Thefastpharma. Health news blog
Apr 11
Evaluation of a child who has no fever depends on many factors: the age of the child, the type of seizure, how soon after the seizure the child is seen, and whether the child has returned to normal. The frequency of various causes of seizures changes with the age of the patient. After taking a [...] [...more]
Posted: under Epilepsy.
Evaluation of a child who has no fever depends on many factors: the age of the child, the type of seizure, how soon after the seizure the child is seen, and whether the child has returned to normal. The frequency of various causes of seizures changes with the age of the patient. After taking a careful history, the physician will look for general physical abnormalities. Abnormalities of the heart’s rhythm or rate may lead to a lack of oxygen to the brain, other heart disease to strokes and seizures. Lung problems can cause brain infection. High blood pressure can cause seizures, as can acute or chronic kidney disease. Some birthmarks provide evidence of problems in the brain that may cause seizures, so your physician will look carefully at your child’s skin. Brain tumors and cancer are rare causes of seizures in children. Your doctor will also want to concentrate on the child’s neurologic function and on your child’s development to detect any new neurologic abnormality that might suggest a stroke, infection, or tumor requiring treatment; to verify that there is no abnormality; or to document old neurologic abnormalities for comparison with future examinations.
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Apr 01
Previously used terms like border line diabetes, chemical diabetes, potential diabetes have been replaced by Impaired Glucose Tolerance. This (IGT) is a state of blood glucose in between a zone of normal blood glucose and criteria justifying diabetes. Many of these patients develop diabetes after a period of time or may revert back to normal [...] [...more]
Posted: under Diabetes.
Previously used terms like border line diabetes, chemical diabetes, potential diabetes have been replaced by Impaired Glucose Tolerance. This (IGT) is a state of blood glucose in between a zone of normal blood glucose and criteria justifying diabetes. Many of these patients develop diabetes after a period of time or may revert back to normal stage of blood glucose.
Patients with IGT have the same risk of developing macro-vascular complication as in diabetes. These patients can be well managed with diet and exercise.
OTHER TYPES OF DIABETES MELLITUS
These are rare in clinical practice and include —
1. Diabetes that is secondary to endocrinological disorder or pancreatic disease.
2. Diabetes due to pancreatic (defects of B-Cell) disorders or receptor abnormalities especially at an early young age.
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Mar 30
Dementias are progressive brain impairments that interfere with memory and normal intellectual functioning. Although there are many types of dementia, one of the most common forms is Alzheimer’s disease. In November 1994, the announcement that former president Ronald Reagan has Alzheimer’s disease dramatized the Alzheimer patient’s struggle for those who had not yet experienced its [...] [...more]
Posted: under Parkinson's.
Dementias are progressive brain impairments that interfere with memory and normal intellectual functioning. Although there are many types of dementia, one of the most common forms is Alzheimer’s disease. In November 1994, the announcement that former president Ronald Reagan has Alzheimer’s disease dramatized the Alzheimer patient’s struggle for those who had not yet experienced its effects on a relative or friend. Attacking over 4 million Americans, and killing over 100,000 of them every year, this disease is one of the most painful and devastating conditions that families can endure. It kills its victims twice: first through a slow loss of personhood (memory loss, disorientation, personality changes, and eventual loss of the ability to function as a person), and then through the deterioration of bodily systems as they gradually succumb to the powerful impact of neurological problems.
Currently, Alzheimer’s afflicts an estimated 1 in 10 people over the age of 65 and 1 in 5 people over the age of 85. These numbers are certain to increase. It is estimated to cost society over 100 billion dollars a year currently. With the U.S. population gradually aging, the economic burden of the future seems even more dismal. While the disease is associated in most people’s minds strictly with the elderly, Alzheimer’s has been diagnosed in people in their late 40s. In fact, about 5 percent of all cases occur before age 65.
What is Alzheimer’s? Actually, contrary to what many people think, Alzheimer’s is not a new disease. Named after Alois Alzheimer, a German neuropathologist who recorded it as early as 1906, Alzheimer’s refers to a degenerative disease of the brain in which nerve cells stop communicating with one another. Ordinarily, brain cells communicate by releasing chemicals that allow the cells to receive and transmit messages for various types of behavior. In Alzheimer’s patients, the brain doesn’t produce enough of these chemicals, cells can’t communicate, and eventually the cells die.
This degeneration happens in the sections of the brain that affect memory, speech, and personality, leaving the parts that control other bodily functions, such as heartbeat and breathing, working just fine. Thus, the mind begins to go as the body lives on. It all happens in a slow, progressive manner, and it may be as long as 20 years before symptoms are noticed.
Alzheimer’s is generally detected first by families, who note changes, particularly unusual memory losses and personality changes, in their loved ones. Medical tests rule out underlying causes and certain neurological tests help confirm the likelihood of this disease.
Alzheimer’s disease is characteristically diagnosed in three stages. During the first stage, symptoms include forgetfulness, memory loss, impaired judgment, increasing inability to handle routine tasks, disorientation, lack of interest in one’s surroundings, and depression. These symptoms accelerate in the second stage, which also includes agitation and restlessness (especially at night), loss of sensory perceptions, muscle twitching, and repetitive actions. Many patients become depressed and tend to be combative and aggressive. In the final stage, disorientation is often complete. The person becomes completely dependent on others for eating, dressing, and other activities. Identity loss and speech problems are common symptoms. Eventually, control of bodily functions may be lost.
Once Alzheimer’s disease strikes, the victim’s life expectancy is cut in half. Tragically, little can be done at present to treat the disorder. Scientists are experimenting with various drug regimens, but it is unlikely that a drug will be discovered in the immediate future that will undo the damage associated with Alzheimer’s disease.
The results of research into the causes of Alzheimer’s disease are inconclusive. Current research is looking into genetic predisposition, malfunction of the immune system, a slow-acting virus, chromosomal or genetic defects, and neurotransmitter imbalance, among other possibilities.
Preliminary research indicates that a defect in the chromosomes may be the most likely cause, partly because virtually everyone with Down syndrome eventually develops Alzheimer’s. Treatments for Alzheimer’s tend to focus on the only medication that has been approved by the Food and Drug Administration, Cognex, which slows the loss of memory by preventing the destruction of neurotransmitters. Unfortunately, this drug seems to be effective for only about 20 percent of the patients who receive it.
Some researchers are looking at anti-inflammatory drugs, theorizing that Alzheimer’s may develop in response to an inflammatory ailment. Others are focusing on estrogen as a possible preventive measure, noting that women who take estrogen during menopause have been found to develop Alzheimer’s much later on average than women who don’t. Still others are focusing on stimulating the brains of Alzheimer’s-prone individuals, believing that as people learn, more connections between cells are formed that may offset those that are lost. All such research is very preliminary.
Much attention has also been focused on the family, as the family is often another victim when Alzheimer’s occurs. Having to decide between trying to tend to the needs of a loved one at home or seeking the assistance of a long-term care facility can be difficult for relatives of Alzheimer’s victims. Caring for such patients is a challenge for even the most dedicated family members. And even the best preparation for the final days of a loved one with this disease does not make the process easy. Knowing what the options are and being able to recognize the differences between normal physiological aging and the ravages of certain diseases can help make age-related problems easier to cope with for both the elderly themselves and their families.
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Mar 23
Paralysis agitans – the involuntary, tremulous motions of the body, with lessened muscular power, is typical of paralysis agitans or the shaking palsy. As this condition develops, the face develops a mask-like appearance, and there is a tendency to bend the trunk forward and to pass from a walking to a running pace to keep [...] [...more]
Posted: under Parkinson's.
Paralysis agitans – the involuntary, tremulous motions of the body, with lessened muscular power, is typical of paralysis agitans or the shaking palsy. As this condition develops, the face develops a mask-like appearance, and there is a tendency to bend the trunk forward and to pass from a walking to a running pace to keep from falling over. Paralysis agitans comes on late in life as a distinct condition, but occurs in younger people following infections of the brain.
The cause of paralysis agitans is not known, although changes in the blood vessels in the brain and in the tissues of the nervous system have been found.
The rate of progress of paralysis agitans varies. In many instances the condition may be confined to one limb or even a finger, for months before other portions of the body are affected.
New drugs have been developed that influence the palsy. These are usually of the belladonna type. Such drugs are: parpanit, artane and parsidol. A surgical procedure has been found which involves the tying-off of some of the blood vessels going to the brain, as a result of which the shaking stops. A more serious operation has been tried but not generally adopted. It involves actually cutting away a portion of the brain concerned with motion.
Strong emotional stimuli may bring about sudden temporary stopping of the shaking. Because this condition was discovered by James Parkinson, it has been called Parkinson’s disease and the tremors called Parkinsonism.
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Mar 16
Although scientists have been searching for a vaccine to protect people from HIV infection since 1983, they have had no success so far. The only effective prevention strategies all closely relate to the means by which people contract HIV As we said earlier, it is not the mere fact of membership in a so-called high-risk [...] [...more]
Posted: under HIV.
Although scientists have been searching for a vaccine to protect people from HIV infection since 1983, they have had no success so far. The only effective prevention strategies all closely relate to the means by which people contract HIV As we said earlier, it is not the mere fact of membership in a so-called high-risk group (homosexuals, sex workers, intravenous drug users, etc.) that increases the probability of HIV infection, but instead risky behaviors.
HIV infection and AIDS are not uncontrollable conditions. You can reduce your risks by the choices you make in sexual behaviors and the responsibilities you take for your health and for that of your loved ones.
Because the status of your immune system is an important factor in your susceptibility to any of the STIs, it is important that you do everything possible to protect yourself. Adequate nutrition, sleep, stress management, vaccinations, and other preventive maintenance strategies can do a great deal to ensure your long-term health.
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Feb 23
HIV viral load assays should not be used for the diagnosis of chronic HIV infection but may be very useful for the diagnosis of primary HIV infection if results are interpreted properly. Viral load testing has become a critical component in the management of chronically HIV-infected patients, as the results may be used to forecast [...] [...more]
Posted: under HIV.
HIV viral load assays should not be used for the diagnosis of chronic HIV infection but may be very useful for the diagnosis of primary HIV infection if results are interpreted properly.
Viral load testing has become a critical component in the management of chronically HIV-infected patients, as the results may be used to forecast a decrement in CD4 cells or guide antiretroviral therapy. These tests are based either on polymerase chain reaction or on DNA polymerization techniques and measure the number of copies of HIV nucleic acid in a patient’s serum.
During primary HIV infection, viral loads are often exceptionally high, almost universally greater than 100,000 copies per milliliter. Since (as noted earlier) ELISA testing may not yet be positive, viral load testing should be performed in patients with suspected primary HIV. However, the results of such testing must be interpreted with caution. Low positive results (less than 10,000 copies per milliliter) are usually not indicative of primary infection and may represent false-positive results for any HIV infection. Therefore, in the case any low positive result, testing should be repeated before the results are used to diagnose acute or chronic infection. It is unclear how to interpret results between 10,000 and 100,000 copies per milliliter when testing for primary HIV infection; consultation with a specialist is advised.
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Feb 16
HIV cannot, like cold or flu viruses, be caught casually HIV transmission depends on specific behaviors; this is true of other STIs (Sexually Transmitted Infections) as well. Countless other STIs have the potential to make you uncomfortable at the very least, increase your risk for cancer, lead to infertility, and/or result in serious, life-threatening consequences. [...] [...more]
Posted: under HIV.
HIV cannot, like cold or flu viruses, be caught casually HIV transmission depends on specific behaviors; this is true of other STIs (Sexually Transmitted Infections) as well. Countless other STIs have the potential to make you uncomfortable at the very least, increase your risk for cancer, lead to infertility, and/or result in serious, life-threatening consequences. It is up to you to behave responsibly. You can do several things to protect yourself and reduce your risk.
First, consider these basic risk-reduction strategies:
• Avoid casual sexual partners. Ideally, only have sex if you are in a long-term mutually monogamous relationship with someone who is equally committed to the relationship and whose HIV status is negative.
• Avoid unprotected intimate sexual activity involving the exchange of blood, semen, or vaginal secretions with people whose present or past behaviors put them at risk for infection. Do not be afraid to ask intimate questions about your partners sexual past. You expose yourself to your partner’s history whenever you choose to have sexual relations. Postpone sexual involvement until you are assured that he or she is not infected.
• All sexually active adults who are not in a lifelong monogamous relationship should practice safer sex by using latex condoms. Remember, however, that condoms still do not provide 100 percent safety.
• Never share injecting needles with anyone for any reason.
• Never share any devices through which the exchange of blood could occur, including needles, razors, tattoo instruments, any body-piercing instruments, and any other sharp objects.
• Avoid injury to body tissue during sexual activity. HIV can enter the bloodstream through microscopic tears in anal or vaginal tissues.
• Avoid unprotected oral sex or any sexual activity in which semen, blood, or vaginal secretions could penetrate mucous membranes through breaks in the membrane. Always use a condom or a dental dam during oral sex.
• Avoid using drugs that may dull your senses and affect your ability to make decisions about responsible precautions with potential sex partners.
• Wash your hands before and after sexual encounters. Urinate after sexual relations and, if possible, wash your genitals.
• Although total abstinence is the only absolute means of preventing the sexual transmission of HIV, abstinence can be a difficult choice to make. If you are in doubt about the potential risks of having sex, consider other means of intimacy, at least until you can assure your safety. Enjoyable and safer alternatives include massage, dry kissing, hugging, holding and touching, and masturbation (alone or with a partner).
• When receiving care from medical professionals such as dentists or doctors, make sure they take appropriate precautions to prevent potential transmission, including washing their hands and wearing gloves and masks. Be sure that all equipment used for treatment is properly sterilized.
• If you are worried about your own HIV status, have yourself tested rather than risk infecting others inadvertently.
• If you are a woman and HIV positive, you should take the steps necessary to ensure that you do not become pregnant.
• If you suspect that you may be infected or if you test positive for HIV antibodies, do not donate blood, semen, or body organs.
Second, at no time in your life is it more important that you communicate openly and honestly than when you are considering having an intimate relationship. Do not be afraid to ask questions, so you can then make an informed decision about whether you should get involved. Remember that you can’t just tell if someone is infected with one of these diseases. Anyone who has ever had sex with anyone else or has injected drugs is at risk, and they may not even know it. The following tips can help you communicate about potential risks:
• Remember that you have a responsibility to your partner to disclose your status. You also have a responsibility to yourself to do what needs to be done to stay healthy. Do not be afraid to ask about your partner’s HIV status. If either person’s status is unknown, suggest going through the testing together as a means of sharing something important.
• Be direct, honest, and determined in talking about sex before you become involved. Do not act silly or evasive. Get to the point, ask clear questions, and do not be put off in receiving a response. Remember, a person who does not care enough to talk about sex probably does not care enough to take responsibility for his or her actions.
• Discuss the issues without sounding defensive or accusatory. Develop a personal comfort level with the subject prior to raising the issue with your partner. Be prepared with complete information and articulate your feelings clearly. Reassure your partner that your reasons for desiring abstinence or safer sex arise from respect and not distrust. Sharing feelings is easier in a calm, suspicion-free environment in which both people feel comfortable.
• Encourage your partner to be honest and to share feelings. This will not happen overnight. If you have never had a serious conversation with this person before you get into an intimate situation, you cannot expect honesty and openness when the lights go out.
• Analyze your own beliefs and values ahead of time. The worst thing you can do is to get yourself into an awkward situation before you have had time to think about what is important to you and what you believe in. Know where you will draw the line on certain actions, and be very clear with your partner about what you expect. If you believe that using a condom is necessary make sure you communicate this to your partner.
• Decide what you will do if your partner does not agree with you. Anticipate your partner’s potential objections or excuses, and prepare your responses accordingly.
• Ask questions about your partner’s history. Although it may seem as though you are prying into another person’s business, your own health future depends upon knowing basic information about your partner’s past. An idea of your partner’s past sexual practices and use of drug injecting is very valuable. Again, it is important to let your partner know why you are concerned and that you are not inquiring due to jealousy or other ulterior motives.
• Ask about the significance of monogamy in your partner’s relationships. A basic question to ask before becoming involved in a regular sexual relationship is: “How important is a committed relationship to you?” You will need to decide early how important this relationship is to you and how much you are willing to work at arriving at an acceptable compromise on lifestyle.
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Feb 09
Rheumatoid arthritis varies from being an acute disease with fever and sudden disability of many joints to a condition that develops gradually in which the patient may at first notice only stiffness or pain in one joint. Some may have deformity of a joint without ever having felt any pain. Sometimes the first signs of [...] [...more]
Posted: under Healthy bones Osteoporosis Rheumatic.
Rheumatoid arthritis varies from being an acute disease with fever and sudden disability of many joints to a condition that develops gradually in which the patient may at first notice only stiffness or pain in one joint. Some may have deformity of a joint without ever having felt any pain. Sometimes the first signs of rheumatoid arthritis are fatigue, loss of appetite and loss of weight. Patients complain of numbness and loss of feeling in hands and arms, feet or legs. On getting up in the morning and at the end of the day, the joints feel stiff. When swellings of the joints are noticed the condition is usually well advanced. The knees and the finger joints may be the first to give pain. Practically all the joints may be involved, however, including those of the spine.
Other signs and symptoms of rheumatoid arthritis are known and noticed by many people. The palms and soles are cold and clammy. Sometimes the lymph glands near the joint become swollen. The finger joints nearest to the wrist swell and the fingers pull to the sides in a distortion that gives the hand a “flipper-like” appearance. Because of failure to move and use the muscles around the swollen joint, the tissue breaks down and the area looks thin and wasted.
Rheumatoid arthritis is a condition that comes and goes. Doctors have noticed particularly that it disappears during pregnancy and during jaundice. These facts helped to reveal the specific effects of ACTH and Cortisone upon the disease.
Nodules appear under the skin in about one fifth of the cases of rheumatoid arthritis. These nodules may persist for months or years. Inflammations of the eye and red spots on the skin are also seen often in chronic rheumatoid arthritis.
Since arthritis is now recognized as affecting the body as a whole and not just the joints, the treatment is changed considerably. Nevertheless, the methods that helped when most of the attention was focused on the joints were not lost and are still valuable in a direct approach to the control of the pain and disability which are features of the disease.
The sooner good treatment can be applied to rheumatoid arthritis the better are the results secured in stopping the progress and the damage done by the disease. While the disease is active, rest and freedom from motion are helpful. If there is fever and severe pain certainly confinement to bed is desirable. Then as these troubles subside motion is permitted, but never to the point of fatigue. During the severe stages the patients are anxious and disturbed, often by solicitous people, and the doctor must protect the patient against emotional upsets.
No special diet cures arthritis. Nevertheless the patient with rheumatoid arthritis needs to be sustained with sufficient proteins, vitamins and minerals and enough carbohydrates and fats to provide needed energy and to avoid damage to tissues. Good animal proteins, calcium and iron must be adequate in the diet.
Europeans with arthritis go regularly to spring and mineral-water resorts, but there is no evidence that these are helpful beyond getting the patient away from his usual surroundings and under a well-regulated routine of rest, diet, baths, and physical therapy. Drugs are prescribed to relieve pain and permit rest. Bee stings, snake poison, and similar methods are not proved to have any real curative value beyond their psychological effect.
For many years a mainstay in treating arthritis has been the application of heat. Heat may be applied by hot bricks wrapped in towels, hot water botties, electric heat pads, infra-red heat lamps, heat cradles containing incandescent bulbs, and other methods. If many joints are involved relief frequently comes from a hot tub bath once or twice a day, but prolonged hot baths are weakening.
Doctors help the patient with painful joints by several devices which require medical knowledge and application. The orthopedic surgeons control movements by splints, braces, and casts. These have to be released several times daily to permit help by rubbing and slight controlled motion. A local anesthetic like procaine may be injected around a joint and relieve pain from the pulling of muscles and ligaments. New drugs are known of the curare type which prevent spasm of muscles and thus relieve pain. While preventing pain, the doctor must be sure there is sufficient motion to prevent wasting of the tissues. After long-continued arthritis deformity of joints may be so severe that surgical orthopedic procedures may be necessary to relieve crippling.
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Jan 26
The knee joint consists of many different components which must work in sync to provide maximum stability and mobility. In this chapter, I describe the different parts of the knee, what they do, and how they work together. The Fascia Fascia is a strong, fibrous structure that encases the leg, providing protection and support. A [...] [...more]
Posted: under Healthy bones Osteoporosis Rheumatic.
The knee joint consists of many different components which must work in sync to provide maximum stability and mobility. In this chapter, I describe the different parts of the knee, what they do, and how they work together.
The Fascia
Fascia is a strong, fibrous structure that encases the leg, providing protection and support. A taut layer of fascia can hold fat deposits under the skin in place, helping the knee to maintain a sleek appearance. As we age, however, fascia can lose some of its tone, which result in bulges of fatty tissue that can be mistaken for swelling. Due to the fact that women tend to be thinner than men, the bulging may be more noticeable in women.
Muscle
There are two groups of muscles that control the knee joint; the quadriceps and the hamstrings. Strong muscles are essential to protect and cushion bones and soft tissue (such as ligaments and tendons) by absorbing the enormous forces that run through the knee.
The quadriceps are a collection of four muscles on the front of the thigh. Along with the quadriceps tendon, the patella (kneecap), and the patellar ligament, the quadriceps are responsible for the extensor mechanism of the leg, that is, the ability to straighten the knee or bring the bent knee to a straight position.
The hamstring muscles, on the back of the thigh, come down from the hip and the pelvis and insert below the knee. They control the knee by allowing it to go from an extended or straight position to a bent position.
The Capsule
The capsule is also a thick, fibrous type structure that wraps around the knee joint. Inside the capsule is soft tissue called synovium. If the knee is injured, the synovium can become inflamed and will secrete excess synovial fluid as a protective mechanism. Inflammatory arthritis, such as rheumatoid arthritis, affects the synovium, which hypertrophies (thickens), secretes fluid, and can potentially destroy the articular cartilage and bone.
Tendons
There are two major tendons about the knee: the quadriceps tendon and the patellar tendon.
By definition, a tendon connects muscle to bone. However, the patellar tendon connects the patella (kneecap) to the tibia (shinbone), which means that the patellar tendon is really a ligament. Through the years, this ligament has become known colloquially as a tendon, and to prevent confusion, I will call it the patellar tendon throughout this book.
The quadriceps tendon connects the quadriceps muscle to the patella and thus provides power for leg extension.
Overuse of any tendon can result in tendinitis, which may cause local pain and tenderness.
Plicae
Plicae are embryological remnants of synovial folds—basically a dividing line along the joint in the embryo. As the embryo matures, the dividing lines are no longer needed, and they often rupture spontaneously. However, these long, elastic plicae (similar to rubber bands) remain in about 70 percent of all people. Plicae rarely cause problems; however, in some cases, the bands or folds can get caught between the femur and kneecap and can cause pain.
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Jan 18
At one time, seizures were classified into two types: big and small— in French, grand and petit. Since seizures were bad—mal in French— they were classified as “grand mal” and “petit mal,” terms still, unfortunately, used by many patients and by many physicians—unfortunately because they are imprecise. Many types of seizures are “big and bad,” [...] [...more]
Posted: under Epilepsy.
At one time, seizures were classified into two types: big and small— in French, grand and petit. Since seizures were bad—mal in French— they were classified as “grand mal” and “petit mal,” terms still, unfortunately, used by many patients and by many physicians—unfortunately because they are imprecise. Many types of seizures are “big and bad,” causing a patient to fall to the ground and shake. Johnny’s seizure and William’s seizure caused each child respectively to fall down and shake, and thus, in the old days, both would have been called grand mal seizures. We know they are different because William’s seizure had a partial, or focal, beginning.
The term “grand mal” (big and bad) means different things to different people. Some people consider a seizure “big” that another, with worse seizures, might consider “small.” If one person has a spell in which he just stops and stares, as Mary did, while another, like William, has a spell in which he stares, smacks his lips, and is confused, and a third, such as Trina, has jerking of the face—are these little spells all “petit mal”? They are different types of seizures, coming from different parts of the brain, with different implications of causation, requiring different evaluation, requiring different medications, and probably having differing outcomes. Thus, the terms grand mal and petit mal are now seldom used in classifying seizures.
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