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Jul
27
2011
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GYNECOLOGICAL CANCER: PHYSICAL CHANGES AND SEXUAL RELATIONS

GYNECOLOGICAL CANCER: PHYSICAL CHANGES AND SEXUAL RELATIONS
Adjustment to surgical scars takes time. Because the surgery often requires extensive removal of major organs, the scar can be long and invasive. Depending on how quickly you heal, the redness and swelling can take some time to reduce. Women with surgical scars often feel a need to hide their body in intimate settings for fear that their partner will be ‘turned off. Many start wanting to have sex in the dark or be covered prior to sex. They fear that their nakedness will expose the scarring and reduce their partner’s impression of them as sexual. It takes a very sensitive and understanding partner to help the woman acknowledge her feelings and sense of ‘loss’ and to accept the scar as irrelevant to their femininity and sexuality. Think of the scar as your life saving device. Show your partner the scar straightaway in hospital. Applying creams or other oils to the scar on a daily basis can feel like a positive step to healing. Discuss the best approach with your nurse. The alternative (a cancer-ridden body and no scar) is not a welcome outcome. If love and intimacy was based purely on body shape and image there would be millions of ‘loveless’ people in the world – both men and women!!
Women with vulva cancer often have the greatest readjustment to make because of the radical extent of the surgery and radiation therapy. Because surgery requires the removal of the external genitals that provide much of the stimulation during sexual intercourse, traditional and former ways of sexual expression are often no longer possible. The vulva is the visible outward sign of female sexuality as the penis is for men. Many women with vulva cancer experience acute pain, inability to have satisfactory penetrating sex, inability to orgasm due to psychological trauma, lack of feeling in the genital area and lymphoedoema in the groin, and in some cases radiation burns on the upper thighs. For some women, especially those in heterosexual relationships the fact that their external genitalia have been removed creates an intense and obsessive desire for its return, and a profound sense of loss of a balanced sexual life. In cases of radical vulvectomy, the external appearance is radically altered with some women describing it as ‘gaping holes’ … in fact this is the removal of the exterior padding of the genitalia. These feelings are quite normal, but often slow down the process of acceptance that the surgery was necessary to preserve their life and realization that a satisfying (but different) sex life can still be achieved – including the ability to still experience orgasm. It is the one gynecological cancer where professional sexual counseling, contact with vulva cancer survivors and extreme sensitivity and understanding on the partner’s part are essential.
*39/144/5*
Adjustment to surgical scars takes time. Because the surgery often requires extensive removal of major organs, the scar can be long and invasive. Depending on how quickly you heal, the redness and swelling can take some time to reduce. Women with surgical scars often feel a need to hide their body in intimate settings for fear that their partner will be ‘turned off. Many start wanting to have sex in the dark or be covered prior to sex. They fear that their nakedness will expose the scarring and reduce their partner’s impression of them as sexual. It takes a very sensitive and understanding partner to help the woman acknowledge her feelings and sense of ‘loss’ and to accept the scar as irrelevant to their femininity and sexuality. Think of the scar as your life saving device. Show your partner the scar straightaway in hospital. Applying creams or other oils to the scar on a daily basis can feel like a positive step to healing. Discuss the best approach with your nurse. The alternative (a cancer-ridden body and no scar) is not a welcome outcome. If love and intimacy was based purely on body shape and image there would be millions of ‘loveless’ people in the world – both men and women!!
Women with vulva cancer often have the greatest readjustment to make because of the radical extent of the surgery and radiation therapy. Because surgery requires the removal of the external genitals that provide much of the stimulation during sexual intercourse, traditional and former ways of sexual expression are often no longer possible. The vulva is the visible outward sign of female sexuality as the penis is for men. Many women with vulva cancer experience acute pain, inability to have satisfactory penetrating sex, inability to orgasm due to psychological trauma, lack of feeling in the genital area and lymphoedoema in the groin, and in some cases radiation burns on the upper thighs. For some women, especially those in heterosexual relationships the fact that their external genitalia have been removed creates an intense and obsessive desire for its return, and a profound sense of loss of a balanced sexual life. In cases of radical vulvectomy, the external appearance is radically altered with some women describing it as ‘gaping holes’ … in fact this is the removal of the exterior padding of the genitalia. These feelings are quite normal, but often slow down the process of acceptance that the surgery was necessary to preserve their life and realization that a satisfying (but different) sex life can still be achieved – including the ability to still experience orgasm. It is the one gynecological cancer where professional sexual counseling, contact with vulva cancer survivors and extreme sensitivity and understanding on the partner’s part are essential.
*39/144/5*
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Written by admin in: Cancer |
Jul
18
2011
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PREGNANCY AND CHILDBIRTH: HOME BIRTH OR IN HOSPITAL?

PREGNANCY AND CHILDBIRTH: HOME BIRTH OR IN HOSPITAL?
As with all well planned events, there is a chance that all will not go according to plan, and the arrival of a new baby into the world is no exception to this rule. Babies can be born at any time and at any place and this may not be near a hospital or the desired place of birth.
Some parents now, as in days of old, choose to have a home birth in familiar surroundings and with the people they love. However, if anything does go wrong and medical help is needed then the best place to be is in hospital. Hospitals have changed in their attitudes to family involvement in the birth of a baby over the past years. The image of the father sitting in a little room out the back smoking cigarettes while the expectant mother lies in an unfriendly room, is no longer true. The truth is that many hospitals encourage the father-to-be by the mother’s side and play an active part in the joyous event. I have found that midwives are not only expert in what they do but also give helpful and loving emotional support. Also most hospitals allow the father and/or close relatives to visit the new mum and baby whenever they like. However, if a home birth is decided upon then it is important to have a qualified midwife in attendance because during the birth of a baby, although it is a natural and usually uncomplicated event, things can go wrong. A friendly hospital may be your best choice.
*18/199/5*
As with all well planned events, there is a chance that all will not go according to plan, and the arrival of a new baby into the world is no exception to this rule. Babies can be born at any time and at any place and this may not be near a hospital or the desired place of birth.
Some parents now, as in days of old, choose to have a home birth in familiar surroundings and with the people they love. However, if anything does go wrong and medical help is needed then the best place to be is in hospital. Hospitals have changed in their attitudes to family involvement in the birth of a baby over the past years. The image of the father sitting in a little room out the back smoking cigarettes while the expectant mother lies in an unfriendly room, is no longer true. The truth is that many hospitals encourage the father-to-be by the mother’s side and play an active part in the joyous event. I have found that midwives are not only expert in what they do but also give helpful and loving emotional support. Also most hospitals allow the father and/or close relatives to visit the new mum and baby whenever they like. However, if a home birth is decided upon then it is important to have a qualified midwife in attendance because during the birth of a baby, although it is a natural and usually uncomplicated event, things can go wrong. A friendly hospital may be your best choice.
*18/199/5*
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Written by admin in: Women's Health |
Jul
02
2011
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EVALUATING HIGH BLOOD PRESSURE

EVALUATING HIGH BLOOD PRESSURE
If you have high blood pressure, your doctor will want to obtain a careful medical history, perform a physical examination, and perform a limited number of tests to answer the following three questions before deciding on the best method of treatment:
1. Is there damage to any organs?
2. Are there other cardiovascular risk factors?
3. Is the high blood pressure primary or a form of secondary (and possibly curable) hypertension?
To answer these questions, your doctor may order some laboratory tests to determine whether you have cardiovascular disease and, if so, its severity. If the physical examination and laboratory findings are normal, most people with mildly elevated blood pressure will not need further tests. However, further assessment may be needed if any of the following conditions exist:
sudden onset or abrupt acceleration of high blood pressure
very high diastolic pressure (greater than 110 mm Hg)
low blood potassium level
evidence of kidney abnormalities
doctor hears a bruit (pronounced “BREW-ee”), which is the sound of blood flowing through a narrowed vessel.
Be sure to tell your doctor if you are taking any prescription or over-the- counter medications, for two reasons. First, some medications raise blood pressure. Cold, allergy and sinus  medicines, nose sprays, and diet pills can all raise blood pressure. Second, certain medications can have dangerous reactions with medications your doctor may prescribe for high blood pressure. These include certain heart medications, psychiatric medications, and diuretics (“water pills”).
*260\252\8*
If you have high blood pressure, your doctor will want to obtain a careful medical history, perform a physical examination, and perform a limited number of tests to answer the following three questions before deciding on the best method of treatment:
1. Is there damage to any organs?
2. Are there other cardiovascular risk factors?
3. Is the high blood pressure primary or a form of secondary (and possibly curable) hypertension?
To answer these questions, your doctor may order some laboratory tests to determine whether you have cardiovascular disease and, if so, its severity. If the physical examination and laboratory findings are normal, most people with mildly elevated blood pressure will not need further tests. However, further assessment may be needed if any of the following conditions exist:
sudden onset or abrupt acceleration of high blood pressure
very high diastolic pressure (greater than 110 mm Hg)
low blood potassium level
evidence of kidney abnormalities
doctor hears a bruit (pronounced “BREW-ee”), which is the sound of blood flowing through a narrowed vessel.
Be sure to tell your doctor if you are taking any prescription or over-the- counter medications, for two reasons. First, some medications raise blood pressure. Cold, allergy and sinus  medicines, nose sprays, and diet pills can all raise blood pressure. Second, certain medications can have dangerous reactions with medications your doctor may prescribe for high blood pressure. These include certain heart medications, psychiatric medications, and diuretics (“water pills”).
*260\252\8*
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Written by admin in: Cardio & Blood-Сholesterol |
Jun
28
2011
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EAT YOUR WAY TO HEALTHY BONES: JULIE’S STORY

EAT YOUR WAY TO HEALTHY BONES: JULIE’S STORY
When I went to have my hone density checked, 1 figured the results would come hack telling me I was “at risk”—isn’t every woman over 601 But I was very surprised when it turned out I already had osteoporosis. I’ve always had a pretty balanced diet, and been a generally active person. I’m no athlete, but I am a half-decent weekend skier.
I am small-boned and thin, like my mom, who was very bent over by the time she died, well into her 80s. As I’ve read about the things that have an impact on your bones, I’ve learned more about my risks. I never have soda, but do usually drink a cup or two of coffee each day. I smoked for more than ten years when I was very young, but I stopped as soon as the Surgeon General’s report about the cancer dangers came out. I didn’t have any menopausal symptoms, so I never even really considered hormone replacement therapy. My doctor brought it up again after my scan, but I cut her off immediately. I’m about to be 65, and have no intention of starting that now, if I haven’t needed it otherwise.
When I found out how much bone I had lost, I started taking Fosamax. After two years on it, a second DEXA scan showed I had increased density by 7 percentage points. That puts me on the borderline between osteopenia and osteoporosis, but definitely on the denser side and out of immediate danger. Though I never had any side effects from it, Fosamax is a difficult medication to take because you have to wait a half hour after you take it before you eat, and you have to stay upright during that time, so you can’t exactly crawl back in bed with the New York Times. Besides, I don’t want to be on this or any drug forever. And in fact, I’m not at all certain just what caused the improvement, since I started a strength training program, became a vegetarian, and began taking vitamin and calcium supplements on the same day I started Fosamax!
That’s why I’ve decided to stop taking the drug and rely on diet and exercise. I’m now a vegetarian, but not vegan—I do eat eggs and dairy. I always say, “I don’t eat anything that had a heartbeat.” That was an enormous change for me, because before that I ate meat at least once a day. I certainly always had meat at dinner, and sometimes it seemed like
I was the last woman alive who would admit to regularly enjoying a steak. It’s funny, though, because giving up meat hasn’t really bothered me. Once I got on a roll with it, it just became second nature.
Regular exercise was also a major lifestyle change for me. I’ve never been a couch potato, but I never followed any particular routine before. Now I exercise daily. I do half an hour of aerobic exercise seven days a week—a cross-country skiing machine, though I don’t use the arm part (I read). Plus, twice a week I work out with weights.
My doctor recommended taking a calcium supplement and a multivitamin, so now every day I get 1,000 milligrams of calcium in pills that also contain vitamin D, magnesium, and trace minerals. I also take a common multivitamin to make sure I cover everything.
I’ve been off Fosamax for six weeks now. This is an experiment on my part, to see if I can maintain the changes I’ve made, without the medication. I’ll get another DEXA scan in a year and then reevaluate my situation. If I lose bone, I suppose I’ll go back to the Fosamax, but I believe the healthy changes I’ve made in my life will give me the strong bones I need.
*37\228\2*
When I went to have my hone density checked, 1 figured the results would come hack telling me I was “at risk”—isn’t every woman over 601 But I was very surprised when it turned out I already had osteoporosis. I’ve always had a pretty balanced diet, and been a generally active person. I’m no athlete, but I am a half-decent weekend skier.
I am small-boned and thin, like my mom, who was very bent over by the time she died, well into her 80s. As I’ve read about the things that have an impact on your bones, I’ve learned more about my risks. I never have soda, but do usually drink a cup or two of coffee each day. I smoked for more than ten years when I was very young, but I stopped as soon as the Surgeon General’s report about the cancer dangers came out. I didn’t have any menopausal symptoms, so I never even really considered hormone replacement therapy. My doctor brought it up again after my scan, but I cut her off immediately. I’m about to be 65, and have no intention of starting that now, if I haven’t needed it otherwise.
When I found out how much bone I had lost, I started taking Fosamax. After two years on it, a second DEXA scan showed I had increased density by 7 percentage points. That puts me on the borderline between osteopenia and osteoporosis, but definitely on the denser side and out of immediate danger. Though I never had any side effects from it, Fosamax is a difficult medication to take because you have to wait a half hour after you take it before you eat, and you have to stay upright during that time, so you can’t exactly crawl back in bed with the New York Times. Besides, I don’t want to be on this or any drug forever. And in fact, I’m not at all certain just what caused the improvement, since I started a strength training program, became a vegetarian, and began taking vitamin and calcium supplements on the same day I started Fosamax!
That’s why I’ve decided to stop taking the drug and rely on diet and exercise. I’m now a vegetarian, but not vegan—I do eat eggs and dairy. I always say, “I don’t eat anything that had a heartbeat.” That was an enormous change for me, because before that I ate meat at least once a day. I certainly always had meat at dinner, and sometimes it seemed like
I was the last woman alive who would admit to regularly enjoying a steak. It’s funny, though, because giving up meat hasn’t really bothered me. Once I got on a roll with it, it just became second nature.
Regular exercise was also a major lifestyle change for me. I’ve never been a couch potato, but I never followed any particular routine before. Now I exercise daily. I do half an hour of aerobic exercise seven days a week—a cross-country skiing machine, though I don’t use the arm part (I read). Plus, twice a week I work out with weights.
My doctor recommended taking a calcium supplement and a multivitamin, so now every day I get 1,000 milligrams of calcium in pills that also contain vitamin D, magnesium, and trace minerals. I also take a common multivitamin to make sure I cover everything.
I’ve been off Fosamax for six weeks now. This is an experiment on my part, to see if I can maintain the changes I’ve made, without the medication. I’ll get another DEXA scan in a year and then reevaluate my situation. If I lose bone, I suppose I’ll go back to the Fosamax, but I believe the healthy changes I’ve made in my life will give me the strong bones I need.
*37\228\2*
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Written by admin in: Healthy bones Osteoporosis Rheumatic |
Jun
17
2011
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SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – RISK-BENEFIT DISCUSSION WITH YOUR PHYSICIANS

SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – RISK-BENEFIT DISCUSSION WITH YOUR PHYSICIANS
Discussion of the possibility of surgery and its risks and benefits should be an ongoing process. Having identified a focus and its location, surgery can become a more serious consideration, and a more detailed discussion of its risks and benefits is possible. The risks will depend on the area to be removed. Surgery is most often performed to remove a focus from the frontal or temporal lobes of the brain, areas from which large amounts of tissue can usually be safely removed without major complications.
As with any operation, there is, of course, a risk of dying or suffering major complications of anesthesia. While the consequences of such a complication could be great, the chances of a major anesthetic complication’s occurring are in the range of less than one per one thousand. Infection also is always a risk; so is bleeding or clotting of a blood vessel. All these are potentially serious and capable of causing additional brain damage. Fortunately, these complications occur infrequently.
Generally, as noted, frontal and temporal lobe removals are considered by neurologists and neurosurgeons to be “safe” procedures, but as with any decision-making process, the risks and their magnitude must be weighed against the possible benefits and the chances of those benefits occurring. What are the benefits of the focal operations? The maximum benefit would be freedom from seizures for your child—freedom from taking anticonvulsant medicine and freedom from neurologic deficit due to the surgery. This is everyone’s goal. What are the chances of that occurring? Surprisingly, it is difficult to give numerical answers to this question. Surgical centers often quote 60-75 percent “good outcomes.” This means that perhaps 50 percent will be cured of their seizures, another 10—25 percent will have substantial decrease in the frequency of their seizures, and about 25 percent—one in four—will not be helped at all.
*157\208\8*
Discussion of the possibility of surgery and its risks and benefits should be an ongoing process. Having identified a focus and its location, surgery can become a more serious consideration, and a more detailed discussion of its risks and benefits is possible. The risks will depend on the area to be removed. Surgery is most often performed to remove a focus from the frontal or temporal lobes of the brain, areas from which large amounts of tissue can usually be safely removed without major complications.
As with any operation, there is, of course, a risk of dying or suffering major complications of anesthesia. While the consequences of such a complication could be great, the chances of a major anesthetic complication’s occurring are in the range of less than one per one thousand. Infection also is always a risk; so is bleeding or clotting of a blood vessel. All these are potentially serious and capable of causing additional brain damage. Fortunately, these complications occur infrequently.
Generally, as noted, frontal and temporal lobe removals are considered by neurologists and neurosurgeons to be “safe” procedures, but as with any decision-making process, the risks and their magnitude must be weighed against the possible benefits and the chances of those benefits occurring. What are the benefits of the focal operations? The maximum benefit would be freedom from seizures for your child—freedom from taking anticonvulsant medicine and freedom from neurologic deficit due to the surgery. This is everyone’s goal. What are the chances of that occurring? Surprisingly, it is difficult to give numerical answers to this question. Surgical centers often quote 60-75 percent “good outcomes.” This means that perhaps 50 percent will be cured of their seizures, another 10—25 percent will have substantial decrease in the frequency of their seizures, and about 25 percent—one in four—will not be helped at all.
*157\208\8*
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Written by admin in: Epilepsy |
Jun
08
2011
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LIVING WITH DIABETES: MARRIAGE AND CHILDREN

LIVING WITH DIABETES: MARRIAGE AND CHILDREN
Should people with diabetes marry? Can they hope to raise families of their own? Marriage to someone with diabetes requires some special adjustments that many people have made successfully. It is a matter of being willing to make the effort. The couple should have frank and open discussions beforehand, about what the treatment of the disease entails and the possibility that complications might develop in the future.
Should people with diabetes marry each other? Specialists used to say no, believing there was a high risk that children might inherit the disease. But most young diabetes patients who are thinking about getting married and having children have Type I rather than Type II diabetes. Now that studies have indicated that heredity does not play the major role in this form of the disease it was formerly thought to have, there seems little reason to discourage such marriages. In fact, some counselors suggest that if two people with diabetes marry each other, they will find it easier to adjust, because both of them already know what living with the disease involves.
Is it safe for people with diabetes to have children? There is no reason why a man with diabetes should not father a child. For a woman the problem is a bit more complicated. Modern treatment methods have greatly increased the chances for a woman with diabetes to bear a normal, healthy child. But the rate of death of babies both before and soon after their birth is still somewhat higher than normal. The disease itself also becomes more difficult to control during pregnancy—the body’s need for insulin increases, and the woman must be carefully watched by her doctor to avoid possible complications that might threaten her or her child. Doctors recommend getting the blood sugar level under strict control well before becoming pregnant, and monitoring it carefully during the pregnancy. A pregnant woman with diabetes may have to undergo frequent and expensive tests to determine how well her baby is growing and when it should be delivered.
*40\268\2*
Should people with diabetes marry? Can they hope to raise families of their own? Marriage to someone with diabetes requires some special adjustments that many people have made successfully. It is a matter of being willing to make the effort. The couple should have frank and open discussions beforehand, about what the treatment of the disease entails and the possibility that complications might develop in the future.
Should people with diabetes marry each other? Specialists used to say no, believing there was a high risk that children might inherit the disease. But most young diabetes patients who are thinking about getting married and having children have Type I rather than Type II diabetes. Now that studies have indicated that heredity does not play the major role in this form of the disease it was formerly thought to have, there seems little reason to discourage such marriages. In fact, some counselors suggest that if two people with diabetes marry each other, they will find it easier to adjust, because both of them already know what living with the disease involves.
Is it safe for people with diabetes to have children? There is no reason why a man with diabetes should not father a child. For a woman the problem is a bit more complicated. Modern treatment methods have greatly increased the chances for a woman with diabetes to bear a normal, healthy child. But the rate of death of babies both before and soon after their birth is still somewhat higher than normal. The disease itself also becomes more difficult to control during pregnancy—the body’s need for insulin increases, and the woman must be carefully watched by her doctor to avoid possible complications that might threaten her or her child. Doctors recommend getting the blood sugar level under strict control well before becoming pregnant, and monitoring it carefully during the pregnancy. A pregnant woman with diabetes may have to undergo frequent and expensive tests to determine how well her baby is growing and when it should be delivered.
*40\268\2*
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Written by admin in: Diabetes |
May
27
2011
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CANCER AND NUTRITION: ZINC

CANCER AND NUTRITION: ZINC
Zinc is a metal that is essential for good growth and development, protein synthesis, and wound healing, and it is a functional part of many enzymes. Danbolt and Closs have shown that zinc deficiency produces the symptoms and problems of an inherited disease called acrodermatitis enteropathica, which consists of multiple skin and gastrointestinal problems. This disease is completely cured by dietary zinc supplementation.
More importantly, zinc is intimately involved in immune function and the development of cancer. This subject has been extensively reviewed by Robert A. Good and colleagues. Zinc has the following effects:
Zinc deficiency decreases the number of T cells and suppressor T cells, which could potentially lead to the development of cancer. However, phagocytes are more efficient with low blood levels of zinc.
Zinc deficiency is seen in patients with several different types of cancers, but this is related to poor dietary habits rather than to the cancer itself.
Zinc excess and zinc deficiency have both been shown to inhibit tumor growth in animals. Whereas zinc deficiency stimulates anticancer inflammatory cells, zinc-supplemented animals have augmented T-cell anticancer activity.
*33\360\2*
Zinc is a metal that is essential for good growth and development, protein synthesis, and wound healing, and it is a functional part of many enzymes. Danbolt and Closs have shown that zinc deficiency produces the symptoms and problems of an inherited disease called acrodermatitis enteropathica, which consists of multiple skin and gastrointestinal problems. This disease is completely cured by dietary zinc supplementation.
More importantly, zinc is intimately involved in immune function and the development of cancer. This subject has been extensively reviewed by Robert A. Good and colleagues. Zinc has the following effects:
Zinc deficiency decreases the number of T cells and suppressor T cells, which could potentially lead to the development of cancer. However, phagocytes are more efficient with low blood levels of zinc.
Zinc deficiency is seen in patients with several different types of cancers, but this is related to poor dietary habits rather than to the cancer itself.
Zinc excess and zinc deficiency have both been shown to inhibit tumor growth in animals. Whereas zinc deficiency stimulates anticancer inflammatory cells, zinc-supplemented animals have augmented T-cell anticancer activity.
*33\360\2*
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Written by admin in: Cancer |
May
18
2011
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WHY YOU CAN’T STAY AWAKE: THE PHYSICAL CAUSES OF SLEEP APNEA

WHY YOU CAN’T STAY AWAKE: THE PHYSICAL CAUSES OF SLEEP APNEA
What is the physical process that leads to sleep apnea? Almost always apneic episodes result from an obstruction of the pharynx occurring somewhere between the nose and the epiglottis— the membrane that prevents food from going down the wrong “pipe.” The upper airway, from the mouth and nose to the lungs, is not just a hollow tube through which breath moves: the coordinated activity of a number of muscles is required if this airway is to work efficiently and effectively. As we breathe in, these muscles must contract, in synchronized fashion, to pull the passage open: this muscle contraction, as well as our instinct to breathe, is controlled by the central respiratory drive in the brain. Like many bodily structures, the upper airway is pretty delicate: it doesn’t take a very big difference in air pressure between the atmosphere and the inside of the throat to cause the passageway to collapse. The muscles must therefore work continually to keep the tube open.
As we have seen, a number of factors—among them drugs, alcohol, and, to some extent, sleep itself—can suppress the central respiratory drive, especially during slow-wave sleep and the REM phase. Alcohol is a particular threat; not only does it suppress the breathing drive, it also relaxes the throat muscles, reducing their ability to keep the airway open. What’s more, alcohol weakens the mechanism that helps us wake up quickly, thus adding to the time it takes to become aroused enough to make the conscious effort needed to breathe. I tell all patients with apnea that use of alcohol, other than perhaps a very small quantity (less than an ounce), is inadvisable. If they must drink, I ask them to do so no later than four to six hours before bedtime.
*136\226\8*
What is the physical process that leads to sleep apnea? Almost always apneic episodes result from an obstruction of the pharynx occurring somewhere between the nose and the epiglottis— the membrane that prevents food from going down the wrong “pipe.” The upper airway, from the mouth and nose to the lungs, is not just a hollow tube through which breath moves: the coordinated activity of a number of muscles is required if this airway is to work efficiently and effectively. As we breathe in, these muscles must contract, in synchronized fashion, to pull the passage open: this muscle contraction, as well as our instinct to breathe, is controlled by the central respiratory drive in the brain. Like many bodily structures, the upper airway is pretty delicate: it doesn’t take a very big difference in air pressure between the atmosphere and the inside of the throat to cause the passageway to collapse. The muscles must therefore work continually to keep the tube open.
As we have seen, a number of factors—among them drugs, alcohol, and, to some extent, sleep itself—can suppress the central respiratory drive, especially during slow-wave sleep and the REM phase. Alcohol is a particular threat; not only does it suppress the breathing drive, it also relaxes the throat muscles, reducing their ability to keep the airway open. What’s more, alcohol weakens the mechanism that helps us wake up quickly, thus adding to the time it takes to become aroused enough to make the conscious effort needed to breathe. I tell all patients with apnea that use of alcohol, other than perhaps a very small quantity (less than an ounce), is inadvisable. If they must drink, I ask them to do so no later than four to six hours before bedtime.
*136\226\8*
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Written by admin in: Anti Depressants-Sleeping Aid |
May
08
2011
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HIV: SKIN PROBLEMS-RED RASH

HIV: SKIN PROBLEMS-RED RASH
A rash is usually either diffusely red all over or red only in spots or blotches. It usually appears on the chest, back, arms, face, and legs. Rashes can be accompanied by other symptoms, including fever, swelling of the face, giant welts, or itching.
The most common cause of a red rash covering large areas of the body in people with HIV infection is an adverse reaction to a drug. The most common offending drug is a sulfa
drug—especially trimethoprim-sulfamethoxazole (Bactrim, Septra), the drug usually given for the treatment or prevention of Pneumocystis carinii pneumonia. Sulfa drugs are also treatments for many other infectious diseases in people with and without AIDS. Rashes that are a reaction to sulfa drugs are especially common in people with HIV infection: 30 percent to 50 percent of people with HIV infection have these rashes. In addition to rashes, many people also have fever, low white blood cell counts, or tests showing hepatitis. All these symptoms disappear when the sulfa drug is stopped.
Other drugs can also cause rashes; rashes simply seem to be especially common with the sulfa drugs. One of the problems with identifying the cause of rashes is that they can occur with almost any drug, and many people with HIV infection are taking many drugs. To find out which drug is causing the rash, the physician may stop one drug at a time every two or three days, beginning with the drug most likely to be responsible. Or the physician may suggest a drug holiday: all drugs are stopped, then only those that are necessary are started again.
When the rash occurs, talk to a physician. This consultation is especially important if the drugs causing the rash are also causing such symptoms as swelling of the face, difficulty breathing, large and itching welts, fever, or dizziness when standing (suggesting low blood pressure).
In addition to stopping the drug, the rashes are often treated with antihistamines like Dramamine which can be purchased without a prescription, or with prescription drugs that are sometimes more effective. More serious reactions may require treatment with corticosteroids.
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A rash is usually either diffusely red all over or red only in spots or blotches. It usually appears on the chest, back, arms, face, and legs. Rashes can be accompanied by other symptoms, including fever, swelling of the face, giant welts, or itching.
The most common cause of a red rash covering large areas of the body in people with HIV infection is an adverse reaction to a drug. The most common offending drug is a sulfa
drug—especially trimethoprim-sulfamethoxazole (Bactrim, Septra), the drug usually given for the treatment or prevention of Pneumocystis carinii pneumonia. Sulfa drugs are also treatments for many other infectious diseases in people with and without AIDS. Rashes that are a reaction to sulfa drugs are especially common in people with HIV infection: 30 percent to 50 percent of people with HIV infection have these rashes. In addition to rashes, many people also have fever, low white blood cell counts, or tests showing hepatitis. All these symptoms disappear when the sulfa drug is stopped.
Other drugs can also cause rashes; rashes simply seem to be especially common with the sulfa drugs. One of the problems with identifying the cause of rashes is that they can occur with almost any drug, and many people with HIV infection are taking many drugs. To find out which drug is causing the rash, the physician may stop one drug at a time every two or three days, beginning with the drug most likely to be responsible. Or the physician may suggest a drug holiday: all drugs are stopped, then only those that are necessary are started again.
When the rash occurs, talk to a physician. This consultation is especially important if the drugs causing the rash are also causing such symptoms as swelling of the face, difficulty breathing, large and itching welts, fever, or dizziness when standing (suggesting low blood pressure).
In addition to stopping the drug, the rashes are often treated with antihistamines like Dramamine which can be purchased without a prescription, or with prescription drugs that are sometimes more effective. More serious reactions may require treatment with corticosteroids.
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Written by admin in: General health,HIV |
Apr
23
2011
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SKIN DISORDERS IN ADULTS: PSORIASIS AND ITS TREATMENT

SKIN DISORDERS IN ADULTS: PSORIASIS AND ITS TREATMENT
Psoriasis is probably the most troublesome and difficult skin condition seen in the adult population. It occurs in approximately five per cent of the population, but accounts for more than ten per cent of dermatology consultations. Psoriasis was first described in ancient Egypt as a type of leprosy. It is a very scaly condition which is quite conspicuous and can be a source of some embarrassment, although it is not contagious.
The exact cause of psoriasis is not well understood. Hereditary factors are important, although there is no strict inheritance pattern. Recent research has shown that immune factors may be important because AIDS sufferers have a higher incidence of psoriasis. It is also known that stress, alcohol and lack of sunlight can cause psoriasis to suddenly appear.
Psoriasis can appear almost anywhere on the body. It commonly occurs on the scalp, elbows and knees, and sometimes on the face. It can also affect the nails and joints.
Treating psoriasis
Psoriasis is treatable, however it cannot be cured. For centuries, sufferers have been the victims of many misleading claims of ‘miracle’ cures. Even the Government of Victoria was hoodwinked into subsidizing the development of a miracle cure for the condition. Like all other fads, this one came and went, while the government lost several million dollars. Likewise, special diets, particularly those high in fish oils, have been advocated for the treatment of psoriasis, but these have not proven very successful. As far as diet is concerned, alcohol is the only substance which should be kept to a minimum.
There is no universal treatment for psoriasis. Rather, there are many different treatments, each having its advantages and disadvantages. Treatment is dependent on things like previous disease patterns, the severity of the condition and the treatment facilities available. It should also be kept in mind that psoriasis can improve spontaneously, irrespective of the treatment used.
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Psoriasis is probably the most troublesome and difficult skin condition seen in the adult population. It occurs in approximately five per cent of the population, but accounts for more than ten per cent of dermatology consultations. Psoriasis was first described in ancient Egypt as a type of leprosy. It is a very scaly condition which is quite conspicuous and can be a source of some embarrassment, although it is not contagious.
The exact cause of psoriasis is not well understood. Hereditary factors are important, although there is no strict inheritance pattern. Recent research has shown that immune factors may be important because AIDS sufferers have a higher incidence of psoriasis. It is also known that stress, alcohol and lack of sunlight can cause psoriasis to suddenly appear.
Psoriasis can appear almost anywhere on the body. It commonly occurs on the scalp, elbows and knees, and sometimes on the face. It can also affect the nails and joints.
Treating psoriasis
Psoriasis is treatable, however it cannot be cured. For centuries, sufferers have been the victims of many misleading claims of ‘miracle’ cures. Even the Government of Victoria was hoodwinked into subsidizing the development of a miracle cure for the condition. Like all other fads, this one came and went, while the government lost several million dollars. Likewise, special diets, particularly those high in fish oils, have been advocated for the treatment of psoriasis, but these have not proven very successful. As far as diet is concerned, alcohol is the only substance which should be kept to a minimum.
There is no universal treatment for psoriasis. Rather, there are many different treatments, each having its advantages and disadvantages. Treatment is dependent on things like previous disease patterns, the severity of the condition and the treatment facilities available. It should also be kept in mind that psoriasis can improve spontaneously, irrespective of the treatment used.
*56/150/5*
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Written by admin in: Skin Care |

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