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July 24th, 2011

Although there are many trigger factors that set off an attack of migraine, the precise way in which this is done is still uncertain. It is known that a change in the diameter (calibre) of vessels to the head plays a part; this alteration can be due to nervous or chemical changes.The passage of an impulse down a nerve is electrical, in other words, there is a wave of changing charge moving down the nerve fibre. On the other hand, the passage of impulses from nerve to nerve is purely chemical, as is the passage of the nerve impulse to the muscle which the nerve controls. Chemicals are stored in the end-buttons of the nerve and, with the arrival of the impulse, packets of these are released either into the space between nerves, where they lead to a further nervous impulse, or into the space between nerve and muscle to cause muscle contraction. In the gap between the nerve terminal and its target are enzymes (specific chemicals that catalyze, or speed up, chemical reactions); these help destroy any transmitter substances not used, or which do not find their way back to their site of origin. An example of one of these enzymes is monoamine oxidase, or MAO.


July 13th, 2011

Selecting the herbal tea that is suitable for your complaint is important and you may use the following guide to help you:Apres contains chamomile, fennel, aniseed and peppermint. This tea is highly suitable for those who suffer anxiety, stress, poor digestion, heartburn and mild insomnia. Chamomile has traditionally been used to soothe colic, upset stomachs in adults and frayed nerves. Fennel, aniseed and peppermint all aid poor digestion and help calm an aggravated stomach.Berry contains hawthorn berries, elderberries and juniper berries. Hawthorn berry has a history of assisting circulatory problems. In recent times this berry has also been found to have anti-oxidant properties. Elder and juniper berries assist the sweet taste of this natural herbal tea. SS Lemon Tang contains lemon grass and peppermint. This tea is ideal after meals to help in the digestive process. It is cooling and soothing in hot weather and assists with kidney function.Petal contains organic red clover, lemon grass, lavender, rose petals, chamomile and buchu. This tea assists in cleansing the blood. Red clover has been used throughout history as a ‘blood purifier’ and we are now seeing it being used as a great balancer for the hormonal system. Lemon grass and buchu assist in stimulating the kidneys and therefore work as a mild diuretic, relieving fluid retention. Lavender, chamomile and rose are known to be ‘calmative’ plants, relaxing and healing for those who suffer stress, anxiety and the general overload of 2 lst-century living.Summer Delight contains organic spearmint, peppermint, lemon grass and aniseed. This minty tea is ideal for helping to detox the digestive system by stimulating digestive enzymes and relaxing and calming the body. Peppermint has a long history of aiding the digestion of fish and meat dishes. This tea is ideal after any meal.Triple E contains liquorice root, aniseed, fennel and peppermint. This tea has a profound effect on the bowel and stomach, helping with sluggishness and heartburn. The healing effects of pure liquorice root as a mild antiinflammatory have been well documented. Hence liquorice is used in most cough medicines and laxative medication.*108\258\8*


July 3rd, 2011

A social worker is a college graduate with two years of postgraduate training and a Master’s of Social Work. Most states require these credentials for a license to practice social work. The actual graduate training is primarily devoted to counseling. In a hospital, a social worker’s primary role is to help people plan what to do when they leave the hospital. These plans, called discharge plans, include making decisions and arrangements for nursing home placement, home care, and outpatient care.      Good social workers also get involved with much more. They arrange for such special services as rehabilitation from intravenous drug use, treatment of alcoholism, psychiatric care, physical rehabilitation, and contact with community organizations. The job of the social worker usually ends when the person is discharged from the hospital.     Social workers can be found not only in hospitals but also in clinics, in private practice, in community organizations devoted to HIV infection, and working as case managers assigned to an individual person. All U.S. hospitals that receive federal funds must have social workers; this means essentially that all hospitals have social workers, since Medicare and Medicaid fund so much of this country’s health care in hospitals.     Information about social workers or case managers may be obtained through the hospital social worker, by referral from physicians, through contact with the local health department, or through the yellow pages of the telephone directory (listed under social workers, therapists, or counseling).*166\191\2*


June 22nd, 2011

ErysipelasErysipelas is a more acute and inflamed variant of cellulitis. Although erysipelas is often described as distinct from cellulitis, the differences can be subjective. It is usually caused by group A streptococci and commonly occurs on the lower legs or the face. Erysipelas is redder, more sharply demarcated, and more superficial than typical cellulitis. Lymphatic streaking and systemic symptoms are common. Because erysipelas is more superficial, edema may be less prominent. Repeated episodes of erysipelas can lead to permanent lymphatic damage and chronic stasis.Some clinicians use penicillin as the drug of choice for erysipelas. Other organisms, especially S. aureus, may cause more than 20% of cases of erysipelas and these bacteria are often resistant to penicillin. Unless streptococcal infection has been confirmed by culture, many clinicians use a broader spectrum antibiotic to cover S. aureus as well.
Blistering Distal DactylitisBlistering distal dactylitis is a superficial infection of the anterior fat pad of the distal fingers. It is most commonly caused by group A beta-hemolytic streptococci. A painful vesicle or pustule forms in the skin adjacent to the nail bed. These pustules do not tend to protrude like those elsewhere on the body. They should be promptly incised and drained, followed by a 10-day course of antibiotics.
Perianal CellulitisPerianal cellulitis is another form of cellulitis caused by group A beta-hemolytic streptococci. It occurs most commonly in children. Patients may present with perirectal itching, rectal pain, or blood-streaked stools. Systemic symptoms are uncommon. On examination, marked circumferential erythema is noted extending as far as 3 cm from the anus. Because recurrences are common, culture should be performed before and after treatment with a 10-day course of oral antibiotics.
Pseudomonas CellulitisPseudomonas aeruginosa typically causes infections in the warm, moist areas that it colonizes: feet, nail beds (green nail), skin folds, foreskin (balanitis), ear canals, and burn sites. P. aeruginosa will not grow if normal, dry skin is inoculated.Pseudomonas infection is characterized by dusky red skin, blue-green Purulence, and a fruity odor. Pseudomonas also fluoresces green-white under a Wood’s lamp because it produces a compound called pyoverdin. Neglected lesions can become eroded and even necrotic.Localized infection can be treated with 5% acetic acid compresses for 20 minutes, four times daily until resolution. For Pseudomonas balanitis, topical mercurochrome twice daily is effective. These infections can also be treated with systemic first- or second-generation fluoroquinolones.*109/348/5*


June 17th, 2011

The female reproductive organs are one of the most common sources of blame for a woman’s physical and psychological reactions to her surroundings (‘Oh she must be suffering PMT!’) Yet, what is often overlooked is that as a complex, unique set of organs in their function of reproduction, they can often give mixed messages about a woman’s health. A range of physical effects such as bloating, and aches and pains may be related to the functions of these organs, so sometimes the early warning signs of gynecological cancer are ignored or mistaken as part of the regular monthly cycle.
Uterus The uterus – sometimes referred to as ‘the womb’ is a pear-shaped organ, which sits right in the middle of the pelvis, behind the bladder and in front of the rectum. The ‘cardinal’ ligaments or ‘parametrium’ supports it. These ligaments hold the uterus in place and prevent it from slipping down into the vagina. The part of the uterus that juts into the vagina is the cervix and arising out of each top corner of the uterus are the fallopian tubes that lead to the ovaries.The bladder (which stores urine) sits above the cervix in front of the lower part of the uterus, while the rectum (which stores faeces or ‘pooh’) sits behind the cervix and vagina.The tubes, which come down from the kidneys to the bladder (ureters), run in the supporting ligaments close to the side of the uterus closely applied to the blood vessels that arise from the side-wall of the pelvis. The ureters are mobilized out during radical surgery for cancer of the cervix. They may become blocked by cancer or may leak urine into the vagina if damaged.The uterus is a tiny organ in the newborn, but as the amount of oestrogen from the ovaries begins to increase, then so does the size of the uterus, largely due to an increase in its musculature (‘the myometrium’). The muscular wall of the uterus varies in thickness, but is usually up to 15 mm deep, whereas the mucous lining of the uterus (the ‘endometrium’) is only 5-10 mm thick, depending on the stage of the menstrual cycle. Under the influence of the hormones produced by the ovaries – principally oestrogen and progesterone – the lining of the uterus fluctuates in thickness and eventually is mostly shed during each period. It rebuilds itself between each period.With menopause, when the ovaries are no longer producing these steroid hormones, such as oestrogen, a reduction in the size of the uterus occurs and the uterus becomes smaller again. The endometrium thins out and lacks activity (‘atrophic’), so that if the uterus is found to be enlarged or the lining thickened after the menopause, then cancer is suspected.*1/144/5*


June 6th, 2011

My clinical television study of Ronald Reagan brings us to a much broader issue. His case is certainly not unique. The paradox of human society is that the age of ascendancy to the summit of power in our political, cultural, and business institutions is also the age of onset of numerous forms of neurological decline. A large number of world political leaders are men and women in their sixties and seventies. And while we accept as a given the inevitability that by this age assorted physical infirmities accumulate, society is by and large oblivious to the fact that by this age dementia also develops in a significant number of people.The illusion that the demigod figures who make it to the summit of human society are spared the indignity of brain rot is precisely that: an illusion. Dementia operates on the basis of age and genetic vulnerability, just like any physical malady. Dementia is an age-related physical malady affecting the brain, just as coronary insufficiency is an age-related physical malady affecting the heart. The mind is not exempt from the fundamental laws of biological decay.One might expect that the individuals who make it to the very top are brighter than the population as a whole, and this is probably mostly true. But history is replete with instances of individuals endowed with great intellectual powers succumbing to dementia toward the end of their lives for reasons of genetics, or for some yet-to-be understood environmental reasons. Contrary to our wishful thinking, an exalted social status does not offer protection in these matters, nor, as it turns out, does a great intellectual power.It is intuitively plausible, and certainly teleologically “desirable,” that great minds should be protected from decay. Indeed, the last decade has witnessed a paradigm shift in neuroscience, as the evidence began to accumulate that vigorous mental life reshapes the brain itself and helps protect it from biological rot. But other factors, like heredity, are less malleable, at least today.The history of science and philosophy is similarly replete with poignant observations of decaying great minds. Isaac Newton, Immanuel Kant, and Michael Faraday all suffered dramatic memory loss with age. Among the more recent examples, Claude Shannon, the father of information theory, was diagnosed with Alzheimer’s disease toward the end of his life.But mental decline in a scientist is not likely to result in a societal disaster. It may have a retarding effect, delaying a great discovery or invention by years, decades, or even generations, but hardly a precipitously catastrophic one. Besides, most great scientists have their definitive insights relatively early in their careers. By the time dementia is likely to strike, they will have already made their seminal contribution to society long ago, and their decline, sad as it may be on a personal level, is no longer of broad historical relevance.Not so with a political leader, a powerful statesman at the helm of a major military or state machine, when the age of supreme power often overlaps with the age of early cognitive decline, under whose shadow fateful decisions are made. Mental infirmity may take many forms, from what I call mild “neuroerosion” to frank dementia, but the brain machinery of the sublime and the ridiculous is fundamentally the same. A world leader whose decisions affect the lives (and deaths) of thousands of people fundamentally employs the same brain machinery as the owner of a family-run neighborhood bodega making a decision about what brand of canned tuna to stock next week. This means that the consequences of an early “mild” dementia, which may be imperceptibly benign in a neighborhood grocer, will be perilously magnified in a world leader through the sheer impact of his mental faux pas.Reagan was in his seventies at the time of my observations. At this age, Alzheimer’s type dementia, multiinfarct dementia (a disease of blood vessels of the brain resulting in a multitude of small strokes), and other forms of dementias are all distinct statistical possibilities. An early-stage dementing disease process often eludes detection by an untrained eye even in a leader who is constantly in the public eye. But it is particularly likely to remain unnoticed or ignored under the conditions of an authoritarian regime, where the leader is relatively exempt from popular scrutiny. Impairment of judgment, self-control, and other higher mental functions, first subtle and then increasingly transparent, takes place well before an individual becomes frankly disoriented, totally disabled, and no longer capable of hiding his mental infirmities even from distant observers.The past century witnessed the stewardship of more than a few “neuroeroding,” dementing, or indeed demented individuals at the helm of major nations. Dementia strikes the villains and heroes of our world in a morally agnostic way.On the villains’ side, Adolf Hitler suffered from severe symptoms of Parkinson’s disease toward the end of World War II. According to some reports, memory decline was also apparent. Contrary to the popular belief, Parkinson’s disease is not just a movement disorder. It often causes some degree of cognitive impairment and even outright dementia. Other conditions also exist whose outward symptoms resemble those of Parkinson’s disease, but in which serious mental impairment is expected to be present. Most common among them is Lewy body dementia, a degenerative brain disease of aging. At the age of fifty-six, toward the end of the war, Hitler was more likely to suffer from Parkinson’s disease than from Lewy body dementia. Either way, based on simple epidemiological considerations, some mental deterioration was highly probable. Indeed, his close associate, Albert Speer writes about Hitler’s “apathy,” “mental torpor,” and difficulties with decision-making becoming increasingly evident during the second half of the war.The brain diseases of aging did not spare the political heroes of the twentieth century either. Woodrow Wilson suffered a severe stroke while in office in 1919. He recovered, but only partly. According to his biographers, Wilson was a different man after his stroke. His mind became rigid, devoid of nuance, casting everything in black and white. These newly acquired untoward traits haunted the last two years of his presidency and undermined his ability to deal with the isolationist Congress, contributing to the ruin of his League of Nations policy.Franklin Delano Roosevelt was felled by a lethal stroke, but a major stroke is often preceded by what is known today as multiinfarct disease, characterized by a gradual accumulation of ministrokes. In FDR’s days this condition was not known, nor were there any diagnostic tests available capable of revealing it (such as a CT scan or an MRI). Nonetheless, the decline of FDR’s mental powers and decision-making abilities, and his “new disinclination to apply himself to serious business” during the final phase of World War II, have been noted by credible historians. He was likely suffering from cognitive decline already well before his final stroke.And so was the man whom I admired more than virtually any other twentieth-century political leader, Winston Churchill. When he was elected to his first term as Britain’s prime minister, Churchill was already sixty-five, older than most of the last century’s other major political leaders at the time of their ascendancy to supreme power.Churchill’s occasional mental lapses during World War II have been noted by both his wartime associates, like Field Marshal Alanbrooke (leaving them occasionally worried about their leader’s mental state), and his biographers, like Roy Jenkins. These lapses nonetheless did not prevent him from dispatching his business with overall brilliance, if with only occasional flagging. Churchill suffered his first known minor stroke in 1949, between his two terms as prime minister. During his second, post-war term in 1951—1955, Churchill was, in the memorable words of Roy Jenkins (as sympathetic a biographer as any pub-he figure can hope for), “gloriously unfit for office.”*13\302\2*


May 20th, 2011

Research in animal models has consistently shown that the administration of antibiotics before (or occasionally shortly after) an induced bacteremia can prevent IE on damaged heart valves. However, proof that this approach is effective in humans is lacking. One major problem with the available literature is that multiple studies repeatedly demonstrate that few high-risk patients take antibiotic prophylaxis. In the largest retrospective case-control studies to date, less than 25% of high-risk patients (based on preexisting structural heart disease) actually took antibiotic prophylaxis before a procedure for which it was indicated. This has led to very small groups of patients in whom an analysis of efficacy can be performed.- A large population-based case-control study of patients with IE in the Philadelphia metropolitan area failed to show that dental treatment was a risk factor for IE, thereby calling into question the role of prophylactic antibiotics before such treatments. Patients who took antibiotic prophylaxis were not protected against development of IE, but the number of patients who took prophylaxis was very small, making it difficult to draw a conclusion from this study alone.- One small (eight cases) case-control study from the Cleveland Clinic showed efficacy of antibiotic prophylaxis but was notable for questionable assignment of causality to distant dental procedures.- A Dutch national case-control study failed to show significant efficacy of antibiotic prophylaxis prior to medical or dental procedures.- A French case-control study concluded that procedures increase the risk of endocarditis but failed to show protective efficacy of antibiotic prophylaxis.To date, the available literature does not suggest a protective benefit of antibiotic prophylaxis. However, these studies have been underpowered to detect a protective effect as large as 20% or greater.*49/348/5*


May 10th, 2011

There is a well-documented link between osteoarthritis and obesity, although the cause is not completely clear. It is often assumed that the connection between lower-limb arthritis and excess body weight is merely due to the increased load these susceptible joints have to support, usually over many years. But it has also been suggested that damage to the joint surface is due to a metabolic effect, caused by the release of cytokines from adipose tissue having a direct inflammatory action leading to arthritis. A cohort of the Framingham study looked at the relative risk of radiographic osteoarthritis of the knee for various weight groups, adjusted for age, physical activity and uric acid levels. It was discovered that women in the heaviest quintile for weight had more than double the risk of osteoarthritis in the knee, whereas men had 1.5 times the risk, but the precise cause of the condition was not postulated. A study at St Thomas’ Hospital found a link between obesity and osteoarthritis of the carpometacarpal joints of the hand, which suggests a metabolic cause because these joints are non-weight-bearing. Van Saase et al  found that obesity was clearly associated with osteoarthritis in all those joints most frequently affected, whether or not they were weight bearing. This implies a metabolic cause and, although not offering an explanation, does suggest the scope for prevention of osteoarthritis by weight loss.A recent paper demonstrated a link between symptomatic spinal osteoarthritis and low birth weight, but also concluded that the problem is worse in those who were low birth weight babies but went on to become overweight as adults. This suggests that weight gain is an important aetiological factor in the condition. A second study on the effects of changing weight revealed that increased weight in women, but not men, was linked to worsening of symptoms of knee osteoarthritis, whereas a reduction of 10% weight by men, but not women, resulted in a significant reduction in symptoms.The most common explanation is backed by the NHANES study, which concluded that there is a link between osteoarthritis and obesity, and that additional mechanical stress is the cause.*1/312/5*


May 9th, 2011

You will suffer wife trauma every time your man goes on an eating binge. Just don’t let him know what you’re going through. My husband had a self-destructive fling that lasted for three days during which he ate everything in sight and convinced me he was experiencing a severe death wish. He never confided his real problem to me. On the fourth day he was back to normal and set about losing the weight he had gained.No matter how much you do for him, you can’t do everything. There will be times you will want to pull your hair out. It’s a fact of life.An oops does not happen on a special occasion, because you know about most of them ahead of time and can more or less budget them into your day. An oops is often a mistake or a forgotten priority, rather than a blatant attempt to eat something forbidden. An oops can be worked off by exercise, or simply forgotten. As long as it doesn’t happen too often, it’s unimportant.Men usually choose to celebrate their special days with nostalgia —a piece of comfort out of their eating past—a drink or two, a piece of cake or pie, ice cream, pasta, or four hot dogs (with buns and loaded with mustard and relish) at the ball game with beer, popcorn, and a chocolate-covered banana on a stick. A special day is sort of like a binge with tradition behind it. Don’t deny him!*136/243/1*


April 28th, 2011

Too many people think that the way to balance their diet is to add here and there some particular vitamin that they think may be missing. This is a very haphazard way of arranging the diet. It is far better to think in terms of food rather than vitamins, and by following a very simple rule one can be quite sure that there will be no deficiency. The rule is: balance the diet in the course of the three meals in the day, not at one meal. For example, let one meal be largely fruit, so that the essential elements in fruit are supplied; let another be mainly raw salad; and let the third be mainly cooked vegetables. In this way we make sure of the important alkaline foods. For the rest we may add chiefly milk or milk products to the fruit meal; starchy foods, such as bread and potatoes, to the salad meal; and meat, fish, cheese, eggs or other protein foods to the cooked vegetable meal. This arrangement of the diet has long been advocated by Nature Cure practitioners, and so far no one has been able to suggest a better one. It embraces all the different kinds of foods, gets them in their best combinations so as to ensure easy digestion, and makes sure, beyond any doubt, that lop-sidedness does not occur.If one desires any further evidence of the relationship between a healthy skin and the digestive processes it may easily be demonstrated by the time-honored practice of fasting. Nothing will release the excess toxins that lie in and around the skin tissues so quickly as a few days’ abstinence from food. By taking the pressure off the digestive tract and enabling the “sea-water” to clear itself of its load the tone of the skin will be greatly improved. A heavy, fluid-laden skin is an indication of poor general health, but more particularly it is the sign of a dyspeptic individual who has taxed his digestion beyond its capacity, and never realized for a moment where the real source of his troubles lay. A brief fast will provide him with the diagnosis and the basis for successful treatment.

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