Mar
28
2011
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MEDICATIONS FOR RA (RHEUMATOID ARTHRITIS): TAKING CYCLOPHOSPHAMIDE

MEDICATIONS FOR RA (RHEUMATOID ARTHRITIS): TAKING CYCLOPHOSPHAMIDE
Before starting cyclophosphamide therapy discuss the following with your physician:
•   A history of blood problems, kidney or liver conditions, HIV infection, previous x-ray therapy or chemotherapy, or a positive tuberculin skin test or tuberculosis.
•   Any medications you are taking, but in particular sleeping medications (barbiturates), diuretics (water pills), or gout medications (allopurinol).
While taking cyclophosphamide:
•   Contact your physician promptly if you notice fever or chills, sore throat, cough, unusual bleeding or bruising, a change in urine color, burning or pain with urination, a change in skin color, or a marked increase in fatigue.
•   Monitor your urination while you are taking cyclophosphamide. Make certain that the frequency of urination has not decreased. Drink large amounts of water each day to flush out your bladder.
•   Never take this medication at bedtime.
Avoid coming into close contact with persons having a viral or bacterial infection.
Pregnancy and breastfeeding
Both men and women must use contraception while taking cyclophosphamide. Birth defects are a distinct possibility. Decreased fertility and sterility are potential side effects of this medication. Nursing is not recommended.
*102/209/5*
Before starting cyclophosphamide therapy discuss the following with your physician:
•   A history of blood problems, kidney or liver conditions, HIV infection, previous x-ray therapy or chemotherapy, or a positive tuberculin skin test or tuberculosis.
•   Any medications you are taking, but in particular sleeping medications (barbiturates), diuretics (water pills), or gout medications (allopurinol).
While taking cyclophosphamide:
•   Contact your physician promptly if you notice fever or chills, sore throat, cough, unusual bleeding or bruising, a change in urine color, burning or pain with urination, a change in skin color, or a marked increase in fatigue.
•   Monitor your urination while you are taking cyclophosphamide. Make certain that the frequency of urination has not decreased. Drink large amounts of water each day to flush out your bladder.
•   Never take this medication at bedtime.
Avoid coming into close contact with persons having a viral or bacterial infection.
Pregnancy and breastfeeding
Both men and women must use contraception while taking cyclophosphamide. Birth defects are a distinct possibility. Decreased fertility and sterility are potential side effects of this medication. Nursing is not recommended.
*102/209/5*
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Written by admin in: Arthritis |
Mar
18
2011
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OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING TRIVIALIZATION OF BDD

OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING TRIVIALIZATION OF BDD
It’s easy to trivialize BDD. Why should she care so much about how she looks? The fact that the person looks okay only compounds the problem. It may lead to reassurance—don’t worry, you look fine—rather than effective treatment. Sometimes BDD is mistaken for vanity. For BDD to be diagnosed and adequately treated, family members and clinicians need to take the symptoms seriously; BDD must be recognized as a serious psychiatric disorder that can cause severe suffering.
What To Do: I hope that after reading this book, you’re convinced that BDD is a serious disorder. If you want someone else in your life to take it seriously, you can talk with him or her about it. Or, you may want them to read this book; many people tell me this has helped other people understand BDD and realize that it’s bona fide disorder and a serious problem.
*234\204\8*
It’s easy to trivialize BDD. Why should she care so much about how she looks? The fact that the person looks okay only compounds the problem. It may lead to reassurance—don’t worry, you look fine—rather than effective treatment. Sometimes BDD is mistaken for vanity. For BDD to be diagnosed and adequately treated, family members and clinicians need to take the symptoms seriously; BDD must be recognized as a serious psychiatric disorder that can cause severe suffering.
What To Do: I hope that after reading this book, you’re convinced that BDD is a serious disorder. If you want someone else in your life to take it seriously, you can talk with him or her about it. Or, you may want them to read this book; many people tell me this has helped other people understand BDD and realize that it’s bona fide disorder and a serious problem.
*234\204\8*
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Written by admin in: Anti Depressants-Sleeping Aid |
Mar
08
2011
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DRUGS TO TREAT RHEUMATOID ARTHRITIS: ENBREL

DRUGS TO TREAT RHEUMATOID ARTHRITIS: ENBREL
Enbrel is the brand name for etanercept, a modern biological response modifier.
There is a cytokine, or chemical messenger, present in the joints called tumor necrosis factor (TNF). This inflammatory mediator is one of the major problem-causing cytokines in RA. (It gets its name because it was found to cause weight loss and the shrinkage of tumors in young animals. Many years ago, it was actually thought of as a means of controlling cancer.) On cells there is a docking mechanism called a cytokine receptor. In order for cytokine (a chemical messenger) to do its job, it must join with a receptor. Enbrel is a laboratory-made receptor. Instead of docking at the regular receptor, the TNF sticks to the laboratory-made receptor Enbrel and is inactivated.
Enbrel is taken by subcutaneous (under the skin) injection twice a week. Most patients administer the injection themselves. It is relatively easy once becoming accustomed to it.
There can be some local allergic reactions at the site of injection. You can also experience headaches, fever, low blood pressure, and upset stomach. If you develop an infection on the drug, you must call your doctor. You will probably have to stop the drug until the infection is treated and you are well enough to start it again.
Your doctor should write a special prescription for you, and you will have to learn how to inject the drug from the doctor.
The drug it can be used with almost anything, including methotrexate.
*37/141/5*
Enbrel is the brand name for etanercept, a modern biological response modifier.
There is a cytokine, or chemical messenger, present in the joints called tumor necrosis factor (TNF). This inflammatory mediator is one of the major problem-causing cytokines in RA. (It gets its name because it was found to cause weight loss and the shrinkage of tumors in young animals. Many years ago, it was actually thought of as a means of controlling cancer.) On cells there is a docking mechanism called a cytokine receptor. In order for cytokine (a chemical messenger) to do its job, it must join with a receptor. Enbrel is a laboratory-made receptor. Instead of docking at the regular receptor, the TNF sticks to the laboratory-made receptor Enbrel and is inactivated.
Enbrel is taken by subcutaneous (under the skin) injection twice a week. Most patients administer the injection themselves. It is relatively easy once becoming accustomed to it.
There can be some local allergic reactions at the site of injection. You can also experience headaches, fever, low blood pressure, and upset stomach. If you develop an infection on the drug, you must call your doctor. You will probably have to stop the drug until the infection is treated and you are well enough to start it again.
Your doctor should write a special prescription for you, and you will have to learn how to inject the drug from the doctor.
The drug it can be used with almost anything, including methotrexate.
*37/141/5*
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Written by admin in: Arthritis |
Feb
28
2011
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MEDICAL TREATMENT OF SEIZURES: COMMON QUESTIONS ABOUT BLOOD LEVELS

MEDICAL TREATMENT OF SEIZURES: COMMON QUESTIONS ABOUT BLOOD LEVELS
Physicians and parents have become enamored of tests and often give them greater importance than is proper. Despite scientific advances, the proper use of anticonvulsants remains an art, not always a science. We are often asked questions by both physicians and parents.
“My doctor says that my child’s blood level is slightly low and wants to increase his dose. What should I do?”
If you ask us this, we would ask if your child is still having seizures. If he is, then the dose should be increased. If he is not, then we would leave the dose alone; the current level may be sufficient to control his seizures. The question of increasing a dose often comes up in a child whose seizures are controlled. As the child grows and increases in size, the blood level will, of course, decrease if your doctor doesn’t increase the dose. But we suggest keeping the dose the same as the child grows and gains weight, unless he is having seizures. If the dose is kept the same, then the blood level gradually falls over the months or years. If the child does not have another seizure, it will be easier and safer to take him off his medicine when he has been free of seizures for two years. If he has a seizure, then you know that he needs to stay on the medication longer.
“My daughter’s blood level is at the upper end of ‘normal,’ and she is still having seizures. My doctor wants to try another drug. Is that the proper thing to do?”
We would suggest first that he try increasing the dose even further, but slowly, since your daughter is close to the point where many people show toxicity. Sometimes seizures will be controlled with a little more drug without any toxic problems. The upper level of the therapeutic range is like a sign post, “WARNING”; it suggests that you and your physician should be watchful for signs of toxicity.
“Rachel’s blood level is ‘high,’ and my doctor wants to lower the dose. I think that she is doing just fine, and she hasn’t had any seizures since that last Increase in dosage. What should we do?”
We would recommend that you leave the dose alone. If Rachel isn’t having any seizures and has no signs of toxicity, then perhaps this is the level she requires. However, since the level is above the usual range, we would suggest that you keep a close eye on her and on her school performance to be sure that the drug is not interfering and that you stay alert for other signs of toxicity.
“Billy’s blood level is right in the middle of the ‘range.’ Is that good?”
The answer to this question is, “It depends.” If Billy is not having any seizures and shows no signs of toxicity, then that level is fine and should not be changed. If he is still having seizures, then the level is too low for him, and he needs more medication. If he is too sleepy, too irritable, or having problems in school, then it is important to find out why. There are many causes for problems such as these. Obviously, you should be sure that he is not having seizures. If the level is not high, then the drug is a less likely cause. However, if you can’t find another cause, then lowering or discontinuing the drug may be worth trying. If the problem disappears, then it may have been due to the drug.
To summarize, the therapeutic range is a guide and nothing more. It will suggest to you and your physician when it may be appropriate to increase the drug and when to look more closely for signs of toxicity. The range does not tell you when the child is taking too much or too little. Control of seizures and signs of toxicity are the only things that tell that.
*112\208\8*
Physicians and parents have become enamored of tests and often give them greater importance than is proper. Despite scientific advances, the proper use of anticonvulsants remains an art, not always a science. We are often asked questions by both physicians and parents.
“My doctor says that my child’s blood level is slightly low and wants to increase his dose. What should I do?”
If you ask us this, we would ask if your child is still having seizures. If he is, then the dose should be increased. If he is not, then we would leave the dose alone; the current level may be sufficient to control his seizures. The question of increasing a dose often comes up in a child whose seizures are controlled. As the child grows and increases in size, the blood level will, of course, decrease if your doctor doesn’t increase the dose. But we suggest keeping the dose the same as the child grows and gains weight, unless he is having seizures. If the dose is kept the same, then the blood level gradually falls over the months or years. If the child does not have another seizure, it will be easier and safer to take him off his medicine when he has been free of seizures for two years. If he has a seizure, then you know that he needs to stay on the medication longer.
“My daughter’s blood level is at the upper end of ‘normal,’ and she is still having seizures. My doctor wants to try another drug. Is that the proper thing to do?”
We would suggest first that he try increasing the dose even further, but slowly, since your daughter is close to the point where many people show toxicity. Sometimes seizures will be controlled with a little more drug without any toxic problems. The upper level of the therapeutic range is like a sign post, “WARNING”; it suggests that you and your physician should be watchful for signs of toxicity.
“Rachel’s blood level is ‘high,’ and my doctor wants to lower the dose. I think that she is doing just fine, and she hasn’t had any seizures since that last Increase in dosage. What should we do?”
We would recommend that you leave the dose alone. If Rachel isn’t having any seizures and has no signs of toxicity, then perhaps this is the level she requires. However, since the level is above the usual range, we would suggest that you keep a close eye on her and on her school performance to be sure that the drug is not interfering and that you stay alert for other signs of toxicity.
“Billy’s blood level is right in the middle of the ‘range.’ Is that good?”
The answer to this question is, “It depends.” If Billy is not having any seizures and shows no signs of toxicity, then that level is fine and should not be changed. If he is still having seizures, then the level is too low for him, and he needs more medication. If he is too sleepy, too irritable, or having problems in school, then it is important to find out why. There are many causes for problems such as these. Obviously, you should be sure that he is not having seizures. If the level is not high, then the drug is a less likely cause. However, if you can’t find another cause, then lowering or discontinuing the drug may be worth trying. If the problem disappears, then it may have been due to the drug.
To summarize, the therapeutic range is a guide and nothing more. It will suggest to you and your physician when it may be appropriate to increase the drug and when to look more closely for signs of toxicity. The range does not tell you when the child is taking too much or too little. Control of seizures and signs of toxicity are the only things that tell that.
*112\208\8*
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Written by admin in: Epilepsy |
Feb
20
2011
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THE SELF-POISONER: PATTERNS OF SELF-INDUCED TOXICITY – GOING OFF HALF-COCKED

THE SELF-POISONER: PATTERNS OF SELF-INDUCED TOXICITY – GOING OFF HALF-COCKED
Because of the possible detrimental consequences to one’s well-being, it is not always realistic to take a stand against a toxic intrusion. It is healthier to tolerate a toxic pattern when the available alternatives would disrupt the person’s ability to satisfy his total needs, even though they might bring relief from the poison of the immediate situation. It is a toxic effort for a person to try to resolve a poisonous situation when he doesn’t have the resources to back himself up or accept the consequences of his action. It is the responsibility of each individual to take a risk to get what he wants or to avoid what he doesn’t want.
Frank W. was characteristically restless and impatient. He sought desperately for ways to use up his enormous energy. At thirty-two, he was already a junior executive in a large corporation; however, he had little appreciation for his work or his achievements. He chronically complained about what he could do if only he had more authority. He had real talent and had been promised continued advancement.
A new executive joined the company who obviously felt threatened by Frank. Frank felt browbeaten and taunted by the attitude of the new executive, who was in a superior position. It was obvious to others as well as to Frank that he was being unfairly treated.
Frank decided to go directly to the president of the company with an ultimatum: “Either this guy goes or I go.” Unfortunately, the president was not willing to submit to this kind of pressure, and Frank went. He had no recourse but to join a new firm and start over again in a lesser, even more boring position. He had brought the toxic intrusions of the new executive to an end, but he paid the price in other ways. He had gone off half-cocked instead of using his resources to evolve a more gradual and more effective way of solving his problem.
Toxic people tend to implement the solution that provides immediate relief without considering the consequences. If they stopped to think, they might then choose moderate alternatives that might eventually be more satisfactory.
*71\350\8*
Because of the possible detrimental consequences to one’s well-being, it is not always realistic to take a stand against a toxic intrusion. It is healthier to tolerate a toxic pattern when the available alternatives would disrupt the person’s ability to satisfy his total needs, even though they might bring relief from the poison of the immediate situation. It is a toxic effort for a person to try to resolve a poisonous situation when he doesn’t have the resources to back himself up or accept the consequences of his action. It is the responsibility of each individual to take a risk to get what he wants or to avoid what he doesn’t want.
Frank W. was characteristically restless and impatient. He sought desperately for ways to use up his enormous energy. At thirty-two, he was already a junior executive in a large corporation; however, he had little appreciation for his work or his achievements. He chronically complained about what he could do if only he had more authority. He had real talent and had been promised continued advancement.
A new executive joined the company who obviously felt threatened by Frank. Frank felt browbeaten and taunted by the attitude of the new executive, who was in a superior position. It was obvious to others as well as to Frank that he was being unfairly treated.
Frank decided to go directly to the president of the company with an ultimatum: “Either this guy goes or I go.” Unfortunately, the president was not willing to submit to this kind of pressure, and Frank went. He had no recourse but to join a new firm and start over again in a lesser, even more boring position. He had brought the toxic intrusions of the new executive to an end, but he paid the price in other ways. He had gone off half-cocked instead of using his resources to evolve a more gradual and more effective way of solving his problem.
Toxic people tend to implement the solution that provides immediate relief without considering the consequences. If they stopped to think, they might then choose moderate alternatives that might eventually be more satisfactory.
*71\350\8*
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Written by admin in: Weight Loss |
Feb
08
2011
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LEGAL TERMINATIONS OF ABORTION: WHY, WHEN AND NOW?

LEGAL TERMINATIONS OF ABORTION: WHY, WHEN AND NOW?
Important reasons for L-T.s exist. A mother acquiring rubella in the first few weeks of pregnancy; severe viral or bacterial Infection in early pregnancy; the need to take heavy medication in early pregnancy; these are some of the reasons that few would argue about. The risk of Down’s syndrome, or spina bifida, increased if there is already one child in the family with these disorders, are well established. However, the entire question is open to extensive discussion. As we said before, get in touch with a competent gynaecologist if you have any problems in this direction.
In early pregnancy, termination is carried out by a method called suction curettage, a safe, quick and efficient method. In later pregnancy (in the fourth, fifth or sixth months, the so-called second trimester) special fluid is often injected into the amniotic sac containing the developing infant, and this soon causes an abortion.
Prostaglandin, a powerful hormone causing uterine contraction, is also being used as another satisfactory method. It may be used orally, as an injection or, more commonly, as a suppository introduced into the vaginal canal.
The risks of a legal termination, carried out in a modern hospital with all facilities, are small. Mortality rates have been quoted as three per 100000 women, much lower than the maternal mortality rate. ‘Moreover, contrary to some predictions, the repotted incidence of debilitating remorse or regrets following an induced abortion has been less than 5 per cent.’
*57\45\4*
Important reasons for L-T.s exist. A mother acquiring rubella in the first few weeks of pregnancy; severe viral or bacterial Infection in early pregnancy; the need to take heavy medication in early pregnancy; these are some of the reasons that few would argue about. The risk of Down’s syndrome, or spina bifida, increased if there is already one child in the family with these disorders, are well established. However, the entire question is open to extensive discussion. As we said before, get in touch with a competent gynaecologist if you have any problems in this direction.
In early pregnancy, termination is carried out by a method called suction curettage, a safe, quick and efficient method. In later pregnancy (in the fourth, fifth or sixth months, the so-called second trimester) special fluid is often injected into the amniotic sac containing the developing infant, and this soon causes an abortion.
Prostaglandin, a powerful hormone causing uterine contraction, is also being used as another satisfactory method. It may be used orally, as an injection or, more commonly, as a suppository introduced into the vaginal canal.
The risks of a legal termination, carried out in a modern hospital with all facilities, are small. Mortality rates have been quoted as three per 100000 women, much lower than the maternal mortality rate. ‘Moreover, contrary to some predictions, the repotted incidence of debilitating remorse or regrets following an induced abortion has been less than 5 per cent.’
*57\45\4*
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Written by admin in: Women's Health |
Jan
30
2011
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HEART RHYTHMS: HEART RATE AND PULSE

HEART RHYTHMS: HEART RATE AND PULSE
Abnormal heart speeds and rhythms can occur in normal persons as well as in those who have various types of heart disease. Some rhythms are harmless, but others may tire the heart by causing it to overwork. As stated, the normal heart rate is 60 to 100 beats per minute. An average person has a rate of 70 to 80. During exercise, excitement, or when a person is running a fever, the heart rate may increase to 120 to 130 beats per minute. This acceleration is perfectly normal.
Some persons are very much aware of an accelerated pulse when they are excited or nervous. Such a person may believe that something is wrong with his heart because he can feel it beating. If he is able to count his pulse, however, and if it is in the range described above, he should realize that there is usually nothing wrong with the heart itself.
The pulse is counted by placing the tip of the index finger of one hand on the opposite wrist at the side of the wrist that the thumb arises from. Cords will be felt running along under the skin, and between these cords a pulsation is felt. If the index finger is pressed too hard, the pulse will be obliterated, and if pressure is too light, no pulse will be felt. To determine the pulse or heart rate, count the number of impulses felt during one minute.
*24/309/5*
Abnormal heart speeds and rhythms can occur in normal persons as well as in those who have various types of heart disease. Some rhythms are harmless, but others may tire the heart by causing it to overwork. As stated, the normal heart rate is 60 to 100 beats per minute. An average person has a rate of 70 to 80. During exercise, excitement, or when a person is running a fever, the heart rate may increase to 120 to 130 beats per minute. This acceleration is perfectly normal.
Some persons are very much aware of an accelerated pulse when they are excited or nervous. Such a person may believe that something is wrong with his heart because he can feel it beating. If he is able to count his pulse, however, and if it is in the range described above, he should realize that there is usually nothing wrong with the heart itself.
The pulse is counted by placing the tip of the index finger of one hand on the opposite wrist at the side of the wrist that the thumb arises from. Cords will be felt running along under the skin, and between these cords a pulsation is felt. If the index finger is pressed too hard, the pulse will be obliterated, and if pressure is too light, no pulse will be felt. To determine the pulse or heart rate, count the number of impulses felt during one minute.
*24/309/5*
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Written by admin in: Cardio & Blood-Сholesterol |
Jan
23
2011
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OTHER CAUSES OF LUNG CANCER: ATMOSPHERIC POLLUTION

OTHER CAUSES OF LUNG CANCER: ATMOSPHERIC POLLUTION
Ideas about the cause of lung cancer have been so dominated by recognition of the effect of smoking for the last forty years that it is sometimes easy to forget that there may be other important causal factors and that lung cancer still occurs in non-smokers. The effect of smoking is so strong that it can be quite difficult to unravel other causes, because the presence of a few smokers in any group will so alter the statistics. However, there are undoubtedly other factors at work in the development of lung cancer and many of them can now be judged.
Passive smoking and the effects of asbestos and industrial hazards can act through atmospheric pollution to cause lung cancer. General atmospheric pollution by coal smoke was probably not a very important cause of lung cancer, although it may have contributed to some lung cancers in smokers.
Radon gas is radioactive and is present in some rocks. Certain geological conditions allow it to be released from the soil and, in some parts of the world, it appears to accumulate with its radioactive products in houses. In the United Kingdom this is most apparent in Devon and Cornwall and in parts of Derbyshire where the concentration of radon gas in houses may be much higher than in the country in general. However, lung cancer is not especially common in Cornwall and the whole question of a relationship between radon and lung cancer is now the subject of careful examination. Studies from Scandinavia and the United Scares do suggest that there may be a link between background radon concentrations and lung cancer, and if this is confirmed in Britain, some houses may well nerd specialized ventilation.
*44\194\4*

Ideas about the cause of lung cancer have been so dominated by recognition of the effect of smoking for the last forty years that it is sometimes easy to forget that there may be other important causal factors and that lung cancer still occurs in non-smokers. The effect of smoking is so strong that it can be quite difficult to unravel other causes, because the presence of a few smokers in any group will so alter the statistics. However, there are undoubtedly other factors at work in the development of lung cancer and many of them can now be judged.

Passive smoking and the effects of asbestos and industrial hazards can act through atmospheric pollution to cause lung cancer. General atmospheric pollution by coal smoke was probably not a very important cause of lung cancer, although it may have contributed to some lung cancers in smokers.

Radon gas is radioactive and is present in some rocks. Certain geological conditions allow it to be released from the soil and, in some parts of the world, it appears to accumulate with its radioactive products in houses. In the United Kingdom this is most apparent in Devon and Cornwall and in parts of Derbyshire where the concentration of radon gas in houses may be much higher than in the country in general. However, lung cancer is not especially common in Cornwall and the whole question of a relationship between radon and lung cancer is now the subject of careful examination. Studies from Scandinavia and the United Scares do suggest that there may be a link between background radon concentrations and lung cancer, and if this is confirmed in Britain, some houses may well nerd specialized ventilation.

*44\194\4*

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Written by admin in: Cancer |
Jan
12
2011
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THE CANDIDA-ASTHMA CONNECTION: NUTRITIONAL NEEDS OF CANDIDA ALBICANS

THE CANDIDA-ASTHMA CONNECTION: NUTRITIONAL NEEDS OF CANDIDA ALBICANS
Growth is promoted by a variety of sugars and polysaccharides, particularly glucose, corn sugar and biotin. It has been found that galactose caused the greatest adherence of Candida albicans, followed by glucose, fructose, sucrose and maltose; while protein-digesting enzymes reduced the ability of Candida albicans to adhere to vaginal and other epilethial surfaces. Because the ability of these organisms to adhere is a measure of their toxicity, it is also important to know that cholesterol and egg phospholipids block adherence while oleic and palmitic acid (as in olive and palm oils) do not.
Candida albicans will grow rapidly in a medium of sugars, biotin and inorganic salts. When starches and other sugars, such as lycogen and dextrene, are added to the medium, the Candida grows a little more slowly but produces more filaments. Candida albicans forms mycelia on human serum with almost all amino acids, glucose and at an acid pH. When Candida albicans growth rates in cultures containing either plenty or very little biotin were compared, it was found that the higher the biotin content, the greater the yeast form grew. So biotin represents a two-edged sword. It encourages an increase in Candida albicans but makes it less likely to change into the myceal form. Since both forms can be pathogenic or change into a pathogenic form, however, the use of biotin can create as many problems as it may solve. There is another problem. During the growth process, the yeast form of Candida albicans is more virulent than the myceal form, and at a lower temperature. If copper is added, then the myceal form becomes more virulent than the yeast form, which is one more reason for avoiding tap water, since it often has a high copper content. The old belief that one form, the myceal, was dangerous and the other (bud yeast) was not, has been shown conclusively to be invalid by the work of Professor Coral Saltarelli. In fact the myceal forms can revert to the bud yeast form if they are supplied with cysteine. The budding forms then tend to be more pathogenic.
The antibiotic tetracyclin was found to increase the toxicity of both the yeast and myceal forms of Candida albicans. Considering the widespread use and abuse of this medication, often in young people with acne or similar skin conditions, one must wonder if this fact alone may be responsible for the increasing incidence of this complaint.
The vitamin and amino acid requirements of Candida albicans have been extensively studied. It was found that some Candida species did not require any vitamins but Candida albicans and some of its variants were definitely in need of biotin. Some amino acids reduce the need for biotin. No external supply of amino acids is needed by Candida albicans, which indicates that it can synthesise all the amino acids it needs in the presence of biotin.
In immunologically compromised people, such as organ transplant recipients, patients taking corticosteroids and people undergoing intensive antibiotic therapy, the organism can spread systematically and even cause death.
When drugs such as the anti-fungals amphotericin B or nystatin were used to treat Candida albicans, they were found to be very successful in killing the fungus. At the same time, if doses were too low, fungal growth was enhanced. In other words, too little anti-fungal medication given for too short a period of time may actually make the problem worse. This is a very important fact to bear in mind because patients often stop taking their prescribed anti-fungals as soon as some of the symptoms disappear or reduce in severity.
Often we see people who have taken anti-fungals at a low dose, say two to four tablets per day for a week or so, who are not aware that this may cause the organism to overgrow later on and cause other, not necessarily vaginal, problems. The same applies to diets, which may have to be followed for many months until the yeast infection and possible allergies or intolerances have been successfully treated.
Many commonly used medications such as sulphonamides, or the antibiotics septrim or bactrim, actually impair the body’s ability to control and kill Candida albicans.
*55\145\2*
Growth is promoted by a variety of sugars and polysaccharides, particularly glucose, corn sugar and biotin. It has been found that galactose caused the greatest adherence of Candida albicans, followed by glucose, fructose, sucrose and maltose; while protein-digesting enzymes reduced the ability of Candida albicans to adhere to vaginal and other epilethial surfaces. Because the ability of these organisms to adhere is a measure of their toxicity, it is also important to know that cholesterol and egg phospholipids block adherence while oleic and palmitic acid (as in olive and palm oils) do not.
Candida albicans will grow rapidly in a medium of sugars, biotin and inorganic salts. When starches and other sugars, such as lycogen and dextrene, are added to the medium, the Candida grows a little more slowly but produces more filaments. Candida albicans forms mycelia on human serum with almost all amino acids, glucose and at an acid pH. When Candida albicans growth rates in cultures containing either plenty or very little biotin were compared, it was found that the higher the biotin content, the greater the yeast form grew. So biotin represents a two-edged sword. It encourages an increase in Candida albicans but makes it less likely to change into the myceal form. Since both forms can be pathogenic or change into a pathogenic form, however, the use of biotin can create as many problems as it may solve. There is another problem. During the growth process, the yeast form of Candida albicans is more virulent than the myceal form, and at a lower temperature. If copper is added, then the myceal form becomes more virulent than the yeast form, which is one more reason for avoiding tap water, since it often has a high copper content. The old belief that one form, the myceal, was dangerous and the other (bud yeast) was not, has been shown conclusively to be invalid by the work of Professor Coral Saltarelli. In fact the myceal forms can revert to the bud yeast form if they are supplied with cysteine. The budding forms then tend to be more pathogenic.
The antibiotic tetracyclin was found to increase the toxicity of both the yeast and myceal forms of Candida albicans. Considering the widespread use and abuse of this medication, often in young people with acne or similar skin conditions, one must wonder if this fact alone may be responsible for the increasing incidence of this complaint.
The vitamin and amino acid requirements of Candida albicans have been extensively studied. It was found that some Candida species did not require any vitamins but Candida albicans and some of its variants were definitely in need of biotin. Some amino acids reduce the need for biotin. No external supply of amino acids is needed by Candida albicans, which indicates that it can synthesise all the amino acids it needs in the presence of biotin.
In immunologically compromised people, such as organ transplant recipients, patients taking corticosteroids and people undergoing intensive antibiotic therapy, the organism can spread systematically and even cause death.
When drugs such as the anti-fungals amphotericin B or nystatin were used to treat Candida albicans, they were found to be very successful in killing the fungus. At the same time, if doses were too low, fungal growth was enhanced. In other words, too little anti-fungal medication given for too short a period of time may actually make the problem worse. This is a very important fact to bear in mind because patients often stop taking their prescribed anti-fungals as soon as some of the symptoms disappear or reduce in severity.
Often we see people who have taken anti-fungals at a low dose, say two to four tablets per day for a week or so, who are not aware that this may cause the organism to overgrow later on and cause other, not necessarily vaginal, problems. The same applies to diets, which may have to be followed for many months until the yeast infection and possible allergies or intolerances have been successfully treated.
Many commonly used medications such as sulphonamides, or the antibiotics septrim or bactrim, actually impair the body’s ability to control and kill Candida albicans.
*55\145\2*
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Written by admin in: Allergies |
Dec
30
2010
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BILIARY INFECTIONS: ACUTE ACALCULOUS CHOLECYSTITIS

BILIARY INFECTIONS: ACUTE ACALCULOUS CHOLECYSTITIS
Infection of the gallbladder may occur in the absence of gallstones in approximately 10% of patients with acute cholecystitis, and this is termed acalculous cholecystitis. Although it is less common than acute calculous cholecystitis, it is much more serious, accounting for an overall mortality rate of approximately 40%. Failure to diagnose and treat к acute acalculous cholecystitis early enough can lead to gangrene or perforation of the gallbladder wall. Cases of this disease are typically found in elderly patients with multiple comorbid conditions or in the critically ill who have undergone major surgery, suffered serious trauma or burns, or are receiving parenteral nutrition.
Pathogenesis
The pathogenesis of acute acalculous cholecystitis is poorly understood but is likely associated with bile stasis and gallbladder dysfunction.
Impaired gallbladder contractile function may occur in the elderly or critically ill, leading to biliary stasis, gallbladder wall inflammation, and ischemia. Necrosis and bacterial invasion of the gallbladder mucosa can subsequently occur.
Clinical Manifestations
The clinical findings of acute acalculous cholecystitis are usually indistinguishable from those of acute calculous cholecystitis. Fever, RUQ abdominal pain, nausea, and anorexia are common. In some situations, however, fever, leukocytosis, and vague abdominal pain may be the only clues. A RUQ mass may be palpable, and jaundice is seen in up to 20% of patients due to partial biliary obstruction induced by inflammation extending into the common bile duct.
Diagnosis
The clinical diagnosis of acalculous cholecystitis can be extremely difficult and requires a high index of suspicion. Leukocytosis, conjugated hyperbilirubinemia, and mild elevations in transaminases are common.
As with acute calculous cholecystitis, abdominal ultrasonography is considered the first-line study and usually demonstrates a large, tense gallbladder without stones. Other findings include a thickened (>5 mm) and edematous gallbladder wall, pericholecystic fluid, biliary sludge, and a sonographic Murphy sign. Abdominal CT scan can also be used to confirm the diagnosis.
Treatment
Prompt institution of therapy is essential. After blood cultures have been drawn, intravenous antibiotics that cover the biliary flora should be started. The definitive treatment is either open or laparoscopic cholecystectomy. With unstable patients in whom surgery is contraindicated, ultrasound-guided cholecystostomy should be considered.
*104/348/5*
Infection of the gallbladder may occur in the absence of gallstones in approximately 10% of patients with acute cholecystitis, and this is termed acalculous cholecystitis. Although it is less common than acute calculous cholecystitis, it is much more serious, accounting for an overall mortality rate of approximately 40%. Failure to diagnose and treat к acute acalculous cholecystitis early enough can lead to gangrene or perforation of the gallbladder wall. Cases of this disease are typically found in elderly patients with multiple comorbid conditions or in the critically ill who have undergone major surgery, suffered serious trauma or burns, or are receiving parenteral nutrition.
Pathogenesis
The pathogenesis of acute acalculous cholecystitis is poorly understood but is likely associated with bile stasis and gallbladder dysfunction.
Impaired gallbladder contractile function may occur in the elderly or critically ill, leading to biliary stasis, gallbladder wall inflammation, and ischemia. Necrosis and bacterial invasion of the gallbladder mucosa can subsequently occur.
Clinical Manifestations
The clinical findings of acute acalculous cholecystitis are usually indistinguishable from those of acute calculous cholecystitis. Fever, RUQ abdominal pain, nausea, and anorexia are common. In some situations, however, fever, leukocytosis, and vague abdominal pain may be the only clues. A RUQ mass may be palpable, and jaundice is seen in up to 20% of patients due to partial biliary obstruction induced by inflammation extending into the common bile duct.
Diagnosis
The clinical diagnosis of acalculous cholecystitis can be extremely difficult and requires a high index of suspicion. Leukocytosis, conjugated hyperbilirubinemia, and mild elevations in transaminases are common.
As with acute calculous cholecystitis, abdominal ultrasonography is considered the first-line study and usually demonstrates a large, tense gallbladder without stones. Other findings include a thickened (>5 mm) and edematous gallbladder wall, pericholecystic fluid, biliary sludge, and a sonographic Murphy sign. Abdominal CT scan can also be used to confirm the diagnosis.
Treatment
Prompt institution of therapy is essential. After blood cultures have been drawn, intravenous antibiotics that cover the biliary flora should be started. The definitive treatment is either open or laparoscopic cholecystectomy. With unstable patients in whom surgery is contraindicated, ultrasound-guided cholecystostomy should be considered.
*104/348/5*
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Written by admin in: Anti-Infectives |

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