06.2.2010

MASTERING MEDICATIONS FOR A HEALTHY HEART: ANTIHYPERTENSIVE AGENTS

To treat, or not to treat, that is the question. Some doctors believe that all patients with high blood pressure should be treated, even if their conditions are mild. Others disagree, pointing to the potential effects of diet and exercise alone, and citing data which show no particular therapeutic advantage to taking the drugs.
There’s no question, however, that hypertension is one of the major risk factors in heart disease and should be controlled in order to prevent future cardiac events. This is especially true for women, who do far worse following heart attack or bypass if their blood pressures are even slightly elevated. Blacks, too, are at increased risk when hypertension enters the equation.
Mild hypertension can be defined as a blood pressure of 140-160 systolic over 90-100 diastolic. This range describes 80 per cent of the hypertensive population.
Norman Kaplan, MD, chief of the hypertension division at the University of Texas Health Science Center in Dallas, voiced the concern of many in the medical community about the benefits of treating mild hypertension with drugs.
“The data on the treatment of mild hypertension and protection against coronary heart disease ate simply nonexistent,” he explained at a meeting of the American Heart Association. “In four of the nine studies conducted to compare hypertension treatment with nontreatment, the benefits were seen on the wrong side, that is the nontreatment side of the study. There has simply been no significant decrease in coronary mortality among the treated population of mild hypertensives. Lowering blood pressure to the lowest possible level simply may not be in the best interests of our patients.”
One of the most common ways to treat hypertension is with diuretic drugs. But diuretics may cause a rise in cholesterol levels. Moreover, diabetic patients may suffer owing to decreased glucose tolerance.
Moreover, even if one has been taking hypertension medications, is it necessary to remain on the drugs for life? Once it was believed that such therapy would need to be continued forever. Now some experts are saying that many patients can safely quit their medications or at least cut way back on the dosage.
But that’s possible only when the patient takes an active role in the management of blood pressure. And that means weight control, proper diet including salt and sodium restriction if sensitive to sodium, and regular physical exercise.
As you can probably tell, I believe in the least possible medication, relying as much as practical on diet and exercise. But there certainly are patients for whom drugs will be necessary even when doing their very best with non-drug methods. For those with very high blood pressure which does not entirely respond to diet and exercise, there are a wide variety of drugs the physician can choose to bring the condition under control.
Remember that regardless of the means used to achieve the end, control of hypertension is essential to prevent future cardiac events. Discuss these matters with your physician. Talk about the different drugs listed in the chart at the end of this chapter and listen to why one or another might be the choice for you. Then follow your doctor’s prescription exactly. Don’t forget that after a while you may be able to cut that dosage down through your program of weight control, diet and exercise. But do not alter your medication dosage without your physician’s prior permission.
*145\85\2*
Cardio & Blood/ Cholesterol
06.2.2010

MASTERING MEDICATIONS FOR A HEALTHY HEART: ANTI-ARRHYTHMIC AGENTS

The healthy heart is a finely tuned instrument, beating in a very predictable manner throughout life. It is so predictable, in fact, that your cardiologist can determine a great deal about its health simply by looking at the paper tracing produced during an electrocardiogram (ECG) as the pumping action tenders easily recognised waves and blips. But this rhythm can become abnormal in a number of ways.
Just as there are a vast array of arrhythmias, there are a large number of drugs from which your doctor may choose. Some of the medications are specifically designed to treat arrhythmias, while others control heartbeat as one of their functions. The beta-blockers, for example, not only slow the rate of the heartbeat, but control its rhythm as well. It may be necessary for you and your doctor to experiment with more than just one of those potential drugs before finding the ideal treatment. Your doctor may choose not to prescribe any anti-arrhythmic agent at all, even though you are uncomfortable with the arrhythmias you experience. That’s because studies have shown serious problems with certain drugs, and there has been question as to the value of medications to treat arrhythmias that are not life-threatening. Again, it’s a matter of teamwork, and it’s important for you to follow the prescription to the letter rather than deciding on your own that you need more today or less tomorrow.
*144\85\2*
Cardio & Blood/ Cholesterol
05.21.2009

CHILD’S HEALTH: HAY FEVER (ALLERGIC RHINITIS)

In Australia at least 15% of the general population suffers from hay fever, and amongst children, adolescents are the most frequent victims.

Hay fever can have effects that range from mild to quite disabling and can burden a child’s daily life, particularly becoming a problem for teenagers around exam time.

Cause

Children who get hay fever suffer most during the season when the pollen count in the air reaches its peak just before summer. Rye grass pollen in particular seems to be the worst offender. These pollens are tiny particles which are breathed in and cause irritation or the delicate lining of the eyes, sinuses and nasal passages. Children of parents who suffer from allergy have a greater chance of developing hay fever themselves.

Clinical features

Sniffling, runny nose, sneezing, and itchy eyes, nose, roof of the mouth and back of the throat are the commonest complaints of hay fever sufferers. Eyes may also water profusely and become red and sore.

While hay fever is usually considered a minor complaint, those children with it are highly sensitive to pollens and can develop other allergic conditions, such as hives, rashes and asthma.

Investigations

Sometimes specific allergy testing may be useful to identify the substances which are causing the hay fever and which need to be avoided. These tests are performed by an allergist. However, they are often of limited usefulness because the results rarely influence the treatment that is given.

*231\90\8*

05.19.2009

NEWBORN’S APPEARANCE: BIRTH WEIGHT, LENGTH AND HEAD CIRCUMFERENCE

Although he may appear fragile, your healthy newborn baby is actually quite robust – do not be scared to pick him up and cuddle him! Each baby is an individual, and appearances vary widely. Keep in mind that most babies come out looking a little ‘squashed’ after their struggle down the birth canal! It takes a few days for them to take on their real appearance. If you have any questions or worries about your baby’s appearance, do not be afraid to discuss them with your doctor or nurse.

Birth weight, length and head circumference

There is a wide variation in babies’ measurements. The averages are given here.

Consult your doctor or maternal and child health nurse if you have any concerns about your own baby’s weight, length or head circumference.

Average birth weight 3-3 1/2 kg

Average birth length 50 cm

Average birth head circumference 37 cm

*64\90\8*

05.18.2009

YOUR MARITAL HEALTH/THE MOST OFTEN ASKED QUESTION: HE THINKS I’M TOO FAT. CAN I EVER BE SEXUALLY ATTRACTIVE TO HIM LIKE THIS?

“He thinks I’m too fat. Can I ever be sexually attractive to him like this? I just don’t think I can ever keep much of this weight off.”

ANSWER: The range of healthy weight seems to be much wider than once thought, and general health, not sexual attractiveness, should be the determinant of weight. One important super marital sex rule is that arousal comes from within, not without. We are all responsible for our own arousal and appearance. To. blame our partner for our own sexual feelings only blocks progress toward total personal and sexual health. A rose is a prickly, thorny, smelly, red thing that blooms only sometimes and is overpriced in flower stores. It can also be a symbol of love, a beautiful, soft, perfumed living symbol to be purchased for what it means, not just for what it costs. As has been said, all perception is mere hypothesis. Super marriage provides the opportunity for developing a hypothesis beyond the physical appearance. The more we look at bodies, the less we see the interaction and the system itself. It is important in super marital sex to be the partner you would like to be married to, and to be that partner in every way, including but not limited to the physical appearance.

*255\97\8*

05.18.2009

TRUE HEALING – PRACTICAL ADVICE /DIET – MINIMISING THE INTAKE OF TOXINS: WHY SHOULDN’T YOU EAT MEET?

Humans have a very long intestinal tract, typical to all plant eating creatures. All meat eaters have several times shorter intestines. What does this have to do with poisoning? Quite a bit. Meat in a long intestine spends a long time, before it is excreted. Too long. Not only is it more difficult to digest and more toxic to start with, but because it spends too much time inside us, it actually clogs the system and starts to rot. When the system is even partially constipated, the waste prepared for excretion is actually absorbed back into the bloodstream.

I am sure that you agree, that in-view of the above, eating meat is just asking for trouble.

Summarising, we should not eat any food, which is not optimal from the point of view of the design of our body.

Suppose that you add some water and/or sugar to your car petrol tank, just because you like it. Clearly the performance of the car will be severely compromised, and if you keep adding those ingredients to your petrol, the engine will eventually stop altogether, requiring a major service. The car engine has not been designed to run on water and sugar added to petrol, even in small quantities.

Similarly, if your computer expects 110VAC and you plug it into 240VAC (I have tried that one) you will hear a loud crack, see a big flash and a cloud of aromatic smoke will come out to indicate the end of computations.

If you do not provide koala with pure eucalyptus leaves (its natural food source), no matter how much “medical” and other attention you give to it, how “nutritious” (in your opinion) food you provide, it will get sick and die quickly.

*45\96\8*

05.15.2009

INFLUENZA – “SWINE FLU”

Every so often, perhaps at 10 or more year intervals, the virus may undergo a major change and antibodies from previous infections or immunisation with vaccine will be totally ineffective.

The virus is usually named from the year and location of the laboratory where it is first isolated.

The great influenza pandemic of 1918-1919 was thought to be due to a strain commonly called “swine flu” because it occurs in pigs as well as man.

The New Jersey strain, first noted when a small outbreak occurred at an army camp, Fort Dix, in New Jersey caused health authorities a lot of worry for it appeared to be the same “swine flu” which caused widespread infection just after World War I.

Fearing another pandemic, the U.S. Government mounted a mass immunisation campaign.

More than 50 million people were immunised and the outbreak was confined to a small area. The feared epidemic did not eventuate.

*460/71/1*

05.15.2009

APPENDICITIS – ANOREXIA (LOSS OF APPETITE)

Pain is the usual obvious symptom. It is initially rather vague, centred around the umbilicus (navel), usually intermittent in character and associated with nausea, vomiting and loss of appetite.

Anorexia or loss of appetite is a constant feature and characteristic of this condition. There may be either diarrhoea or constipation.

If the inflammation progresses and the outside of the appendix becomes involved, the character of the pain changes. It moves to the right lower abdomen and becomes constant.

When the doctor examines the patient, he may find a slight elevation of temperature, the tongue is often furred and the breath is offensive.

Examination of the abdomen usually reveals some tightness of the muscles over the appendix in the right lower side and, if the peritoneum or covering of the organs and the inside wall of the abdomen is inflamed, rebound tenderness is present — when the abdomen is pressed and then let go suddenly, there is a sharp stab of pain.

*205/71/1*

05.8.2009

THE INCIDENCE OF ENDOMETRIOSIS AMONG RELATIVES

Who, then, is most likely to be a genetic candidate for the disease? Ten to twenty years ago (perhaps longer), the implicit assumption was that endometriosis was a disease carried by and exclusive to white middle-class women who were under stress and career-oriented. No real data was collected on the incidence of the disease within these women’s families. Researchers simply tended to associate it with women who fit this characteristic scenario, and did not probe any further. The first real study was done privately in 1970 by Dr. Brooks Ranney, a South Dakota gynecologist, who first noticed a distinct biological pattern among his patients with endometriosis—many were related to each other. Dr. Ranney sent questionnaires to these women. Based on their responses, he calculated that 22 percent reported relatives (both near and distant) who had undergone surgery for endometriosis.

How coincidental is endometriosis among female relatives, and were Ranney s figures high or low for the general population? A study at Baylor College of Medicine, in Texas, in which 123 women participated, attempted to provide more conclusive evidence. In this 1980 study, researchers attempted to trace lineage patterns of the disease by classifying female relatives into categories, then looking at their medical histories. “First-degree” relatives were defined as mothers, daughters, and sisters; “second-degree” relatives included maternal grandmothers, aunts, and nieces; and “third-degree” relatives were female first cousins.

The results were telling: overall, the Baylor team estimated that women whose first-degree relatives developed endometriosis are seven times more likely to develop the disease. Of that percentage, severe endometriosis involved 61.1 percent of family-related cases and 23.8 percent of nonfamilial cases. This meant, clearly; that a woman whose mother or sister had severe endometriosis was a high-risk candidate for the disease and should be tested for carry detection and treatment.

In 1986 another study, this one at the Medical College of Wisconsin, expanded on Baylor’s investigation. This team added some interesting points. Of women participating in the study who reported other family members with endometriosis, about 79 percent of the cases involved maternal lineage and 7 percent implicated the father’s side. Of the women studied, nearly 35 percent of mothers and 21 percent of sisters suffered from endometriosis, too. For second-degree relatives, numbers were significantly lower: for grandmothers the numbers were 0.4 percent, and for aunts the percentage tallied at 3.1 percent. (Such low numbers among an older generation do not necessarily mean lower incidence of the disease. This generation observed different conventions: they married younger and bore children at an earlier age. Fewer reported cases may have also had to do with fewer available diagnostic methods decades ago.)

What do these studies tell US about coincidence of the disease in families? A hereditary factor does, obviously, exist, but it is not an exclusive indicator of endometriosis. There is a stronger hereditary predisposition toward menstrual cramps than endometriosis and that endometriosis may evolve with them.

*29\43\4*

05.8.2009

SKIN INFECTIONS: TREATMENT OF HERPES SIMPLEX

The treatment of herpes is unsatisfactory. Usually it is simply a minor cosmetic disability and clears rapidly without interference. Otherwise a spirit lotion may encourage the blisters to dry, and is preferable to an ointment. An antispetic cream may reduce the possibility of secondary infection, but will not aid the virus’s normal resolution. Numerous other measures have been tried on both types of herpes infection with variable results. These include: frequent applications of ether, which tends to destroy the virus coating; frequent applications of idoxuridine in spirit or, if available, in D.M.S.O. (dimethyl sulphoxidel— this is very effective in eye infections; photo-inactivation of the virus using dyes, such as proflavine, or neutral red, and exposing it to a light source; either the application of or the intravenous administration of cytosine arabinoside— this is a most useful drug for internal herpetic infection, but as yet, has no place in the treatment of the skin; large doses of zinc and vitamin C. Finally, work is in progress attempting to harness Interferon, a specific anti-viral agent, and also to develop an anti-herpes vaccine.

*56\44\4*