Archive for April, 2009

posted by admin on Apr 29

Some people make the various steps in sexual knowledge and experience from childhood to maturity much more easily than do others. In this respect the shy introvert typically has greater difficulties that his more robust extrovert contemporaries. The introvert, either boy or girl, is inclined to be timid and embarrassed by matters of sex. As a result he withdraws from it. His knowledge is incomplete, and his emotional and physical contacts with the other sex are limited. He tends to fill in the gaps in his knowledge by daydreaming. His uncertainties and perplexities are increased, and the general level of his anxiety remains high. Strange as it may seem, such a pattern established in adolescence may later persist through marriage.

In an attempt to put an end to his complicated feeling in the matter, the shy introvert not infrequently decides to have a sexual experience. This usually lacks any spontaneous naturalness, and is often preceded by much thought and determination to bring himself to do it. The whole matter is out of character with his general personality, and instead of making things better the experience almost always has the reverse effect. The tension which accompanies it makes it physically difficult, and the sensitivity of the introvert adds guilt to his anxiety. Experience in psychotherapy with young people shows quite clearly that the inhibited introvert of either sex is greatly helped by talking over these matters with an experienced physician or psychiatrist.

I recently had come to me a young woman who was very shy—very nice, attractive in her quiet way, well-mannered, but painfully shy. Her parents, successful and easy in company, were socially ambitious for the girl. But she was held back; she just could not be natural with people. Then with tears and great distress she told me how a boy had touched her sexually, but really quite innocently. “I can never forgive myself.” Then when she had pulled herself together, “How do you know where to draw the line?”

This is a problem that we all must face. She is twenty, but so timid and shy that she draws the line too high. And in her present state this must necessarily be so. We must not forget that different people need different solutions to similar problems according to their individual personality.

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posted by admin on Apr 29

The simple answer to this question is ‘yes.’

Professor H Hippius, formerly chair of psychiatry in Munich, writes:

The 1996 German list of available drugs, the Rote Liste, includes 28 Hypericum preparations. Since these preparations are not chemically defined single-substances or combination preparations, but whole extracts of the St John’s Wort plant, it cannot automatically be assumed that the various medicinal preparations from various manufacturers have the same composition and therefore the same therapeutic efficacy at the same dosage.

I agree with Professor Hippius. In other words, since we do not know which substances in St John’s Wort are responsible for its anti-depressant effects, we cannot assume that all plant preparations are equivalent, even if the amount of hypericin, which is supposedly standardized across different preparations, is the same. I say ‘supposedly’ based on my experience with the use of certain generic anti-depressants. Generic anti-depressants are supposed to have the same amount and quality of the active compound in them as the original brand-name products. Yet I have often observed a relapse of depressive symptoms in patients who have previously been doing very well when they switch from a certain brand-name anti-depressant to its generic counterpart. If different brands of a synthetic compound produced under the supervision of the US Food and Drug Administration result in different clinical effects, how much more reason do we have to doubt the equivalency of different herbal products with their complex combinations of active substances and produced under much looser regulatory conditions? Consider, for example, how wines that are made from the same type of grape will vary in taste not only from one country or region to another but even from vintage to vintage. The substances in the wine that imbue it with its special bouquet and flavour will change with the soil, the amount of sunshine and the rainfall. A similar situation can be expected to apply to the composition of an extract of St John’s Wort, where the variable of interest is not the flavour but rather the anti-depressant effects or the side-effects of the preparation.

Once we acknowledge that herbal preparations are likely to vary in their composition, where does that leave us in terms of choosing the best preparation? Yet most of the research in which the anti-depressant effects of St John’s Wort have been established has been performed using the brand called Jarsin™ produced by the leading German manufacturer of the herbal remedy. This has led clinician and researcher Hans-Peter Volz of Jena in Germany to conclude that ‘taken in sum, the anti-depressive action of Hypericum is only sufficiently documented for Jarsin™.’

The good news is that Jarsin™ is now available over the counter under the brand name of Kira™. It is essentially identical to the German compound and is clearly the brand of choice at this time.

Another reason to use an herbal product known to be made under carefully supervised conditions is that you can feel more confident that there are no potentially toxic contaminants in the preparations, such as have been known to occur in other food supplements. The contaminant in L-tryptophan that resulted in several fatalities in the US was a particularly dramatic case in point.

Some local brands of St John’s Wort are less expensive than Kira™ and for certain individuals the cost difference may be a significant consideration. If this is the case, I would suggest at least starting with the Kira™ brand. If your depression does not respond, you can then be more confident that it is not because of the brand of the herbal remedy but for other reasons. Once your depression does respond to Kira™, if cost is a significant consideration you might then try to switch to a less expensive brand and see if you maintain the same level of anti-depressant response.

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posted by admin on Apr 28

A tumour arising within the brain understandably causes great anxiety-perhaps more so than with tumours elsewhere in the body, as a brain tumour may appear to strike at the very centre of one’s soul and being. Many people with simple headaches due to anxiety or stress believe that they have a brain tumour which is causing their headache. However, the incidence of primary tumour is very low (10 per 100 000 per year). It is, however, true that tumours can cause epilepsy. This is much more likely to happen in adults than in children.

Brain tumours are either primary or secondary. A secondary tumour is one that has been carried in the blood to the brain from another site. Cancers of the lung (bronchus) or breast are by far the most common of these. Usually the site of the original cancer is known, and the appearance of seizures in such a patient is an ominous sign indicating that a secondary tumour has arisen within the brain. Sometimes, however, the original cancer has not been discovered at the time of the first seizure, and a careful clinical examination will reveal a small tell-tale lump in the breast, or the lung cancer will be seen on a chest X-ray.

Primary tumours of the brain do not arise in nerve cells. These tumours are called gliomas and meningiomas. There are other types of primary cerebral tumours, such as those arising from the cells lining the cavities of the brain, or from blood vessels, but these are rare.

Primary brain tumours are not like cancer of the breast, or bowel, or bronchus. They show no tendency to develop blood-borne secondary deposits in other organs. This is fortunate, but there are other characteristics which hinder effective treatment. The gliomas infiltrate normal brain extensively, so there is no apparent margin beyond which one can be quite certain that no abnormal cells have reached. This makes recurrence after surgical excision very likely. Meningiomas, however, are encapsulated tumours, and can often be removed completely, with a good chance of complete eradication. However, meningiomas often have an extensive blood supply, so complete removal may be technically very difficult.

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posted by admin on Apr 28

Mr. G.Y. of Texas writes: “I found out about CMO through a friend … Even though I really could not afford it, I decided that I had to give it a try.

“I am a 57 year old man. I have had three colon surgeries that left me with only 18″ of colon. I had arthritis in my back, hips, and legs. I also had arthritis in my hands and they were always swollen. I had to sleep on my knees in a crouched position because the pain and discomfort of arthritis was driving me crazy. I was really bad off and the doctors told me to get my affairs in order because I didn’t have long on this earth. I was willing to try CMO as a last resort. What did I have to lose except the cost of it if it didn’t work. This is the result after … CMO.

“My sleeping has improved by at least 85%. My arthritis pain and swelling in my hands is gone and there is no more pain in my back, hips or legs. I am also suffering from emphysema and have noticed an improvement, I’d say at least 40%. It seems to be getting better every day. I can walk and do my shopping now and not have to stop every few steps to catch my breath. I have gained back most of my health in more ways than I can explain. CMO seems to be the one thing I needed 10 years ago. I am getting better every day. [Editor's comment: Many people find that the healing process continues long after they finish their CMO capsules.]

“After using the product I can say that it is well worth the cost. I would pay ten times the price if I ever need it again. If you think you can’t afford it, think again. For what it does for your body and health, you can’t afford not to get it if you really want to be helped. CMO does what it says and much more.”

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posted by admin on Apr 28

Home care

A child with mono needs rest, aspirin or paracetamol, and a general diet as tolerated. Although mono is contagious, it’s not necessary to isolate the child and it’s unlikely that other family members will contract the disease. The child can return to school as soon as the weakness and fatigue disappear and the child feels well enough. If the spleen is enlarged, however, the child’s activity should be restricted. An enlarged spleen protrudes beneath the ribs, which normally protect it, and is susceptible to injury or rupture. In this situation, the child should not take part in contact sports or other energetic activity until the spleen returns to its normal size; this can take weeks or months.

Precautions

• If your child is being treated with antibiotics for a strep infection but the condition does not improve within 24 to 48 hours of starting the medication, inform your doctor.

• If the child’s spleen is enlarged, contact sports and other strenuous activity should be avoided.

Medical treatment

Your doctor will examine the child thoroughly, paying special attention to the lymph nodes, liver, and spleen. The doctor will also take a throat culture. If the throat culture reveals a strep infection, the child will be given penicillin or another antibiotic. Although most cases of mono can be treated at home with proper rest, diet, and a medication such as aspirin or paracetamol, some severe cases require hospitalization. This would be the case where the child needed to be given fluids intravenously or other types of supportive care.

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posted by admin on Apr 23

Eczema is an itchy dermatitis that is usually allergic in origin and occurs in families. It usually starts with patches of dry, itchy skin which in babies and young children (the commonest sufferers of the condition) are behind the ears and knees, in the body creases at the elbows and the neck, on the face and on the trunk or scalp. When the eczema is bad the skin is red, raw, weeping and crusted and may become infected.

Eczema is not infectious and most babies grow out of their infantile eczema. For a few, though, allergic eczema can persist throughout life. About three children in a hundred suffer from it and many of these have a family history of eczema, asthma, hay fever or other allergies.

What causes it?

• There is no doubt that there is a familial susceptibility.

• As eczema is much more common in bottle-fed as opposed to breastfed babies there is little doubt that an allergy to cows’ milk plays a part in many children. Some children are allergic to other foods too.

• Scratching makes it worse, so it is best to avoid wool and nylon next to the skin because these make the skin hot and sweaty.

• Feathers, down and wool bedding make it worse.

• The single greatest preventive measure is undoubtedly to breastfeed a baby right from the very start and not to give him or her even one bottle of cows’ milk. This will need very careful supervision because it is still the practice in many maternity hospitals to take babies away from their mothers at night and to feed them the odd bottle of cows’ milk formula.

• The way round this is to talk to your family doctor and midwife before the baby is due to ensure that everyone knows that you have a baby that is ‘at risk’ and is to be totally breast-fed from birth. If eventually you find breastfeeding impossible (which is rare with good advice) then you will have to use a soy-based milk. There are several on the market.

Aim to feed your baby breast milk exclusively for at least four months and preferably longer. The protective effect is greater the longer you continue but after about six months you should add in other (non milk-containing) foods.

Unfortunately, even this way of feeding a baby may not prevent all eczema. This comes about for two reasons. First, the child may be allergic to some other allergen, such as the house-dust mite; and second, antigens in the mother’s diet may be transmitted to the baby via her milk. Recent research suggests that eating large quantities of certain allergens during pregnancy can sensitize a susceptible child in utero. The answer here is to take all foods in moderation during pregnancy, especially foods that are likely to induce allergies in children. These include cows’ milk and all its products, eggs, wheat, nuts, fish, tomatoes and colourings and preservatives. If you have a family history of allergy, and especially of eczema, it makes sense to avoid these foods as much as possible during pregnancy and breastfeeding, or at least certainly never to binge on them. Don’t worry about the calcium you will be missing-it can be eaten in other forms, and you can take zinc and calcium supplements (Sandocal effervescent tablets are good) which more than compensate for the calcium loss in dairy products. Start weaning your solely breast-fed baby at about 5-6 months and be sure to breastfeed after each meal until the end of the first year of life. Introduce vegetables and fruit first of all and then add milk-free margarine. Over a few weeks add in foods that are ‘safe’ (not on the above list of common culprits) and see how it goes. If ever a food seems to precipitate eczema stop giving it and don’t try it again until the child is 2. If a child is allergic to eggs he or she might also be allergic to chicken, so beware.

• Having done your best to prevent eczema at source dress your child with soft cotton next to the skin-never wool or nylon. These latter will make him or her hot and sweaty, which makes any early eczema likely to progress further than it otherwise would. Choose loose clothing styles that keep the child neither too hot nor too cold.

• Disposable nappies may irritate -use soft terry nappies. Change nappies frequently and clean the child’s bottom well. Avoid plastic pants if there is any sign of nappy rash. Never wash nappies in biological detergents because very allergic babies are allergic to the enzymes in them. Drying clothes out of doors helps destroy house-dust mites and bacteria. Avoid feather, down and wool bedding because these can irritate eczema. Use duvets filled with synthetic filler and cotton cellular blankets and cotton sheets. Change bedding twice a week at least, and damp-dust and vacuum the child’s room daily.

• Join a self-help group to help you cope with the day-to-day problems and prevent family discord. Having a baby or child with severe eczema can be exhausting for all the family and you will be grateful for tips on how to cope.

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posted by admin on Apr 23

Macmillan nurses

The Cancer Relief Macmillan Fund (CRMF) was set up in 1911 to provide care and support for cancer patients. This national charity now helps to improve the quality of life for cancer patients and their families at home, in hospitals and in special cancer units.

The CRMF has trained more than 1000 Macmillan nurses who work in the community and in hospitals around Britain. It continues to fund these specially trained nurses for up to 3 years in posts in hospitals, after which the health authority takes over the financial responsibility.

A GP or district nurse may suggest involving a Macmillan nurse to help care for a woman with incurable breast cancer. Macmillan nurses play a similar role to that of hospice-based nurses, giving advice and emotional support to women and their families, and working closely with other medical professionals to advise about pain relief and symptom control as necessary. They are also involved in the training of doctors and nurses to help them develop the special skills required for the care of cancer patients and, with hospice staff, have been largely responsible for the increased awareness of other health professionals to the particular care these patients need.

Other treatment centers

There are a few private centers in Britain which advocate special non-medical therapies to help people ‘fight’ or live with cancer. Your GP, consultant or a specialist nurse should be able to give you details of such centers in your area, or you can contact one of the associations whose addresses are given in Appendix I. Although alternative therapy centers are not funded by the NHS, some have trust funds to help meet the costs for those who cannot afford them.

One such complementary treatment centre is The Bristol Cancer Help Centre which, despite some bad publicity based on inaccurate reports, has been responsible for helping many people with cancer to lead full and satisfying lives and to come to terms with their disease. An increasing number of people contact the centre for advice when their cancer is first diagnosed, and the current climate in Britain which encourages people to play an active role in their own health care is in part responsible for this.

The Cancer Help Centre provides support to cancer sufferers and teaches a holistic approach to cancer therapy based on looking at ways of improving people’s mental, spiritual and medical health. It emphasizes the learning of coping devices such as meditation, relaxation and visualization techniques to help people deal with the stress in their lives, as well as encouraging them to eat highly nutritious diets – both of which strategies are aimed at helping to improve the ability of the body’s immune system to fight disease and to respond to medication. The highly nourishing diets the centre recommends and the use of vitamin and other dietary supplements are based on the generally accepted findings of research into the effects of diet on the development and course of disease.

The Bristol Cancer Help Centre is just one example of centers throughout Britain which offer a complementary approach to cancer therapy which can be practiced alongside conventional surgical and medical treatment.

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posted by admin on Apr 23

GnRH agonists, also known as LHRH agonists, are a group of drugs that have been developed over the last two decades. Since the mid 1980s they have been used in clinical trials in Australia and overseas for the treatment of endometriosis. They have also been used to treat a range of other conditions including anovulation (absence of ovulation) and fibroids.

The GnRH agonists are modified versions of a naturally occurring hormone, gonadotropin releasing hormone (usually abbreviated to GnRH), which helps to control the menstrual cycle.

Initially, it was thought that the GnRH agonists would not be suitable for the treatment of endometriosis as it was assumed that they would stimulate the production of oestrogen. However, it was discovered that prolonged use of the GnRH agonists actually suppressed the production of oestrogen and caused the oestrogen levels in most women to decrease to the levels found in women following the menopause. Consequently, researchers began to investigate their use for the treatment of endometriosis.

How GnRH agonists work

The GnRH agonists eradicate endometrial implants by suppressing ovulation and oestrogen secretion. The resulting low levels of oestrogen in the body mean that the endometrial implants are no longer stimulated to grow and breakdown each month so they gradually degenerate and waste away.

Most women stop ovulating and menstruating during treatment and resume ovulation and menstruation again within one to two months of completing their treatment.

Dosages of GnRH agonists generally used

Since 1971 more than 2,000 GnRH agonists have been developed by various pharmaceutical companies. Some of them are still being developed and tested while others have been released for use in some countries. At present none of them are available in Australia for the treatment of endometriosis, except under special circumstances.

None of the current GnRH agonists are effective when taken by mouth because they are broken down in the digestive system. Other methods of administering the drugs have been developed, including nasal sprays, daily injections and monthly injections.

Side effects of GnRH agonists

The side effects experienced by most women are usually a result of low oestrogen levels. The majority of women experience hot flushes and some also experience other menopausal-type symptoms, including vaginal dryness, decreased libido, headaches and depression. The side effects usually disappear soon after the cessation of treatment.

The GnRH agonists appear to have no adverse effects on the levels of fats and cholesterol in the blood.

One possible long-term side effect of GnRH agonist therapy is osteoporosis (loss of bone density). In trials conducted so far some women have shown a decrease in the density of the bones in their spines; it appears that this effect is reversed and the bone density usually returns to normal within six months of ceasing treatment.

At present it seems that this loss of bone density is not likely be a significant long-term problem if the treatment lasts only six to nine months but considerable further research is needed before the complete picture is known.

How effective are the GnRH agonists

The results of the clinical trials indicate that the GnRH agonists are effective in eradicating endometriosis and relieving its symptoms but, like all the other hormonal drugs, they have no significant effect on adhesions or endometriomas and they are not a permanent cure. Overall, the GnRH agonists appear to be as effective as Danazol. When they have been approved for use in Australia they will probably assume an important place in the hormonal treatment of endometriosis.

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posted by admin on Apr 23

Some physicians have experimented with the use of hormones to treat anorexia. Insulin, for example, stimulates the metabolism of glucose (blood sugar). When the glucose level drops, it causes hypoglycemia (low blood sugar), which in turn triggers the appetite center in the brain to send out “feed me” signals. Thus, administration of insulin can stimulate appetite. This technique has largely fallen out of favor, however; among other things, as we have seen, lack of appetite is not the central problem in anorexia.

Recently there’s been increasing interest in the use of cyproheptadine (sold under the brand name Periactin). This antihistamine is used to treat allergies and often causes mild weight gain as a side effect. Cyproheptadine is a serotonin antagonist – that is, it keeps serotonin from linking up with its receptors in the brain. By blocking serotonin, cyproheptadine lets the patient keep eating and thus gain weight. Studies seem to indicate that while cyproheptadine is a little better than a placebo (a “sugar pill”) at relieving depression and at helping some hospitalized anorexics gain weight, the difference is generally not significant. Interestingly, this drug seems to produce some weight gain in non-bulimic anorexics, especially those who were born at lower weights than normal, but not in bulimic anorexics.

Because marijuana stimulates appetite, researchers wondered if marijuana’s active ingredient, tetrahydrocannabinol, might work in anorexia.

Some medications might have use, not for the anorexia itself, but for some of the other physical problems associated with the disorder. For example, many patients relearning how to eat complain that the presence of food in their stomachs causes them to feel painful bloating. This is normal, even predictable, since their bodies have largely forgotten what it feels like to take in food. Anorexia disrupts many of the feedback loops regulating digestion. In some cases, use of medications to speed up emptying might help. Other such medications include bethanechol and metoclopramide. We don’t yet have all the facts we need, however, to use these medications regularly as part of the medical treatment plan. Simethicone, a compound used to reduce gas and found in many over-the-counter digestive aids, can also help relieve the discomfort of re-feeding.

I’ve just given you several pages of information on drugs that have been investigated as possible treatments for anorexia. I must state again, however, that medications have not yet proved as helpful for anorexia as they have for bulimia. In my experience, no medication can substitute for a comprehensive program that addresses the many behavioral, cognitive, and family issues contributing to the illness. At best, drugs serve as a means of temporarily relieving a symptom, of taking some of the heat off the patient, so that we can begin to tackle the real problem.

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posted by admin on Apr 23

Lori LaRizzio found the willpower to forgo fast food once her weight-loss success became an issue of pride, money, and her best friend’s wedding.

At age 30, Lori, of Jim Thorpe, Pennsylvania, seemed to have everything: the love of her husband, two great kids, a wonderful career in nursing. But at 5 feet, 5 inches and 205 pounds, she hated her body—and shopping for clothes. To avoid feeling humiliated, she looked at purses and earrings while her friends tried on miniskirts and bikinis.

But humiliation was exactly what Lori felt when she was fitted for a bridesmaid’s dress for her best friend’s wedding. The seamstress shouted out Lori’s 44-37-45 measurements for all to hear. Then she said brassily, “You’ll need to pay more. You’re too big for regular sizes.”

Sobbing, Lori headed straight for McDonald’s to indulge in french fries and a sundae, her favorite comfort foods. But by the

time she got there, she had changed her mind. She bought a diet Coke and drove home, where she immediately called the seam- ^ stress and ordered a smaller size. The woman argued. Lori insisted.

Five months and lots of low-fat meals, walks, and bicycle rides later, Lori got her sweet revenge. |

Since her friend’s wedding, Lori’s efforts to slim down have continued to pay off. She’s down to 140 pounds, a weight that she has maintained for more than 3 years.

“Despite her rudeness, I actually have to thank that seamstress,” Lori says. “She catapulted me to a new, healthier way of living.”

WINNING ACTION

Don’t let someone else’s problem become yours. Like Lori, many of us can be so hurt by someone’s cruelty that we feel the need to drown it out—usually with food. Instead of using that as an excuse to binge, slow down and focus on what you need to do at that moment to make yourself feel better, not worse.

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