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Zoophobia, or animal phobia, is the irrational fear or aversion towards animals (excluding humans). Zoophobia is the general negative reaction to animals, but it is usually divided into many subgroups, each being of a specific type of zoophobia. Although zoophobia as a whole is quite rare, types of the fear are common. As mentioned before by Sigmund Freud, an animal phobia is one of the most frequent psychoneurotic diseases among children. Zoophobia is almost never towards mammals, but instead towards non-mammalia creatures. A list of common zoophobias is shown below.

Ailurophobia- fear of cats

Arachnophobia- fear of arachnids

Batrachophobia- fear of amphibians

Chiroptophobia- fear of bats

Cynophobia- fear of dogs

Entomophobia- fear of insects

Equinophobia- fear of horses

Ichthyophobia- fear of fish

Lepidopterophobia- fear of butterflies and/or moths

Melissophobia- fear of bees

Musophobia- fear of mice and rats

Ophidiophobia-fear of snakes

Ornithophobia- fear of birds

Ostraconophobia- fear of shellfish

Ranidaphobia- fear of frogs

Vermiphobia- fear of worms

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Abdominal aortic aneurysm (AAA)

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Abdominal aortic aneurysm (AAA) screening is a way of checking if there's a bulge or swelling in the aorta, the main blood vessel that runs from your heart down through your tummy.

This bulge or swelling is called an abdominal aortic aneurysm, or AAA.

It can be serious if it's not spotted early on because it could get bigger and eventually burst (rupture).

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Who's screened for AAA

In England, screening for AAA is offered to men during the year they turn 65.

Men aged 65 or over are most at risk of getting AAAs. Screening can help spot a swelling in the aorta early on when it can usually be treated.

Screening for AAA is not routinely offered to:

women

men under 65

people who have already been treated for an AAA

This is because the risk of getting an AAA is much smaller in these groups.

If you're over 65 years old, you can ask for a scan to check for an AAA if you think you might need one but have not been offered a screening test.

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How to get screened for AAA

If you're a man and registered with a GP, you'll get a screening invitation in the post when you're 64 or soon after your 65th birthday. You can then arrange an appointment that suits you.

If you're a man over 65 and have not been screened before, you can ask for a test by contacting your local AAA screening service directly.

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Benefits of AAA screening

An AAA will often cause few or no obvious symptoms, but if it's left to get bigger, it could burst and cause life-threatening bleeding inside your tummy.

About 8 in every 10 people who have a burst AAA die before they get to hospital or do not survive emergency surgery to repair it.

Screening can pick up an AAA before it bursts. If an AAA is found, you can choose to have regular scans to monitor it or surgery to stop it bursting.

The screening test is very quick, painless and reliable. Research suggests it can halve the risk of dying from an AAA.

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Deciding to be screened

It's up to you to decide if you want to be screened for AAA.

While there are clear benefits of screening, you should also consider the possible risks.

There's no risk from the screening test itself, but there's a risk of:

anxiety from being told you have a potentially life-threatening condition

serious complications of surgery carried out to treat an AAA

Call your local screening service and ask to be removed from its list if you do not want to be screened.

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What happens during AAA screening

Screening for AAA involves a quick and painless ultrasound scan of your tummy.

This is similar to the scan pregnant women have to check on their baby.

When you arrive for your appointment, a screening technician will check your details, explain the scan and ask if you have any questions.

For the scan:

you lie down on a table and lift up or unbutton your top (you do not need to undress)

the technician rubs a clear gel on your tummy and moves a small handheld scanner over your skin – pictures from the scanner are shown on a monitor and the technician will measure how wide your aorta is

the gel is wiped away and you pull down or button up your top

the technician tells you the result straight away

The whole test usually takes about 10 to 15 minutes.

Sometimes the technician might not be able to see your aorta clearly. This is not anything to worry about.

If this happens, you'll be asked to have another scan, usually on a different day.

Results of AAA screening

You'll be told your result at the end of the test.

If a problem is found, you'll also be a sent letter confirming the result and letting you know what happens next.

There are 4 possible screening results.

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No aneurysm found

If your aorta is less than 3cm wide, this means it's not enlarged. Most men have this result.

You will not need to have any treatment or monitoring afterwards, and will not be invited for AAA screening again.

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Small AAA

If you have a small AAA, this means your aorta measures 3cm to 4.4cm across.

Just over 1% of men screened have a small AAA.

You will not need any treatment at this stage as the chance of the AAA bursting is small.

You'll be invited back for a scan every year to check its size.

Treatment will usually only be needed if it becomes a large AAA.

You'll also be given advice on how you can stop an AAA getting bigger, such as stopping smoking, eating healthily and exercising regularly.

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Medium AAA

If you have a medium AAA, this means your aorta measures 4.5cm to 5.4cm across.

About 0.5% of men screened have a medium AAA.

You will not need any treatment at this stage as the chance of the AAA bursting is small.

You'll be invited back for a scan every 3 months to check its size.

Treatment will usually only be needed if it becomes a large AAA.

You'll also be given advice on how you can stop an AAA getting bigger, such as stopping smoking, eating healthily and exercising regularly.

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Large AAA

If you have a large AAA, this means your aorta measures 5.5cm or more across.

About 0.1% of men screened have a large AAA.

As large AAAs have the highest risk of bursting if left untreated, you'll be referred to a specialist surgeon within 2 weeks to talk about your treatment options.

Most men with a large AAA are advised to have surgery to stop it getting bigger or bursting.

While surgery carries a risk of serious complications, this is generally smaller than the risk of not treating a large AAA.

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Resources

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I̳n̳t̳e̳r̳s̳e̳x̳

Intersex is a general term used for a variety of situations in which a person is born with reproductive or sexual anatomy that doesn't fit the boxes of “female” or “male.” Doctors do surgeries on intersex babies and children to make their bodies fit binary ideas of “male” or “female”.

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C̳a̳u̳s̳e̳s̳

Intersex can be divided into 4 categories:

46, XX intersex

46, XY intersex

True gonadal intersex

Complex or undetermined intersex

Each one is discussed in more detail below

In many children, the cause may remain undetermined

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4̲6̲, X̲X̲ I̲N̲T̲E̲R̲S̲E̲X̲

The person has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male. This most often is the result of a female fetus having been exposed to excess male hormones before birth. The labia ("lips" or folds of skin of the external female genitals) fuse, and the clitoris enlarges to appear like a penis. In most cases, this person has a normal uterus and fallopian tubes. This condition is also called 46, XX with virilization. It used to be called female pseudohermaphroditism. There are several possible causes:

Congenital adrenal hyperplasia (the most common cause).

Male hormones (such as testosterone) taken or encountered by the birthgiver during pregnancy.

Male hormone-producing tumors in the mother: These are most often ovarian tumors. Mothers who have children with 46, XX intersex should be checked unless there is another clear cause.

Aromatase deficiency: This one may not be noticeable until puberty. Aromatase is an enzyme that normally converts male hormones to female hormones. Too much aromatase activity can lead to excess estrogen (female hormone); too little to 46, XX intersex. At puberty, these XX children, who had been raised as girls, may begin to take on male characteristics.

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4̲6̲, X̲Y̲ I̲N̲T̲E̲R̲S̲E̲X̲

The person has the chromosomes of a man, but the external genitals are incompletely formed, ambiguous, or clearly female. Internally, testes may be normal, malformed, or absent. This condition is also called 46, XY with undervirilization. It used to be called male pseudohermaphroditism. Formation of normal male external genitals depends on the appropriate balance between male and female hormones. Therefore, it requires the adequate production and function of male hormones. 46, XY intersex has many possible causes:

Problems with the testes: The testes normally produce male hormones. If the testes do not form properly, it will lead to undervirilization. There are a number of possible causes for this, including XY pure gonadal dysgenesis.

Problems with testosterone formation: Testosterone is formed through a series of steps. Each of these steps requires a different enzyme. Deficiencies in any of these enzymes can result in inadequate testosterone and produce a different syndrome of 46, XY intersex. Different types of congenital adrenal hyperplasia can fall in this category.

Problems with using testosterone: Some people have normal testes and make adequate amounts of testosterone, but still have 46, XY intersex due to conditions such as 5-alpha-reductase deficiency or androgen insensitivity syndrome (AIS).

People with 5-alpha-reductase deficiency lack the enzyme needed to convert testosterone to dihydrotestosterone (DHT). There are at least 5 different types of 5-alpha-reductase deficiency. Some of the babies have normal male genitalia, some have normal female genitalia, and many have something in between. Most change to external male genitalia around the time of puberty.

AIS is the most common cause of 46, XY intersex. It has also been called testicular feminization. Here, the hormones are all normal, but the receptors to male hormones don't function properly. There are over 150 different defects that have been identified so far, and each causes a different type of AIS.

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T̲R̲U̲E̲ G̲O̲N̲A̲D̲A̲L̲ I̲N̲T̲E̲R̲S̲E̲X̲

The person must have both ovarian and testicular tissue. This may be in the same gonad (an ovotestis), or the person might have 1 ovary and 1 testis. The person may have XX chromosomes, XY chromosomes, or both. The external genitals may be ambiguous or may appear to be female or male. This condition used to be called true hermaphroditism. In most people with true gonadal intersex, the underlying cause is unknown, although in some animal studies it has been linked to exposure to common agricultural pesticides.

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C̲O̲M̲P̲L̲E̲X̲ O̲R̲ U̲N̲D̲E̲T̲E̲R̲M̲I̲N̲E̲D̲ I̲N̲T̲E̲R̲S̲E̲X̲ D̲I̲S̲O̲R̲D̲E̲R̲S̲ O̲F̲ S̲E̲X̲U̲A̲L̲ D̲E̲V̲E̲L̲O̲P̲M̲E̲N̲T̲

Many chromosome configurations other than simple 46, XX or 46, XY can result in disorders of sex development. These include 45, XO (only one X chromosome), and 47, XXY, 47, XXX - both cases have an extra sex chromosome, either an X or a Y. These disorders do not result in a condition in which there is a discrepancy between internal and external genitalia. However, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes.

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S̳y̳m̳p̳t̳o̳m̳s̳

The symptoms associated with intersex will depend on the underlying cause. They may include:

Ambiguous genitalia at birth

Micropenis

Clitoromegaly (an enlarged clitoris)

Partial labial fusion

Apparently undescended testes (which may turn out to be ovaries) in boys

Labial or inguinal (groin) masses (which may turn out to be testes) in girls

Hypospadias (the opening of the penis is somewhere other than at the tip; in females, the urethra [urine canal] opens into the vagina)

Otherwise unusual-appearing genitalia at birth

Electrolyte abnormalities

Delayed or absent puberty

Unexpected changes at puberty

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E̳x̳a̳m̳s̳ a̳n̳d̳ T̳e̳s̳t̳s̳

The following tests and exams may be done:

Chromosome analysis

Hormone levels (for example, testosterone level)

Hormone stimulation tests

Electrolyte tests

Specific molecular testing

Endoscopic exam (to verify the absence or presence of a vagina or cervix)

Ultrasound or MRI to evaluate whether internal sex organs are present (for example, a uterus)

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T̳r̳e̳a̳t̳m̳e̳n̳t̳

Ideally, a team of health care professionals with expertise in intersex should work together to understand and treat the child with intersex and support the family.

Parents should understand controversies and changes in treating intersex in recent years. In the past, the prevailing opinion was that it was generally best to assign a gender as quickly as possible. This was often based on the external genitals rather than the chromosomal gender. Parents were told to have no ambiguity in their minds as to the gender of the child. Prompt surgery was often recommended. Ovarian or testicular tissue from the other gender would be removed. In general, it was considered easier to reconstruct female genitalia than functioning male genitalia, so if the "correct" choice was not clear, the child was often assigned to be a girl.

More recently, the opinion of many experts has shifted. Greater respect for the complexities of female sexual functioning has led them to conclude that suboptimal female genitalia may not be inherently better than suboptimal male genitalia, even if the reconstruction is "easier." In addition, other factors may be more important in gender satisfaction than functioning external genitals. Chromosomal, neural, hormonal, psychological, and behavioral factors can all influence gender identity.

Many experts now urge delaying definitive surgery for as long as is healthy, and ideally involving the child in the gender decision.

Clearly, intersex is a complex issue, and its treatment has short- and long-term consequences. The best answer will depend on many factors, including the specific cause of the intersex. It is best to take the time to understand the issues before rushing into a decision. An intersex support group may help acquaint families with the latest research, and may provide a community of other families, children, and adult individuals who have faced the same issues.

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S̳u̳p̳p̳o̳r̳t̳ G̳r̳o̳u̳p̳s̳

More information and support for people with intersex condition and their families can be found at:

Association for X and Y Chromosome Variations (AXYS) -- genetic.org

CARES Foundation -- caresfoundation.org

InterACT -- interactadvocates.org/

Turner Syndrome Society of the United States -- www.turnersyndrome.org

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W̳h̳e̳n̳ t̳o̳ C̳o̳n̳t̳a̳c̳t̳ a̳ M̳e̳d̳i̳c̳a̳l̳ P̳r̳o̳f̳e̳s̳s̳i̳o̳n̳a̳l̳

If you notice that your child has unusual genitalia or sexual development, discuss this with your health care provider.

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A̳l̳t̳e̳r̳n̳a̳t̳i̳v̳e̳ N̳a̳m̳e̳s̳

Disorders of sex development; DSDs; Pseudohermaphroditism; Hermaphroditism; Hermaphrodite

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R̳e̳f̳e̳r̳e̳n̳c̳e̳s̳

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I'll be posting definitions and information on medical conditions both mental and physical