapy is called deep brain stimulation. Some scientists believe that by implanting electrodes in the brain, electrical currents can reach specific sections of the brain, which may help regulate brain waves and reduce tics.

A recent study found that deep brain stimulation may help relieve symptoms of Tourette’s syndrome, but more research is still required to pinpoint the best areas of the brain to stimulate.

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Natural remedies

Person sitting cross-legged and meditating.
Meditation and light exercise may treat tics.

Doctors may also recommend natural treatments for facial tics. Stress is believed to play a role in the development and persistence of tics, so natural remedies will involve reducing stress in the person’s life.

Stress-relieving activities include:

  • light exercises
  • imaginative play
  • yoga
  • meditation

Getting a full night’s rest is also crucial for people looking to reduce stress and find relief. Sometimes, a doctor may recommend counseling.

When to see a doctor

Often, facial tics are transient and will go away on their own. A person should see a doctor if they experience any tic that lasts longer than a year.

Anyone who experiences tics that are severe, persistent, or affect many different muscle groups should contact their doctor for a proper diagnosis.

It is not always possible to prevent facial tics, but many do not require treatment and subside on their own.

Treatments that can help people manage the tic are available for persistent tics. Learning stress relief techniques and seeing a therapist may also help some people.

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Medical News Today: Religious belief may extend life by 4 years

If you believe in a higher power, you may live longer, suggests a new study. Having religious faith may extend your life by as much as 4 years.
woman praying
Religion may hold unexpected health and longevity benefits.

Although the reason for this remains a mystery, it’s a known fact that women tend to live longer than men.

In the United States, women might live to 81.2 years, on average, whereas men have a life expectancy of just 76.4 years.

As well as sex, researchers are unearthing more and more factors that have the potential to prolong our lives.

Social interaction, having a pet, and walking faster have all been recently shown to boost one’s longevity.

Could religion have the same effect on our lifespan? New research suggests so. Researchers led by Laura Wallace, a doctoral researcher in psychology at the Ohio State University in Columbus, have conducted two studies whose results show that religion could give believers a 4-year longevity boost.

The findings were published in the journal Social Psychological and Personality Science.

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Religion boosts lifespan by up to 6.48 years

In the first study, Wallace and colleagues analyzed 505 obituaries published in the Des Moines Register between January and February 2012.

The second study analyzed 1,096 obituaries published online in 42 major cities across the U.S. between August 2010 and August 2011.

In both studies, the researchers accounted for sex and marital status, as well as the number of religious social activities the people had participated in.

The first study showed that religious believers lived 9.45 years longer than those who did not have a religious affiliation in their obituary.

After their sex and marital status had been accounted for, believers lived 6.48 years longer, on average, than non-believers.

In the second study, that gap was 5.64 years at first, then 3.82 years after considering sex and marital status.

Religious affiliation had nearly as strong an effect on longevity as gender does, which is a matter of years of life.”

Laura Wallace

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Why religion may promote health

As aforementioned, studies have highlighted the importance of social activities for longevity. Thus, Wallace and team wanted to verify that the longevity boost was not explained by the social and volunteer activities that the people had participated in.

“We found that volunteerism and involvement in social organizations only accounted for a little less than 1 year of the longevity boost that religious affiliation provided,” notes Wallace. “There’s still a lot of the benefit of religious affiliation that this can’t explain.”

The researchers speculate on potential reasons why religion gives a longevity boost. Baldwin Way, a co-author of the study and an associate professor of psychology at Ohio State University, says that religious believers may refrain from unhealthful practices such as drug and alcohol use.

Moreover, “many religions promote stress-reducing practices that may improve health, such as gratitude, prayer, or meditation,” the researcher adds.

While these are just hypotheses, one thing that the study did show with a fair degree of certainty was that conformity mediates the relationship between religion and longevity — that is, in cities where conformity was important, believers lived longer than non-believers.

The study provides persuasive evidence that there is a relationship between religious participation and how long a person lives.”

Baldwin Way

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Medical News Today: Everything you need to know about allergic eczema

Allergic eczema, also known as contact dermatitis, is a skin condition that occurs when a person’s skin comes into contact with an allergen.

Allergic eczema causes a red and itchy rash, which can become painful and infected without treatment.

In this article, learn about the causes and symptoms of allergic eczema, as well as the treatment options.

What is allergic eczema?

allergic eczema on mans wrist
Allergic eczema occurs when a person comes into contact with an allergen.

Allergic eczema is a form of eczema that occurs in response to contact with an allergen. An allergen is any substance to which a person may be allergic. It is commonly called contact dermatitis.

The primary symptom of allergic eczema and other eczema types is a dry, itchy rash. Some types of eczema may be painful or cause blisters to form.

Researchers do not fully understand why eczema occurs in some people and not others. However, there are specific environmental triggers, and it is likely that genetics also play a role.


A person can experience allergic eczema after touching an allergen, consuming something they are allergic to, or coming into contact with an airborne allergen, such as pollen.

Some of the most common causes of contact dermatitis include:

  • cocamidopropyl betaine, a detergent that manufacturers use to thicken shampoos, lotions, and soaps
  • fragrances
  • metals, such as chromium, cobalt, and nickel
  • paraphenylenediamine (PPD), a chemical that commonly occurs in hair dye
  • preservatives, such as formaldehyde
  • antibacterial ointments, including neomycin and bacitracin
  • antifungal or antibacterial products, such as methylisothiazolinone

Exposure to these allergens will not cause eczema in most people but may trigger a reaction in people with the condition.

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woman with rash on neck
PPD, a chemical common in hair dye, can cause contact dermatitis.

Symptoms of allergic eczema usually only occur in the area of the skin that comes into contact with the allergen. However, people who have severe reactions may notice the symptoms elsewhere.

The most common symptoms of allergic eczema include:

  • blistering
  • itching
  • burning
  • rash
  • redness
  • swelling

The hands are often the most vulnerable to allergic eczema symptoms because they are more likely to touch items that cause an allergic reaction.


According to the National Eczema Association, three types of contact dermatitis occur most frequently:

  • Allergic contact dermatitis: This condition occurs when a person’s skin comes into contact with an allergen, such as nickel, paint, hair dye, or flowers. The reaction may not occur until 48–96 hours after exposure.
  • Contact urticaria: This condition causes significant swelling and redness almost immediately after contact with an allergen. A person with contact urticaria can even experience an anaphylactic reaction, which is a severe reaction that causes breathing difficulties.
  • Irritant contact dermatitis: This condition causes skin inflammation when the skin comes into contact with an irritant, such as soap, friction, or heat. A person with a wound or atopic dermatitis is more likely to experience irritant contact dermatitis.


applying cream to eczema on hands
Applying a hydrocortisone cream to the affected skin can help relieve symptoms.

The best treatment for allergic eczema is prevention, which means avoiding any irritants known to cause the reaction.

Avoiding allergens can be difficult though, especially if a person comes into contact with them as a result of their occupation.

Other treatments for allergic eczema include:

  • applying an over-the-counter (OTC) hydrocortisone cream to reduce itching
  • moisturizing the skin at least twice daily with a fragrance-free moisturizer
  • taking antihistamines
  • taking oatmeal baths
  • wearing protective clothing and gloves when in contact with a known allergen

If a person has a severe allergic eczema reaction, which may involve extreme swelling with oozing and crusting, they should see their doctor. A doctor may prescribe an oral or topical antibiotic to prevent infection.

Another common treatment for allergic eczema is light therapy or phototherapy. Research has shown that exposure to special types of light can reduce eczema symptoms in some people. However, a person should only use phototherapy with a doctor’s prescription.

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Related conditions

There are several different types of eczema. In addition to allergic or contact dermatitis, other eczema varieties include:

  • Atopic dermatitis: Atopic dermatitis is a chronic skin condition that often begins in childhood. The condition causes dry skin, redness, itching, and cracking. People with a family history of asthma or hay fever (allergic rhinitis) are more likely to develop atopic dermatitis.
  • Dyshidrotic eczema: This eczema type causes small blisters, typically on the fingers, toes, and palms, and on the soles of the feet. Women are more likely to experience this condition than men. Dyshidrotic eczema is sometimes due to stress, moisture, or prolonged exposure to certain metals or chromium salts.
  • Nummular eczema: Nummular eczema causes coin-shaped, itchy, scaly spots to develop on the skin. Sometimes the affected areas can turn into open sores. The condition most often occurs after an insect bite.
  • Seborrheic dermatitis: This eczema type occurs where there are sweat glands, which are also called sebaceous glands. Dandruff, a dry, flaking scalp, is a common form of seborrheic dermatitis. People can also experience the condition on their face, back, or upper chest.
  • Stasis dermatitis: Also called venous eczema, stasis dermatitis occurs when a person has poor circulation to their lower legs. This causes excess fluid to leak from the veins, resulting in swelling, itching, scaling, and pain.


Allergic eczema or contact dermatitis is an itchy, irritating skin condition that occurs after exposure to certain allergenic substances. These reactions may occur immediately, or there may be a delay.

In addition to avoiding the allergen, a person can usually treat eczema with OTC creams, including topical hydrocortisone.

If a person has a severe reaction with open sores, they should see a doctor for antibiotics or prescription treatments.

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Medical News Today: Early risers have lower risk of depression, study finds

Do sleep-wake preferences influence our risk of depression? A new study confirms that they do, and “morning people” are on the winning side.
person enjoying sunrise
Are you up bright and early each day? You’ll be glad to learn that this may help to protect your mental health.

People’s chronotypes — that is, their sleep and waking preferences — could affect their well-being, studies have shown.

Whether we are early birds (early sleepers and risers) or night owls (late sleepers and risers) may affect our chance of developing mental health issues such as depression.

Researchers from the University of Colorado Boulder and the Channing Division of Network Medicine at Brigham and Women’s Hospital in Boston, MA, have decided to investigate the relationship between sleep-wake preferences and the risk of depression.

They did so by looking at the data of a set of participants from the Nurses’ Health Study II, a large, ongoing population study focused on identifying the risk factors for major chronic diseases in women.

“Our results show a modest link between chronotype and depression risk,” notes lead study author Céline Vetter. “This,” she adds, “could be related to the overlap in genetic pathways associated with chronotype and mood.”

This is the biggest and most thorough study into the link between mood disorders and chronotype conducted to date. The team’s findings are reported in the Journal of Psychiatric Research.

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Are early birds on the safe side?

In the new study, the researchers analyzed the relevant medical data of 32,470 female participants, aged 55 on average. All were depression-free at baseline, in 2009, and they reported any changes to their health status through questionnaires 2 years apart (in 2011 and 2013).

Vetter and team allowed for the impact of environmental factors, such as exposure to light and work schedule, on a person’s sleep-wake cycle. Other risk factors for depression — including weight, level of physical activity, existing chronic diseases, and sleep duration — were also accounted for.

Of all participants, 37 percent identified as early risers, 10 percent as “night owls,” and 53 percent as in-between these categories.

First, the researchers’ analysis revealed that late sleepers/late risers are more likely to live on their own and less likely to be married, as well as more likely to have a smoking habit and to report irregular sleep patterns.

Then, even after accounting for possible modifying factors, the team saw that “early birds” had a 12–27 percent lower risk of depression than “intermediate type” participants.

Also, “night owls” had a 6 percent higher risk of developing this mood disorder than “intermediate types,” though it should be noted that this risk increase is so mild it cannot be considered statistically significant.

According to Vetter, “This tells us that there might be an effect of chronotype on depression risk that is not driven by environmental and lifestyle factors.”

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Lifestyle factors vs. genetic factors

Genetic factors, however, may play a role in influencing our chronotypes, the researchers explain. Existing family studies have suggested that, to some extent, when we prefer to go to sleep and wake up is down to our genes.

Other studies have also linked certain genetic variants, such as RORA and PER2, to both sleep cycle regulation and the risk of depression.

But Vetter notes that many other factors that influence sleep patterns also influence depression risk, and it may be difficult to assess them individually. Nevertheless, she suggests that this is something that researchers need to pay more attention to.

Alternatively, when and how much light you get also influences chronotype, and light exposure also influences depression risk. Disentangling the contribution of light patterns and genetics on the link between chronotype and depression risk is an important next step.”

Céline Vetter

Also, though sleep-wake preferences may influence the risk of depression, Vetter stresses that this does not mean that people who are late sleepers and later risers will necessarily develop a mood disorder.

“Yes, chronotype is relevant when it comes to depression,” she continues, “but it is a small effect.”

Morever, Vetter says, individuals can take easy steps to modify their chronotype if they are worried that it impacts their well-being in a negative way.

“Being an early type seems to beneficial, and you can influence how early you are,” she says, going on to say that people should aim to maintain good sleep hygiene, get enough exercise, and make sure they benefit from as much natural daylight as they are able to.

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Medical News Today: What to know about Freon poisoning

Refrigerant poisoning can occur if a person inhales or consumes the chemicals — also known by the brand name of Freon — from cooling appliances, such as refrigerators and air conditioners.

Accidental refrigerant poisoning is rare but can occur when a person works directly with cooling chemicals. Poisoning is more common in people who use the substance as a recreational drug.

Mild exposure to Freon in a well-ventilated area is usually not serious, including having a small amount on the skin or having a localized leak in the home. However, if a person notices symptoms of refrigerant poisoning, they should contact their doctor or emergency service immediately.

In this article, learn about the symptoms of refrigerant poisoning, as well as how to treat and prevent it happening.

What is refrigerant poisoning?

Toxicity warnings on tubes of hazardous chemical substances.
Toxicity warnings on tubes of hazardous chemical substances.

Refrigerant poisoning happens when a person inhales chemicals used in cooling appliances.

Certain appliances, such as refrigerators, air conditioners, and freezers, contain chemicals called fluorinated hydrocarbons. People often refer to these chemicals as Freon, which is a leading brand name.

Freon is a dangerous substance. This almost odorless and tasteless gas can cause severe symptoms if a person inhales too much at once.

Because refrigerants cut off the oxygen supply, some people use the gas to get high. This is very dangerous, as breathing in refrigerants in high concentrations or large amounts can lead to death.

If a person suspects they have inhaled refrigerants accidentally, they should contact the emergency services immediately.

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Symptoms of refrigerant poisoning vary based on exposure. If exposure happens accidentally due to a leaking appliance in a well-ventilated area, poisoning is not likely to occur.

Accidental poisoning is rare. Most cases of poisoning occur due to intentional exposure when someone wants to get high, or they inhale the gas in an enclosed space.

Symptoms of mild to moderate refrigerant poisoning may include:

  • headache
  • irritation of eyes, ears, and throat
  • dizziness
  • frostbite if exposed to quickly expanding gas or liquid coolant
  • vomiting
  • chemical burn on the skin
  • nausea
  • coughing

Severe refrigerant poisoning can cause symptoms, including:

  • vomiting blood
  • breathing difficulties
  • loss of consciousness
  • bleeding or fluid buildup in the lungs
  • seizure
  • feeling of the food pipe burning
  • irregular heartbeat
  • confusion
  • coma or sudden death


Row of refrigerators at dump.
Accidental exposure can cause refrigerant poisoning.

The most common cause of refrigerant poisoning is substance abuse. Refrigerants are easy to obtain because of their low cost and use in many appliances.

A person may use a rag, a small container, bag, or an appliance soaked with refrigerant chemicals to get high.

Freon is one of several common inhalants used by teens and adults with the aim of getting a high from the fumes. Inhaled substances usually have short-lasting effects, so it is not uncommon for a person to inhale several deep breaths in a row to extend the high. Taking multiple breaths also substantially increases the chance of causing refrigerant poisoning.

Though not as common, it is possible to get refrigerant poisoning from accidental exposure. This is most likely to occur if a person works in a facility that uses refrigerants.

Accidental exposure may also occur from working on products that contain the chemicals.

It is not likely that a person will develop poisoning from a leaking home appliance, assuming it is in a well-ventilated area.

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It is vital to call the emergency service or Poison Control in the United States, which runs a 24-hour telephone guidance service for poisoning emergencies, if a person is showing signs of refrigerant poisoning.

If possible, a bystander should help a person move to a well-ventilated area or outdoors where they can get fresh air while waiting for the ambulance.

In the emergency room, doctors will monitor a person’s heart rate, breathing, and blood pressure.

Direct treatment will attempt to fix any internal or external damage from the poisoning.

Treatments the doctor may use include:

  • medication to treat symptoms or internal damage
  • oxygen through a breathing tube
  • removal or treatment of any burned skin
  • removal of liquid from the stomach, using a tube if ingested

There are currently no drugs available to treat the poisoning directly.

Also, doctors do not have a formal way to diagnose the condition, but they will administer treatment if they expect or can confirm exposure to refrigerants.


Spray cans on stone floor.
People abusing refrigerants may use spray cans to inhale the chemicals.

Preventing refrigerant poisoning focuses on stopping or preventing drug abuse.

People should secure any appliances that contain refrigerants and lock up refrigerants that are in storage so that they are not accessible unintentionally.

It is also crucial for parents, teens, and professionals who work with children to recognize the signs of inhalant abuse.

Signs of inhalant abuse include:

  • sudden weight loss
  • watery eyes
  • seeming to be drunk
  • slurred speech
  • loss of coordination
  • breath or clothing that smells of chemicals
  • hidden signs of abuse, such as chemical-soaked rags or empty spray cans
  • excitability
  • stains on a person’s face, hands, or clothing

Being educated about the dangers of refrigerant poisoning can also help stop people from inhaling coolant chemicals for the first time.

Even one-time use of coolant chemicals can cause death. Other complications that may occur due to inhaling coolant chemicals include:

  • depression
  • damage to the lungs, nerves, brain, or other vital organs
  • weight loss
  • loss of strength or coordination
  • irritability
  • psychosis
  • irregular and rapid heartbeat

If a person suspects someone they know is abusing refrigerants, they can call the Substance Abuse Treatment Facility Locator from the National Institute on Drug Abuse at 1-800-662-HELP (4357).

Alternatively, they may also visit for more information.

Behavioral health facilities can help treat a person’s addiction and help identify and treat any other underlying health problems, such as anxiety or depression.

To help prevent accidental poisoning, a person or company working with refrigerants can take steps to make their workplace safer.

People working with refrigerants should only do so in a well-ventilated area. They should also take precautionary measures to avoid exposure to the skin.

It is important for people working with refrigerants to following all guidelines and procedures. They should receive training on how to safely handle chemicals before using them.

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Deliberately inhaling refrigerants is very dangerous. It is possible for someone to die even if it is their first time using the substance. Damage to the lungs or brain can be irreversible.

If a person seeks medical attention immediately after accidental exposure, they have a better chance of recovering.

A person using refrigerants for recreational purposes can seek help from a doctor or drug abuse specialist.

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Medical News Today: Do eye wrinkles make us appear more sincere?

Following in the footsteps of Darwin, who first established facial expressions as a universal language, a recent study revealed that the wrinkles around a person’s eyes can portray how sincere or intense their emotions are.
Eye wrinkles
What do your eye wrinkles tell other people about you?

These new findings take us a step closer toward understanding facial expressions and how they relate to our understanding of emotion.

The research was conducted at the University of Western Ontario in London, Canada, in collaboration with investigators from the University of Miami in Coral Gables, FL.

The results were published recently in the journal Emotion.

Daniel Messinger, Ph.D. — a professor of psychology at the University of Miami — says, “Since Darwin, scientists have wondered if there is a language of facial expression. This research suggests one key to this language is constriction of the eyes.”

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Using the Duchenne smile marker

The Duchenne smile is essentially a “genuine” smile; it is named after the French physician Duchenne de Boulogne, who proved that smiles from “true happiness” involve not only the muscles of the mouth, but also the eyes.

The new study focused on the Duchenne marker, which is a measurement of eye wrinkles appearing in facial expressions. Using a method known as visual rivalry, study participants were shown photographs of facial expressions with and without the Duchenne marker.

Visual rivalry tests are designed to find which of two pictures the brain pays most attention to. They found that expressions including Duchenne markers were perceived as more important to our subconscious minds.

When the study group was asked to rate the scale of expressions, Duchenne expressions were also rated as more intense and sincere than their counterparts.

The expressions involving the Duchenne marker were always dominant. So if the emotion is more intense, your brain actually prefers to bring it into perceptual awareness for a longer time.”

Lead investigator Dr. Julio Martinez-Trujillo

Facial expression analysis

Truly understanding the relationship between facial expressions and emotions could lead to groundbreaking real-world applications. In fact, discoveries in the field have already led to initiatives and programs that help to teach people how to read emotion.

Dr. Martinez-Trujillo is interested in whether the results of the current study would be the same for those on the autistic spectrum. He explains:

“When you have social interactions you need to perceive whether a person is sincere or not. So my interest now is, what will be the results if we do this same test with people with autism spectrum disorder. They often have trouble reading out emotions from other people, so we wonder if that might have to do with their ability to read this marker for sincerity.”

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Researchers have been investigating facial expressions for more than 100 years. Darwin’s study in 1872 is regarded as the most significant contribution, being the first to suggest that facial expressions are universal.

He deduced that emotions and their expressions were biologically innate and evolutionarily adaptive, and that similarities can be seen in closely related species.

Arguably the most significant smile-focused study was conducted in 1989 by psychologist Robert Zajonc, who asked subjects to repeat vowel sounds that forced their faces into smiles or pouty expressions. Zajonc’s study proved that even a fake smile can induce a feeling of happiness.

This new study is an interesting development in the field of facial expression analysis.

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A universal language for reading emotions

Ultimately, this study proved that eye wrinkles represent and communicate sincere emotions. First study author Nour Malek, Ph.D., says, “These findings provide evidence of a potential universal language for reading emotions.”

“In other words,” she continues, “a given facial action may have a single role across multiple facial expressions — especially if that facial action shapes your social interactions.”

“For example,” Malek concludes, “knowing if a stranger’s smile is genuine and whether that person can be trusted, warns you whether you should evade or not.”

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Medical News Today: What to know about ischemic colitis

Ischemic colitis occurs when there is not enough blood flowing to the colon, also known as the large intestine. It is more likely to occur in people who are over 60, smoke cigarettes, or have diabetes.

Ischemic colitis is the most common type of gut-based ischemia, accounting for 1 in every 2,000 hospital admissions.

Symptoms of ischemic colitis include pain, tenderness, and digestive problems. It is often mistaken for irritable bowel disease (IBD) or other gastrointestinal issues.

The condition can develop over time (chronic) or come on suddenly (acute). Sometimes, chronic ischemic colitis can heal on its own, but some people may still need treatment to prevent infection or colon damage.

Ischemic colitis that comes on suddenly is considered a medical emergency and requires urgent care.

This article describes the causes and symptoms of ischemic colitis, along with the available treatment options.


Ischemic colitis
A person with ischemic colitis will usually experience stomach cramping and pain.

The most typical symptom of ischemic colitis is stomach cramping and pain. The pain may be mild or moderate, and it often occurs suddenly. Typically, pain occurs on the left side of the abdomen.

Some people may notice blood in their stool, but excessive bleeding suggests another condition, such as Crohn’s disease or cancer.

Other symptoms of ischemic colitis include:

  • stomach pain after meals
  • tenderness in the stomach
  • an urgent need to pass stool
  • diarrhea
  • vomiting
  • nausea

The risk of complications is higher when symptoms develop on the right side of the stomach, and pain in this area may be more severe as well. Pain on the right side suggests a blockage in the arteries leading to the small intestine as well as the colon.


A lack of blood flow to the colon causes ischemic colitis. This lack of blood flow (ischemia) can occur for many reasons.

In people with coronary artery disease (CAD) or peripheral vascular disease (PVD), inadequate blood supply may result from a hardening of the mesenteric arteries that lead to the intestines.

Other factors that contribute to ischemic colitis include:

  • blood clots in the arteries leading to the intestines
  • severely low blood pressure (hypotension)
  • bowel obstructions due to scar tissue, tumors, or hernias
  • conditions that affect the blood, including vasculitis and sickle cell anemia
  • surgical procedures that involve the heart, blood vessels, colon, or surrounding areas
  • use of cocaine or methamphetamines
  • colon cancer, in rare cases

Rarely, medications can cause ischemic colitis, including:

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Risk factors

Ischemic colitis is more common amongst the elderly
People over the age of 60 are most at risk of ischemic coiltis, as their arteries harden with age.

Certain factors increase a person’s chance of developing ischemic colitis. These include:

Age. Adults over the age of 60 are most at risk, possibly because arteries tend to harden with age.

Clotting abnormalities. Disorders such as Factor V Leiden increase the risk of blood clots.

Other medical conditions. Diabetes, congestive heart failure, and low blood pressure all increase the risk of ischemic colitis.

Prior surgery. People who have previously had surgery involving the aorta or abdomen are at higher risk than others of developing ischemic colitis.

Heavy exercise. Engaging in strenuous activities, such as running a marathon, can limit blood flow to the colon.


Treatment for ischemic colitis depends on its severity.

Mild cases may resolve within a few days. If treatments are required, they include:

  • antibiotics, to prevent infection
  • a liquid diet
  • intravenous fluids, to prevent dehydration
  • medication for pain relief

Other ways to manage the condition include:

  • treating underlying medical conditions, including diabetes and congestive heart failure
  • avoiding medications that cause vasoconstriction (narrowing of the blood vessels)

Acute ischemic colitis is a medical emergency. Treatments include medications such as thrombolytic drugs for blood clots or vasodilators to widen narrow arteries.

Typically, follow-up colonoscopies are performed to check for healing and complications.

Severe ischemic colitis that does not respond to other treatments may require surgery. An estimated 20 percent of people with the condition will need some form of surgical intervention.

Those with underlying medical conditions are more likely to need surgery.

Surgeons may operate to:

  • repair damage to the colon
  • bypass a blockage in the mesenteric arteries
  • remove scar tissue


Ischemic colitis ultrasound scan
An ultrasound scan can help to diagnose ischemic colitis in a person.

Ischemic colitis shares symptoms with other digestive disorders, particularly inflammatory bowel diseases, which include Crohn’s disease and ulcerative colitis. This can make diagnosis more complicated.

After taking a medical history, a doctor may order imaging tests to confirm a diagnosis and rule out other conditions. Imaging tests used to diagnose ischemic colitis include:

  • Ultrasound or abdominal CT scan. Both ultrasound and CT scans allow doctors to see images of the colon and intestines.
  • Mesenteric angiogram. A mesenteric angiogram test uses X-rays to detect blockages inside the arteries that supply the intestines with blood.

Other diagnostic tests include:

    • Blood test. If a blood test shows a high white blood cell count, it suggests acute ischemic colitis.
    • Stool analysis. A stool sample can help identify if an infection is causing the symptoms.
    • Colonoscopy. A colonoscopy involves inserting a flexible tube into the rectum to the colon. The tube has a light and a camera that allow the doctor to see images of the colon.

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The most serious complication of ischemic colitis is gangrene (tissue death). Gangrene results from a loss of blood flow to the tissue and can be life-threatening. People who experience gangrene need surgery to remove the blockage and damaged tissue.

Other complications include:

  • a hole, or perforation, in the intestine
  • bowel obstruction called ischemic stricture
  • bowel inflammation called segmented ulcerating colitis
  • peritonitis, which is an inflammation of the abdominal lining
  • sepsis, a potentially fatal bacterial infection that spreads through the bloodstream


Most people with chronic ischemic colitis recover with medication, and those experiencing severe ischemic colitis can have surgery. People may need to make some lifestyle changes to prevent the condition from returning.

Examples of helpful lifestyle changes include quitting smoking, exercising regularly, and eating a balanced diet. People may need to stop taking medications that contribute to ischemic colitis, with a doctor’s advice.

Acute ischemic colitis has a poorer outlook and a higher mortality rate than chronic ischemic colitis because it often causes gangrene. Swift medical treatment is crucial in acute cases.

People who experience symptoms of ischemic colitis should see a doctor promptly to improve the outlook and reduce the risk of complications. People should not ignore bloody stools. Seek emergency medical attention for severe abdominal pain that makes it difficult to sit down or get comfortable.

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Medical News Today: Toxic synovitis: Causes and symptoms

Toxic synovitis, also called transient synovitis or irritable hip, is a condition that causes inflammation and pain in the hip. It primarily affects children.

A child with toxic synovitis may limp, complain of hip and leg pain, or otherwise be reluctant to walk. The condition is not contagious and usually clears up within 2 weeks.

In this article, learn more about the symptoms of toxic synovitis. We also look into the treatment options and whether it can occur in adults.

What is toxic synovitis?

person pointing of x-ray of hip joint with pen.
Toxic synovitis usually affects the hip joints.

Toxic or transient synovitis is a temporary condition that causes pain and inflammation of a joint, almost always in the hip. It usually affects children.

Although symptoms can start suddenly and alarm caregivers, toxic synovitis typically clears up within 1–2 weeks. Some cases last as long as 5 weeks. It does not usually cause any long-term complications.

Toxic synovitis primarily affects children, and it may also occur in adults. However, adult cases are rare and have not been documented well. It is more likely that these adults developed septic arthritis, which can be confused with toxic synovitis.

Septic arthritis can cause similar pain in the hip joint. However, bacterial infection causes this condition, and it can lead to permanent damage if a person does not receive treatment.

Who gets toxic synovitis?

The condition is most common in children between the ages of 3 and 8. It can occur at any age, but it is very unlikely to appear in adults.

Toxic synovitis is more prevalent in boys than girls.

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The most common symptom is the sudden occurrence of hip or leg pain on one side of the body. The pain typically causes a limp.

Other symptoms of toxic synovitis include:

  • walking on tiptoes
  • unintentionally turning the legs out
  • crying (in young children)
  • a low-grade fever
  • complaining about hip discomfort after sitting or resting for a long time
  • having a recent viral infection
  • having pain with walking
  • not wanting to walk
  • having pain in knee or thigh

In infants, the signs may include:

  • crying when moving the hips
  • abnormal crawling
  • unexplained crying

Toxic synovitis is unlikely to occur in adults, but they can develop septic arthritis. This primarily causes pain and swelling in a single joint, possibly in the knee, elbow, or hip.

Additional symptoms of septic arthritis include:

  • redness and swelling in the joint
  • intense pain in the joint
  • loss of mobility in the joint
  • fever and chills


Man with cold blowing nose into tissue.
Toxic synovitis often occurs after a viral infection.

Doctors are still uncertain about the exact cause of toxic synovitis, but it often occurs following a viral infection, such as those that cause diarrhea or a cold.

Because of this, there is a suspicion that the child’s immune system creates something while fighting the infection that then causes toxic synovitis.

In cases of septic arthritis, a person develops joint pain following bacterial or fungal infection. The infection often spreads to the joint from another part of the body.


Toxic synovitis can be difficult to diagnose because a doctor must first rule out other conditions. Conditions with similar symptoms include:

  • septic arthritis
  • slipped capital femoral epiphysis (SCFE)
  • Legg-Calvé-Perthes disease, which causes insufficient oxygen to reach the hip, leading to its collapse
  • unrecognized trauma or musculoskeletal pain

A doctor usually asks about the child’s symptoms, then conducts a physical examination. During this, they move the joints of the legs around, to confirm the location of the pain.

A doctor may also order an ultrasound of the hip. This allows them to look for inflammation and fluid in the joint.

A blood test can show the extent of swelling and some signs of bacterial infection. An X-ray can help the doctor to rule out both SCFE and Legg-Calvé-Perthes disease.

Diagnosing adults

A doctor conducts a physical examination. To rule out septic arthritis, they may also take a sample of fluid from the joint.

The doctor will also take a culture sample to check for bacteria that indicate septic arthritis.

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Woman tipping medication into palm.
A doctor may prescribe anti-inflammatory medication to treat toxic synovitis.

Rest is a crucial part of treating toxic synovitis. A child should avoid strenuous physical activity and try not to move around too much when diagnosed.

A doctor will likely prescribe or recommend anti-inflammatory medications, such as ibuprofen and naproxen. These can reduce the inflammation in the joint, helping the child to walk more comfortably.

Over-the-counter medications are often sufficient, but if the child continues to experience discomfort, the doctor may prescribe a stronger dosage.


A child should fully recover within 1–2 weeks. In some cases, it may take up to 5 weeks. While recovering, a child should avoid strenuous activities, including physical activity during recess, after-school sports, and gym class.

If symptoms do not clear up, return to the doctor. They may need to run additional tests and rule out other conditions.

Recurrence rates

Toxic synovitis causes no long-term complications. However, some children develop it multiple times.

Authors of one review found that the recurrence rate for toxic synovitis was 0–26 percent in their sample of studies.

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A child with toxic synovitis who receives basic treatment will usually make a full recovery within 2 weeks.

It is essential to see a doctor for a proper diagnosis so that they can rule out more serious conditions. This is an especially good idea if the child:

  • is younger than 3 or older than 8
  • has a high fever
  • refuses to walk
  • otherwise appears to be ill

Adults are unlikely to develop toxic synovitis. They can develop septic arthritis, which feels similar. This condition can be severe and lead to permanent damage if a person does not receive treatment.

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