In part 3 of the Healthy Aging Presentation, we are going to examine the very common but under-reported phenomenon of Adverse Drug Reactions.
In North America:
• There are over 2 million serious adverse drug reactions each year
• Over 100,000 deaths occur yearly due to adverse drug reactions
• According to the Journal of the American Medical association (JAMA); most serious (often fatal) adverse drug events are preventable.
To illustrate the problem of adverse drug reactions, we are going to use a case study of a patient named Jenny.
Jenny’s is a single 48 year old, working mother with 2 teen age boys. Jenny experienced a health crisis from an adverse drug reaction compounded by self medication.
Jenny presented to her physician with the following symptoms:
• Anxiety
• Headaches
• Fatigue
• Low back pain
The medical examination findings revealed:
• Increased Total Cholesterol
• She was 40 pounds overweight
• An increase in blood pressure (measured at 150/100)
• Extreme Tenderness of her low back and neck muscles
Therefore, Jenny was diagnosed with:
• Hypercholesterolemia
• Hypertension
• Tension headaches
• Anxiety
She was prescribed the following medications to treat her symptoms:
• Lipitor (to decrease cholesterol)
• Ativan (to decrease anxiety)
• Naproxen (an anti-inflammatory) to relieve symptoms of her back pain and headaches
Each and every medication has common side effects. The common side effects of Lipitor include:
• 1. Headaches
• 2. Constipation/diarrhea
• 3. Stomach pain
• 4. Muscle and Joint Pain
• 5. Rash
• 6. Muscle weakness and tenderness
After taking the medication exactly as prescribed for 2 weeks, Jenny experienced:
• 1. Increased intensity of headaches
• 2. Increased fatigue which prevented her from performing her regular job duties.
• 3. Severe Abdominal pain
• * These are all signs of an ADVERSE DRUG REACTION
Instead of reporting the symptoms to her doctor, Jenny decided to self medicate by taking Tylenol #3 and Percocet. Both these medications are very potent analgesics. It is no surprise that Jenny ended up in the hospital with a diagnosis of:
• 1. Adverse Drug Reaction
• 2. Adverse Drug Interaction from self medication
After being treated at the hospital, Jenny decided to visit her local chiropractor. She explained her problems to the chiropractor and asked him if there was anything that he could do. After taking a thorough history and performing a comprehensive physical examination, the chiropractor told Jenny that he agreed with the medical diagnosis. Jenny was somewhat perplexed and asked the chiropractor 2 questions:
• 1. Why do I have high cholesterol, high blood pressure, and ache all over?
• 2. Why can’t I lose weight Doc?
The chiropractor said that all her signs and symptoms pointed to one underlying cause. His diagnosis was that she suffered from Couch Potato Syndrome! Her symptoms were mainly due to inactivity and a sedentary lifestyle. She was looking for a quick fix with pills and potions.
After several minutes of a heated discussion, the chiropractor proposed the following treatment program.
• 1. Walk 30 minutes daily with Nordic walking poles
• 2. Yoga classes
• 3. Regular Chiropractic care
• 4. Take all old medications to her local pharmacy in a brown bag for proper disposal.
• 5. In future, report all side effects of medication to the physician.
Jenny agreed that the treatment plan made sense, but quickly retorted that she didn’t have time to exercise. The doctor replied, “What fits your busy schedule better? Exercising 1 hour a day or being dead 24 hours a day?”
Jenny finally agreed to the treatment program and has never looked back since.
After 2 months of following her treatment plan Jenny has:
• 1. Lost 15 pounds
• 2. Takes only 1 medication
• 3. Reduced frequency and intensity of her headaches
• 4. Has signed up for her first ever 5 kilometer fun run!
Remember the facts:
• In North America there are over 2 million serious adverse drug reactions each year from prescriptions taken as prescribed
• Over 100,000 deaths occur yearly due to adverse drug reactions
• Adverse drug reactions are the 4th leading cause of death ahead of AIDS, pneumonia, accidents and automobile deaths
Medications are necessary, may be life saving and may improve the quality of your life, but why not try safer conservative measures first?
When was the last time your doctor wrote you a prescription for exercise?
Today’s action steps are:
• 1. Put all old prescriptions in a brown paper bag and bring to your local pharmacy for proper disposal.
• 2. Make an Appointment for a Chiropractic Check up today.
• 3. Take a walk around the block with your family and friends. Instead of playing cards or drinking coffee, meet at the park every week to exercise!
Saturday, September 29, 2007
Friday, September 28, 2007
Hypertension - What Exactly Causes High Blood Pressure?
High blood pressure (hypertension) is often called the "Silent Killer" because of a distinct lack of symptoms. The first time someone finds out they may have hypertension is after a routine test at the doctor's office.
Your doctor can quickly and easily check your blood pressure, but do be warned, there is a very real syndrome called "White Coat Syndrome" where people's blood pressure actually increases as a direct response to visiting the doctor. Mine did just that, so every test the doctor did pointed to high blood pressure. My solution to this was to buy a home digital blood pressure monitor. They are relatively cheap, and are very accurate (although do get it checked by your doctor for accuracy). The results were amazing, as my blood pressure taken at home was usually normal.
Since hypertension is a major factor in strokes and coronary heart disease, it is vital that we all get checked frequently.
While some people are at more risk of developing high blood pressure, the sad truth is that 90% or more of cases have unknown causes. For this reason, it is not possible to fully answer the question of what causes high blood pressure, although we can highlight a number of factors thought to be involved.
Blood pressure is carefully controlled by the human body, keeping it within very strict limits. Simply put, if blood pressure drops, the body can contract the smooth muscles in arteries and arterioles, decreasing the size of the blood vessels, which in turn increases the resistance encountered by the blood trying to push its way through. Blood pressure increases. If blood pressure becomes too high, the body can reverse this process.
This obviously does not explain long-term hypertension, which places a huge strain on both arteries and the heart itself. The factors which have been linked to causing high blood pressure include the following:
Excessive alcohol
Smoking
Obesity
Salt in the diet
Stress
Caffeine
Genetic factors
Obviously most of these factors are within our own control (with the exception of genetics), so we do have the potential to lower our blood pressure by more natural means. Following a healthy diet with increased fruit and vegetables intake, while reducing those factors harmful to our health can help lower blood pressure. If you are over-weight, losing a few pounds can help a lot. Even walking for 30 minutes, 3 times a week can have beneficial effects on your blood pressure. There is a diet called the DASH diet that has been clinically proven to lower blood pressure. Its worth looking it up.
However, as with all things medical, consult your doctor before starting any exercise program or radically changing your diet.
Your doctor can quickly and easily check your blood pressure, but do be warned, there is a very real syndrome called "White Coat Syndrome" where people's blood pressure actually increases as a direct response to visiting the doctor. Mine did just that, so every test the doctor did pointed to high blood pressure. My solution to this was to buy a home digital blood pressure monitor. They are relatively cheap, and are very accurate (although do get it checked by your doctor for accuracy). The results were amazing, as my blood pressure taken at home was usually normal.
Since hypertension is a major factor in strokes and coronary heart disease, it is vital that we all get checked frequently.
While some people are at more risk of developing high blood pressure, the sad truth is that 90% or more of cases have unknown causes. For this reason, it is not possible to fully answer the question of what causes high blood pressure, although we can highlight a number of factors thought to be involved.
Blood pressure is carefully controlled by the human body, keeping it within very strict limits. Simply put, if blood pressure drops, the body can contract the smooth muscles in arteries and arterioles, decreasing the size of the blood vessels, which in turn increases the resistance encountered by the blood trying to push its way through. Blood pressure increases. If blood pressure becomes too high, the body can reverse this process.
This obviously does not explain long-term hypertension, which places a huge strain on both arteries and the heart itself. The factors which have been linked to causing high blood pressure include the following:
Excessive alcohol
Smoking
Obesity
Salt in the diet
Stress
Caffeine
Genetic factors
Obviously most of these factors are within our own control (with the exception of genetics), so we do have the potential to lower our blood pressure by more natural means. Following a healthy diet with increased fruit and vegetables intake, while reducing those factors harmful to our health can help lower blood pressure. If you are over-weight, losing a few pounds can help a lot. Even walking for 30 minutes, 3 times a week can have beneficial effects on your blood pressure. There is a diet called the DASH diet that has been clinically proven to lower blood pressure. Its worth looking it up.
However, as with all things medical, consult your doctor before starting any exercise program or radically changing your diet.
Thursday, September 27, 2007
Outbreak of Common Warts on The Body
Common warts are the most seen warts on people.Dogs and cats can also get common warts. Some people believe that common warts are caused by frogs, this is not true. Common warts tend to be caused by an overgrowth of skin cells on the outside of the skin causing a lump to appear. Common warts however will not be seen on areas of the body like the soles of the feet or genitals. Like all warts, common warts are caused by the human papillomavirus. The strain which causes common warts to appear on the body remains dormant in millions of people and may only cause wart outbreaks on some people. Warts tend to be caused by an overgrowth of skin cells on the outside of the skin causing a lump to appear.
Warts are generally seen on parts of the body such as the hands fingers and finger nail regions sometimes causing an overgrowth of warts to occur on the nail. Warts found on the hands are different from those found elsewhere on the body. Warts also have different names depending on where they are on the body but typically can be treated the same way as the virus remains the same. Anyone can get warts although the HPV virus may not always be just random it can be hereditary. The good thing to know about regular warts on the hands is they cannot be spread to others. Normal warts are more of a common annoyance than anything else.
Warts may appear on the hands as large pink lumps; sometimes the warts have a rough texture. Warts may appear singly or appear in clusters appearing to be white and bubbling. There are many different ways to get rid of warts but many leave scars and are very painful.
Warts are generally seen on parts of the body such as the hands fingers and finger nail regions sometimes causing an overgrowth of warts to occur on the nail. Warts found on the hands are different from those found elsewhere on the body. Warts also have different names depending on where they are on the body but typically can be treated the same way as the virus remains the same. Anyone can get warts although the HPV virus may not always be just random it can be hereditary. The good thing to know about regular warts on the hands is they cannot be spread to others. Normal warts are more of a common annoyance than anything else.
Warts may appear on the hands as large pink lumps; sometimes the warts have a rough texture. Warts may appear singly or appear in clusters appearing to be white and bubbling. There are many different ways to get rid of warts but many leave scars and are very painful.
Wednesday, September 26, 2007
The Truth About Xanax Side Effects
You've probably heard all sorts of things about Xanax (brand name of the drug Alprazolam, used for anxiety and panic disorder treatment). No, Xanax doesn't give you brain damage. No, you aren't likely to become permanently addicted to it either. There's alot to learn.
This article outlines the Common, Uncommon, and Rare side effects of Xanax use and is the product of various personal and professional research
Common Side Effects. Side effects, if they occur, are generally observed at the beginning of therapy and usually disappear upon continued use. The most commonly reported side effects in clinical trials were drowsiness, fatigue, impaired coordination, irritability, light-headedness, memory impairment, insomnia, and headache. Here are some common side effects:
* drowsiness
* light-headedness
* tiredness
* dizziness
* irritability
* talkativeness
* dry mouth
* increased salivation
* changes in sex drive or ability
* changes in appetite
* weight changes
* difficulty urinatingnull
The most frequent side effects of alprazolam taken at lower doses are drowsiness or lightheadedness, which probably reflect the action of the drug. Side effects of higher dosages (those used for panic attacks) include fatigue, memory problems, speech problems, constipation, and changes in appetite with resultant changes in weight.
Feelings of being 'groggy'. Unintentional daytime sedation, hangover effect (residual drowsiness and impaired reaction time on awakening), and rebound insomnia may also occur.
Uncommon Side Effects
Sometimes there can be more serious side effects of Xanax. The treatment for serious side effects of xanax require physician's advice or emergency attention depending upon the seriousness of the effect.
The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
* seizures
* seeing things or hearing voices that do not exist (hallucinating)
* severe skin rashnull
* yellowing of the skin or eyes
* memory problems
* confusion
* problems with coordination
Less common Xanax side effects can also include:
* thrombophlebitis
* vertigo
* paradoxical excitation
* aggression and hostility
* respiratory depression
* respiratory arrest
* arrhythmias
* severe hypotension
* abdominal cramps
* anterograde amnesia
* constipation
* dry mouth
* hyperventilation
* blurred vision
* nausea
* chest
* pain
* decreased libido / change in sex drive
* confusion
* headache
* change in appetite
* insomnia
* unusual dreams
* change in salivation
* low blood
* pressure
* racing heartbeat
* fainting
* severe nasal congestion
* difficulty urinating
* sweating
* weight change
* skin irritation
* twitching or tremors
* nervous or anxious state
* sun sensitivity
* respiratory infection
* memory impairment
* loss of coordination
Rare Side Effects
As with all benzodiazepines, paradoxical reactions such as stimulation, increased muscle spasticity, sleep disturbances, hallucinations, and other adverse behavioral effects such as agitation, rage, irritability, and aggressive or hostile behavior have been reported rarely.
If you notice your eyes or skin turning a yellow colour, stop taking Xanax and contact your doctor straight away.
Rarer side effects (that strongly suggest you should taper or discontinue treatment) include:
* allergic reactions, including rash and anaphylaxis
* blood disorders, including leucopenia and leucocytosis
* jaundice
* difficulty concentrating
* slurred or unusual speech
* double vision
* fear or anxiety
* altered sense of taste
* lack of inhibition
* muscle cramps or spasms
* urination problems
* tingling
* incontinence
* warmth
* weakness
* change in muscle tone
* yellow eyes and skin
* hyperexcitement or overstimulation
* hallucinations
* rage or other hostile behavior
* transient elevated liver function tests
* tremors
* insomnia or sleeping difficultiesnull
The less common side effects of xanax can also be manifested as the following:
* Neurological effects: Blurred vision, headache, seizures, slurred speech, difficulty in depth perception.
* Psychiatric effects: Mental confusion, depression, irritability, nervousness, sleep disturbances, euphoria, lethargy, stupor.
* Gastrointestinal effects: Dry mouth, nausea, non-specific gastrointestinal disturbances, vomiting.
* Muscular effects: Muscle spasm, muscle weakness.
* Cardiovascular effects: Hypotension, palpitations, tachycardia.
* Dermatological effects: Pruritus, rash.
* Genitourinary effects: Incontinence, change in libido.
* Hematological effects: Decreased hemoglobin and hematocrit, increased and decreased WBC.
* Hepatic effects: Elevations of alkaline phosphates, bilirubin, AST (SGOT), ALT (SGPT).
* Miscellaneous: Increased and decreased blood sugar levels.
This article outlines the Common, Uncommon, and Rare side effects of Xanax use and is the product of various personal and professional research
Common Side Effects. Side effects, if they occur, are generally observed at the beginning of therapy and usually disappear upon continued use. The most commonly reported side effects in clinical trials were drowsiness, fatigue, impaired coordination, irritability, light-headedness, memory impairment, insomnia, and headache. Here are some common side effects:
* drowsiness
* light-headedness
* tiredness
* dizziness
* irritability
* talkativeness
* dry mouth
* increased salivation
* changes in sex drive or ability
* changes in appetite
* weight changes
* difficulty urinatingnull
The most frequent side effects of alprazolam taken at lower doses are drowsiness or lightheadedness, which probably reflect the action of the drug. Side effects of higher dosages (those used for panic attacks) include fatigue, memory problems, speech problems, constipation, and changes in appetite with resultant changes in weight.
Feelings of being 'groggy'. Unintentional daytime sedation, hangover effect (residual drowsiness and impaired reaction time on awakening), and rebound insomnia may also occur.
Uncommon Side Effects
Sometimes there can be more serious side effects of Xanax. The treatment for serious side effects of xanax require physician's advice or emergency attention depending upon the seriousness of the effect.
The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
* seizures
* seeing things or hearing voices that do not exist (hallucinating)
* severe skin rashnull
* yellowing of the skin or eyes
* memory problems
* confusion
* problems with coordination
Less common Xanax side effects can also include:
* thrombophlebitis
* vertigo
* paradoxical excitation
* aggression and hostility
* respiratory depression
* respiratory arrest
* arrhythmias
* severe hypotension
* abdominal cramps
* anterograde amnesia
* constipation
* dry mouth
* hyperventilation
* blurred vision
* nausea
* chest
* pain
* decreased libido / change in sex drive
* confusion
* headache
* change in appetite
* insomnia
* unusual dreams
* change in salivation
* low blood
* pressure
* racing heartbeat
* fainting
* severe nasal congestion
* difficulty urinating
* sweating
* weight change
* skin irritation
* twitching or tremors
* nervous or anxious state
* sun sensitivity
* respiratory infection
* memory impairment
* loss of coordination
Rare Side Effects
As with all benzodiazepines, paradoxical reactions such as stimulation, increased muscle spasticity, sleep disturbances, hallucinations, and other adverse behavioral effects such as agitation, rage, irritability, and aggressive or hostile behavior have been reported rarely.
If you notice your eyes or skin turning a yellow colour, stop taking Xanax and contact your doctor straight away.
Rarer side effects (that strongly suggest you should taper or discontinue treatment) include:
* allergic reactions, including rash and anaphylaxis
* blood disorders, including leucopenia and leucocytosis
* jaundice
* difficulty concentrating
* slurred or unusual speech
* double vision
* fear or anxiety
* altered sense of taste
* lack of inhibition
* muscle cramps or spasms
* urination problems
* tingling
* incontinence
* warmth
* weakness
* change in muscle tone
* yellow eyes and skin
* hyperexcitement or overstimulation
* hallucinations
* rage or other hostile behavior
* transient elevated liver function tests
* tremors
* insomnia or sleeping difficultiesnull
The less common side effects of xanax can also be manifested as the following:
* Neurological effects: Blurred vision, headache, seizures, slurred speech, difficulty in depth perception.
* Psychiatric effects: Mental confusion, depression, irritability, nervousness, sleep disturbances, euphoria, lethargy, stupor.
* Gastrointestinal effects: Dry mouth, nausea, non-specific gastrointestinal disturbances, vomiting.
* Muscular effects: Muscle spasm, muscle weakness.
* Cardiovascular effects: Hypotension, palpitations, tachycardia.
* Dermatological effects: Pruritus, rash.
* Genitourinary effects: Incontinence, change in libido.
* Hematological effects: Decreased hemoglobin and hematocrit, increased and decreased WBC.
* Hepatic effects: Elevations of alkaline phosphates, bilirubin, AST (SGOT), ALT (SGPT).
* Miscellaneous: Increased and decreased blood sugar levels.
Tuesday, September 25, 2007
The Truth About Xanax Side Effects
You've probably heard all sorts of things about Xanax (brand name of the drug Alprazolam, used for anxiety and panic disorder treatment). No, Xanax doesn't give you brain damage. No, you aren't likely to become permanently addicted to it either. There's alot to learn.
This article outlines the Common, Uncommon, and Rare side effects of Xanax use and is the product of various personal and professional research
Common Side Effects. Side effects, if they occur, are generally observed at the beginning of therapy and usually disappear upon continued use. The most commonly reported side effects in clinical trials were drowsiness, fatigue, impaired coordination, irritability, light-headedness, memory impairment, insomnia, and headache. Here are some common side effects:
* drowsiness
* light-headedness
* tiredness
* dizziness
* irritability
* talkativeness
* dry mouth
* increased salivation
* changes in sex drive or ability
* changes in appetite
* weight changes
* difficulty urinatingnull
The most frequent side effects of alprazolam taken at lower doses are drowsiness or lightheadedness, which probably reflect the action of the drug. Side effects of higher dosages (those used for panic attacks) include fatigue, memory problems, speech problems, constipation, and changes in appetite with resultant changes in weight.
Feelings of being 'groggy'. Unintentional daytime sedation, hangover effect (residual drowsiness and impaired reaction time on awakening), and rebound insomnia may also occur.
Uncommon Side Effects
Sometimes there can be more serious side effects of Xanax. The treatment for serious side effects of xanax require physician's advice or emergency attention depending upon the seriousness of the effect.
The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
* seizures
* seeing things or hearing voices that do not exist (hallucinating)
* severe skin rashnull
* yellowing of the skin or eyes
* memory problems
* confusion
* problems with coordination
Less common Xanax side effects can also include:
* thrombophlebitis
* vertigo
* paradoxical excitation
* aggression and hostility
* respiratory depression
* respiratory arrest
* arrhythmias
* severe hypotension
* abdominal cramps
* anterograde amnesia
* constipation
* dry mouth
* hyperventilation
* blurred vision
* nausea
* chest
* pain
* decreased libido / change in sex drive
* confusion
* headache
* change in appetite
* insomnia
* unusual dreams
* change in salivation
* low blood
* pressure
* racing heartbeat
* fainting
* severe nasal congestion
* difficulty urinating
* sweating
* weight change
* skin irritation
* twitching or tremors
* nervous or anxious state
* sun sensitivity
* respiratory infection
* memory impairment
* loss of coordination
Rare Side Effects
As with all benzodiazepines, paradoxical reactions such as stimulation, increased muscle spasticity, sleep disturbances, hallucinations, and other adverse behavioral effects such as agitation, rage, irritability, and aggressive or hostile behavior have been reported rarely.
If you notice your eyes or skin turning a yellow colour, stop taking Xanax and contact your doctor straight away.
Rarer side effects (that strongly suggest you should taper or discontinue treatment) include:
* allergic reactions, including rash and anaphylaxis
* blood disorders, including leucopenia and leucocytosis
* jaundice
* difficulty concentrating
* slurred or unusual speech
* double vision
* fear or anxiety
* altered sense of taste
* lack of inhibition
* muscle cramps or spasms
* urination problems
* tingling
* incontinence
* warmth
* weakness
* change in muscle tone
* yellow eyes and skin
* hyperexcitement or overstimulation
* hallucinations
* rage or other hostile behavior
* transient elevated liver function tests
* tremors
* insomnia or sleeping difficultiesnull
The less common side effects of xanax can also be manifested as the following:
* Neurological effects: Blurred vision, headache, seizures, slurred speech, difficulty in depth perception.
* Psychiatric effects: Mental confusion, depression, irritability, nervousness, sleep disturbances, euphoria, lethargy, stupor.
* Gastrointestinal effects: Dry mouth, nausea, non-specific gastrointestinal disturbances, vomiting.
* Muscular effects: Muscle spasm, muscle weakness.
* Cardiovascular effects: Hypotension, palpitations, tachycardia.
* Dermatological effects: Pruritus, rash.
* Genitourinary effects: Incontinence, change in libido.
* Hematological effects: Decreased hemoglobin and hematocrit, increased and decreased WBC.
* Hepatic effects: Elevations of alkaline phosphates, bilirubin, AST (SGOT), ALT (SGPT).
* Miscellaneous: Increased and decreased blood sugar levels.
This article outlines the Common, Uncommon, and Rare side effects of Xanax use and is the product of various personal and professional research
Common Side Effects. Side effects, if they occur, are generally observed at the beginning of therapy and usually disappear upon continued use. The most commonly reported side effects in clinical trials were drowsiness, fatigue, impaired coordination, irritability, light-headedness, memory impairment, insomnia, and headache. Here are some common side effects:
* drowsiness
* light-headedness
* tiredness
* dizziness
* irritability
* talkativeness
* dry mouth
* increased salivation
* changes in sex drive or ability
* changes in appetite
* weight changes
* difficulty urinatingnull
The most frequent side effects of alprazolam taken at lower doses are drowsiness or lightheadedness, which probably reflect the action of the drug. Side effects of higher dosages (those used for panic attacks) include fatigue, memory problems, speech problems, constipation, and changes in appetite with resultant changes in weight.
Feelings of being 'groggy'. Unintentional daytime sedation, hangover effect (residual drowsiness and impaired reaction time on awakening), and rebound insomnia may also occur.
Uncommon Side Effects
Sometimes there can be more serious side effects of Xanax. The treatment for serious side effects of xanax require physician's advice or emergency attention depending upon the seriousness of the effect.
The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
* seizures
* seeing things or hearing voices that do not exist (hallucinating)
* severe skin rashnull
* yellowing of the skin or eyes
* memory problems
* confusion
* problems with coordination
Less common Xanax side effects can also include:
* thrombophlebitis
* vertigo
* paradoxical excitation
* aggression and hostility
* respiratory depression
* respiratory arrest
* arrhythmias
* severe hypotension
* abdominal cramps
* anterograde amnesia
* constipation
* dry mouth
* hyperventilation
* blurred vision
* nausea
* chest
* pain
* decreased libido / change in sex drive
* confusion
* headache
* change in appetite
* insomnia
* unusual dreams
* change in salivation
* low blood
* pressure
* racing heartbeat
* fainting
* severe nasal congestion
* difficulty urinating
* sweating
* weight change
* skin irritation
* twitching or tremors
* nervous or anxious state
* sun sensitivity
* respiratory infection
* memory impairment
* loss of coordination
Rare Side Effects
As with all benzodiazepines, paradoxical reactions such as stimulation, increased muscle spasticity, sleep disturbances, hallucinations, and other adverse behavioral effects such as agitation, rage, irritability, and aggressive or hostile behavior have been reported rarely.
If you notice your eyes or skin turning a yellow colour, stop taking Xanax and contact your doctor straight away.
Rarer side effects (that strongly suggest you should taper or discontinue treatment) include:
* allergic reactions, including rash and anaphylaxis
* blood disorders, including leucopenia and leucocytosis
* jaundice
* difficulty concentrating
* slurred or unusual speech
* double vision
* fear or anxiety
* altered sense of taste
* lack of inhibition
* muscle cramps or spasms
* urination problems
* tingling
* incontinence
* warmth
* weakness
* change in muscle tone
* yellow eyes and skin
* hyperexcitement or overstimulation
* hallucinations
* rage or other hostile behavior
* transient elevated liver function tests
* tremors
* insomnia or sleeping difficultiesnull
The less common side effects of xanax can also be manifested as the following:
* Neurological effects: Blurred vision, headache, seizures, slurred speech, difficulty in depth perception.
* Psychiatric effects: Mental confusion, depression, irritability, nervousness, sleep disturbances, euphoria, lethargy, stupor.
* Gastrointestinal effects: Dry mouth, nausea, non-specific gastrointestinal disturbances, vomiting.
* Muscular effects: Muscle spasm, muscle weakness.
* Cardiovascular effects: Hypotension, palpitations, tachycardia.
* Dermatological effects: Pruritus, rash.
* Genitourinary effects: Incontinence, change in libido.
* Hematological effects: Decreased hemoglobin and hematocrit, increased and decreased WBC.
* Hepatic effects: Elevations of alkaline phosphates, bilirubin, AST (SGOT), ALT (SGPT).
* Miscellaneous: Increased and decreased blood sugar levels.
Monday, September 24, 2007
Living With an Alien: Sjogrens Syndrome
This is about me, a person who has lived with a disease. I am a person who had a dream of realizing self-potential yet, had to accept not physically being able to manifest this dream.
As I stated in an earlier article, Sjogrens is an autoimmune disease, a connective tissue disease. The medical community has not found a cure.
I had never heard of Sjogrens Syndrome until April of 2004 when death came to visit and tried to take me back with it.
Most of us are familiar with the high profile diseases -- MS, Rheumatoid Arthritis, and Lupus etc. Let me preface this story by saying I am not a doctor, I am not an expert I am a patient diagnosed with Sjogrens, I will call it SJS. Technicality is not my forte and this literary journey is in layman's miles, not always logical, never the less just as valuable for those who live and feel the effects of this alien that has invaded our bodies.
Are there any Trekkies out there? SJS, like any other disease is akin to the unrelenting nemesis the Borg of Star Trek. This autoimmune disease occupies our bodies threatening assimilation of different organs and body systems. At times, I think I can hear it whispering, "Resistance is futile".
SJS is different in each person that it tries to assimilate. In my case the symptoms are: aching muscles, debilitating fatigue, dry aching eyes, dry mouth, pancreantitus (which led to diabetes), painful legs and feet, neuropathy, and depression. Writing this is therapeutic, and hopefully, it will help those who suffer from the same alien, or any other alien for that matter, to not feel so alone.
Those of us who suffer from Sjogrens not only must live with the disease also must contend with friends and family who cannot comprehend what we are going through. We hear them say, "you don?t look sick" or "why are you always so tired" or "why are you always sick?" Why, why, why, I am sick to death of that question.
Earlier in my life I was a Susan Powter, groupie, I also tried Weight Watchers and Atkins as you can guess by those references I am over weight. My journey will begin in the early nineties, if your eyes get tired stop reading my story and go put some artificial tears in your eyes, close them and rest them. Come back and finish reading my story, if you do not, you will hurt my feelings and if by some chance you get bored, read the words any way!
In the summer of 1996, I decided it was time to do something about my weight. I bought a book by the newest lose weight guru of that time Susan Powter. If I remember correctly, she had a television exercise show, then again, my memory is not the best and I could be wrong. I do however remember following her diet and exercise advice. I got up faithfully every morning took James, that?s my son, to school came back home to get the dog, here name was Mandy, and went for a walk.
I remember Susan always marching to an invisible drummer, blowing in and out saying, "move people, breathe people" that was Susan?s greatest motto. I moved by walking and breathed deep, sucking breath until my stomach hugged my spine. The first week I began walking around the block, a week later two blocks eventually, I was walking 3 miles a day. I had reached the stage of power walking. I would walk hard and fast, swinging my hips left to right, like hooker-hips at a washing machine pace. I pumped my arms like a track star going for the gold.
After a while instead of getting stronger and having more energy, my body grew weak and more tired each day. I was loosing weight on a steady pace yet my life force seemed to be dropping along with the unwanted pounds.
All that breathing deep and heel to toe pavement work was literally killing me. I came down with infection after infection with 104-degree temperatures. Sleeping eight to ten hours, a night still left me feeling wrung out like an over used dish-rag. My doctor ran every test he could think of finding no results. The only reason he did not diagnose me as a hypochondriac was that my temperatures were consistently high along with other notable symptoms.
Sjogrens Syndrome is a symptomatic disease. Doctors will run test for years and not be able to find the root cause. Frustration then becomes second nature. It is difficult to stay upbeat when getting out of bed in the morning is a chore. When a person has to sit down while taking a shower or go lie down afterwards is not a normal circumstance.
My quality of life has suffered over these last twenty years. Being a single Mom with no emotional or financial support, I had a son to raise, therefore I had to work, oh yes work! I worked for the U.S. Postal service, which was no picnic even for a healthy person. Being sick all the time and calling off did not sit well with the job. In retrospect, these circumstances would not sit well with any employer.
Finally in 2004 Sjogrens tricked my body into attacking itself. I almost died. I spent 1 week in intensive care and 1 week in a regular hospital room. Still, doctors could not figure out why my body was shutting down.
Needless to say, I am alive sitting here writing this story. Sitting here wondering when and if there will be a break through. All I can say and believe is that we must continue to persevere.
Every day doctors are finding out more about this disease and are discovering medicines to improve the quality of our lives. One day, they may find a cure.
If anyone reading this knows of anyone who suffers from this disease or if you know someone who exhibits the symptoms, please be patient and understanding. The sufferer is truly suffering regardless of how they look.
For those of you who are suffering from this or any other disease please take gentle care of yourself.
Symptom recap:
· Dry eyes
· Dry mouth
· Dental cavities
· Fatigue
· Fever
· Enlarged parotid glands ? one particular set of your salivary glands, located behind your jaw and in front of your ears
· Difficulty swallowing or chewing
· Change in sense of taste
· Hoarseness
· Oral yeast infections, such as candidiasis
· Irritation and mild bleeding in your nose
· Skin rashes or dry skin
· Vaginal dryness
· Dry cough that doesn't produce sputum
· Joint pain, swelling and stiffness
As I stated in an earlier article, Sjogrens is an autoimmune disease, a connective tissue disease. The medical community has not found a cure.
I had never heard of Sjogrens Syndrome until April of 2004 when death came to visit and tried to take me back with it.
Most of us are familiar with the high profile diseases -- MS, Rheumatoid Arthritis, and Lupus etc. Let me preface this story by saying I am not a doctor, I am not an expert I am a patient diagnosed with Sjogrens, I will call it SJS. Technicality is not my forte and this literary journey is in layman's miles, not always logical, never the less just as valuable for those who live and feel the effects of this alien that has invaded our bodies.
Are there any Trekkies out there? SJS, like any other disease is akin to the unrelenting nemesis the Borg of Star Trek. This autoimmune disease occupies our bodies threatening assimilation of different organs and body systems. At times, I think I can hear it whispering, "Resistance is futile".
SJS is different in each person that it tries to assimilate. In my case the symptoms are: aching muscles, debilitating fatigue, dry aching eyes, dry mouth, pancreantitus (which led to diabetes), painful legs and feet, neuropathy, and depression. Writing this is therapeutic, and hopefully, it will help those who suffer from the same alien, or any other alien for that matter, to not feel so alone.
Those of us who suffer from Sjogrens not only must live with the disease also must contend with friends and family who cannot comprehend what we are going through. We hear them say, "you don?t look sick" or "why are you always so tired" or "why are you always sick?" Why, why, why, I am sick to death of that question.
Earlier in my life I was a Susan Powter, groupie, I also tried Weight Watchers and Atkins as you can guess by those references I am over weight. My journey will begin in the early nineties, if your eyes get tired stop reading my story and go put some artificial tears in your eyes, close them and rest them. Come back and finish reading my story, if you do not, you will hurt my feelings and if by some chance you get bored, read the words any way!
In the summer of 1996, I decided it was time to do something about my weight. I bought a book by the newest lose weight guru of that time Susan Powter. If I remember correctly, she had a television exercise show, then again, my memory is not the best and I could be wrong. I do however remember following her diet and exercise advice. I got up faithfully every morning took James, that?s my son, to school came back home to get the dog, here name was Mandy, and went for a walk.
I remember Susan always marching to an invisible drummer, blowing in and out saying, "move people, breathe people" that was Susan?s greatest motto. I moved by walking and breathed deep, sucking breath until my stomach hugged my spine. The first week I began walking around the block, a week later two blocks eventually, I was walking 3 miles a day. I had reached the stage of power walking. I would walk hard and fast, swinging my hips left to right, like hooker-hips at a washing machine pace. I pumped my arms like a track star going for the gold.
After a while instead of getting stronger and having more energy, my body grew weak and more tired each day. I was loosing weight on a steady pace yet my life force seemed to be dropping along with the unwanted pounds.
All that breathing deep and heel to toe pavement work was literally killing me. I came down with infection after infection with 104-degree temperatures. Sleeping eight to ten hours, a night still left me feeling wrung out like an over used dish-rag. My doctor ran every test he could think of finding no results. The only reason he did not diagnose me as a hypochondriac was that my temperatures were consistently high along with other notable symptoms.
Sjogrens Syndrome is a symptomatic disease. Doctors will run test for years and not be able to find the root cause. Frustration then becomes second nature. It is difficult to stay upbeat when getting out of bed in the morning is a chore. When a person has to sit down while taking a shower or go lie down afterwards is not a normal circumstance.
My quality of life has suffered over these last twenty years. Being a single Mom with no emotional or financial support, I had a son to raise, therefore I had to work, oh yes work! I worked for the U.S. Postal service, which was no picnic even for a healthy person. Being sick all the time and calling off did not sit well with the job. In retrospect, these circumstances would not sit well with any employer.
Finally in 2004 Sjogrens tricked my body into attacking itself. I almost died. I spent 1 week in intensive care and 1 week in a regular hospital room. Still, doctors could not figure out why my body was shutting down.
Needless to say, I am alive sitting here writing this story. Sitting here wondering when and if there will be a break through. All I can say and believe is that we must continue to persevere.
Every day doctors are finding out more about this disease and are discovering medicines to improve the quality of our lives. One day, they may find a cure.
If anyone reading this knows of anyone who suffers from this disease or if you know someone who exhibits the symptoms, please be patient and understanding. The sufferer is truly suffering regardless of how they look.
For those of you who are suffering from this or any other disease please take gentle care of yourself.
Symptom recap:
· Dry eyes
· Dry mouth
· Dental cavities
· Fatigue
· Fever
· Enlarged parotid glands ? one particular set of your salivary glands, located behind your jaw and in front of your ears
· Difficulty swallowing or chewing
· Change in sense of taste
· Hoarseness
· Oral yeast infections, such as candidiasis
· Irritation and mild bleeding in your nose
· Skin rashes or dry skin
· Vaginal dryness
· Dry cough that doesn't produce sputum
· Joint pain, swelling and stiffness
Sunday, September 23, 2007
Aromatherapy Through the Ages
The term aromatherapy is one that has only been used since the 20th century but the practice of it has been around since almost the beginning of mankind. The extraction and use of essential oils we know has been around at least one thousand years, with the Chinese being at the forefront of using plants and its oils for medical purposes. Even further back than this, the ancient Egyptians used extracted oils from aromatic plants to treat ailments and more significantly they also used oils like of cedar wood, clove, cinnamon, nutmeg and myrrh for embalming the dead.
The ancient Greeks also practiced aromatherapy where the fumigation of oils was carried out both for physical and spiritual healing. It should be noted however that during this period the process of distilling essential oils was limited more to the extraction of floral water and not the oils themselves. It was not until around 1200 AD that the distillation of essential oils was possible due to the invention of coiled cooling pipes.
Thus in the centuries that followed essential oils started to become more popular and more types of plants started to have their oils extracted through the distillation process which were then sold in apocathery shops during the middle ages with more and more oils introduced as their popularity increased.
More recently essential oils of plants have been studied more closely for their medicinal qualities so much so that some components have been isolated to create medicines. However it is the synthetic man made chemical medicines produced in latter century and their sometime harmful side effects that have in recent times propelled aromatherapy and the use of essential oils as a more natural and preferable alternative health substitute which has stood the test of time.
The ancient Greeks also practiced aromatherapy where the fumigation of oils was carried out both for physical and spiritual healing. It should be noted however that during this period the process of distilling essential oils was limited more to the extraction of floral water and not the oils themselves. It was not until around 1200 AD that the distillation of essential oils was possible due to the invention of coiled cooling pipes.
Thus in the centuries that followed essential oils started to become more popular and more types of plants started to have their oils extracted through the distillation process which were then sold in apocathery shops during the middle ages with more and more oils introduced as their popularity increased.
More recently essential oils of plants have been studied more closely for their medicinal qualities so much so that some components have been isolated to create medicines. However it is the synthetic man made chemical medicines produced in latter century and their sometime harmful side effects that have in recent times propelled aromatherapy and the use of essential oils as a more natural and preferable alternative health substitute which has stood the test of time.
Saturday, September 22, 2007
Medication Overuse Headaches: The Vicious Cycle of Analgesic Rebound
Victims of frequent headaches often take painkillers frequently. And when their headaches occur even more often, they respond by taking painkillers more often, too. After a while, they might notice (though often don't) that they're taking painkillers almost every day. In short, they're taking medicine more and more frequently and yet experiencing more and more days of headaches.
Although the typical victim of this scenario assumes that the headaches are occurring more frequently in spite of taking painkillers more frequently, the truth of the matter is that the increased headaches are probably occurring because of the increased use of painkillers. The headache victim has inadvertently entered a self-inflicted, vicious cycle in which the medications she takes are making her headaches worse and less treatable. This condition is known as "medication overuse headaches" (MOHs). Another name is "analgesic-rebound headaches." An analgesic is a painkiller and "rebound" means just what it sounds like -- a bounce-back. But in this case it's not a basketball that's bouncing. Instead, it's pain in the head that's bouncing back from the temporary relief afforded by the prior dose of painkilling medication.
The MOH phenomenon occurs not only with prescription-strength painkillers, but also with over-the-counter analgesics like aspirin, acetaminophen, ibuprofen and naproxen. And when caffeine is used as part of an analgesic combination, it can be a culprit, too. The MOH phenomenon cannot be avoided by periodically replacing one painkiller with another. As far as the MOH-generating system is concerned, one painkiller is about the same as another.
MOHs are not rare. In a recent survey of 64,560 people, researchers at the Norwegian University of Science and Technology in Trondheim found that 1.3% of women and 0.7% of men had this condition. The prevalence increased steadily from 20 years of age until about 50 years and then steadily declined.
In my community-based practice of general neurology, I find that patients have rarely heard of MOHs. They're just not being discussed on TV talk shows or in magazines. So how can a victim of frequent headaches defend herself from something she never heard of? It's tough. And another unfortunate fact is that MOHs are a mess to get out of. It's better not to even go there in the first place. It's easier to prevent a MOH syndrome than to get out of it once it is present.
Like other people with pain that is never-ending or occurs in frequent attacks, victims of frequent headaches live from moment to moment with their pain. It's easy to see how they get into a pattern of taking lots of painkillers. To them, yesterday and tomorrow are irrelevant. All they know is that they hurt right now and they want to do something about it. So they reach for their bottle of over-the-counter or prescription-strength painkiller and deal with that moment's pain. And the painkiller does afford temporary benefit (otherwise, they wouldn't keep taking it). But after another 4-24 hours, when the pain is bouncing back, they're in the same pickle they were in previously, and reach for yet another round of painkillers.
One might think that people with frequent, distressing and disabling pain could recount with great precision the frequency, duration and intensity of their attacks, or provide reliable estimates of how often they have severe, moderate or just mild pain. But, when I interview people who have this problem, I usually find just the opposite. What they want to tell me about is the pain they have right now even though I'm seeing them for the first time for a problem they have had for months or even years. They seem genuinely puzzled (or even angry) when I ask picayune questions like, "How many days per typical month does your head hurt?" or, "How many days per month do you go all day, 100% pain-free?"
Moreover, when patients try to come up with numbers to characterize their burden of symptoms, they are naturally drawn to their "headaches from hell" -- the worst of the worst -- and discount their non-severe "regular headaches" which they don't consider to be much of a problem, even though they take pills for them and they occur almost every day. In brief, it seems difficult for patients with MOH syndrome to see the big picture or adopt a long-term perspective.
In any case, the basic idea in MOH syndrome is that frequent use of as-needed painkillers transforms the original headache disorder from whatever it started as -- perhaps migraine, tension-type headaches or even a combination of the two -- into a condition that is worse. The painkillers swamp the original headache disorder and make it into a new problem with different characteristics. Specific treatments directed toward the original headache disorder are ineffectual until the MOH phenomenon washes out.
And the MOHs don't wash out until the headache victim stops taking the painkillers and does so on a sustained basis. It can take up to two months for MOHs to wash out. The definitive approach is to do without painkillers entirely. While one can prevent MOHs by not taking analgesics more than 10-12 days per month, once MOHs are present, decreasing the use of painkillers to just 10-12 days per month is probably not sufficient to make them go away. The cleanest approach is to avoid them entirely. And the goal of doing so is to get back to the original headache disorder. Once the analgesic-rebound headaches have subsided, then the original headache disorder can be treated with more targeted treatments (typically including preventive-type medication instead of relying on crisis-driven treatments as the mainstay) with improved prospects of meaningful improvement.
When I discuss MOHs with people who are unlucky enough to have them, they usually respond by nodding their heads. They've seen with their own eyes what I'm describing. They're usually glad to learn there's a name for what is affecting them and that studies have been done that provide guidance on what needs to be done to get them out of the pickle they're in. I insist on mentioning that if what they were doing already was good enough, then they wouldn't have needed to see me in the first place. Or alternatively, if what they were already doing was destined to be an effective strategy, then they should have seen the benefits by now. But because their headaches are worsening, in order to do better, a new strategy is called for.
The program we sketch out together has two necessary components -- stopping the painkillers and tracking each day's headache symptoms with a recording system. The recording system doesn't need to be fancy, and can be as simple as rating each day's pain as none, mild, moderate or severe. The important feature is that the patient records each day's pain experience before the day is done. This tool helps both the patient and the doctor to see the big picture and gain a long-term perspective. Also, each month's recordings can be converted to numbers and compared with any other month's results.
Everything else is secondary. Sometimes it is useful to prescribe a "preventive" medicine like amitriptyline, but only if the patient understands that it is not a replacement for the more important change of doing without painkillers. When prescribed, the main purpose of a preventive is to reduce the numbers of migraine and tension-type headaches once the analgesic-rebound syndrome has washed out. The preventive medication is a nice embellishment, but if it distracts the patient from stopping their analgesics (e.g. "That new pill you gave me didn't do any good") then it it's better to do without it until the analgesic-rebound effect has washed out.
Although the typical victim of this scenario assumes that the headaches are occurring more frequently in spite of taking painkillers more frequently, the truth of the matter is that the increased headaches are probably occurring because of the increased use of painkillers. The headache victim has inadvertently entered a self-inflicted, vicious cycle in which the medications she takes are making her headaches worse and less treatable. This condition is known as "medication overuse headaches" (MOHs). Another name is "analgesic-rebound headaches." An analgesic is a painkiller and "rebound" means just what it sounds like -- a bounce-back. But in this case it's not a basketball that's bouncing. Instead, it's pain in the head that's bouncing back from the temporary relief afforded by the prior dose of painkilling medication.
The MOH phenomenon occurs not only with prescription-strength painkillers, but also with over-the-counter analgesics like aspirin, acetaminophen, ibuprofen and naproxen. And when caffeine is used as part of an analgesic combination, it can be a culprit, too. The MOH phenomenon cannot be avoided by periodically replacing one painkiller with another. As far as the MOH-generating system is concerned, one painkiller is about the same as another.
MOHs are not rare. In a recent survey of 64,560 people, researchers at the Norwegian University of Science and Technology in Trondheim found that 1.3% of women and 0.7% of men had this condition. The prevalence increased steadily from 20 years of age until about 50 years and then steadily declined.
In my community-based practice of general neurology, I find that patients have rarely heard of MOHs. They're just not being discussed on TV talk shows or in magazines. So how can a victim of frequent headaches defend herself from something she never heard of? It's tough. And another unfortunate fact is that MOHs are a mess to get out of. It's better not to even go there in the first place. It's easier to prevent a MOH syndrome than to get out of it once it is present.
Like other people with pain that is never-ending or occurs in frequent attacks, victims of frequent headaches live from moment to moment with their pain. It's easy to see how they get into a pattern of taking lots of painkillers. To them, yesterday and tomorrow are irrelevant. All they know is that they hurt right now and they want to do something about it. So they reach for their bottle of over-the-counter or prescription-strength painkiller and deal with that moment's pain. And the painkiller does afford temporary benefit (otherwise, they wouldn't keep taking it). But after another 4-24 hours, when the pain is bouncing back, they're in the same pickle they were in previously, and reach for yet another round of painkillers.
One might think that people with frequent, distressing and disabling pain could recount with great precision the frequency, duration and intensity of their attacks, or provide reliable estimates of how often they have severe, moderate or just mild pain. But, when I interview people who have this problem, I usually find just the opposite. What they want to tell me about is the pain they have right now even though I'm seeing them for the first time for a problem they have had for months or even years. They seem genuinely puzzled (or even angry) when I ask picayune questions like, "How many days per typical month does your head hurt?" or, "How many days per month do you go all day, 100% pain-free?"
Moreover, when patients try to come up with numbers to characterize their burden of symptoms, they are naturally drawn to their "headaches from hell" -- the worst of the worst -- and discount their non-severe "regular headaches" which they don't consider to be much of a problem, even though they take pills for them and they occur almost every day. In brief, it seems difficult for patients with MOH syndrome to see the big picture or adopt a long-term perspective.
In any case, the basic idea in MOH syndrome is that frequent use of as-needed painkillers transforms the original headache disorder from whatever it started as -- perhaps migraine, tension-type headaches or even a combination of the two -- into a condition that is worse. The painkillers swamp the original headache disorder and make it into a new problem with different characteristics. Specific treatments directed toward the original headache disorder are ineffectual until the MOH phenomenon washes out.
And the MOHs don't wash out until the headache victim stops taking the painkillers and does so on a sustained basis. It can take up to two months for MOHs to wash out. The definitive approach is to do without painkillers entirely. While one can prevent MOHs by not taking analgesics more than 10-12 days per month, once MOHs are present, decreasing the use of painkillers to just 10-12 days per month is probably not sufficient to make them go away. The cleanest approach is to avoid them entirely. And the goal of doing so is to get back to the original headache disorder. Once the analgesic-rebound headaches have subsided, then the original headache disorder can be treated with more targeted treatments (typically including preventive-type medication instead of relying on crisis-driven treatments as the mainstay) with improved prospects of meaningful improvement.
When I discuss MOHs with people who are unlucky enough to have them, they usually respond by nodding their heads. They've seen with their own eyes what I'm describing. They're usually glad to learn there's a name for what is affecting them and that studies have been done that provide guidance on what needs to be done to get them out of the pickle they're in. I insist on mentioning that if what they were doing already was good enough, then they wouldn't have needed to see me in the first place. Or alternatively, if what they were already doing was destined to be an effective strategy, then they should have seen the benefits by now. But because their headaches are worsening, in order to do better, a new strategy is called for.
The program we sketch out together has two necessary components -- stopping the painkillers and tracking each day's headache symptoms with a recording system. The recording system doesn't need to be fancy, and can be as simple as rating each day's pain as none, mild, moderate or severe. The important feature is that the patient records each day's pain experience before the day is done. This tool helps both the patient and the doctor to see the big picture and gain a long-term perspective. Also, each month's recordings can be converted to numbers and compared with any other month's results.
Everything else is secondary. Sometimes it is useful to prescribe a "preventive" medicine like amitriptyline, but only if the patient understands that it is not a replacement for the more important change of doing without painkillers. When prescribed, the main purpose of a preventive is to reduce the numbers of migraine and tension-type headaches once the analgesic-rebound syndrome has washed out. The preventive medication is a nice embellishment, but if it distracts the patient from stopping their analgesics (e.g. "That new pill you gave me didn't do any good") then it it's better to do without it until the analgesic-rebound effect has washed out.
Friday, September 21, 2007
Avian Flu - Can Tamiflu Cure The Deadly Bird Flu Virus?
Discovery of Bird Flu
A question posed by most people: For going into this aspect of Tamiflu, I would like to open the doors to the discussion on avian flu or the bird flu. Starting with the discovery of Bird Flu, the discovery of bird flu can be traced back to as early as 1918. But the recorded facts are of quite recent years when a kind of respiratory disease was detected in poultry by farmers in the year 1983. This was rather discovered by the farmers of Virginia’s Shenandoah Valley. Virginia’s Shenandoah Valley is considered as the leading producer of the country’s (United States) poultry products. Quarantine was imposed on the valley which was not lifted for more than a year. This resulted in the culling of more than a million birds in terms of turkeys and chickens.
The estimated losses faced by the farmers of the valley were to a tune of about 40 million dollars. After this mass culling of the birds, the United States was able to contain the disease. This led the United States to pass some regulations on how poultry products should be handled and what should be done by poultry farmers. The United States was aware that the world was sitting on a ticking time bomb. With passage of time, the strains of the flu resurfaced in Hong Kong. A few people lost their lives to the flu. This later on surfaced in different countries in different forms of the viral strain, taking its toll wherever it goes.
Symptoms of Bird Flu
The symptoms of the flu are like any other flu. The reason it is called bird flu is that the flu spreads from the birds to the human beings. One used to suffer from a sore throat and then followed by body pains. This was followed by a feeling of nausea and dizziness. Now the flu has fully taken over. It is very important to recognize the symptoms of the flu at a very early stage. Once the symptoms have been recognized you should follow it up with medication. This being a viral infection, antibiotics cannot play a role. Antibiotics can only cure bacterial infections. Tamiflu is the only drug available in the market to fight viral infections. But as an advice do not take Tamiflu without a discussion with your doctor.
Advantages of Tamiflu
This medicine Tamiflu is advertised as a medicine to cure influenza. Tamiflu is the only medicine that attacks the source of the viral infection and prevents the flu from spreading throughout the body. It is advertised as a medication for adults, adults with flu like symptoms, which has shown up within the last couple of days. However the medication can be taken by children below the age of thirteen also.
Another advantage of Tamiflu is that you can take this medicine as a preventive measure. If you had been exposed to persons who have contacted the flu, you should also take the medicine. But the dosage will vary. Here as a preventive measure you will take only one pill a day. In the case of affected patients, they will go in for to pills a day.
Flu of the type influenza A and influenza B is the only flu that has shown to readily respond to the drug Tami flu. Bird flu is covered under the flu of influenza A. So this type of flu will respond to Tami flu.
In a case you do not respond to the medication Tamiflu contact your doctor or your health case practitioner and ask him as to what could be the problem.
A question posed by most people: For going into this aspect of Tamiflu, I would like to open the doors to the discussion on avian flu or the bird flu. Starting with the discovery of Bird Flu, the discovery of bird flu can be traced back to as early as 1918. But the recorded facts are of quite recent years when a kind of respiratory disease was detected in poultry by farmers in the year 1983. This was rather discovered by the farmers of Virginia’s Shenandoah Valley. Virginia’s Shenandoah Valley is considered as the leading producer of the country’s (United States) poultry products. Quarantine was imposed on the valley which was not lifted for more than a year. This resulted in the culling of more than a million birds in terms of turkeys and chickens.
The estimated losses faced by the farmers of the valley were to a tune of about 40 million dollars. After this mass culling of the birds, the United States was able to contain the disease. This led the United States to pass some regulations on how poultry products should be handled and what should be done by poultry farmers. The United States was aware that the world was sitting on a ticking time bomb. With passage of time, the strains of the flu resurfaced in Hong Kong. A few people lost their lives to the flu. This later on surfaced in different countries in different forms of the viral strain, taking its toll wherever it goes.
Symptoms of Bird Flu
The symptoms of the flu are like any other flu. The reason it is called bird flu is that the flu spreads from the birds to the human beings. One used to suffer from a sore throat and then followed by body pains. This was followed by a feeling of nausea and dizziness. Now the flu has fully taken over. It is very important to recognize the symptoms of the flu at a very early stage. Once the symptoms have been recognized you should follow it up with medication. This being a viral infection, antibiotics cannot play a role. Antibiotics can only cure bacterial infections. Tamiflu is the only drug available in the market to fight viral infections. But as an advice do not take Tamiflu without a discussion with your doctor.
Advantages of Tamiflu
This medicine Tamiflu is advertised as a medicine to cure influenza. Tamiflu is the only medicine that attacks the source of the viral infection and prevents the flu from spreading throughout the body. It is advertised as a medication for adults, adults with flu like symptoms, which has shown up within the last couple of days. However the medication can be taken by children below the age of thirteen also.
Another advantage of Tamiflu is that you can take this medicine as a preventive measure. If you had been exposed to persons who have contacted the flu, you should also take the medicine. But the dosage will vary. Here as a preventive measure you will take only one pill a day. In the case of affected patients, they will go in for to pills a day.
Flu of the type influenza A and influenza B is the only flu that has shown to readily respond to the drug Tami flu. Bird flu is covered under the flu of influenza A. So this type of flu will respond to Tami flu.
In a case you do not respond to the medication Tamiflu contact your doctor or your health case practitioner and ask him as to what could be the problem.
Wednesday, September 19, 2007
Avian Flu - Steps To Protect Yourself From The Deadly Bird Flu Virus
Avian Flu
The avian flu is a kind of flu that affects birds in general. Then you may ask why we as human beings should take precautions. The flu is able to transmit from birds to human beings and this is a dangerous thing. As of date there is no transmission of the bird flu from humans to humans. If such a day is to come, then god forbid, we are in for a disaster in the terms of a pandemic, so one must take few steps to prevent oneself from being effected by the avian flu.
With this I feel you should know a bit more about what avian flu / bird flu is.
More about Avian/Bird Flu
Avian flu leads to a respiratory disease found in birds. This is caused by the virus strain the H5N1. There are a number of virus strains that are responsible for flu; the most dangerous among them being the H5N1 strain. The affected birds fall prey to the flu and they die in a matter of a few days. Their saliva and droppings transmit the flu from one bird to another. Water ducks are considered the main transmitter of the virus and carrier of the virus. The infected ducks pollute whole body of water like the lake of stream that they pad in. The virus is found in the dead body of the bird. Any man or animal who consumes this flesh also get affected by the deadly virus. But the virus is not able to live in temperatures above 30 degree centigrade. When exposed to temperatures above 70 degree centigrade for more than a second the virus is no more.
There are different kinds of strains found in this flu as I have told you in the preceding paragraph. There are sixteen different avian flu viruses, which are classified as subtypes of the virus. The one I will be discussing about is the H5N1 type of virus. The H5N1 virus is considered to be highly pathogenic. Highly pathogenic means they can cause severe diseases in human beings and are considered to be highly infectious in nature. This strain of virus can be transmitted from the birds to the human beings either directly of by a carrier animal like pigs or cats.
Now that you have an idea as to what is the avian flu, I will be discussing the steps to be taken to prevent yourself from the infection.
Steps to prevent you from Infection
First and foremost “avoid”. In case there is a known case of influenza virus attack in a particular region the basics is to avoid contact with persons from that region. This is in itself a big tool. Take your annual flu shot. This reduces the chances of you being infected by the flu. Avoid contact with infected poultry and farm products. Handle the droppings of the infected birds with proper care and attention, so as not to come in contact directly with the droppings. Make use of masks, gloves and protective clothing in case of a flu outbreak. The recommended mask for handling bird flu infection is the N 95 type mask. This mask is recommended by the Center for diseases control. It passes all the stringent quality tests prescribed by this institution, which includes the porosity test and the pressure test.
When choosing the mask, make sure it fits smugly over your face and over the bridge of your nose. We would not want you getting infected even after wearing a mask. Other things that are to be worn with the mask are gloves, boots and full-sleeved coveralls. The mask should not be used for more than six hours continuously. Discard the mask and use a new mask if you have to work in an infected area for more than six hours. When you change your mask, wash your hands with a mild disinfectant follow it up with soap and water. For a disinfectant you may make use of rubbing alcohol. Now you may don your new mask.
To clear your house of the virus, clean your house with a good vacuum cleaner, paying attention to the corners and all places where dust is likely to collect. Then use bleach and rubbing alcohol for giving your house a rubbing down. Use alcohol on doorknobs and other places where one is likely to use as a hold for the hand.
In case you have livestock on your farm, follow the following precautions:
1. Do not let all the farm animals to water from a single water hole.
2. Keep animals apart, like do not let your poultry stray in your pigsty.
3. Observe your livestock for any change in behavioral patterns. Contact a good vet when you notice any abnormality.
4. Do not let all your animals feed from the same bowl.
5. Do not store your chicken pens one over the other.
The avian flu is a kind of flu that affects birds in general. Then you may ask why we as human beings should take precautions. The flu is able to transmit from birds to human beings and this is a dangerous thing. As of date there is no transmission of the bird flu from humans to humans. If such a day is to come, then god forbid, we are in for a disaster in the terms of a pandemic, so one must take few steps to prevent oneself from being effected by the avian flu.
With this I feel you should know a bit more about what avian flu / bird flu is.
More about Avian/Bird Flu
Avian flu leads to a respiratory disease found in birds. This is caused by the virus strain the H5N1. There are a number of virus strains that are responsible for flu; the most dangerous among them being the H5N1 strain. The affected birds fall prey to the flu and they die in a matter of a few days. Their saliva and droppings transmit the flu from one bird to another. Water ducks are considered the main transmitter of the virus and carrier of the virus. The infected ducks pollute whole body of water like the lake of stream that they pad in. The virus is found in the dead body of the bird. Any man or animal who consumes this flesh also get affected by the deadly virus. But the virus is not able to live in temperatures above 30 degree centigrade. When exposed to temperatures above 70 degree centigrade for more than a second the virus is no more.
There are different kinds of strains found in this flu as I have told you in the preceding paragraph. There are sixteen different avian flu viruses, which are classified as subtypes of the virus. The one I will be discussing about is the H5N1 type of virus. The H5N1 virus is considered to be highly pathogenic. Highly pathogenic means they can cause severe diseases in human beings and are considered to be highly infectious in nature. This strain of virus can be transmitted from the birds to the human beings either directly of by a carrier animal like pigs or cats.
Now that you have an idea as to what is the avian flu, I will be discussing the steps to be taken to prevent yourself from the infection.
Steps to prevent you from Infection
First and foremost “avoid”. In case there is a known case of influenza virus attack in a particular region the basics is to avoid contact with persons from that region. This is in itself a big tool. Take your annual flu shot. This reduces the chances of you being infected by the flu. Avoid contact with infected poultry and farm products. Handle the droppings of the infected birds with proper care and attention, so as not to come in contact directly with the droppings. Make use of masks, gloves and protective clothing in case of a flu outbreak. The recommended mask for handling bird flu infection is the N 95 type mask. This mask is recommended by the Center for diseases control. It passes all the stringent quality tests prescribed by this institution, which includes the porosity test and the pressure test.
When choosing the mask, make sure it fits smugly over your face and over the bridge of your nose. We would not want you getting infected even after wearing a mask. Other things that are to be worn with the mask are gloves, boots and full-sleeved coveralls. The mask should not be used for more than six hours continuously. Discard the mask and use a new mask if you have to work in an infected area for more than six hours. When you change your mask, wash your hands with a mild disinfectant follow it up with soap and water. For a disinfectant you may make use of rubbing alcohol. Now you may don your new mask.
To clear your house of the virus, clean your house with a good vacuum cleaner, paying attention to the corners and all places where dust is likely to collect. Then use bleach and rubbing alcohol for giving your house a rubbing down. Use alcohol on doorknobs and other places where one is likely to use as a hold for the hand.
In case you have livestock on your farm, follow the following precautions:
1. Do not let all the farm animals to water from a single water hole.
2. Keep animals apart, like do not let your poultry stray in your pigsty.
3. Observe your livestock for any change in behavioral patterns. Contact a good vet when you notice any abnormality.
4. Do not let all your animals feed from the same bowl.
5. Do not store your chicken pens one over the other.
Tuesday, September 18, 2007
Abatement and the Conquests of Bacteria and Virus Adaptations
When breakouts occur in human populations teams are sent into find the culprit and sometimes what they find is a little unnerving and disheartening. Sometimes they find that a virus has adapted or a bacteria is out of control and spreading. How do these things spread?
They spread in various ways, some are water borne and spread thru the water. Others spread in the air and get into the lungs of humans. Some spread thru the blood making the Mosquito a potentially vary dangerous vector. Once we find how these things are spread and what they are; flu, disease, bacteria or virus then the vector needs to be looked at. Lets call that the supply chain. Is the supply chain a rat like the in the plague? Is the vector a bat, a mosquito, the water or other humans?
If the supply chain can be stopped through abatement or treatment of the local vectoring species by helping them to some vaccinated food then that is one way to stop them? This is similar in sports tactics, business competition, warring armies as much as it is in fighting outbreaks you see?
Sometimes it makes sense to consider a more philosophical combat plan when considering the abatement and the conquests of Bacteria and Virus Adaptations. Perhaps we need to consider a little more the abstract thoughts on these things. Think on this in 2006.
They spread in various ways, some are water borne and spread thru the water. Others spread in the air and get into the lungs of humans. Some spread thru the blood making the Mosquito a potentially vary dangerous vector. Once we find how these things are spread and what they are; flu, disease, bacteria or virus then the vector needs to be looked at. Lets call that the supply chain. Is the supply chain a rat like the in the plague? Is the vector a bat, a mosquito, the water or other humans?
If the supply chain can be stopped through abatement or treatment of the local vectoring species by helping them to some vaccinated food then that is one way to stop them? This is similar in sports tactics, business competition, warring armies as much as it is in fighting outbreaks you see?
Sometimes it makes sense to consider a more philosophical combat plan when considering the abatement and the conquests of Bacteria and Virus Adaptations. Perhaps we need to consider a little more the abstract thoughts on these things. Think on this in 2006.
Sunday, September 16, 2007
Doctor... What's the Best Treatment for Arthritis?
Regardless of the type of arthritis, the goals of arthritis treatment are similar.
These include the following:
• Relieve pain/inflammation
• Minimize risks of therapy
• Retard disease progression
• Provide patient education
• Prevent work disability
• Enhance quality of life and functional independence
While the goals are similar they are achieved using different approaches depending on the diagnosis. The effective management includes a combination of conventional medicines, effective alternative treatments, changes in diet and food, rest, exercise, lifestyle changes (e.g., weight loss if needed), and joint protection.
Factors involved in decision making include the diagnosis, the severity of disease, and the patient’s response to previous therapies.
The decision making doesn’t end there either. As a patient is followed over time, things change. What initially was felt to be an effective arthritis treatment may no longer be effective...and side-effects may occur.
Additions and deletions of medications need to be considered. Drug interactions with other therapies are a concern.
Co-morbid conditions (other medical illnesses) enter into the equation. Newer therapies, when they arrive, may change the picture.
Patient preference, when it can be accommodated, should also be considered. And this dovetails with a patient’s lifestyle... The right therapy for a working man of 35 may not be the right therapy for a retired woman of 80. The correct arthritis treatment for a hard-driving executive may not be ideal for a laid back person who wants to use as many natural remedies as possible.
Finally, the ever-changing landscape of insurance issues plays a role... in my opinion, way too big a role in decision making. In fact, I feel patients should not- not ever- make a decision to see a rheumatologist based on whether the physician “participates in their insurance plan” or not. The reason is that insurance plans do not pay a good physician what they are worth. If you value your health enough to get better, to feel less pain, to avoid crippling, then you owe it to yourself to see the best specialist, not the cheapest, and not just the one who “participates in your insurance plan.”
These include the following:
• Relieve pain/inflammation
• Minimize risks of therapy
• Retard disease progression
• Provide patient education
• Prevent work disability
• Enhance quality of life and functional independence
While the goals are similar they are achieved using different approaches depending on the diagnosis. The effective management includes a combination of conventional medicines, effective alternative treatments, changes in diet and food, rest, exercise, lifestyle changes (e.g., weight loss if needed), and joint protection.
Factors involved in decision making include the diagnosis, the severity of disease, and the patient’s response to previous therapies.
The decision making doesn’t end there either. As a patient is followed over time, things change. What initially was felt to be an effective arthritis treatment may no longer be effective...and side-effects may occur.
Additions and deletions of medications need to be considered. Drug interactions with other therapies are a concern.
Co-morbid conditions (other medical illnesses) enter into the equation. Newer therapies, when they arrive, may change the picture.
Patient preference, when it can be accommodated, should also be considered. And this dovetails with a patient’s lifestyle... The right therapy for a working man of 35 may not be the right therapy for a retired woman of 80. The correct arthritis treatment for a hard-driving executive may not be ideal for a laid back person who wants to use as many natural remedies as possible.
Finally, the ever-changing landscape of insurance issues plays a role... in my opinion, way too big a role in decision making. In fact, I feel patients should not- not ever- make a decision to see a rheumatologist based on whether the physician “participates in their insurance plan” or not. The reason is that insurance plans do not pay a good physician what they are worth. If you value your health enough to get better, to feel less pain, to avoid crippling, then you owe it to yourself to see the best specialist, not the cheapest, and not just the one who “participates in your insurance plan.”
Friday, September 14, 2007
All About Cialis
Cialis is an effective drug approved for the treatment of impotence in men. Impotence or Erectile Dysfunction refers to difficulty in having and maintaining an erection.
Cialis relaxes muscles within the penis. It works by allowing an increase of blood flow into the penis. This increased blood flow into certain internal areas of the penis results in an erection.
Differentiation from other ED treatment drugs
As compared to other ED treatment drugs, Cialis remains in the body for a very long period, thus enhancing its effectiveness. However, there are no statistics to prove its safety or side effects in comparison to other drugs.
Intake of Cialis
Cialis is available in the form of a tablet and can be easily taken orally before sexual activity. However, the dose and frequency may differ from individual to individual. One may need to check with a doctor to confirm dose.
The most common side effects observed includes headache, indigestion, back pain, muscle pain, flushing, and stuffy nose. Back pain and muscle aches are less severe effects and typically go away within 12 to 24 hours of intake of Cialis. A small number of patients consuming Cialis may also feel abnormal vision. However, this is very rare. In case it happens, call for a doctor immediately. Cialis may be dangerous for some patients taking nitrates (such as nitroglycerin tablets or patches) or any alpha blocker daily should be aware not to take Cialis under any situation. This may prove fatal for their lives. This is because the combination of these drugs with Cialis results in a significantly lower blood pressure, thus leading to fainting or even death. Anyone can buy Cialis from an online Cialis pharmacy. It is cheap and easily available.
Cialis relaxes muscles within the penis. It works by allowing an increase of blood flow into the penis. This increased blood flow into certain internal areas of the penis results in an erection.
Differentiation from other ED treatment drugs
As compared to other ED treatment drugs, Cialis remains in the body for a very long period, thus enhancing its effectiveness. However, there are no statistics to prove its safety or side effects in comparison to other drugs.
Intake of Cialis
Cialis is available in the form of a tablet and can be easily taken orally before sexual activity. However, the dose and frequency may differ from individual to individual. One may need to check with a doctor to confirm dose.
The most common side effects observed includes headache, indigestion, back pain, muscle pain, flushing, and stuffy nose. Back pain and muscle aches are less severe effects and typically go away within 12 to 24 hours of intake of Cialis. A small number of patients consuming Cialis may also feel abnormal vision. However, this is very rare. In case it happens, call for a doctor immediately. Cialis may be dangerous for some patients taking nitrates (such as nitroglycerin tablets or patches) or any alpha blocker daily should be aware not to take Cialis under any situation. This may prove fatal for their lives. This is because the combination of these drugs with Cialis results in a significantly lower blood pressure, thus leading to fainting or even death. Anyone can buy Cialis from an online Cialis pharmacy. It is cheap and easily available.
Thursday, September 13, 2007
The Facts You Need To Know About Long Term Care
When most people think of long-term care, they think of someone in the golden years of their life, but an illness or accident can strike anyone of any age and make this a necessary part of their life. It isn't easy for many people to admit they need help with their every day living, but for some, the simple task of eating becomes a chore.
Another misconception is that long-term care means a stay in a nursing home or rehabilitation center, but this is not always the case. With the portability of medical equipment today, it is often preferred that patients remain in their own home if possible. Insurance companies prefer to pay for full-time home care instead of nursing home care, feeling that it is more cost effective and beneficial to the patient's well being.
Long-term care doesn't even need to mean that the patient cannot do for himself or herself. It can mean simply a patient who has an ongoing condition that requires the services of a health care professional on a routine basis for things the patient is no longer able to do for him or herself. This can mean preparing and planning meals, care of personal hygiene, dressing, household chores including shopping and paperwork, and any medical needs.
In addition to in-home and nursing home facilities, another type of long-term care facility is called assisted living. In this setting, the patient has his or her own apartment or quarters where the patient lives and tends to their needs as much as possible. However, the patient is close enough to the nursing home facility that someone is readily available to assist the patient whenever needed, thus the term, "assisted living." This allows the patient some type of independence while giving them the assistance they need as well. Many people who become dependent on others feel like they are a burden, but with assisted living, help is there if it's needed, and the patient is able to do the things for himself that he is able to do.
Fortunately, the term long-term care has lost the stigma it used to have for patients, and they are now more receptive to accepting help when it is needed. This is likely due to the introduction of both the assisted living and the in-home nursing care that allows a patient to remain in the comfort of his home as long as possible. Even twenty years ago this was a "baby" to the medical field, but with the insurance companies pushing for less hospital time, and the patients wanting to hurry home from the hospital to tend to other family members, it has become commonplace. As the generation of middle-aged citizens enters their senior years, this practice will likely become more common. Long-term care is changing its face every day.
Another misconception is that long-term care means a stay in a nursing home or rehabilitation center, but this is not always the case. With the portability of medical equipment today, it is often preferred that patients remain in their own home if possible. Insurance companies prefer to pay for full-time home care instead of nursing home care, feeling that it is more cost effective and beneficial to the patient's well being.
Long-term care doesn't even need to mean that the patient cannot do for himself or herself. It can mean simply a patient who has an ongoing condition that requires the services of a health care professional on a routine basis for things the patient is no longer able to do for him or herself. This can mean preparing and planning meals, care of personal hygiene, dressing, household chores including shopping and paperwork, and any medical needs.
In addition to in-home and nursing home facilities, another type of long-term care facility is called assisted living. In this setting, the patient has his or her own apartment or quarters where the patient lives and tends to their needs as much as possible. However, the patient is close enough to the nursing home facility that someone is readily available to assist the patient whenever needed, thus the term, "assisted living." This allows the patient some type of independence while giving them the assistance they need as well. Many people who become dependent on others feel like they are a burden, but with assisted living, help is there if it's needed, and the patient is able to do the things for himself that he is able to do.
Fortunately, the term long-term care has lost the stigma it used to have for patients, and they are now more receptive to accepting help when it is needed. This is likely due to the introduction of both the assisted living and the in-home nursing care that allows a patient to remain in the comfort of his home as long as possible. Even twenty years ago this was a "baby" to the medical field, but with the insurance companies pushing for less hospital time, and the patients wanting to hurry home from the hospital to tend to other family members, it has become commonplace. As the generation of middle-aged citizens enters their senior years, this practice will likely become more common. Long-term care is changing its face every day.
About Eczema: Conventional versus Natural Treatment!
Eczema is an inflammation of the skin frequently seen in association with allergic conditions such as asthma and hay fever. The parts affected by eczema, develop lesions which will often appear as patches, blisters and/or scratches. The vicinities affected by eczema are very itchy and uncomfortable. The affected areas may become abnormally thick. Thickening of the skin can be brought through trauma to the patches from scratching and rubbing. The affected spots will be typically dry in comparison to unaffected areas. The face, elbows, behind the knees, wrists are more likely to develop eczema than other body parts.
One of the major causes of eczema is the imbalance in a person’s immune function and is probably a form of response to the environmental substances such as dust, pollution, yeast, cosmetic products, chemicals such as: detergents, oils, greases, solvents at home or in the work place. In addition, stress can cause a depletion of certain body nutrients (vitamins and minerals), which ultimately leads to a sensitivity towards eczema.
Corticoid creams containing hydrocortisone are the most common conventional treatment for eczema. Hydrocortisone is similar to a natural hormone secreted by adrenal gland, which controls the inflammation process and actively participates in the ionic body balance. The hydrocortisone creams are effective for reducing inflammation, swelling, redness and itching thereby allowing the affected area to heal.
In spite of temporarily reducing the effects of eczema, these creams can lead to skin thinning and damaging. At high doses or at low doses for extended time the hydrocortisone can accumulate through the body and induce metabolic changes in salt and water balance, potassium and calcium balance and increases the blood sugar level. The reasons for accumulation are multiple. One important cause is the competition between the naturally secreted hormone and the topical hydrocortisone for the same receptors, which can raise the uncoupled hormone level. Another important cause is the steroid structure of the hormone, which makes elimination through the kidney difficult.
The corticosteroid creams have to be used with a low dose of hormone and for short period of time as sometimes indicated on the label. On the other hand, sudden discontinuation of the corticosteroid cream can lead to the worsening of the eczema.
Herbal therapy is a mild but long lasting alternative for eczema treatment. Many herbs are known for their beneficial qualities in the treatment of eczema such as: Burdock, Calendula, St. John Wort, Chamomile, Chickweed, Yarrow, Nettle, Licorice. They can be used as teas, tinctures or for topical treatment. Since eczema is a complex skin disease one single herb is not enough to relieve the symptoms of the eczema or eradicate the disease. A complex mixture of beneficial herbs is more likely to succeed in the treatment.
The antioxidant therapy has been successfully used in the prevention and treatment of different skin diseases, which usually are characterized by a high percentage of free radicals at the site of the affected areas. A good example of natural antioxidants is Sea Buckthorn and Grape seed oils. They contain a wide range of antioxidants such as vitamin E, A, C, selenium, beta carotene, anthocyanidins, which can be beneficial in the case of eczema and other skin disorders.
In conclusion: Natural alternative may be longer than the conventional solution for eczema treatment but much safer for the skin and health in general.
One of the major causes of eczema is the imbalance in a person’s immune function and is probably a form of response to the environmental substances such as dust, pollution, yeast, cosmetic products, chemicals such as: detergents, oils, greases, solvents at home or in the work place. In addition, stress can cause a depletion of certain body nutrients (vitamins and minerals), which ultimately leads to a sensitivity towards eczema.
Corticoid creams containing hydrocortisone are the most common conventional treatment for eczema. Hydrocortisone is similar to a natural hormone secreted by adrenal gland, which controls the inflammation process and actively participates in the ionic body balance. The hydrocortisone creams are effective for reducing inflammation, swelling, redness and itching thereby allowing the affected area to heal.
In spite of temporarily reducing the effects of eczema, these creams can lead to skin thinning and damaging. At high doses or at low doses for extended time the hydrocortisone can accumulate through the body and induce metabolic changes in salt and water balance, potassium and calcium balance and increases the blood sugar level. The reasons for accumulation are multiple. One important cause is the competition between the naturally secreted hormone and the topical hydrocortisone for the same receptors, which can raise the uncoupled hormone level. Another important cause is the steroid structure of the hormone, which makes elimination through the kidney difficult.
The corticosteroid creams have to be used with a low dose of hormone and for short period of time as sometimes indicated on the label. On the other hand, sudden discontinuation of the corticosteroid cream can lead to the worsening of the eczema.
Herbal therapy is a mild but long lasting alternative for eczema treatment. Many herbs are known for their beneficial qualities in the treatment of eczema such as: Burdock, Calendula, St. John Wort, Chamomile, Chickweed, Yarrow, Nettle, Licorice. They can be used as teas, tinctures or for topical treatment. Since eczema is a complex skin disease one single herb is not enough to relieve the symptoms of the eczema or eradicate the disease. A complex mixture of beneficial herbs is more likely to succeed in the treatment.
The antioxidant therapy has been successfully used in the prevention and treatment of different skin diseases, which usually are characterized by a high percentage of free radicals at the site of the affected areas. A good example of natural antioxidants is Sea Buckthorn and Grape seed oils. They contain a wide range of antioxidants such as vitamin E, A, C, selenium, beta carotene, anthocyanidins, which can be beneficial in the case of eczema and other skin disorders.
In conclusion: Natural alternative may be longer than the conventional solution for eczema treatment but much safer for the skin and health in general.
Prednizone Side Effects - Should I Be Worried if I Take this Drug?
Prednizone- the correct spelling is “prednisone”- is a commonly used oral glucocorticoid medicine.
The adrenal glands manufacture a natural form of glucocorticoid. Glucocorticoids are responsible for many functions in the body including maintenance of blood pressure, proper use of sugar, protein, and fat metabolism, response to stress, and many other tasks.
Glucocorticoids manufactured by the body are referred to as endogenous steroids- meaning a person’s own body makes these steroids.
When steroids are taken in from the outside either by mouth, intramuscularly or intravenously, they are referred to as exogenous steroids. Taking glucocorticoids orally or intravenously can reduce the ability of the person’s own adrenal glands to continue to manufacture glucocorticoids.
Without the ability to increase steroid production in the face of stressors such as injury, infection, and surgery, a patient can go into shock.
The chances of the adrenal glands being suppressed increase as the dose of “outside” steroid exceeds the average daily equivalent output of the adrenal glands which is about 5.0-7.5 mg prednisone, therapy continues for more than a few weeks or months, doses are given late in the day or in split doses, or long-acting corticosteroid preparations are used.
Patients who require high doses of prednisone (more than 20 mgs a day) for extended periods of time often will develop side-effects.
Taking steroids on an alternate day (every other day) schedule lessens the chance of adrenal insufficiency but does not do away with it altogether.
Other side-effects include:
• Increased risk of bacterial or opportunistic infections such as fungi, tuberculosis, pneumocystis carinii
• Elevated blood sugar
• Fat distribution changes leading to moon face, buffalo hump
• Elevated blood lipids
• Aggravation of hypertension
• Electrolyte abnormalities such as low blood potassium
• Fluid retention leading to edema
• Easy bruisibility
• Increased body hair
• Increased sweating
• Purple stretch marks
• Impaired wound healing
• Glaucoma
• Cataracts
• Muscle wasting
• Stomach ulcers
• Pancreatitis
• Accelerated hardening of the arteries
• Osteonecrosis (bone death)
• Psychiatric disturbance
• Insomnia
• Bowel perforation
• Masking of infection
The adrenal glands manufacture a natural form of glucocorticoid. Glucocorticoids are responsible for many functions in the body including maintenance of blood pressure, proper use of sugar, protein, and fat metabolism, response to stress, and many other tasks.
Glucocorticoids manufactured by the body are referred to as endogenous steroids- meaning a person’s own body makes these steroids.
When steroids are taken in from the outside either by mouth, intramuscularly or intravenously, they are referred to as exogenous steroids. Taking glucocorticoids orally or intravenously can reduce the ability of the person’s own adrenal glands to continue to manufacture glucocorticoids.
Without the ability to increase steroid production in the face of stressors such as injury, infection, and surgery, a patient can go into shock.
The chances of the adrenal glands being suppressed increase as the dose of “outside” steroid exceeds the average daily equivalent output of the adrenal glands which is about 5.0-7.5 mg prednisone, therapy continues for more than a few weeks or months, doses are given late in the day or in split doses, or long-acting corticosteroid preparations are used.
Patients who require high doses of prednisone (more than 20 mgs a day) for extended periods of time often will develop side-effects.
Taking steroids on an alternate day (every other day) schedule lessens the chance of adrenal insufficiency but does not do away with it altogether.
Other side-effects include:
• Increased risk of bacterial or opportunistic infections such as fungi, tuberculosis, pneumocystis carinii
• Elevated blood sugar
• Fat distribution changes leading to moon face, buffalo hump
• Elevated blood lipids
• Aggravation of hypertension
• Electrolyte abnormalities such as low blood potassium
• Fluid retention leading to edema
• Easy bruisibility
• Increased body hair
• Increased sweating
• Purple stretch marks
• Impaired wound healing
• Glaucoma
• Cataracts
• Muscle wasting
• Stomach ulcers
• Pancreatitis
• Accelerated hardening of the arteries
• Osteonecrosis (bone death)
• Psychiatric disturbance
• Insomnia
• Bowel perforation
• Masking of infection
Wednesday, September 12, 2007
Celiac Disease Versus Gluten Sensitivity: New Role for Genetic Testing and Fecal Antibody Testing?
Celiac disease (CD) has a prevalence of 1/100. Between 90-99% of Celiacs are HLA DQ2 and/or DQ8 positive. Every individual has two DQ serotypes. Because the molecular HLA nomenclature can be confusing DQ serotyping is a method for simplifying the results. There are four major types and 5 subtypes: HLA DQ1, DQ2, DQ3 and DQ4; DQ1 has two subtypes; DQ5 and DQ6 whereas DQ3 has three subtypes; DQ7, DQ8 and DQ9. Each individual has two copies of HLA DQ. One DQ type is inherited from each parent.
Though 35-45% of individuals of Northern European ancestry are DQ2 &/or DQ8 positive only 1% have classic CD as defined by abnormal blood tests and small intestine biopsies. Several autoimmune conditions also occur more frequently in DQ2 and DQ8 positive individuals.
There is accumulating scientific evidence that many individuals are gluten sensitive and respond to a gluten free diet though they have normal blood tests and/or normal intestinal biopsies (fail to meet strict criteria for CD). This is more commonly being referred to as non-Celiac gluten sensitivity (NCGS). Many individuals who have NCGS are relatives of confirmed Celiacs and were previously referred to as latent Celiacs. Electron microscopy and immunohistochemistry studies of individuals with normal biopsies but suspected of or at risk (1st degree relatives of Celiacs) have revealed ultrastructural abnormalities of the intestine and those who chose gluten free diet usually responded and many who did not ultimately developed abnormal biopsies on long term follow-up. Seronegative Celiac has also been recognized, that is blood tests are negative, but the biopsy reveals classic abnormalities of Celiac and the individual responds to gluten free diet.
Fecal antibody testing for gliadin (AG) and tissue transglutaminase (tTG) by Enterolab in Dallas has revealed elevations in 100% of Celiacs tested and up to 60% of symptomatic individuals without Celiac disease (NCGS) even if not DQ2 or DQ8 positive. (Fine, K unpublished data, www.enterolab.com). The only DQ pattern he found not associated with gluten sensitivity is DQ4/DQ4, a pattern typically found in non-Caucasians who are known to have a low prevalence of Celiac disease.
Testing for DQ2/DQ8 has been suggested as a way to exclude CD. That is, if you are negative for DQ2 and DQ8, then you are very unlikely to have CD. However, well documented cases of CD and Dermatitis Herpetiformis (DH) have been confirmed in DQ2 and DQ8 negative individuals. Moreover, we now have the clinical experience that other DQ patterns predispose to gluten sensitivity because these individuals frequently have elevated fecal antibodies to AG or tTG and respond to gluten free diet.
Why some people develop Celiac Disease or become sensitive gluten is not well understood. Risk factors include onset of puberty, pregnancy, stress, trauma or injury, surgery, viral or bacterial infections including those of the gut, medication induced gut injury or toxicity (e.g. NSAIDs), immune suppression or autoimmune diseases, and antibiotic use resulting in altered gut flora (dysbiosis). The severity of the sensitivity is related to the DQ type, pre-existing intestinal injury, degree of exposure to gluten (how frequent and large a gluten load an individual is exposed to), and immune status. Once initiated, gluten sensitivity tends to lifelong. True CD requires lifelong complete gluten avoidance to prevent serious complications, cancers, and early death.
Serotypes can be determined from blood or buccal mucosal cells obtained by oral swab from several commercial labsl including Prometheus, Labcorp, Quest, The Laboratories at Bonfils, and Enterolabs. Fecal IgA anti-gliadin and IgA tissue transglutaminase antibody testing is only available in the U.S. commerically through Enterolabs. The fecal AG and tTG testing may be helpful in those with normal blood tests for Celiac and/or a normal small bowel biopsy but suspected of being gluten sensitive. Though the fecal antibody results are not widely accepted by many "Celiac experts" numerous testimonials of individuals testing positive only on fecal tests who have responded to gluten free diet can be found in support groups, web postings, personal communication from Dr. Fine and this physician's clinical experience.
Though 35-45% of individuals of Northern European ancestry are DQ2 &/or DQ8 positive only 1% have classic CD as defined by abnormal blood tests and small intestine biopsies. Several autoimmune conditions also occur more frequently in DQ2 and DQ8 positive individuals.
There is accumulating scientific evidence that many individuals are gluten sensitive and respond to a gluten free diet though they have normal blood tests and/or normal intestinal biopsies (fail to meet strict criteria for CD). This is more commonly being referred to as non-Celiac gluten sensitivity (NCGS). Many individuals who have NCGS are relatives of confirmed Celiacs and were previously referred to as latent Celiacs. Electron microscopy and immunohistochemistry studies of individuals with normal biopsies but suspected of or at risk (1st degree relatives of Celiacs) have revealed ultrastructural abnormalities of the intestine and those who chose gluten free diet usually responded and many who did not ultimately developed abnormal biopsies on long term follow-up. Seronegative Celiac has also been recognized, that is blood tests are negative, but the biopsy reveals classic abnormalities of Celiac and the individual responds to gluten free diet.
Fecal antibody testing for gliadin (AG) and tissue transglutaminase (tTG) by Enterolab in Dallas has revealed elevations in 100% of Celiacs tested and up to 60% of symptomatic individuals without Celiac disease (NCGS) even if not DQ2 or DQ8 positive. (Fine, K unpublished data, www.enterolab.com). The only DQ pattern he found not associated with gluten sensitivity is DQ4/DQ4, a pattern typically found in non-Caucasians who are known to have a low prevalence of Celiac disease.
Testing for DQ2/DQ8 has been suggested as a way to exclude CD. That is, if you are negative for DQ2 and DQ8, then you are very unlikely to have CD. However, well documented cases of CD and Dermatitis Herpetiformis (DH) have been confirmed in DQ2 and DQ8 negative individuals. Moreover, we now have the clinical experience that other DQ patterns predispose to gluten sensitivity because these individuals frequently have elevated fecal antibodies to AG or tTG and respond to gluten free diet.
Why some people develop Celiac Disease or become sensitive gluten is not well understood. Risk factors include onset of puberty, pregnancy, stress, trauma or injury, surgery, viral or bacterial infections including those of the gut, medication induced gut injury or toxicity (e.g. NSAIDs), immune suppression or autoimmune diseases, and antibiotic use resulting in altered gut flora (dysbiosis). The severity of the sensitivity is related to the DQ type, pre-existing intestinal injury, degree of exposure to gluten (how frequent and large a gluten load an individual is exposed to), and immune status. Once initiated, gluten sensitivity tends to lifelong. True CD requires lifelong complete gluten avoidance to prevent serious complications, cancers, and early death.
Serotypes can be determined from blood or buccal mucosal cells obtained by oral swab from several commercial labsl including Prometheus, Labcorp, Quest, The Laboratories at Bonfils, and Enterolabs. Fecal IgA anti-gliadin and IgA tissue transglutaminase antibody testing is only available in the U.S. commerically through Enterolabs. The fecal AG and tTG testing may be helpful in those with normal blood tests for Celiac and/or a normal small bowel biopsy but suspected of being gluten sensitive. Though the fecal antibody results are not widely accepted by many "Celiac experts" numerous testimonials of individuals testing positive only on fecal tests who have responded to gluten free diet can be found in support groups, web postings, personal communication from Dr. Fine and this physician's clinical experience.
Monday, September 10, 2007
Stop Telling Your Children to Brush Their Teeth!
The nightly conflict
We have all heard the routine. Maybe last night was the last time you heard or were involved. It time for bed and the parent/s are at the usual bedtime routine.
“Have you brushed your teeth, Billy?”, comes the irritated parental voice. A kind of pregnant silence follows. The question comes again but this time there is more irritation.
“Billy, did you hear me?? Have you brushed your teeth, yet??”
“No.., not yet, Mum” come the muffled, yet noticeably exasperated reply.
“Well, get to it, - straight away. I will be checking so don’t try to skive off”
“O...K Mum!”, Billy’s voice is resigned.
Ten minutes have passed and the voice from below stairs breaks the silence. “Have you got your teeth done, Billy?”
“Just doing it now, Mum”, calls back Billy's with a ‘sounding busy’ air, as he flicks the TV channel with the remote control.
“Well hurry up about it, I want you in bed in ten minutes, right?”
“Right, Mum...” Billy throws the remote on the bed and drags himself toward the bathroom. “Stupid bloody teeth... so boring...who cares anyway...” mutters Billy as he mindlessly goes through the motions with toothpaste and brush.
The shocked reaction
When I tell Mums and Dads to STOP telling their children to brush their teeth, they look at me as though I had just committed perjury. Some give me a quizzical look with a half smile waiting for me to admit that I was only joking. Others begin to laugh assuming that it is a joke. When I tell them that I could not be more serious, they are shocked and disbelieving that a dentist could speak these ‘crazy’ words.
“And whose going to tell them?” some ask mockingly.
“What kind of a parent would I be if I don’t do my duty?” one very caring mother asked me. “Don’t you think that that is a very irresponsible attitude for a dentist to have?”
These are all very understandable reactions because my advice seems to go against all understanding and reason. Surely it is the solemn duty of all parents to make sure that their children are looking after their teeth. Parents are responsible for the care of their children. Parents who do not take this responsibility seriously are not behaving as good parents.
The simple explanation
The explanation for all of this is very simple. What I have said seems to make no sense and indeed many would call it insane. Yet if we are prepared to look in simple honesty, we will see that it is society’s idea of how to teach and care for the children’s health that is actually ‘insane‘. Let me be very clear, I totally agree that it is a parents responsibility to teach their children to care for their teeth. It is on the question of how to achieve that noble goal that I differ from society. All methods are evaluated on how well they can achieve the stated goal. We ask then what it is we want to achieve and then whether or not we are achieving it. If we are not achieving what we set out to achieve, it makes sense that we then re-evaluate our methods.
When we examine the exchange between Billy and his Mum, we can gain enormous understanding of what goes wrong, why it goes wrong and how it goes wrong!
First of all, Billy doesn’t want to brush his teeth and ‘has’ to be forced by his Mum. Why is that? Why does he not want to do it? Most people assume that this behaviour is typical of a child. They believe that all children are just like that and that it something in the make up of the child. It is true to say that the behaviour is common and scenes like this one occur in most homes up and down the country. It is worthwhile noting that this applies not only to tooth-brushing but to many other things as well. How many could relate to similar problems at the table with food. Do conflicts begin at the table with a parent saying something like - “Come on now, Lucy, eat up all your dinner. How do you hope to be healthy unless you eat properly?”
Most people know these routines and are part of them in their lives one way or another. They believe that it’s just the way things are. Its one of the difficulties that parents just have to deal with. It’s not pleasant, it’s not easy but it must be done. Many of these conflicts then spill over into conflict between the parents with one parent saying to leave the child alone and the other insisting that the teeth have to be brushed, dinner has to be eaten. Now the conflict often deepens as each parent feels unsupported by the partner and begins to hold a grievance against the other.
The Gentle Light of Understanding
This is the term that I always use to describe the way in which conflict is resolved by a deep understanding of the nature of the problem. It is through this gentle light that we can release ourselves from difficulty and bring resolution and peace. So how do we solve the problem?
We need to firstly acknowledge that our assumptions about the situation may be wrong. Secondly, we might then acknowledge that it would be better if we were wrong. By this I simply mean that if we are correct in our assumptions then things cannot change and the conflict is inevitable, whereas if we are mistaken in our assumptions then change can happen and with it the possibility for the resolution of the conflict.
The solution is to realise that the problem is not caused by the child but by the method that is employed by the adult. Essentially, it is the use of pressure, criticism or force. By getting on to the children to do something in this way, you engender negativity in the child and a desire not to want to do it. In the simplest terms the human tendency is to resist being pushed. If someone pushes you, you will tend to react by pushing back This is true of adults as much as children. If a child feels put upon or pushed he/she will resist. Therefore if we want our children to brush their teeth, we must stop getting on (pushing) to them to do it.
What should we do?
Simply allow the child to see that you brush your teeth and comment on how nice it feels to have clean teeth. They will soon want to experience it themselves and if the experience is positive they will want to make a habit of it. By being gentle with them and with your own brushing, teach them to be gentle. When they try, always encourage them even if they do not do well at first (nobody gets it right first time). Never comment negatively on their effort or criticise them no matter what! Say how nice they look with their teeth sparkling and I promise that you will have difficulty stopping them from brushing.
Suggest, help and praise but please, no force, push or criticism Be gentle and fun but please not harsh or hard Find always ways to praise the good and completely overlook the error,
Remember
Children don’t do what you tell them, they do what you do!!
My name is Philip Christie. I qualified as a Dental Surgeon at Trinity College, Dublin (Ireland) in 1980 and completed a Master’s Programme in Dental Science, again at Trinity College Dublin, by research in 1995. I have been working full time in dental care either in general practice or specialist practice since qualification. My main interest is and always has been prevention.
We have all heard the routine. Maybe last night was the last time you heard or were involved. It time for bed and the parent/s are at the usual bedtime routine.
“Have you brushed your teeth, Billy?”, comes the irritated parental voice. A kind of pregnant silence follows. The question comes again but this time there is more irritation.
“Billy, did you hear me?? Have you brushed your teeth, yet??”
“No.., not yet, Mum” come the muffled, yet noticeably exasperated reply.
“Well, get to it, - straight away. I will be checking so don’t try to skive off”
“O...K Mum!”, Billy’s voice is resigned.
Ten minutes have passed and the voice from below stairs breaks the silence. “Have you got your teeth done, Billy?”
“Just doing it now, Mum”, calls back Billy's with a ‘sounding busy’ air, as he flicks the TV channel with the remote control.
“Well hurry up about it, I want you in bed in ten minutes, right?”
“Right, Mum...” Billy throws the remote on the bed and drags himself toward the bathroom. “Stupid bloody teeth... so boring...who cares anyway...” mutters Billy as he mindlessly goes through the motions with toothpaste and brush.
The shocked reaction
When I tell Mums and Dads to STOP telling their children to brush their teeth, they look at me as though I had just committed perjury. Some give me a quizzical look with a half smile waiting for me to admit that I was only joking. Others begin to laugh assuming that it is a joke. When I tell them that I could not be more serious, they are shocked and disbelieving that a dentist could speak these ‘crazy’ words.
“And whose going to tell them?” some ask mockingly.
“What kind of a parent would I be if I don’t do my duty?” one very caring mother asked me. “Don’t you think that that is a very irresponsible attitude for a dentist to have?”
These are all very understandable reactions because my advice seems to go against all understanding and reason. Surely it is the solemn duty of all parents to make sure that their children are looking after their teeth. Parents are responsible for the care of their children. Parents who do not take this responsibility seriously are not behaving as good parents.
The simple explanation
The explanation for all of this is very simple. What I have said seems to make no sense and indeed many would call it insane. Yet if we are prepared to look in simple honesty, we will see that it is society’s idea of how to teach and care for the children’s health that is actually ‘insane‘. Let me be very clear, I totally agree that it is a parents responsibility to teach their children to care for their teeth. It is on the question of how to achieve that noble goal that I differ from society. All methods are evaluated on how well they can achieve the stated goal. We ask then what it is we want to achieve and then whether or not we are achieving it. If we are not achieving what we set out to achieve, it makes sense that we then re-evaluate our methods.
When we examine the exchange between Billy and his Mum, we can gain enormous understanding of what goes wrong, why it goes wrong and how it goes wrong!
First of all, Billy doesn’t want to brush his teeth and ‘has’ to be forced by his Mum. Why is that? Why does he not want to do it? Most people assume that this behaviour is typical of a child. They believe that all children are just like that and that it something in the make up of the child. It is true to say that the behaviour is common and scenes like this one occur in most homes up and down the country. It is worthwhile noting that this applies not only to tooth-brushing but to many other things as well. How many could relate to similar problems at the table with food. Do conflicts begin at the table with a parent saying something like - “Come on now, Lucy, eat up all your dinner. How do you hope to be healthy unless you eat properly?”
Most people know these routines and are part of them in their lives one way or another. They believe that it’s just the way things are. Its one of the difficulties that parents just have to deal with. It’s not pleasant, it’s not easy but it must be done. Many of these conflicts then spill over into conflict between the parents with one parent saying to leave the child alone and the other insisting that the teeth have to be brushed, dinner has to be eaten. Now the conflict often deepens as each parent feels unsupported by the partner and begins to hold a grievance against the other.
The Gentle Light of Understanding
This is the term that I always use to describe the way in which conflict is resolved by a deep understanding of the nature of the problem. It is through this gentle light that we can release ourselves from difficulty and bring resolution and peace. So how do we solve the problem?
We need to firstly acknowledge that our assumptions about the situation may be wrong. Secondly, we might then acknowledge that it would be better if we were wrong. By this I simply mean that if we are correct in our assumptions then things cannot change and the conflict is inevitable, whereas if we are mistaken in our assumptions then change can happen and with it the possibility for the resolution of the conflict.
The solution is to realise that the problem is not caused by the child but by the method that is employed by the adult. Essentially, it is the use of pressure, criticism or force. By getting on to the children to do something in this way, you engender negativity in the child and a desire not to want to do it. In the simplest terms the human tendency is to resist being pushed. If someone pushes you, you will tend to react by pushing back This is true of adults as much as children. If a child feels put upon or pushed he/she will resist. Therefore if we want our children to brush their teeth, we must stop getting on (pushing) to them to do it.
What should we do?
Simply allow the child to see that you brush your teeth and comment on how nice it feels to have clean teeth. They will soon want to experience it themselves and if the experience is positive they will want to make a habit of it. By being gentle with them and with your own brushing, teach them to be gentle. When they try, always encourage them even if they do not do well at first (nobody gets it right first time). Never comment negatively on their effort or criticise them no matter what! Say how nice they look with their teeth sparkling and I promise that you will have difficulty stopping them from brushing.
Suggest, help and praise but please, no force, push or criticism Be gentle and fun but please not harsh or hard Find always ways to praise the good and completely overlook the error,
Remember
Children don’t do what you tell them, they do what you do!!
My name is Philip Christie. I qualified as a Dental Surgeon at Trinity College, Dublin (Ireland) in 1980 and completed a Master’s Programme in Dental Science, again at Trinity College Dublin, by research in 1995. I have been working full time in dental care either in general practice or specialist practice since qualification. My main interest is and always has been prevention.
Sunday, September 9, 2007
Why Chiropractic Is A Good Idea
You've probably heard about chiropractors, chiropractic therapy, or even chiropractic treatment while watching a sports news about your favorite athlete getting therapy because of an injury. It's not uncommon since chiropractic treatment is commonly associated with sports. If you're thinking that you don't need it since you don't do sports, think again. Chiropractic medicine are not isolated to the sports world; in fact, you might even have an injury that needs chiropractic attention.
Unknown to many, chiropractic practices are based on several key principles. The basic assumptions behind this form of therapy include the belief that the body can heal itself and that the brain controls body functions through the nervous system. The belief that spinal malfunction has direct effect on the nervous system as well as on the body's general health is also an underlying factor of chiropractic treatment. This is because chiropractic treatments are usually focused on neuromusculoskeletal disorders or NMS. NMS disorders are usually diagnosed at the back muscles and the spinal cord.
A founding principle of chiropractic is adjustment. Adjustment in this case is a distinct type of manipulation of joints by using controlled direction, leverage, force, velocity, and amplitude. Adjustments can be practiced on almost all joints in the body. This can be accompanied by cavitation usually characterized by a popping sound. The goal of adjustments is to affect nerves and nervous system to ease the body in returning to homeostasis by restoring the normal function and condition of the joints. These may sound to technical but chiropractors, chiropractic therapists, and chiropractic practitioners maintain that chiropractic treatment is also an art. Art in chiropractic medicine is viewed as the intuition, expertise, and skill that practitioners employ to accurately diagnose dysfunction and abnormality of the body's NMS system. Specific tests are administered to the patient to determine the injury, its extent, and the proper treatment or technique that must be used to correct it. Art is also seen in perspective as the finesse of the practitioner in applying techniques. Chiropractors insist that grace and fluidity of movement are necessary so as not to shock the NMS system and aggravate injury.
Though people with some sports injuries are still on top of the list, other injuries or ailments can also be treated by chiropractors, chiropractic, and chiropractic treatment. Reports indicate that there is an increasing number of people availing of chiropractic help to ease head aches, neck pain, arthritis, and other muscular pain. Patients also indicate that they function better and feel energetic after undergoing chiropractic treatment. Also, there is no need to worry as chiropractors have undergone rigorous training and study for as much as 4 to 6 years before they can get certified. As a plus, the practice is also less expensive than NMS surgery that you might need if continue to ignore your NMS problems.
Unknown to many, chiropractic practices are based on several key principles. The basic assumptions behind this form of therapy include the belief that the body can heal itself and that the brain controls body functions through the nervous system. The belief that spinal malfunction has direct effect on the nervous system as well as on the body's general health is also an underlying factor of chiropractic treatment. This is because chiropractic treatments are usually focused on neuromusculoskeletal disorders or NMS. NMS disorders are usually diagnosed at the back muscles and the spinal cord.
A founding principle of chiropractic is adjustment. Adjustment in this case is a distinct type of manipulation of joints by using controlled direction, leverage, force, velocity, and amplitude. Adjustments can be practiced on almost all joints in the body. This can be accompanied by cavitation usually characterized by a popping sound. The goal of adjustments is to affect nerves and nervous system to ease the body in returning to homeostasis by restoring the normal function and condition of the joints. These may sound to technical but chiropractors, chiropractic therapists, and chiropractic practitioners maintain that chiropractic treatment is also an art. Art in chiropractic medicine is viewed as the intuition, expertise, and skill that practitioners employ to accurately diagnose dysfunction and abnormality of the body's NMS system. Specific tests are administered to the patient to determine the injury, its extent, and the proper treatment or technique that must be used to correct it. Art is also seen in perspective as the finesse of the practitioner in applying techniques. Chiropractors insist that grace and fluidity of movement are necessary so as not to shock the NMS system and aggravate injury.
Though people with some sports injuries are still on top of the list, other injuries or ailments can also be treated by chiropractors, chiropractic, and chiropractic treatment. Reports indicate that there is an increasing number of people availing of chiropractic help to ease head aches, neck pain, arthritis, and other muscular pain. Patients also indicate that they function better and feel energetic after undergoing chiropractic treatment. Also, there is no need to worry as chiropractors have undergone rigorous training and study for as much as 4 to 6 years before they can get certified. As a plus, the practice is also less expensive than NMS surgery that you might need if continue to ignore your NMS problems.
Saturday, September 8, 2007
Bird Flu (Avian Influenza) Pandemic, the Cytokine Storm: What Drugs Work and Don't Work
What is a Cytokine Storm?
by Steven P. Petrosino, Ph.D. and Angela L. Petrosino, MPH
A cytokine storm, also called "systemic inflammatory response syndrome" (SIRS) is the systemic expression of a healthy and vigorous immune system resulting in the release of more than 150 inflammatory mediators (cytokines, oxygen free radicals, and coagulation factors). Both pro-inflammatory cytokines (such as Tumor Necrosis Factor-alpha, InterLeukin-1, and InterLeukin-6) and anti-inflammatory cytokines (such as interleukin 10, and interleukin 1 receptor antagonist) are elevated in the serum, and the fierce and often lethal interplay of these cytokines is referred to as a "Cytokine Storm". The primary contributors to the cytokine storm are TNF-a (Tumor Necrosis Factor-alpha) and IL-6 (Interleukin-6). The cytokine storm is an inappropriate (greatly exaggerated) immune response that is caused by rapidly proliferating and highly activated T-cells or natural killer (NK) cells. These cells are themselves activated by infected macrophages. The cytokine storm must be treated and suppressed or lethality can result.
Acute respiratory viral infection results in a cytokine storm effecting the lungs, and subsequent damage to alveoli and lung tissue results in the lethality seen in more severe flu viral infections, especially those fatalities among young healthy adults.
In the absence of prompt medical intervention to stop the "cytokine storm", the lung will suffer permanent damage. Many of these patients will develop acute respiratory distress syndrome (ARDS), i.e. will present with pulmonary edema that is not caused by volume overload, or a depressed left ventricular function. Deaths will usually result from multisystem organ failure, and not from lung failure.
Sepsis, Viral Infections, and Cytokine Storm
Sepsis is a severe systemic inflammatory response and is one example of a pathologic condition associated with "cytokine storm". Sepsis is an often lethal hemodynamic collapse which is usually the result of a super infection by gram-negative bacterial endotoxins. Sepsis is also classified as septic shock syndrome (SSS).
Cytokine storm can also result from viral infections such as influenza, and an exaggerated systemic immune response to that particular viral infection (designated a type A, subtype "H1N1" virus) may have been the cause of high lethality seen in the influenza pandemic of 1918 to 1919. The great influenza pandemic was the most destructive pandemic in recorded world history, and killed more people (estimated between 20 to 50 million) than all casualties resulting from the first World War. Although the Spanish Flu pandemic affected an enormous percentage of the world wide population (up to 20% of the world population according to some sources), and killed between 20 and 50 million persons, no more than 5% of the people who contracted the Spanish Flu died (Brown et. al reported the highest death rate in India at 50 deaths per 1000 persons contracting the disease, or a five percent fatality rate). After 218 human cases of avian influenza (bird flu) have been confirmed world-wide (as of May, 2006), the lethality rate stands at 57%. Should this strain develop into a pandemic, and should it keep its current mortality rate, it has the potential to be 10 times more lethal than the 1918 pandemic.
Is the World Health Organization Adequately Defending against a Potential Pandemic of Avian Influenza
Avian Influenza (also called the "Bird flu") currently is 10 times more lethal than the strain of Spanish Flu that caused the great influenza pandemic of 1918 and killed up to 50 million people world-wide, and it could become the most lethal flu pandemic of all history if the virus mutates allowing it to be more easily passed from person to person. Bird Flu patients die from acute respiratory distress syndrome (ARDS) caused by the "cytokine storm", and NOT directly from the virus. Neuraminidase inhibitors (i.e. Tamiflu, Relenza) are not proven effective for bird flu patients, although they have been recommended by the World Health Organization for this use, are currently used to treat almost all bird flu patients, and are being stockpiled by governments world-wide (including the United States) to treat a potential pandemic should the avian influenza virus undergo a final mutation which would allow it to be more easily passed from person to person. A treatment to prevent or reduce the autoimmune reaction (cytokine storm) associated with the bird flu is commercially available by prescription, but is not currently being recommended by the World Health Organization to treat these patients.
Influenza A, The most lethal influenza and the precursor of all Pandemic Viruses
Influenza viruses responsible for causing pandemics are influenza type A viruses which emerge as a result of a process called "antigenic shift”. Antigenic shift causes an abrupt or sudden, major change in certain proteins on the surface of the influenza A virus (specifically the hemagglutinin or “HA” protein and the neuraminidase or the “NA” protein).Certain antigenic shifts may allow the virus to become more easily transmissible, more "contagious". Once this type of shift occurs, wide-spread infection usually follows quickly. Antigenic shift is most dangerous when it occurs in a virus that has demonstrated high lethality, such as the H5N1 bird flu.
History has recorded 10 pandemics of influenza A in the past 300 years. The sudden appearance of new influenza A virus subtypes during the 20th century has caused three pandemics, all of which spread world-wide within 1 year of first being detected.
Influenza Pandemics of the 20th Century
* 1918-19, "Spanish flu," [Type A, subtype (H1N1)], caused the highest number of known influenza deaths: more than one-half million people died within the United States (nearly half of the deaths were young healthy adults aged 20-40), and between 50 and 100 million people may have died worldwide. Most deaths occurred within the first few days after infection, some deaths within hours of symptom onset, and other deaths occurred later as a result of complications. Influenza A (H1N1) viruses still circulate today after having been reintroduced in the 1970s. Although called the "Spanish Flu" because the first widely reported deaths were in Spain, it probably originated in China.
* 1957-58, "Asian flu," [Type A, subtype (H2N2)], caused about 70,000 deaths in the United States. The "asian flu" was initially identified in China in late February 1957. Three months later, it spread to the United States with early reports of infection as early as June 1957.
* 1968-69, " Hong Kong flu," [Type A subtype (H3N2)], was responsible for about 34,000 deaths in the United States. The "Hong Kong flu" virus was first detected in Hong Kong in early 1968 and spread to the United States within a few months. Influenza A (H3N2) viruses still circulate today.
Both the 1957-58 and 1968-69 pandemics were caused by viruses containing a combination of genes from a human influenza virus and an avian influenza virus. The origin of the 1918-19 pandemic virus is not clear, but if its origin was in China as suspected, it could have similarly been caused by a genetic recombination of human and avian influenza viruses. This can more easily occur if humans are in close proximity to both live birds and pigs, as can occur in public markets in Asia. Osterholm reports the last influenza pandemic (1968) occurred 37 years ago, emerging in China. At that time China's human population was 790 million, its pig population was 5.2 million, and its poultry population was 12.3 million. Today, these populations number 1.3 billion, 508 million, and 13 billion, respectively. The human and animal populations of other Asian countries have similarly increased exponentially, which has increased the chances for close contact between birds, pigs and humans in these countries, creating optimal conditions for the emergence of new viruses, such as the H5N1 subtype.
On August 12, 2004, the Vietnamese Ministry of Health reported three confirmed human deaths to the World Health Organization (WHO) from confirmed avian influenza H5 infection. If the virus is confirmed to belong to the same H5N1 strain that caused 22 cases (15 deaths) in Vietnam and 12 cases (8 deaths) in Thailand in 2005, and human-to-human contact versus human to bird or human-to-swine contact is suspected, this may indicate that H5N1 has adapted to the point that it is transmissible and has the potential to cause the next pandemic. In May 2006, it was reported that a family of 7 died of the bird flu after having no detectible contact with an infected bird. If this is the case, the virus may have undergone a final mutation giving it the potential to cause a pandemic.
What Are the Symptoms of the Bird Flu:
Initial Presentaion of Influenza A (H5N1) Avian Influenza:
o Pulmonary: Radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other severe respiratory illness for which an alternate diagnosis cannot be established
o One or more of the following: cough and/or sore throat and/or shortness of breath, AND a history of contact with poultry (e.g., visited a poultry farm, a household raising poultry, or a bird market) or contact with a known or suspected human case of influenza A (H5N1) in an H5N1-affected country within 10 days of symptom onset.
o Dyspnea
o Fever (temperature of >38°C or >100.4°F)
Symptoms Of The Cytokine Storm:
The end stage, or final result, of cytokine storm (SIRS) or sepsis is multiple organ dysfunction syndrome (MODS). The end-stage symptoms of the bird flu, or other infection precipitating the cytokine storm may include:
o hypotension
o tachycardia
o dyspnea
o fever (temperature of >38°C or >100.4°F)
o Ischemia, or insufficient tissue perfusion (especially involving the major organs)
o uncontrollable hemorrhage
o and multisystem organ failure (caused primarily by hypoxia, tissue acidosis, and severe metabolism dysregulation
Oxygen free radicals, histamine, complement factor C5a, Beta-endorphin, thromboxane B2, and platelet activating factor are implicated in SSS. The major pro-inflammatory cytokines which are implicated in SSS are TNF-alpha, IL1, IL6 and IL8. Serum TNF alpha concentrations in excess of 1 ng/mL are frequently predictive of a lethal outcome, however serum concentrations of other inflammatory cytokines involved in the pathophysiology of Septic shock are usually not reliable predictors of the severity of the shock state or clinical outcome. These cytokines are released by macrophages following activation by bacterial endotoxins.
by Steven P. Petrosino, Ph.D. and Angela L. Petrosino, MPH
A cytokine storm, also called "systemic inflammatory response syndrome" (SIRS) is the systemic expression of a healthy and vigorous immune system resulting in the release of more than 150 inflammatory mediators (cytokines, oxygen free radicals, and coagulation factors). Both pro-inflammatory cytokines (such as Tumor Necrosis Factor-alpha, InterLeukin-1, and InterLeukin-6) and anti-inflammatory cytokines (such as interleukin 10, and interleukin 1 receptor antagonist) are elevated in the serum, and the fierce and often lethal interplay of these cytokines is referred to as a "Cytokine Storm". The primary contributors to the cytokine storm are TNF-a (Tumor Necrosis Factor-alpha) and IL-6 (Interleukin-6). The cytokine storm is an inappropriate (greatly exaggerated) immune response that is caused by rapidly proliferating and highly activated T-cells or natural killer (NK) cells. These cells are themselves activated by infected macrophages. The cytokine storm must be treated and suppressed or lethality can result.
Acute respiratory viral infection results in a cytokine storm effecting the lungs, and subsequent damage to alveoli and lung tissue results in the lethality seen in more severe flu viral infections, especially those fatalities among young healthy adults.
In the absence of prompt medical intervention to stop the "cytokine storm", the lung will suffer permanent damage. Many of these patients will develop acute respiratory distress syndrome (ARDS), i.e. will present with pulmonary edema that is not caused by volume overload, or a depressed left ventricular function. Deaths will usually result from multisystem organ failure, and not from lung failure.
Sepsis, Viral Infections, and Cytokine Storm
Sepsis is a severe systemic inflammatory response and is one example of a pathologic condition associated with "cytokine storm". Sepsis is an often lethal hemodynamic collapse which is usually the result of a super infection by gram-negative bacterial endotoxins. Sepsis is also classified as septic shock syndrome (SSS).
Cytokine storm can also result from viral infections such as influenza, and an exaggerated systemic immune response to that particular viral infection (designated a type A, subtype "H1N1" virus) may have been the cause of high lethality seen in the influenza pandemic of 1918 to 1919. The great influenza pandemic was the most destructive pandemic in recorded world history, and killed more people (estimated between 20 to 50 million) than all casualties resulting from the first World War. Although the Spanish Flu pandemic affected an enormous percentage of the world wide population (up to 20% of the world population according to some sources), and killed between 20 and 50 million persons, no more than 5% of the people who contracted the Spanish Flu died (Brown et. al reported the highest death rate in India at 50 deaths per 1000 persons contracting the disease, or a five percent fatality rate). After 218 human cases of avian influenza (bird flu) have been confirmed world-wide (as of May, 2006), the lethality rate stands at 57%. Should this strain develop into a pandemic, and should it keep its current mortality rate, it has the potential to be 10 times more lethal than the 1918 pandemic.
Is the World Health Organization Adequately Defending against a Potential Pandemic of Avian Influenza
Avian Influenza (also called the "Bird flu") currently is 10 times more lethal than the strain of Spanish Flu that caused the great influenza pandemic of 1918 and killed up to 50 million people world-wide, and it could become the most lethal flu pandemic of all history if the virus mutates allowing it to be more easily passed from person to person. Bird Flu patients die from acute respiratory distress syndrome (ARDS) caused by the "cytokine storm", and NOT directly from the virus. Neuraminidase inhibitors (i.e. Tamiflu, Relenza) are not proven effective for bird flu patients, although they have been recommended by the World Health Organization for this use, are currently used to treat almost all bird flu patients, and are being stockpiled by governments world-wide (including the United States) to treat a potential pandemic should the avian influenza virus undergo a final mutation which would allow it to be more easily passed from person to person. A treatment to prevent or reduce the autoimmune reaction (cytokine storm) associated with the bird flu is commercially available by prescription, but is not currently being recommended by the World Health Organization to treat these patients.
Influenza A, The most lethal influenza and the precursor of all Pandemic Viruses
Influenza viruses responsible for causing pandemics are influenza type A viruses which emerge as a result of a process called "antigenic shift”. Antigenic shift causes an abrupt or sudden, major change in certain proteins on the surface of the influenza A virus (specifically the hemagglutinin or “HA” protein and the neuraminidase or the “NA” protein).Certain antigenic shifts may allow the virus to become more easily transmissible, more "contagious". Once this type of shift occurs, wide-spread infection usually follows quickly. Antigenic shift is most dangerous when it occurs in a virus that has demonstrated high lethality, such as the H5N1 bird flu.
History has recorded 10 pandemics of influenza A in the past 300 years. The sudden appearance of new influenza A virus subtypes during the 20th century has caused three pandemics, all of which spread world-wide within 1 year of first being detected.
Influenza Pandemics of the 20th Century
* 1918-19, "Spanish flu," [Type A, subtype (H1N1)], caused the highest number of known influenza deaths: more than one-half million people died within the United States (nearly half of the deaths were young healthy adults aged 20-40), and between 50 and 100 million people may have died worldwide. Most deaths occurred within the first few days after infection, some deaths within hours of symptom onset, and other deaths occurred later as a result of complications. Influenza A (H1N1) viruses still circulate today after having been reintroduced in the 1970s. Although called the "Spanish Flu" because the first widely reported deaths were in Spain, it probably originated in China.
* 1957-58, "Asian flu," [Type A, subtype (H2N2)], caused about 70,000 deaths in the United States. The "asian flu" was initially identified in China in late February 1957. Three months later, it spread to the United States with early reports of infection as early as June 1957.
* 1968-69, " Hong Kong flu," [Type A subtype (H3N2)], was responsible for about 34,000 deaths in the United States. The "Hong Kong flu" virus was first detected in Hong Kong in early 1968 and spread to the United States within a few months. Influenza A (H3N2) viruses still circulate today.
Both the 1957-58 and 1968-69 pandemics were caused by viruses containing a combination of genes from a human influenza virus and an avian influenza virus. The origin of the 1918-19 pandemic virus is not clear, but if its origin was in China as suspected, it could have similarly been caused by a genetic recombination of human and avian influenza viruses. This can more easily occur if humans are in close proximity to both live birds and pigs, as can occur in public markets in Asia. Osterholm reports the last influenza pandemic (1968) occurred 37 years ago, emerging in China. At that time China's human population was 790 million, its pig population was 5.2 million, and its poultry population was 12.3 million. Today, these populations number 1.3 billion, 508 million, and 13 billion, respectively. The human and animal populations of other Asian countries have similarly increased exponentially, which has increased the chances for close contact between birds, pigs and humans in these countries, creating optimal conditions for the emergence of new viruses, such as the H5N1 subtype.
On August 12, 2004, the Vietnamese Ministry of Health reported three confirmed human deaths to the World Health Organization (WHO) from confirmed avian influenza H5 infection. If the virus is confirmed to belong to the same H5N1 strain that caused 22 cases (15 deaths) in Vietnam and 12 cases (8 deaths) in Thailand in 2005, and human-to-human contact versus human to bird or human-to-swine contact is suspected, this may indicate that H5N1 has adapted to the point that it is transmissible and has the potential to cause the next pandemic. In May 2006, it was reported that a family of 7 died of the bird flu after having no detectible contact with an infected bird. If this is the case, the virus may have undergone a final mutation giving it the potential to cause a pandemic.
What Are the Symptoms of the Bird Flu:
Initial Presentaion of Influenza A (H5N1) Avian Influenza:
o Pulmonary: Radiographically confirmed pneumonia, acute respiratory distress syndrome (ARDS), or other severe respiratory illness for which an alternate diagnosis cannot be established
o One or more of the following: cough and/or sore throat and/or shortness of breath, AND a history of contact with poultry (e.g., visited a poultry farm, a household raising poultry, or a bird market) or contact with a known or suspected human case of influenza A (H5N1) in an H5N1-affected country within 10 days of symptom onset.
o Dyspnea
o Fever (temperature of >38°C or >100.4°F)
Symptoms Of The Cytokine Storm:
The end stage, or final result, of cytokine storm (SIRS) or sepsis is multiple organ dysfunction syndrome (MODS). The end-stage symptoms of the bird flu, or other infection precipitating the cytokine storm may include:
o hypotension
o tachycardia
o dyspnea
o fever (temperature of >38°C or >100.4°F)
o Ischemia, or insufficient tissue perfusion (especially involving the major organs)
o uncontrollable hemorrhage
o and multisystem organ failure (caused primarily by hypoxia, tissue acidosis, and severe metabolism dysregulation
Oxygen free radicals, histamine, complement factor C5a, Beta-endorphin, thromboxane B2, and platelet activating factor are implicated in SSS. The major pro-inflammatory cytokines which are implicated in SSS are TNF-alpha, IL1, IL6 and IL8. Serum TNF alpha concentrations in excess of 1 ng/mL are frequently predictive of a lethal outcome, however serum concentrations of other inflammatory cytokines involved in the pathophysiology of Septic shock are usually not reliable predictors of the severity of the shock state or clinical outcome. These cytokines are released by macrophages following activation by bacterial endotoxins.
Friday, September 7, 2007
New Antidepressants
The SSRIs act by inhibiting serotonin reuptake, and are considered the most popular, effective and safe prescription medications. The new prescription SSRIs used to treat depression include citalopram (Celexa), escitalopram oxalate (Lexapro), fluoxetine (Prozac, Prozac Weekly, Sarafem), paroxetine (Paxil, Paxil CR), and sertraline (Zoloft). Citalopram, a chiral compound, has its serotonin reuptake inhibitory activity in the S-enantiomer. Escitalopram, the S-enantiomer of citalopram has demonstrated Antidepressant activity in animal models. Prozac has shown significant success in the treatment of depression and prevention of suicide. It exhibits less potential side effects as compared to TCAs and MAOIs. Paroxetine exhibits anti-cholinergic effect and causes sedation. Zoloft has few drug interactions, but has the side effect of causing diarrhea and male sexual dysfunction.
The currently available SNRIs (desipramine, duloxetine, nefazodone, and venlafaxine) keep both serotonin and norepinephrine at the right level to alleviate depressive symptoms. Nefazodone alleviates anxiety, causes sedation and positively affects sleep. Venlafaxine (Effexor) has significant anticholinergic effects (dry mouth, blurred vision, urinary hesitancy, and constipation), induces sedation and has potential withdrawal effects.
The drug bupropion (Wellbutrin, Wellbutrin SR) is the most commonly used member of the novel Antidepressant class. It is quite unique in its efficiency to inhibit the reuptake of dopamine, serotonin and norepinephrine. Reuptake lowers reception of feel-good brain chemicals. Maprotiline (Ludiomil) and mirtazapine (Remeron) are the two main drugs from the group of tetracyclic Antidepressants. Mirtazapine acts by increasing the amount of noradrenaline and serotonin, and is of benefit in particular for the treatment of depression accompanied with anxiety, agitation and /or sleep disturbances.
The currently available SNRIs (desipramine, duloxetine, nefazodone, and venlafaxine) keep both serotonin and norepinephrine at the right level to alleviate depressive symptoms. Nefazodone alleviates anxiety, causes sedation and positively affects sleep. Venlafaxine (Effexor) has significant anticholinergic effects (dry mouth, blurred vision, urinary hesitancy, and constipation), induces sedation and has potential withdrawal effects.
The drug bupropion (Wellbutrin, Wellbutrin SR) is the most commonly used member of the novel Antidepressant class. It is quite unique in its efficiency to inhibit the reuptake of dopamine, serotonin and norepinephrine. Reuptake lowers reception of feel-good brain chemicals. Maprotiline (Ludiomil) and mirtazapine (Remeron) are the two main drugs from the group of tetracyclic Antidepressants. Mirtazapine acts by increasing the amount of noradrenaline and serotonin, and is of benefit in particular for the treatment of depression accompanied with anxiety, agitation and /or sleep disturbances.
Thursday, September 6, 2007
Blood Pressure Medications
There are many over-the-counter drugs available for controlling high or low blood pressure, but it’s best to consult a physician before taking any medication to avoid complications.
Angiotensin II is a hormone that causes blood vessels to constrict. Drugs such as angiotensin can block this hormone and cause blood vessels to relax.
Nerve impulses might also cause the flow of blood to slow and blood pressure to increase. These impulses can be slowed with alpha-blockers, alpha-beta-blockers, and beta-blockers. Beta-blockers also reduce the heartbeat and blood flow to control blood pressure. The nervous system inhibitors, Vasodilators are used when blood vessels are to be opened directly.
If calcium enters invades heart muscles or blood vessels, arteries constrict, calling for the use of calcium channel blockers or the drug Minoxidil.
Another reason for increased blood pressure is excess water and minerals such as sodium in the kidney. Diuretics or diuretic preparations like indapamide can control these.
Peripheral artery walls can be relaxed using hydralazine.
And some drugs such as methyldopa and moxonidine can be helpful in stimulating the alpha-receptors in the brain to relax blood vessels.
High blood pressure has a variety of causes and should be properly diagnosed and prescribed for by a physician. It is important to remember that high or low blood pressure is an indicator that the heart is working too hard, or that the heart is not experiencing enough resistance. The imbalance should be restored with a combination of proper diet, aerobic exercise, and, if necessary, blood pressure medications.
Angiotensin II is a hormone that causes blood vessels to constrict. Drugs such as angiotensin can block this hormone and cause blood vessels to relax.
Nerve impulses might also cause the flow of blood to slow and blood pressure to increase. These impulses can be slowed with alpha-blockers, alpha-beta-blockers, and beta-blockers. Beta-blockers also reduce the heartbeat and blood flow to control blood pressure. The nervous system inhibitors, Vasodilators are used when blood vessels are to be opened directly.
If calcium enters invades heart muscles or blood vessels, arteries constrict, calling for the use of calcium channel blockers or the drug Minoxidil.
Another reason for increased blood pressure is excess water and minerals such as sodium in the kidney. Diuretics or diuretic preparations like indapamide can control these.
Peripheral artery walls can be relaxed using hydralazine.
And some drugs such as methyldopa and moxonidine can be helpful in stimulating the alpha-receptors in the brain to relax blood vessels.
High blood pressure has a variety of causes and should be properly diagnosed and prescribed for by a physician. It is important to remember that high or low blood pressure is an indicator that the heart is working too hard, or that the heart is not experiencing enough resistance. The imbalance should be restored with a combination of proper diet, aerobic exercise, and, if necessary, blood pressure medications.
Tuesday, September 4, 2007
Cialis: Making Lives Evergreen
Being eternal is unattainable but living the life to its apex is now in your control. If you ever thought that you can’t enjoy sex for more than 45-50 years you were really mistaken, believe me you can enjoy your sexual life as long as 100 years. Sex unarguably is one of the best gifts of nature, and to betray sex is equivalent to betraying nature itself. Sex has been and will remain an integral part of our life since the day Adam had the apple.
Man has been striving since long to achieve a better performance in order to satiate both his as well his partner’s urge to sex. Albeit, there have been a lot of factors that have been instrumental in being a barrier to the Sex like age, hormonal imbalances, society, money and many other things, but none of those have been powerful enough to sustain the Sex flow. Medicinal herbs, therapeutic fruits, meditation, yoga have helped him in one way or the other but there has always been a search for that extra punch to help men in his sexual disorders. Erectile dysfunction has been one of the most commonly occurring sexual disorders.
Erectile dysfunction has been an imperative factor in breaking many blooming affairs; it is defined as a condition wherein you can’t sustain your erection necessary for sexual activity fulfillment.
What exactly is erectile dysfunction?
Erectile dysfunction is a male sexual disorder wherein a person is not able to maintain penile erection required for the minimum time to have a successful intercourse or to attain sexual gratification or satiety. ED was formerly known as IMPOTENCY. Erectile dysfunction being the most commonly occurring sexual disorders in men; pharmacologists, doctors tried to discover some medication urgently. There are a good number of reasons that cause ED like psychological factors, hormonal factors, arterial or muscular factors. The diseases associated with it are Diabetes Mellitus, Major Depression, etc.
What is Cialis?
Flaunted as a “fountain of youth”, CIALIS is the best discovered cure for erectile dysfunction. The FDA approved medication CIALIS has achieved astonishing success in the treatment of impotence. CIALIS works by inhibiting the PDE5 enzyme, "That means that if we take a pill, then have sexual stimulation, the drug can amplify the natural erectile response”. It works like Viagra, acting by inhibiting an enzyme called phosphodiesterase which releases Nitric Oxide from nerve endings and endothelium causing relaxation of smooth muscle and hence penile erection. This is a product developed by Eli Lilly and ICOS and it was launched under the trade name of the product called Tadalafil launched in the market in 2003. It is unlikely that untreated ED contributes to decreased survival, even though it may contribute to emotional distress and strained relationships.
Who all can benefit?
Men with ED due to some arterial disorders will benefit the most. There is a wide spread myth that a person as soon as taking the drug will have erection but that is not the case. It starts taking action only when a person starts physical activity. Men with prostate cancer who have their prostate removed are usually free of cancer, but the procedure often comes with a cost -- impotence. A new study, however, shows that Viagra (Sildenafil), the popular medication for erectile dysfunction, can restore impotency lost in surgery. Whether men respond, however, depends on how much nerve damage occurred during surgery.
Man has been striving since long to achieve a better performance in order to satiate both his as well his partner’s urge to sex. Albeit, there have been a lot of factors that have been instrumental in being a barrier to the Sex like age, hormonal imbalances, society, money and many other things, but none of those have been powerful enough to sustain the Sex flow. Medicinal herbs, therapeutic fruits, meditation, yoga have helped him in one way or the other but there has always been a search for that extra punch to help men in his sexual disorders. Erectile dysfunction has been one of the most commonly occurring sexual disorders.
Erectile dysfunction has been an imperative factor in breaking many blooming affairs; it is defined as a condition wherein you can’t sustain your erection necessary for sexual activity fulfillment.
What exactly is erectile dysfunction?
Erectile dysfunction is a male sexual disorder wherein a person is not able to maintain penile erection required for the minimum time to have a successful intercourse or to attain sexual gratification or satiety. ED was formerly known as IMPOTENCY. Erectile dysfunction being the most commonly occurring sexual disorders in men; pharmacologists, doctors tried to discover some medication urgently. There are a good number of reasons that cause ED like psychological factors, hormonal factors, arterial or muscular factors. The diseases associated with it are Diabetes Mellitus, Major Depression, etc.
What is Cialis?
Flaunted as a “fountain of youth”, CIALIS is the best discovered cure for erectile dysfunction. The FDA approved medication CIALIS has achieved astonishing success in the treatment of impotence. CIALIS works by inhibiting the PDE5 enzyme, "That means that if we take a pill, then have sexual stimulation, the drug can amplify the natural erectile response”. It works like Viagra, acting by inhibiting an enzyme called phosphodiesterase which releases Nitric Oxide from nerve endings and endothelium causing relaxation of smooth muscle and hence penile erection. This is a product developed by Eli Lilly and ICOS and it was launched under the trade name of the product called Tadalafil launched in the market in 2003. It is unlikely that untreated ED contributes to decreased survival, even though it may contribute to emotional distress and strained relationships.
Who all can benefit?
Men with ED due to some arterial disorders will benefit the most. There is a wide spread myth that a person as soon as taking the drug will have erection but that is not the case. It starts taking action only when a person starts physical activity. Men with prostate cancer who have their prostate removed are usually free of cancer, but the procedure often comes with a cost -- impotence. A new study, however, shows that Viagra (Sildenafil), the popular medication for erectile dysfunction, can restore impotency lost in surgery. Whether men respond, however, depends on how much nerve damage occurred during surgery.
Monday, September 3, 2007
Drug Side Effects: Combivent Dangerous? You Bet It Is!
Drugs have side effects. Period. So does Combivent, a drug that I use. Is Combivent dangerous? I think it is. First, I need to give a little history here, and then we can talk shop.
In 2000, I moved home with my mom to begin assisting her with her care because she had developed cancer. Her ordeal was terrible, and primarily it was because in addition to the effects of the cancer itself, the drugs therapies she was on were horrendously brutal on her health and constitution. One of the drugs she used to combat her lung cancer was something called Combivent.
I had been using Albuteral since the early 90's to help manage some of the symptoms that come with having Cystic Fibrosis. My doctor prescribed it as a quick fix for times when allergies made my chest tight, or when I felt particularly congested...
Well, when I moved in with my mom I eventually became curious about her inhaler. I asked my doctor if I might try the use of Combivent every so often, and when I tried it I liked it. It had a two-pronged benefit of both opening my lungs and reducing inflammation. For some reason, it helped me clear more congestion more easily. So, I began to use it as a replacement for Albuterol. It should be noted that Combivent (a play on the word "combine" perhaps?) is a combination of Albuterol and a steroid known as Ipratropium.
My problem with all drugs, and Combivent in particular, is that all drugs have side effects. Doctors play them down, but I am here to tell you that you CANNOT and MUST NOT minimize the importance of these side effects.
Read up on Combivent. You will see what I am talking about. Do your own research. Combivent can be fatal if you overdose on it! At the very least it can cause adverse reactions that you need to be aware of.
In fact, I believe that I have systematically been OD'ing on it since 2000. The way in which an overdose takes place is simple, especially when you consider the symptoms that Combivent can create.
If you do you research you will see that Combivent can cause increased congestion and shortness of breath as a side effect. So, with that as a side effect, and given the nature of CF itself, a vicious cycle can begin whereby a person can accidentally OD on Combivent.
Let's say you take two hits on the drug. Initially you get relief of your symptoms. It really helps open your airways, right? You feel better, right? But in a few minutes you notice you are coughing more. You think to yourself, "OK, I have CF, coughing is what I do. Maybe the Combivent just loosened up something."
Well, maybe. And maybe not. It could also be that you may be having a reaction to the drug.
In another hour, your chest feels tighter. So, you take another hit. You don't get the relief you got earlier, so you take one more just to be on the safe side. It helps some, but in 30 minutes you are coughing more, you fell poorly and your lungs begin to hurt. So, you take one more hit. Next thing you know, you have full blown symptoms that look like pneumonia for Pete's Sake! And if you are lucky, that's all that will happen, but it can get MUCH worse.
I have OD'ed on Combivent several times in my life without realizing what was happening. The most recent time was 3 days ago, Monday this past.
Since I had just gotten over what my doctor thought was pneumonia (and he could have been right, but who knows for sure, because I may have been having a reaction to too much Combivent), I assumed that the pneumonia was coming back, even though the Ciprofloxacin he had given me had taken care of it. My lungs were hurting as they had been before. I took another hit on my Combivent and the symptoms worsened and it was then that I began to think I was hurting myself with the drug. I had used it several times that morning, to deal with symptoms that got increasingly worse as time passed. So, even though I was unable to breath, I stopped the Combivent.
Within an hour, my lungs had returned to normal and I was feeling fine, but after an ordeal that lasted nearly 3 hours, I had had an epiphany of sorts. Combivent is not necessarily a good thing. It can even create the very symptoms it is formulated to alleviate.
Since then, I have made sure that at least 4-5 hours pass between doses, and I feel good. I am less congested and for the time being I am breathing better.
My who point is that drugs do not always help us. Few drugs, if any, come without a price in the form of side effects. Do your research on your drugs. Always consider the risks of using a drug vs. the risks of not using it. Pay close attention to your doses. Monitor how you feel. And discontinue the use of a drug if it makes you feel worse. Even something as seemingly harmless as an inhaler can be dangerous.
In 2000, I moved home with my mom to begin assisting her with her care because she had developed cancer. Her ordeal was terrible, and primarily it was because in addition to the effects of the cancer itself, the drugs therapies she was on were horrendously brutal on her health and constitution. One of the drugs she used to combat her lung cancer was something called Combivent.
I had been using Albuteral since the early 90's to help manage some of the symptoms that come with having Cystic Fibrosis. My doctor prescribed it as a quick fix for times when allergies made my chest tight, or when I felt particularly congested...
Well, when I moved in with my mom I eventually became curious about her inhaler. I asked my doctor if I might try the use of Combivent every so often, and when I tried it I liked it. It had a two-pronged benefit of both opening my lungs and reducing inflammation. For some reason, it helped me clear more congestion more easily. So, I began to use it as a replacement for Albuterol. It should be noted that Combivent (a play on the word "combine" perhaps?) is a combination of Albuterol and a steroid known as Ipratropium.
My problem with all drugs, and Combivent in particular, is that all drugs have side effects. Doctors play them down, but I am here to tell you that you CANNOT and MUST NOT minimize the importance of these side effects.
Read up on Combivent. You will see what I am talking about. Do your own research. Combivent can be fatal if you overdose on it! At the very least it can cause adverse reactions that you need to be aware of.
In fact, I believe that I have systematically been OD'ing on it since 2000. The way in which an overdose takes place is simple, especially when you consider the symptoms that Combivent can create.
If you do you research you will see that Combivent can cause increased congestion and shortness of breath as a side effect. So, with that as a side effect, and given the nature of CF itself, a vicious cycle can begin whereby a person can accidentally OD on Combivent.
Let's say you take two hits on the drug. Initially you get relief of your symptoms. It really helps open your airways, right? You feel better, right? But in a few minutes you notice you are coughing more. You think to yourself, "OK, I have CF, coughing is what I do. Maybe the Combivent just loosened up something."
Well, maybe. And maybe not. It could also be that you may be having a reaction to the drug.
In another hour, your chest feels tighter. So, you take another hit. You don't get the relief you got earlier, so you take one more just to be on the safe side. It helps some, but in 30 minutes you are coughing more, you fell poorly and your lungs begin to hurt. So, you take one more hit. Next thing you know, you have full blown symptoms that look like pneumonia for Pete's Sake! And if you are lucky, that's all that will happen, but it can get MUCH worse.
I have OD'ed on Combivent several times in my life without realizing what was happening. The most recent time was 3 days ago, Monday this past.
Since I had just gotten over what my doctor thought was pneumonia (and he could have been right, but who knows for sure, because I may have been having a reaction to too much Combivent), I assumed that the pneumonia was coming back, even though the Ciprofloxacin he had given me had taken care of it. My lungs were hurting as they had been before. I took another hit on my Combivent and the symptoms worsened and it was then that I began to think I was hurting myself with the drug. I had used it several times that morning, to deal with symptoms that got increasingly worse as time passed. So, even though I was unable to breath, I stopped the Combivent.
Within an hour, my lungs had returned to normal and I was feeling fine, but after an ordeal that lasted nearly 3 hours, I had had an epiphany of sorts. Combivent is not necessarily a good thing. It can even create the very symptoms it is formulated to alleviate.
Since then, I have made sure that at least 4-5 hours pass between doses, and I feel good. I am less congested and for the time being I am breathing better.
My who point is that drugs do not always help us. Few drugs, if any, come without a price in the form of side effects. Do your research on your drugs. Always consider the risks of using a drug vs. the risks of not using it. Pay close attention to your doses. Monitor how you feel. And discontinue the use of a drug if it makes you feel worse. Even something as seemingly harmless as an inhaler can be dangerous.
Sunday, September 2, 2007
The Future Of Big Pharma – How New Challenges And Generic Competition Is Shaping The Future
A way of analysing this shift in market share and the rise in generic competition is by looking at what “Big Pharma” is currently focusing on and where it may be failing. Many of the industry’s professionals would share the opinion that their activity and business strategies have remained the same for the past decade. Disappointingly, the focus for discussion and growth appear to be limited to corporate restructuring, redefining product portfolios, and looking out for the interests of the shareholder. As if that was the be-all and end-all.
Launching new blockbuster drugs has always drawn positive results for a company with regards to increasing market share and capitalizing on huge margins. Take Pfizer, for example: its new anti-smoking drug Chantix is the fourth drug to received FDA clearance this year. But the launch of a blockbuster drug (that which exceeds the $1 bn barrier, so as to cover the supposed costs of R&D, marketing and sales) is proving to be an almost impossible feat. The reality is that no more new and innovative drugs in the majority of the therapeutic categories are left to be discovered. This drawback has led the way to pharma companies developing existing medications and subsequently marketing them as a “improved and revolutionary” new products to the uninformed end user. (It comes as no surprise then that a recent study claims that the super drug Lipitor - with 2005 sales of $12.2 bn - cuts risk of repeat stroke by 16%, just when its patent is due to expire this year.) The brutal fact is that in the last decade almost 65% of all approved drugs are simply modified versions of medications that already exist on the market.
Moreover, further uncertainties are brought to light surrounding the business strategies adopted by Big Pharma in the face of changing trends within the market place. Greater emphasis has been directed at playing out competition, drawing big question marks over their competitive practice and the ever-present moral debate that arises over the production of cheaper drugs for developing countries. Not only is it creating an unnecessary delay for those patients who urgently need life-saving medications, but many would agree that the effects are simply devastating and irrational.
By and large, increasing market share and product portfolios through mergers and acquisitions is also proving insufficient in the long term, caused by patient medical programs, hospitals, health services, physicians and consumers who continue looking for cheaper alternatives. Additionally, the rise in law suits over patent disputes is only diverting attention away from the research and development of new drugs. And if these so-called competitive practices were not enough, the situation goes from the sublime to the ridiculous, evident through the practice of unethical pharmaceutical marketing. If it isn’t drug makers of sleeping pills paying doctors to publish bad press about competing drugs from generic manufacturers (numerous news articles recently came to light regarding this), it’s big drug companies coming under fire for paying off generic competition to delay market entry of their products. It appears that the common practice that had previously riddled the industry with of reaching key prescribing physicians with incentives is now just a thing of the past. Today, the only certainty is that more than 55% of all prescriptions made in the US are for generic medications, and this is expected to rise to 70% by 2010.
So what does the future hold for each side of the industry coin? Despite the clear changes within the market, the future is by no means lost for the big brand-name powerhouses of old, who only a decade ago would bad-mouth generic medicine as inferior. These days, they have joined the bandwagon including the giant brand-name manufacturer Novartis, who is now also striving to become a major player in the generics field. More so, Swiss-based Roche announced only last week that it has reached an agreement with the South African company Aspen for the production of a generic version of oseltamivir for Africa, as part of continued efforts to increase and speed up availability of the medicine for influenza pandemic planning world wide.
A very significant, but also much overlooked method of addressing the challenges of the pharmaceutical industry’s weakening pipelines is through the creation of partnerships and building effective collaborations across the industry with innovative pharmaceutical companies, generic players and healthcare communication providers.
On the other hand, what is also evident is that segmentation and targeting have taken on a new importance, which additionally does not require increasing sales & marketing forces.
But it’s not only Big Pharma that are seeing hard times ahead. Generic manufacturers are also being faced with strong market pressures caused by weak product pipelines, limited growth possibilities, and increasing numbers of generic competitors fighting over pricing. Avantis, Ranbaxy and Dr. Reddy are fine examples of companies that are directing huge capital on takeovers in the EU block, and further a field in the US, as a means of fighting for their survival and corporate growth.
Launching new blockbuster drugs has always drawn positive results for a company with regards to increasing market share and capitalizing on huge margins. Take Pfizer, for example: its new anti-smoking drug Chantix is the fourth drug to received FDA clearance this year. But the launch of a blockbuster drug (that which exceeds the $1 bn barrier, so as to cover the supposed costs of R&D, marketing and sales) is proving to be an almost impossible feat. The reality is that no more new and innovative drugs in the majority of the therapeutic categories are left to be discovered. This drawback has led the way to pharma companies developing existing medications and subsequently marketing them as a “improved and revolutionary” new products to the uninformed end user. (It comes as no surprise then that a recent study claims that the super drug Lipitor - with 2005 sales of $12.2 bn - cuts risk of repeat stroke by 16%, just when its patent is due to expire this year.) The brutal fact is that in the last decade almost 65% of all approved drugs are simply modified versions of medications that already exist on the market.
Moreover, further uncertainties are brought to light surrounding the business strategies adopted by Big Pharma in the face of changing trends within the market place. Greater emphasis has been directed at playing out competition, drawing big question marks over their competitive practice and the ever-present moral debate that arises over the production of cheaper drugs for developing countries. Not only is it creating an unnecessary delay for those patients who urgently need life-saving medications, but many would agree that the effects are simply devastating and irrational.
By and large, increasing market share and product portfolios through mergers and acquisitions is also proving insufficient in the long term, caused by patient medical programs, hospitals, health services, physicians and consumers who continue looking for cheaper alternatives. Additionally, the rise in law suits over patent disputes is only diverting attention away from the research and development of new drugs. And if these so-called competitive practices were not enough, the situation goes from the sublime to the ridiculous, evident through the practice of unethical pharmaceutical marketing. If it isn’t drug makers of sleeping pills paying doctors to publish bad press about competing drugs from generic manufacturers (numerous news articles recently came to light regarding this), it’s big drug companies coming under fire for paying off generic competition to delay market entry of their products. It appears that the common practice that had previously riddled the industry with of reaching key prescribing physicians with incentives is now just a thing of the past. Today, the only certainty is that more than 55% of all prescriptions made in the US are for generic medications, and this is expected to rise to 70% by 2010.
So what does the future hold for each side of the industry coin? Despite the clear changes within the market, the future is by no means lost for the big brand-name powerhouses of old, who only a decade ago would bad-mouth generic medicine as inferior. These days, they have joined the bandwagon including the giant brand-name manufacturer Novartis, who is now also striving to become a major player in the generics field. More so, Swiss-based Roche announced only last week that it has reached an agreement with the South African company Aspen for the production of a generic version of oseltamivir for Africa, as part of continued efforts to increase and speed up availability of the medicine for influenza pandemic planning world wide.
A very significant, but also much overlooked method of addressing the challenges of the pharmaceutical industry’s weakening pipelines is through the creation of partnerships and building effective collaborations across the industry with innovative pharmaceutical companies, generic players and healthcare communication providers.
On the other hand, what is also evident is that segmentation and targeting have taken on a new importance, which additionally does not require increasing sales & marketing forces.
But it’s not only Big Pharma that are seeing hard times ahead. Generic manufacturers are also being faced with strong market pressures caused by weak product pipelines, limited growth possibilities, and increasing numbers of generic competitors fighting over pricing. Avantis, Ranbaxy and Dr. Reddy are fine examples of companies that are directing huge capital on takeovers in the EU block, and further a field in the US, as a means of fighting for their survival and corporate growth.
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