About Diseases Info

Adenovirus infection

noreply@blogger.com (Anonymous) — Sat, 19 Mar 2011 14:03:00 +0000

Adenovirus infections most commonly cause illness of the respiratory system; however, depending on the infecting serotype, they may also cause various other illnesses, such as gastroenteritis, conjunctivitis, cystitis, and rash illness. Symptoms of respiratory illness caused by adenovirus infection range from the common cold syndrome to pneumonia, croup, and bronchitis. Patients with compromised immune systems are especially susceptible to severe complications of adenovirus infection. Acute respiratory disease (ARD), first recognized among military recruits during World War II, can be caused by adenovirus infections during conditions of crowding and stress.

Asthma: what triggers it?

noreply@blogger.com (Anonymous) — Fri, 19 Jun 2009 04:00:00 +0000

Any number of environmental stimuli can trigger asthma attacks including air temperature, respiratory viruses, pollution, odors, certain foods such as sulfites, allergens, stress, chemicals, dust, and cigarette smoke (active or passive). Some asthmatics are allergic to aspirin and ibuprofen, especially those with the "allergic triad" of asthma, nasal polyps, and sinusitis.

Asthma may be genetically inherited or acquired, usually through a viral infection. Adults who are susceptible usually get asthma as a result of viral or respiratory infections. One of the leading causes of asthma in children is second-hand cigarette smoke. Although they may grow out of it, there is still a chance that asthma may reappear when they are adults.

Allergens

An allergen is a foreign substance, one your body does not produce, that causes you to have an allergic reaction. These allergens can be absorbed by your body through your airways, namely your nose and throat - you breathe them in. If you are asthmatic, you have particularly sensitive or extra-irritable airways that react to these allergens by becoming inflamed.

Infection

Viral infections, such as the common cold or flu, may bring on asthma attacks. If a bad flu develops into a severe bronchial infection and is left untreated, asthma may develop as a permanent condition.

Sinusitis is an inflammation of your nasal sinuses and often begins as an upper respiratory infection. Asthma may be aggravated by drainage of mucus into your nose, throat, and bronchial tubes. Symptoms of sinusitis in children include wheezing, postnasal drip, nighttime cough, and enlarged lymph nodes. Adolescents and adults may suffer headaches and sinus pressure and pain.

Weather

Cold and rainy days bring increased humidity, which causes a sudden temperature change. If you are asthmatic, these conditions can irritate and narrow your airways, which in turn can bring on coughing attacks and breathlessness.

Exercise

Cool, dry air, like that found in a gym or air conditioned exercise facility, can trigger an asthma attack in people who are susceptible. Rapid breathing in and out can also cause airway irritability because it dries the airways.

Long term, strenuous activities, such as long distance running, are most likely to induce an attack while swimming is least likely. This type of asthma is known as exercise induced asthma or exercise induced bronchospasm.

Work environment

Occupational asthma is a very real illness and can take months or years to manifest. Chemicals, such as isocyanates, can act as asthma triggers and are found in industries like insulation installation, spray painting, plastics, rubber and foam

manufacturing. Hydrochloric acid, sulfur dioxide, and ammo

nia, all used in the petroleum industries, also act as irritants. A

irborne fumes and irritants from factories, pulp mills, and sulfur dumps can trigger asthma attacks in people who live nearby.

ASTHMA Wheezing

noreply@blogger.com (Anonymous) — Fri, 19 Jun 2009 03:56:00 +0000

Asthma is a chronic lung condition. The airways become inflamed and swollen, causing them to narrow. Air can't move through the lungs as well as it should, making it difficult to breathe. For reasons we do not completely understand, asthma is becoming more common each year, especially in children.

Causes

The cause of asthma is poorly understood, but it may be partly inherited. Everyone's lungs are sensitive to different thing

s such as pollen, air pollution, or strong chemicals. In simple terms, people with asthma have lungs that are more sensitive than average.

There are three processes in the lungs that produce asthma symptoms. First, the inner linings of the airways become inflamed. They swell up, leaving less room for air to pass through. Second, the muscles around the airways can tighten, closing th

em further. Finally, the airways produce mucus in response to the inflammation, clogging the shrunken tubes.

Asthma is in part an allergic response. It maybe triggered by some external substance that particularly irritates your lungs. These triggers are often small protein particles called allergens. Some people are sensitive to more than one trigger. Common allergens include:

grass, tree, and ragweed pollen
molds
house dust mites
cockroach particles
animal dander

Other people can get an asthma attack from something they swallow rather than breathe. Examples of these triggers include:

aspirin* and other anti-inflammatory medications
preservatives found in some drinks or foods
nuts or shrimp

While most people develop asthma as children, adults can become asthmatic by being exposed to allergens for a long time. People who work with the following products may be at increased risk:

foams and paints
antibiotics
cotton and flax
detergents
grains and cereals
insulation and packaging materials

Asthma attacks can also be triggered by non-allergic irritants such as:

viral infections such as the common cold or the flu
laughing hard, crying, shouting
smog and smoke
strong smells (e.g., paint fumes, perfumes, cleaning products)
suddenly breathing cold air
vigorous exercise

Symptoms and Complications

Some children feel an itch on the back of the neck just prior to an asthma attack. Most people have some warning sign that they can learn to recognize. Some signs, like a sore throat, are obvious. Others, like dark circles under your eyes or a change in the color of your face, may go unnoticed.

Asthma varies in its severity. Some people experience asthma symptoms continuously while others experience symptoms only if exposed to triggers. Regardless of the severity, typical asthma symptoms include:

chest tightness
coughing
shortness of breath
wheezing

With more severe asthma, these symptoms may occur at night.

Wheezing is the best-known asthma symptom, but not everyone with asthma wheezes. Some people only have a cough that doesn't seem to go away.

A really severe asthma attack is life threatening. Even if some air is coming in, deadly carbon dioxide builds up in the blood. If you or a family member can't breathe and the normal medication isn't working, call an ambulance.

Appendicitis

noreply@blogger.com (Anonymous) — Tue, 26 May 2009 08:03:00 +0000

The Facts

A sudden inflammation or swelling of the appendix is called appendicitis. The appendix is a tube-like structure that branches off where the large intestine (colon) begins. It's pencil-thin and normally about 4 inches (7 cm) long. For many years, scientists were unsure of the function the appendix had in the body. Now we know it helps make immunoglobulins, substances that are part of the immune system. Immunoglobulins are made in many parts of the body. Thus, removing the appendix does not seem to result in problems with the immune system.

Appendicitis is rarely fatal these days, due to today's use of antibiotics and safe surgery. The condition affects one in 15 people and strikes men more than women. It hardly ever affects children under age three; it occurs most commonly between 10 and 30 years of age.

Causes

Inflammation of the appendix is usually the result of blockage causing an infection. The appendix is open at one end where it connects to the large intestine. Appendicitis may occur when the appendix is blocked by hardened masses of feces or a foreign body in the intestine. This blockage can cause inflammation of the appendix directly and can encourage bacterial infection.

Blockage may also occur if lymph nodes in the appendix swell. Less common causes of blockage are vegetable and fruit seeds, stomach worms, and thickened barium from prior X-rays.

In seniors, appendicitis is occasionally caused by a tumor (cancer) of the colon.

Symptoms and Complications

Early symptoms of acute appendicitis may include:

constipation, diarrhea, or gas
dull pain beginning around the navel, turning to sharp pain in the lower right portion of the abdomen - this takes place over about two hours
loss of appetite
low fever (99° to 102°)
nausea and vomiting
tenderness when pressed in the lower right front abdomen. Rebound tenderness is a good indicator of appendicitis - this means it hurts more when the finger is pulled back suddenly from the abdomen than it does when it is pressed forward

These are the classic symptoms common in adolescents and young adults. In younger children, pain is less localized, and there may be no tender points. In older adults, there is generally less pain.

Symptoms of more advanced appendicitis include:

abdominal swelling and rigidity
pain on the right side of the abdomen when pressed on the left side

These are both signs that inflammation has spread to the abdominal cavity or peritoneum. Left untreated, appendicitis will proceed from mild to severe symptoms. When the infection has reached this stage, it's called peritonitis, which is life-threatening, and a doctor should be seen immediately.

The great danger in appendicitis is rupture or perforation of the appendix. All the inflammatory agents and bacteria in the appendix spill out into the abdominal cavity, causing severe peritonitis. Sometimes there's mild peritonitis even before the appendix ruptures.

Occasionally, a mass of scar tissue forms an abscess around the appendix. In some ways, this reduces risk, since it insulates the abdomen from the dangerous pus inside. It tends to complicate surgery, however, often requiring two operations.

ChickenPOX-Varicella

noreply@blogger.com (Anonymous) — Wed, 20 May 2009 02:14:00 +0000

The Facts

Chickenpox is a very common illness caused by the varicella-zoster virus. It's extremely contagious. The rash that it produces is usually harmless and goes away on its own. While you can get chickenpox at any age, 90% of cases occur before the age of 14. Anyone who's had the disease once is immune for life, although they can still get shingles, a painful skin rash caused when the varicella-zoster virus becomes active again, even many years after you've had chickenpox.

Chickenpox usually occurs in late winter and early spring. Since the introduction of the chickenpox vaccine, many children never get chickenpox.

Causes

The varicella-zoster virus may be spread through the air or by direct contact with the blisters (lesions) of someone infected with chickenpox or shingles.

Once someone is infected, the virus usually incubates for 14 to 16 days before a rash appears although incubation can last from 10 days to 21 days. There are no symptoms during incubation and a person is contagious from one to two days before symptoms appear. The person remains contagious until all the blisters have dried and scabs have formed.

Symptoms and Complications

Flu-like symptoms start to develop a day or two before an itchy red rash appears. Fatigue, mild headache, fever, chills, and muscle or joint aches are typical. The rash emerges as raised red bumps that turn to teardrop-shaped blisters that are extremely itchy. These blisters may appear anywhere on the body, usually starting on the scalp, spreading to the trunk or torso, and then to the arms and legs. The face and hands are rarely affected heavily, though some people get rashes all over their body.

The blisters come in waves, with new crops developing as old ones burst. New blisters stop forming within about five days. By the sixth day, most blisters will have burst, dried, and crusted over. Two weeks after that, most of the scabs will have disappeared. Children usually have a much milder infection and recover faster than adults. Babies, adults, and those with weakened immune systems tend to have more severe and longer-lasting symptoms. They are at higher risk of developing complications, including inflammation of the brain (encephalitis) and pneumonia. There is a 30% death rate in newborns whose mothers develop chickenpox a few days before or after birth.

Children who have had the chickenpox vaccine can still get chickenpox. However, they usually have a much milder case with a smaller number of blisters.

Cellulitis (a skin infection from bacteria) is by far the most common complication in children. It may leave scarring, especially if the child scratches the lesions. Necrotizing fasciitis ("flesh-eating disease") in children, though extremely rare, can occur as a complication of infection entering through the chickenpox lesions. An awkward problem occurs when chickenpox blisters appear in the mouth, throat, or anus. Lesions in these places are very uncomfortable. If the rash gets near the eyes, consult your doctor.

Like many viruses, the varicella-zoster virus is never completely gone once it has entered your body. Anyone who's had chickenpox carries dormant viruses in the roots of their nerve cells. These can sometimes reappear years later as shingles, a painful skin rash which affects a particular area of skin.

Shingles can appear at times of emotional stress, or when the immune system is low. It's not always known what has provoked the virus to come out of hiding. It's important to know that the shingles rash can transmit chickenpox. People who have already had chickenpox are immune, but people who haven't can get it from other people's shingles.

High blood pressure: what is it?

noreply@blogger.com (Anonymous) — Sun, 17 May 2009 04:51:00 +0000

High blood pressure (or hypertension) is a condition in which the blood pressure in your arteries is higher than normal. High blood pressure doesn't usually present any symptoms until a vital organ is damaged. If left untreated, high blood pressure can lead to stroke, aneurysm, heart failure, heart attack, kidney damage, and other problems.

To check for high blood pressure, your systolic and diastolic pressures must be recorded. The systolic value, which is the higher value, is checked when your heart contracts. The diastolic value, or lower value, is checked when your heart relaxes, between beats. Blood pressure is written as the systolic pressure followed by a slash, followed by the diastolic pressure. For example: 120/80mm Hg (millimeters of mercury), or "one twenty over eighty."

High blood pressure is generally defined by a systolic pressure, that averages or is greater than 140 mm Hg; and by diastolic pressure that averages or is greater than 90 mm Hg. Recent studies, however, indicate that for many people even lower readings than 140/90 would be best.

Isolated Systolic Hypertension (ISH) occurs when your systolic pressure is 140 mm Hg or more but your diastolic pressure is less than 90 mm Hg - or in the normal range. Just as the risk of high blood pressure increases with age, so too does the risk of ISH.

Malignant hypertension is a severe and fairly rare form of very high blood pressure. If left untreated, malignant hypertension can lead to death, sometimes within three to six months. Malignant hypertension is considered a medical emergency.

In many people, the cause of high blood pressure is unknown, and the condition is referred to as essential or primary hypertension. It is likely that essential hypertension may have more than one cause, wherein several changes in the heart and blood vessels could combine to elevate the blood pressure.

When the cause of high blood pressure is known, it is referred to as secondary hypertension. Obesity, a sedentary lifestyle, stress, alcohol, smoking and bad diet - too much fat and salt - can all contribute to the development of high blood pressure, which can lead to heart disease, if left untreated.

If you have been diagnosed with high blood pressure, your doctor will also want to evaluate its effects on your blood vessels, heart, brain and kidneys, and other key organs.

Breast CANCER

noreply@blogger.com (Anonymous) — Sat, 16 May 2009 02:31:00 +0000

A woman's breast is made up of milk glands and milk ducts, surrounded by fatty tissue and connective supports. Uncontrolled growth of cells in any of these breast tissues can cause breast cancer.

Breast cancer is the most common cancer among women. It tends to occur at an earlier age than do other cancers or heart attacks and strokes. Chances of developing breast cancer rise dramatically as women age: at age 25, the chances of getting the disease are less than 1 in 1,000; at age 50, the incidence has gone up to 1 in 63 women, and at age 75, it's 1 in 15. Breast cancer is rare in men, accounting for about 3% of all cases.

Causes

The body's cells reproduce themselves throughout your lifetime, as tissues wear out and their cells are replaced in a controlled manner. Breast cancer - like all cancers - occurs when that control is lost, and cells begin to divide at an unusually high rate.

No single trigger or cause has been identified for breast cancer. Certain risk factors exist, though, that increase a woman's chance of developing it:

* age: it's more common in women over 50
* family history: if a woman's mother or sister had the disease before menopause, this is occasionally associated with one of two genes linked to breast cancer
* previous breast cancer
* family history of cervical, uterine, colorectal, or ovarian cancers
* age of pregnancy: women who haven't had children, or whose first child was born after age 30, run a slightly higher chance of breast cancer than women who had children before age 25
* age of menstruation: starting periods at a young age - under 12 years old - or entering menopause later - over age 55 - increases breast cancer risks
* recent research suggests that women who start smoking regularly within five years of the onset of their menstrual periods are 70% more likely to develop breast cancer before the age of 50 than non-smokers.
* alcohol consumption contributes to the risk of breast cancer, with women who consume three drinks a day having a 40% increased risk of this disease
* hormone replacement therapy (HRT - estrogen plus progesterone): increases the risk of breast cancer slightly after five years of therapy
* oral contraceptives: increase risks slightly, if used over many years
* obesity with excess caloric and fat intake

The increased risks of getting breast cancer associated with the above factors are often statistically quite small. Any concerns should be discussed with your doctor.

GLAUCOMA

noreply@blogger.com (Anonymous) — Fri, 15 May 2009 03:09:00 +0000

Glaucoma is part of a group of diseases of the optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy. Raised intraocular pressure is a significant risk factor for developing glaucoma (above 22mmHg). One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressure for years and yet never develop damage. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

Glaucoma can be divided roughly into two main categories, "open angle" or chronic glaucoma and "closed angle" or acute glaucoma. Angle closure, acute glaucoma appears suddenly and often with painful side effects and so is usually diagnosed quickly, although damage and loss of vision can also occur very suddenly. Open angle, chronic glaucoma tends to progress more slowly and so the patient may not notice it until the disease has progressed quite significantly.

Glaucoma has been nicknamed the "sneak thief of sight" because the loss of visual field often occurs gradually over a long time and may only be recognized when it is already quite advanced. Once lost, this damaged visual field can never be recovered. Worldwide, it is the second leading cause of blindness. Glaucoma affects one in two hundred people aged fifty and younger, and one in ten over the age of eighty. If the condition is detected early enough it is possible to arrest the development or slow the progression with medical and surgical means.

Symptoms

To begin with there may be no symptoms, so it is important to have regular eye checks to diagnose the disease. Patchy peripheral vision is sometimes noticed as the nerve cell layer is affected and there is often a loss of contrast sensitivity. A contrast sensitivity test should be performed along with a field test to measure visual loss. A field test has to be performed by an ophthalmologist or optometrist, but a contrast sensitivity test can be performed regularly at home. If any loss of contrast sensitivity is detected an eye specialist consultation is recommended. Symptoms may include pain in or behind the eye ball, headache and sensitivity to pressure.

Meningitis

noreply@blogger.com (Anonymous) — Wed, 13 May 2009 04:22:00 +0000

Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs.Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency.

The most common symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia). Sometimes, especially in small children, only nonspecific symptoms may be present, such as irritability and drowsiness. If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash.

A lumbar puncture may be used to diagnose or exclude meningitis. This involves inserting a needle into the spinal canal to extract a sample of cerebrospinal fluid (CSF), the fluid that envelops the brain and spinal cord. The CSF is then examined in a medical laboratory. The usual treatment for meningitis is the prompt application of antibiotics and sometimes antiviral drugs. In some situations, corticosteroid drugs can also be used to prevent complications from overactive inflammation. Meningitis can lead to serious long-term consequences such as deafness, epilepsy, hydrocephalus and cognitive deficits, especially if not treated quickly.Some forms of meningitis (such as those associated with meningococci, Haemophilus influenzae type B, pneumococci or mumps virus infections) may be prevented by immunization.

What is STROKE?

noreply@blogger.com (Anonymous) — Sun, 10 May 2009 01:42:00 +0000

Stroke is a type of cardiovascular disease. It affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it starts to die.

CT scan slice of the brain showing a right-hemispheric ischemic stroke (left side of image).

A stroke is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood supply) caused by thrombosis or embolism or due to a hemorrhage. As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech or inability to see one side of the visual field. In the past, stroke was referred to as cerebrovascular accident or CVA, but the term "stroke" is now preferred.

A stroke is a medical emergency and can cause permanent neurological damage, complications and death. It is the leading cause of adult disability in the United States and Europe. In the UK, it is the second most common cause of death, the first being heart attacks and third being cancer. It is the number two cause of death worldwide and may soon become the leading cause of death worldwide. Risk factors for stroke include advanced age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke.

A stroke is occasionally treated with thrombolysis ("clot buster"), but usually with supportive care (speech and language therapy, physiotherapy and occupational therapy) in a "stroke unit" and secondary prevention with antiplatelet drugs (aspirin and often dipyridamole), blood pressure control, statins, and in selected patients with carotid endarterectomy and anticoagulation.

SCHIZOPHRENIA

noreply@blogger.com (Anonymous) — Fri, 08 May 2009 11:21:00 +0000

Schizophrenia is a psychiatric diagnosis that describes a mental disorder characterized by abnormalities in the perception or expression of reality. Distortions in perception may affect all five senses, including sight, hearing, taste, smell and touch, but most commonly manifests as auditory hallucinations and to a lesser extent, visual hallucinations, which are typically accompanied by paranoid or bizarre delusions, or disorganized speech and thinking with significant social or occupational dysfunction.

Data from a PET study suggests that the less the frontal lobes are activated (red) during a working memory task, the greater the increase in abnormal dopamine activity in the striatum (green), thought to be related to the neurocognitive deficits in schizophrenia.

Symptoms

A person diagnosed with schizophrenia may demonstrate auditory hallucinations, delusions, and disorganized and unusual thinking and speech; this may range from loss of train of thought and subject flow, with sentences only loosely connected in meaning, to incoherence, known as word salad, in severe cases. Social isolation commonly occurs for a variety of reasons. Impairment in social cognition is associated with schizophrenia, as are symptoms of paranoia from delusions and hallucinations, and the negative symptoms of avolition (apathy or lack of motivation).

INFLUENZA

noreply@blogger.com (Anonymous) — Fri, 08 May 2009 09:54:00 +0000

Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses), that affects birds and mammals. The name influenza comes from the Italian influenza, meaning "influence" (Latin: influentia). The most common symptoms of the disease are chills, fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort.Fever and coughs are the most frequent symptoms.

In more serious cases, influenza causes pneumonia, which can be fatal, particularly for the young and the elderly. Although it is often confused with the common cold and other influenza-like illnesses, influenza is a much more severe disease and is caused by a different type of virus.Influenza may produce nausea and vomiting, particularly in children, but these symptoms are more common in the unrelated disease gastroenteritis, which is sometimes called "stomach flu" or "24-hour flu".

People who contract influenza are most infective between the second and third days after infection and infectivity lasts for around ten days.Children are much more infectious than adults and shed virus from just before they develop symptoms until two weeks after infection. The transmission of influenza can be modeled mathematically, which helps predict how the virus will spread in a population.

Influenza can be spread in three main ways: by direct transmission when an infected person sneezes mucus into the eyes, nose or mouth of another person; through people inhaling the aerosols produced by infected people coughing, sneezing and spitting; and through hand-to-mouth transmission from either contaminated surfaces or direct personal contact, such as a hand-shake.The relative importance of these three modes of transmission is unclear, and they may all contribute to the spread of the virus. In the airborne route, the droplets that are small enough for people to inhale are 0.5 to 5 µm in diameter and inhaling just one droplet might be enough to cause an infection.Although a single sneeze releases up to 40,000 droplets,most of these droplets are quite large and will quickly settle out of the air.How long influenza survives in airborne droplets seems to be influenced by the levels of humidity and UV radiation: with low humidity and a lack of sunlight in winter probably aiding its survival.

As the influenza virus can persist outside of the body, it can also be transmitted by contaminated surfaces such as banknotes,doorknobs, light switches and other household items. The length of time the virus will persist on a surface varies, with the virus surviving for one to two days on hard, non-porous surfaces such as plastic or metal, for about fifteen minutes from dry paper tissues, and only five minutes on skin. However, if the virus is present in mucus, this can protect it for longer periods. Avian influenza viruses can survive indefinitely when frozen.

introducing of diseases

noreply@blogger.com (Anonymous) — Fri, 08 May 2009 09:49:00 +0000

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs.^[1]^[2]^[3] It may be caused by external factors, such as invading organisms, or it may be caused by internal dysfunctions, such as autoimmune diseases.

In human beings, "disease" is often used more broadly to refer to any condition that causes extreme pain, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories.