Health News and Information

PRACTICAL MATTERS: LEGAL RIGHTS AND OBLIGATIONS-STATE LAWS THAT APPLY TO HIV INFECTION: YOUR RIGHT TO PUBLIC ACCOMMODATIONS

admin — Tue, 26 Jul 2011 11:19:58 +0000

Most states also have laws that protect the citizens of that state against discrimination on grounds of handicap. Whether HIV infection is included in a state’s definition of handicap depends on the state: the laws that apply to people with HIV infection, needless to say, vary from state to state. The state laws against discrimination on grounds of handicap are often different from the federal laws. Some people with HIV infection find it useful to pursue claims of discrimination under either federal or state laws, or under both. (Note: Some laws use the word handicap; others use the word disability. The two words mean the same thing.) In general, state laws against discrimination govern such issues as your right to public accommodations, your right to housing and employment, your right to confidentiality, and your medical rights. Your right to public accommodations-Public accommodations are more important than they sound. A public accommodation is any place open to and serving the public. Exactly which places are defined as public accommodations vary from state to state: some states include doctors’ offices, for instance, and some do not. Depending on the state, then, public accommodations can include schools, doctors’ offices, hospitals, hospices, barber and beauty shops, nursing homes, funeral homes, public transportation, restaurants, and hotels. Any place defined as a public accommodation cannot discriminate according to race, sex, creed, color, or (depending on the state) handicap. In most states, AIDS is defined as a handicap. In some states, having HIV infection but not AIDS may also be defined as a handicap. Although all laws governing the right to public accommodations are similar, they will differ in detail according to the state. In some states, for instance, beauty shops are not allowed to treat someone with a contagious disease, and since HIV infection is contagious, those states could conceivably bar a person with that virus from a beauty shop. This is, however, an obviously unrealistic use of the word contagious, since the type of exposure that occurs in beauty shops carries no risk of transmitting HIV. To find out the laws in your state, ask a lawyer. Lawyers can also draw up wills and help sort out problems with the Social Security system and with insurance companies. Another source of information about discrimination is an agency called, in some states, the state human relations commission. In other states, it is called the state civil rights commission. If you think you have been denied public accommodations because of your HIV status, file a complaint with the state human relations or civil rights commission, and they will investigate. You will not need a lawyer to file a complaint. You will, however, need to be a pest, because agencies move slowly. You also need to remember that filing such a complaint will involve giving up the confidentiality of your HIV status.*198\191\2*

REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: ELEVATED CHOLESTEROL – THE EFFECT OF LOWERING YOUR CHOLESTEROL & DISCOURAGING AND ENCOURAGING FACTS ABOUT CHOLESTEROL

admin — Mon, 11 Jul 2011 11:08:07 +0000

The effect of lowering your cholesterolYou go to the doctor for a checkup. A blood test reveals a total cholesterol level of 260 mg/dl. You carefully and consistently adjust your diet and exercise. When your cholesterol is rechecked in 6 months, it is 208 mg/dl. Because that is a decrease of 20 percent, your predicted risk for the development of coronary disease has decreased by 40 percent if you maintain the improved level.Discouraging and encouraging facts about cholesterolApproximately 55 percent of American adults have a total cholesterol level of more than 200 mg/dl.If your total cholesterol is 300 mg/dl, the risk for development of coronary disease is double what it would be if your total cholesterol were 150 mg/dl.The risk of dying from coronary disease if your total cholesterol is 300 mg/dl is four times what it would be if your total cholesterol were 180 mg/dl. Dietary measures alone can usually reduce the average LDL cholesterol by about 15 percent or more. Dietary measures are less likely to be effective if the triglyceride level is normal, though.A 10 percent reduction in cholesterol level results in a 20 percent reduction in future coronary risk. A 1 mg/dl increase in HDL cholesterol reduces your risk of coronary disease by 2 to 3 percent. Aggressive life-style modification, including cholesterol reduction, can cause at least a little reversal of coronary artery blockage in about one of three people.*244\252\8*

REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: HEALTH BENEFITS OF QUITTING

admin — Fri, 08 Jul 2011 10:03:52 +0000

From a health perspective, benefits are most obvious if you never begin smoking in the first place. If you do smoke, however, the gains from stopping are enormous. After you quit, the risk of heart disease from smoking drops dramatically within about 2 years. Although your risk probably will never be as low as if you had never smoked, it can certainly approach that level.Researchers have found that if you smoke two packs of cigarettes per day your risk of death from heart disease alone (not considering death from other causes or ill health not resulting in death) is double that if you never smoked. If you stop smoking (and do not resume), the risk of death from heart disease is reduced to 1.3 times what it would have been if you never smoked.Even among relatively older individuals, there is a dramatic advantage to discontinuing cigarette use. For example, if you are older than 50 and stop smoking, the chance of dying from any cause is reduced by one-half during the next 15 years. The risk of dying of heart disease decreases by about 30 percent. Recent studies have shown that smokers older than age 60 could add 5 to 7 years to their lives by quitting. It is never too late to quit.*235\252\8*

HIV INFECTION AND ITS EFFECTS ON INTERPERSONAL RELATIONS: HELPLESSNESS, DEPENDENCY, AND CONTROL-COMING TO TERMS WITH LOSS OF CONTROL

admin — Mon, 27 Jun 2011 08:27:56 +0000

The trick is to balance acceptance of help with preservation of control. First, don’t give up independence too easily. “I have a friend with AIDS,” says Steven, “who sometimes asks me to bring stuff down from his attic or install his screen windows—things I know he can do for himself. I say no. I know, because I have other friends with AIDS, that he has to take some responsibility. Lots of people give up, but mental and physical health go hand in hand.” People feel better about accepting help if they think they’ve done their best to accomplish the task on their own first. Next, accept the fact that having some help is going to be necessary. Certainly such physical limitations as fatigue require that you accept help. Helen, who had worried about depending on her parents or on welfare, made her peace with getting help. “I know I’m not going to be able to count on myself for everything,” she finally said. “I’m not going to be afraid of becoming dependent, of saying I need help. My father and stepmother have been very supportive. My church will always help.” Some people feel they need help so badly they have no choice but to accept it. Some people feel they can accept help because they have helped others: what goes around comes around, they say. Some can accept help because they understand that their caregivers need to be involved with them. Some know that if circumstances were reversed and their caregivers were sick, they would help their caregivers. Some feel they have led good enough lives that they are worthy recipients of care.
*84\191\2*

PROTECTING YOUR JOINTS: THE SEARCH FOR CHONDROPROTECTIVE AGENTS

admin — Thu, 16 Jun 2011 08:15:35 +0000

Although standard drugs for osteoarthritis reduce pain, there is worrisome evidence that they may contribute to the problem by interfering with the efforts of cartilage to repair itself. When this was discovered, researchers in Europe began to look for substances that could protect cartilage from further harm. The term for such a substance is a “chondroprotective agent.” The concept of chondroprotective agents has not been widely accepted among U.S. physicians, although veterinarians in the United States have begun to use it.A number of substances have been proposed as chondroprotective agents. The reasoning behind two of them, glucosamine and chondroitin, is almost embarrassingly simple: They contain raw materials necessary for rebuilding cartilage. Hypothetically, supplying extra amounts of these raw materials may enable cartilage to repair itself faster.Another proposed chondroprotective agent, S-adenosylme-thionine, is believed to help cartilage repair and possibly exert other helpful effects.If chondroprotective agents live up to their name, they might even stop osteoarthritis from following its natural course and becoming worse with time. If so, they could be called “disease-modifying drugs,” unlike other treatments that just reduce symptoms temporarily. More research, however, is necessary before we can say for sure that chondroprotective agents really work this way.7/306/5*

GYNECOLOGICAL CANCER GUIDE: CERVIX CANCER

admin — Thu, 02 Jun 2011 07:52:27 +0000

The cervix is the neck of the uterus that juts into the upper vagina. It is usually about 3-4 cm long and 2-3 cm in diameter. The cervix often gets bigger following pregnancy. The outside of the cervix is usually covered by the same tissue as that which lines the vagina (‘squamous’). The inside of the cervix consists of glandular tissue responsible for producing mucus which in turn ensures that sperm is able to swim up into the uterus and subsequently along the tubes to meet the egg so that fertilization can take place and pregnancy occur.The junction where the outside skin and inner glandular material meet is called the ‘transformation zone’ and it is at this site where precancerous change develops. In younger women this site is on the outside of the cervix. In postmenopausal women it is usually within the canal of the cervix, which is why a brush sample is routinely taken during a Pap smear.The principal reason why cancer of the cervix develops is due to an infection with a virus – the ‘human papilloma virus’ (HPV). It is estimated that at least 80% of the sexually active adult population at some point are both exposed to and infected with human papilloma viruses of which there are over 100 different types. Approximately 15-20% of these can affect the female genital tract and can be responsible not only for the development of cancer of the cervix, but in some cases can also cause vaginal cancer and vulval cancer.Since these viruses are transmitted sexually, infections are usually quickly resolved through a woman’s immunity and therefore do not result in cancer. It is still unclear as to why in some women these infections persist and eventually lead to precancerous and ultimately cancerous changes. Certainly smoking cigarettes increases the risk by about 4 times. It is obvious that the more times a woman can be exposed to such viruses, then the higher the chances of her getting cancer of the cervix.The incidence of this cancer is increased in women with multiple sexual partners, particularly when barrier contraception, such as condoms, is not used. Lesbian women also have a risk of developing cancer of the cervix and need to have regular Pap tests.There are two common cancers affecting the cervix. In about 80% of cases, the cancer arises from the outside skin of the cervix – the ‘squamous epithelium’, thus these are called squamous cancers.In about 20% of cases, however, the cancers can arise either from the glandular tissue in the canal of the cervix (‘adenocarcinoma’), or can be mixed cancers called ‘adenosquamous cancers. These cancers grow locally into the upper vagina and into the ligaments supporting the cervix – the so-called ‘cardinal’ ligaments or ‘parametrium’. Because the tube running from the kidney to the bladder runs in the parametrium, if local spread of cancer does occur, these tubes can get blocked and the kidneys become swollen causing pain in the back, below the ribs on either side of the midline.These particular cancers are prone to infection, so foul smelling discharge and heavy bleeding can be a problem if left untreated. In advanced cases the bleeding can be life threatening. As in uterine cancers, advanced cancers of the cervix can invade into the bladder and into the rectum with leakage of bladder and/or rectal contents into the vagina. Because the nerves supplying the pelvis run along the ligaments supporting the cervix, then pain can be a feature, particularly in advanced cases.Cancers of the cervix take a while to spread outside of the pelvic area. The cancer spreads most often to the lungs and occasionally to the bones so that a cough or chest pain and/or bone pain becomes prominent.*4/144/5*

IF THE SYMPTOMS OF ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER) ARE RELATIVELY SIMILAR THROUGHOUT LIFE, WHY IS IT NECESSARY THAT THEY BE ANALYZED ACCORDING TO AGE AND DEVELOPMENTAL LEVEL?

admin — Wed, 18 May 2011 16:08:29 +0000

It’s important to break it down this way because children look very different at various ages, their developmental tasks are different, and the environment in which they are behaving and living is different. Consequently, the underlying disorders of ADHD will manifest themselves uniquely at those ages and have a distinct effect on the most crucial aspects of development.When ADHD presents itself in an older school-age child, an adolescent, or even an adult, so much has gone into developing that person’s character that to say ADHD is the only force at work is extremely simplistic. We must go back to the beginning and look at how the syndrome first appeared, as well as how the difficulties related to it interacted with the child’s environment to distort his development right from the start.It often helps to think of attention deficit hyperactivity disorder as an onion, made up of layers, each having a dramatic impact on the next. Parents need to have a strong understanding of this multilayered aspect of ADHD in order to design the treatment approach that will be most helpful for their child.*14\173\2*

PRIMARY PERITONITIS: DIAGNOSIS

admin — Sat, 07 May 2011 15:34:13 +0000

The diagnosis of peritonitis is based on analysis of ascitic fluid obtained by abdominal paracentesis. Paracentesis has been found to be safe, even in cirrhotic patients with coagulopathy. There is an approximately 1% chance of abdominal wall hematoma, 0.01% chance of hemoperitoneum, and 0.01% chance of iatrogenic infection.The ascitic fluid should be sent for cell count, differential, Gram stain, and bacterial culture. Ten to 20 mL of fluid should be inoculated into blood-culture bottles at the bedside, which yields bacterial growth in about 80% of cases of neutrocytic (neutrophil-predominant) ascites, compared to less than 50% with conventional culture techniques. If there is a suspicion for tuberculous peritonitis, fluid should be sent for mycobacterial smear and culture, although the sensitivity of these tests is very low. In contrast, a peritoneal biopsy for tuberculosis approaches a sensitivity of 100%. Measurement of adenosine deaminase activity in peritoneal fluid has been found to be an insensitive test for tuberculous peritonitis in the United States, especially in cirrhotic patients, but is helpful if the result is positive.The diagnosis of SBP is confirmed by an ascitic fluid polymorphonuclear (PMN) count of 250 cells/mm3 or greater and a positive bacterial culture. Two other variants of primary peritonitis exist that do not meet these criteria:• Culture-negative neutrocytic ascites (CNNA) is present when there is a PMN count of 250 cells/mm3 or greater but a negative bacterial culture. This may also occur in the setting of peritoneal carcinomatosis, pancreatitis, and tuberculous peritonitis, and these conditions must be ruled out. CNNA has similar clinical and prognostic features as SBP and is treated in the same way.• Bacterascites is defined as the isolation of bacteria in ascitic fluid cultures with a PMN count of less than 250 cells/mm3. The clinical course of bacterascites depends on whether or not the patient is symptomatic. If signs and symptoms of infection are present, the clinical course, mortality, and treatment are similar to SBP and CNNA. In the absence of symptoms, the colonization usually resolves without antibiotics.*89/348/5*

SKIN AND DISEASE: USE OF HOT FOMENTATIONS

admin — Fri, 29 Apr 2011 15:04:15 +0000

In many cases where there is a collection of pus near the surface of the body – as in the case of boils, septic spots and minor abscesses – the hot fomentation is indispensable. It helps to soften the skin so that natural drainage may take place, and the heat appears to hasten the “ripening” process. But there are many other skin troubles where the hot fomentation may be used with great advantage. In some such cases the skin in certain parts of the body will become hardened and form thick scales, showing that the normal function of elimination is too slow. Such areas need to be stimulated into greater activity, and there is no better measure than heat applied in a moist fomentation.A piece of woolen cloth should be wrung out in water as hot as can be borne and then applied to the parts; this should be well covered by a dry material to keep in the heat, and the whole fomentation changed when it has cooled off. It is often made still more effective in restoring flexibility to the skin if a little olive oil has been gently anointed to the surface before the fomentation is applied.The hot fomentation may be used to great advantage in some of the chronic skin complaints, like psoriasis, for example, where years of faulty skin action have led to changes in the superficial tissues. Some of these troubles become so extensive that they may cover almost the whole of the body, and then the baths mentioned earlier may be the proper treatment. But generally speaking, there are patches which will be found to be more affected than others, and these should receive the extra stimulation of the hot fomentation.A dressing with a little olive oil is often very useful after the fomentation. It may be applied to the surface in very small quantities and allowed to be absorbed, or a little may be applied to a cloth and worn over the parts for a few hours.
*24/154/5*

THE ENDOMETRIOSIS DIET THAT HELPS HEALING: THE B VITAMINS

admin — Sun, 10 Apr 2011 12:56:07 +0000

The “complex” B’s are actually a group of eleven separate but interrelated vitamins. They are vitamin B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), B3 (niacin), B12 (cobalamin), pantothenic acid, biotin, folic acid, choline, inositol, and PABA (para-aminobenroic acid). All B vitamins are intimately involved with the breakdown of carbohydrate, protein, and fat in the body, powering the mechanisms that release energy to the muscle cells. B6 has been shown to influence the release of the brain’s neurotransmitters dopamine and serotonin and may be the most critical vitamin for women. These neurotransmitters regulate mood, and a lack may cause a sense of agitation or depression. Folic acid and B12 are instrumental in red blood cell production, and red blood cells, in turn, transport oxygen to muscles. Research on choline points to some evidence that this vitamin is linked to brain chemistry and may be a factor in memory retention. Physical activity, alcohol, refined sugar, birth control pills, and emotional stress deplete B vitamins, and since they aren’t stored in the body, the more active or under stress you are, the more you need.These vitamins not only regulate the menstrual cycle but are also crucial for the well-being of women with endometriosis and have been known to help lessen symptoms of PMS. To begin, B vitamins are implicated in liver function and in the synthesis of estrogen. This hormone is broken by the liver into a more benign form, called estriol, which will not make cells proliferate. Undegraded estrogen, called estradiol, is closely linked to endometriosis as well as to cases of fibrocystic disease and breast cancer, uterine fibroids, and heavy menstrual flow. If a woman’s diet is poor in B complex vitamins, liver function is impaired and more estradiol enters the system, causing greater endometrial inflammation.Women who are taking oral contraceptives, arc pregnant and/or lactating, and those with endometriosis are all subject to greater B complex needs because of altered or unbalanced hormonal states. An intake of these vitamins should help to elevate moods, control fluid retention, and improve hair and skin qualityDosage: B complex is best taken in a balanced-formula pill. Taking an overload of one of these vitamins may increase the need for the others. Since these vitamins arc water-soluble, you’ll do best to rake them with meals. A full stomach will also offset any side effects of the dosage, such as mild nausea. To keep mood and hormones balanced harmoniously, endometriosis sufferers should begin with a 100-mg B complex tablet, with an additional 50-200 mg of B6. From the two weeks before the menstrual cycle, increase vitamin B6 intake to 500 mg and take it along with B complex and magnesium tablets. This combination should help reduce estrogen overloading. It’s a good idea not to take a high-dosage vitamin C supplement at the same time you are taking the B’s. Vitamin C in large quantities tends to destroy B12.Best selection of foods with B vitamins: These critically important vitamins are often sacrificed by overcooking, canning, overprocessing, and long-term storage—an unfortunate byproduct of the modem food industry. It may not be an intentional disservice, but nevertheless, we are sometimes consuming prepackaged foods that are poor in B complex vitamins when they should be naturally B complex rich. Strive, then, for the freshest food products. To benefit most, the best sources are liver, brewer’s yeast, whole grains (wheat bran, rice bran, and oatmeal), soybeans, peanuts, peas, lima beans, dark leafy vegetables, tuna, turkey, veal, asparagus, walnuts, and raw pecans.*79\43\4*