Health News

BREAST CANCER TREATMENTToday, women with breast cancer (and people with nearly any other type of cancer) have many decisions to make in determining the best treatment options available for them. Fortunately, there are services available to help you get the best information, even if you live in a fairly remote area of the country. The important thing to remember is that in most instances, taking the time to thoroughly check out your physician’s track record and his or her philosophy on the best treatment is always a good idea. Is his or her treatment recommendation consistent with that of the major cancer centers in the country? Check out the doctor’s credentials and the past experiences of patients who have seen this doctor as well as the surgeon who will perform your biopsy and other surgical techniques. If possible, seek a facility that has a significant number of breast cancer patients, does many surgeries, is regarded as a “teaching facility” for new oncologists, treats large numbers of patients, has the “latest and greatest” in terms of technology, and is highly regarded by past patients. Often, cancer support groups can give you invaluable information and advice. Treatments range from the simple lumpectomy to radical mastectomy to various combinations of radiation or chemotherapy. Remember that it is always a good idea to seek more than one opinion before making a decision.*20/277/5*

DELIRIUM: TREATMENT-OPTIMIZING THE ENVIRONMENTIt has long been known that delirious patients do best in a quiet, stable environment. The typical hospital room is hardly such a place: it is usually located in a noisy ward and contains another patient, television sets, intercoms, and telephones. The room is entered by a changing variety of family, friends, physicians, nurses, social workers, physical therapists, phlebotomists, dietary aides, housekeepers, and other hospital personnel. At night there is less commotion but also less light, which increases the possibility of disorientation and visual illusions.     The environment of an intensive care unit can be especially disorganizing for a delirious patient. Although such units generally offer single rooms, the sensory bombardment is often greater than on an ordinary ward, where there are fewer electronic monitors and medical emergencies. From the patient’s point of view, there is sometimes little difference between day and night in these settings.     If at all feasible, a delirious patient should be in a single room, with the television switched off. A clock and a calendar should be placed in the patient’s field of view, as well as a placard stating the name and location of the hospital. The room should be fully illuminated during the day and partially so at night. This last suggestion attempts to balance the patient’s need for sleep with his risk of disorientation and perceptual abnormalities when sensory stimuli are ambiguous. That risk can be reduced if a member of the family or nursing staff is present at night to orient and reassure the patient.     The potential value of an attendant at the bedside of a delirious patient can hardly be overestimated, especially if the attendant is given a few pointers on dealing with an individual whose consciousness and cognition are impaired. First, when talking to the patient, it is important to use simple concepts and short sentences. Metaphorical expressions (e.g., “Keep your shirt on” or “Hold your horses”) are best avoided. Next, the attendant should make sure that she has been understood. Some delirious patients appear to comprehend what they have been told but cannot repeat the gist of it when asked to do so. Finally, when the patient must be touched, the attendant should give an explanation beforehand. An innocuous procedure, if misunderstood, can be experienced as an assault.     The patient’s environment is an important variable in the course of his delirium. If it helps him feel safe, he is less likely to become agitated and therefore less likely to need sedating medications and restraints, both of which can have side effects. A familiar companion and a quiet room help a delirious patient keep his grip on reality.*31\172\2*

DIAGNOSTIC EVALUATION OF CHRONIC HEPATITIS СAlanine Aminotransferase LevelsALT levels may be useful in monitoring HCV infection but are insensitive in predicting disease progression to cirrhosis. ALT levels may be normal or fluctuate in those with HCV infection, and a single normal value does not eliminate active infection, progressive liver disease, or cirrhosis. HCV-positive patients with normal transaminase values should undergo serial ALT measurements over 6 to 12 months to confirm the persistence of normal levels. Serial measurements of ALT levels may also be helpful in monitoring the effectiveness of HCV therapy in the intervals between molecular testing, and the resolution of elevated ALT values appears to be an important indicator of disease response.
Liver BiopsySince ALT abnormalities do not accurately predict the degree of hepatic inflammation and fibrosis, histologic evaluation of a liver biopsy specimen remains the gold standard for reliably estimating the prognosis and likelihood of disease progression in patients with HCV.  Biopsy specimens are graded on a scale of 0 to 4, representing the degree of hepatic inflammation and necrosis, and staged on a similar scale, signifying the degree of fibrosis. Histologic grade and stage correlate with the risk of subsequent progression to cirrhosis. Concurrent disease processes (steatohepatitis, iron overload) that can contribute to hepatic injury may also be identified. In addition, liver biopsy aids in the selection of HCV-positive patients for treatment and helps to correctly time various therapeutic interventions. However, it is not always considered mandatory prior to the initiation of therapy, and patients infected with genotypes 2 or 3, in particular, may not need liver biopsy to make a decision to treat.
GenotypeWorldwide, six genetically distinct groups of HCV isolates, called genotypes, and multiple subtypes have been identified. The known genotypes have been numbered from 1 through 6, and the subtypes have been labeled a, b, and c, in order of discovery. In the United States and Western Europe, genotypes 1a and 1b are the most common, followed by genotypes 2 and 3. The other genotypes are rarely found in these countries but may be identified in other areas, such as Egypt in the case of genotype 4, South Africa in the case of genotype 5, and Southeast Asia in the case of genotype 6. The genotype is the strongest predictor of response to current therapy and is useful in determining the duration of HCV treatment.
Hepatocellular Carcinoma ScreeningMany clinicians screen patients with HCV-induced cirrhosis for hepatocellular carcinoma with serum alfa-fetoprotein and abdominal ultrasonography every 6 months, but data on the clinical utility of this practice are lacking.
HIV ScreeningMany risk factors for HCV infection are shared by HIV infection. Patients with HCV who are at risk for HIV infection should be offered testing with appropriate pretest and post-test counseling.
Hepatitis В Screening. Since co-infection with hepatitis В virus accelerates the progression to cirrhosis and increases the risk of hepatocelliular carcinoma, patients with HCV should also be tested for antibodies to hepatitis В virus.*83/348/5*

BDD BEHAVIOURS – DISTRACTION TECHNIQUESAnother BDD behavior is accentuating or improving certain aspects of one’s appearance as a distraction. The thinking goes like this: by making an acceptable or attractive body part look even better, other people’s attention will be directed to the attractive body part, rather than the “defective” one. About 17% of people with people with BDD use distraction techniques. Distracting with makeup is most common (in 10%) followed by clothes (9%), hairstyle (5%), and jewelry (4%).You may recall that Jennifer used lots of makeup to accentuate what she considered her more attractive features and distract people from her skin. Another woman, who thought her breasts looked fine, was nonetheless considering breast augmentation to distract people from her “ugly” nose.A man I saw excessively combed his hair, which he considered one of his primary assets, to make it even more attractive and thereby distract people from his “sunken” eyes. “People will be looking at my hair instead of my eyes,” he said. “I get a lot of compliments on my hair. It helps me feel less self-conscious about my eyes.”*112\204\8*

DISORDERS THAT ARE NOT DUE TO ALLERGIC CAUSES: IMMUNOLOGIC NASAL DISEASE, HORMONAL AND INFECTIOUS RHINITISHormonal/Endocrine RhinitisRhinitis can result from an imbalance in either thyroid hormones or male/female sexual hormones.Hypothyroidism: Some patients with an under-functioning thyroid gland experience nasal symptoms. Their predominant symptom is nasal congestion.Sex Hormones: Many women experience annoying nasal symptoms, particularly nasal congestion, when various sex hormone levels are increased, such as during pregnancy, ovulation, or while taking birth control pills. Both men and women may experience nasal congestion and runny nose during sexual excitation.
Immunologic Nasal DiseaseNormally, our immune system helps protect our nose against infection. As such, nasal symptoms can occur as a complication of the improper functioning of one’s immune system. Symptoms can include any of those associated with abnormal nose function: congestion, runny nose, sneezing, drainage, bleeding, loss of sense of smell, and foul odors.
Infectious RhinitisWe have all had this type of rhinitis: the common cold. It is caused by infection from one of hundreds of viruses. Viruses, like bacteria, are microscopic organisms. However, they are much smaller than bacteria, and unlike most bacteria, they are incapable of growth and reproduction outside of living cells. Hence, they live in our cells as parasites. Viral infections account for 90 percent of all cases of infectious rhinitis.The common cold usually begins with a sore throat, then quickly progresses to include runny nose, increased postnasal drainage, nasal congestion, sniffling, and sneezing. It generally lasts 7 to 14 days and is commonly associated with a sensation of fatigue, a low-grade fever, enlarged lymph nodes in the neck, some general achiness, and reduced appetite.Unappreciated is the fact that it is normal for children to have up to five colds each year. Almost equally unappreciated is the fact that many children in day-care environments will have many more colds per year than this, simply because of their increased exposure.Bacterial infections can cause infectious rhinitis, but they do so in only about 10 percent of all cases. Bacteria are microscopic organisms, larger than viruses, and generally capable of maintaining their life outside of living cells. They are common causes of ear infections, sinus infections, and pneumonia.*29/322/5*

RHEUMATOID ARTHRITIS: COPING WITH PAIN For the person who has rheumatoid arthritis (RA), pain and fatigue may be overwhelming at times, so much so that they leave the person feeling anxious and depressed as well as in pain and tired. But both pain and fatigue come and go, and their severity changes as well. (In fact, pain and fatigue are often most limiting during the early stages of RA.)There’s no question that pain and fatigue are complicated symptoms that are frequently difficult to explain and understand. Like other aspects of RA, however, pain and fatigue are most effectively controlled when they are understood. For this reason, the person who makes the effort and takes the time to learn the causes, significance, and aggravating factors of his or her pain and fatigue is much more likely to be able to manage these symptoms.
PainThe pain of RA may be the most burdensome feature of your illness, especially when pain interferes with your ability to function as you once did. Because RA is a chronic condition, you may wonder whether you’ll always suffer this much pain. The answer is No!A very simple explanation of pain is that it begins as a message from stimulated nerve endings (or pain receptors); this message is transmitted from the nerves to the spinal cord to the brain, where the message is interpreted as pain. Irritation, inflammation, or injury can activate the pain receptors. Even when the message is painful, we have to be thankful for it because it can prevent a more severe injury. For example, when you accidentally touch a hot stove, stimulated pain receptors in your fingertips send a message to your brain that a dangerous situation exists – tissue is being damaged. After your brain interprets the signal, it quickly sends a message back to the hand: “That hurts. . . . Pull away!” Pain can protect us!The circuitry from the painful stimulus to the brain and back is incredibly intricate. In 1965 Ronald Melzack and Patrick Wall proposed the gate theory of pain, which helps us understand just how complex pain perception is. They suggested that there is a “gate” located in the spinal cord which can be opened or closed under various situations. According to these researchers, when the gate is open, pain messages can pass through to the brain (although only a limited amount of sensory information can pass through the gate at one time). Interestingly enough, the body can send messages that compete with each other; one message can send a pain signal, and another can effectively close the gate to prevent that signal from being received.If you have ever stubbed your toe or banged your elbow you have experienced this phenomenon. Once you begin rubbing the affected area (as most of us will do under the circumstances!) you send a message that competes with the pain message. This instinctive reaction to pain actually works because the sensation of rubbing is transmitted to the spinal cord through nerve fibers which are larger than the fibers through which pain travels to the spinal cord. The message of rubbing is dispatched rapidly to the spinal cord, whereas the message of pain travels slowly, through small nerve fibers. Reaching the spinal cord before the pain message, the comforting, rubbing message blocks out the slower, sharp pain signal and prevents it from reaching the brain. Without knowing it, you have closed the pain gate by your instinctive reaction.The brain also appears to have its own mechanisms for decreasing acute pain; that is, in times of need, the brain apparently has the capacity to send signals to close the gate. This capacity to close the gate is extremely powerful. *39/209/5*

LOWERING YOUR BLOOD PRESSURE FOR A LONGER LIFE: QUESTIONS AND ANSWERS
Why do you call low blood pressure the key to longer life?Because insurance company statistics clearly indicate that it is. Their figures show that people with lower blood pressures generally live longer than those whose blood pressures are higher.
I have heard that people who have high blood pressure tend to die earlier than others. Are you saying that even among people whose blood pressure is considered normal, the ones with the lower reading enjoy longer life expectancies?That is exactly what I am saying. Take the case of a 35-year-old man whose blood pressure measures 130/90. He is considered to have quite normal blood pressure. However, he will, on the average, die four years sooner than a similarly aged male whose blood pressure is 120/80. If his blood pressure or BP, as we shall call it, rises to 140/95, it will still fall within the normal range by some standards. Yet he now can expect to die nine years earlier than his 120/80 counterpart.
You mean that if my blood pressure is lower than yours, I can be sure of living longer than you?Not quite. Statistics don’t work that way. They deal with groups, not individuals, and with probabilities rather than certainties. In any particular case, it may and often does happen that an individual lives longer than another individual whose BP is lower. However, the chances are that the reverse will occur. When it comes to longevity and, for that matter, health in general, the odds almost consistently favour those with lower blood pressure.
You seem to have used 120/80 as something of an ideal. But what about someone with a BP of 110/70? Does he or she have an advantage over someone with a reading of 120/80?Yes. According to Dr. Edward D. Freis, a hypertension, or high blood pressure, specialist at the Veterans Administration Hospital in Washington, D.C., a reading of 120/80 is good but a reading of 110/70 is still better.
But can’t a person’s blood pressure get too low?It can, but this happens only rarely. And it has to go down pretty far before it starts to become a problem. I know a woman physician whose blood pressure measures 90/48. Yet she feels, and claims to be, just fine. Of course, this might not make a desirable reading for everyone but it does indicate that BP can sink pretty low before we need to get concerned. It is blood pressure
Just how many people suffer from blood pressure that is too high?It depends on what we call high. For example, if we take 110/70 as the desirable figure, then a large majority of all the adults in this country have high blood pressure. Certainly, nearly all these people would, for the most part, benefit from reducing their blood pressure. If we take 120/80 as the cut-off figure – and Dr. Fries describes any reading greater than this as “not good” – then we would still include almost half of all adults. However, high blood pressure (HBP) or hypertension as it is called, is usually ascribed to higher levels. The National Health Survey of 1962 defined hypertension as anything over 160/95. It found that the BP of almost one out of five adult Americans exceeded at least one of these two figures. This finding prompted the survey to call hypertension the most common ailment in America today.
*8/151/5*

GYNECOLOGICAL CANCERS AND THEIR TREATMENTThe human body is made up of millions of cells. Most of these have a specific function and all cells are constantly dying and being renewed. The life cycle of the cell is dependent upon its genetic programming. The time it takes before it dies, or alternatively divides, depends on the genes present within the cell’s chromosomes.Genes have a variety of functions, but two major actions are to either switch the cell on to grow and divide or alternatively the opposite effect to stop it growing and dividing.Cancer occurs because of a lack of balance between these two sets of genes. If the genes are abnormal (‘mutated’) then cells will divide more rapidly. If the genes responsible for switching off cell growth are in some way altered, then the switching off process does not happen and the cell will continue to divide and cancer eventually develops. What is currently unknown in the vast majority of cancers is why and how these genes undergo the changes responsible for causing the cell to lose its programming and to have such rapid growth.As the cell grows and divides more frequently than it is supposed to, it produces an abnormal lump or ‘mass’. The cell will in some way signal the tissues in which it finds itself with a message that it wants to grow into these tissues and eventually spread.
Cancer is a very clever animal. When it breeds it builds bridges over veins and eats you up. I have the simplistic idea that I can talk to the germs, bacteria or whatever they are, it’s very primitive really, and I think they are like ‘beings’ inside me.AngeliqueFor cells to spread elsewhere in the body they have to invade surrounding tissue and to get into either lymph channels or blood vessels. They often do this by forming new blood vessels (‘angiogenesis’) that are different to the normal blood vessels since they have a very thin wall that is more swollen. The blood flow through these vessels is altered and can be detected as being different by ultrasound.Cancer therapies have traditionally been aimed at stopping cells dividing, but new approaches include trying to stop the development of new blood vessels (‘anti-angiogenesis’) and also interfering with the signals between the growing cells and the surrounding tissues.*8/144/5*

THE PROCESS PARADIGM IN PSYCHIATRY: COUPLED EFFECTSWhat we observe and experience is differentiated according to the channels we observe in. Hence, you can feel something in your body such as temperature or pressure proprioceptively. You can hear voices auditoralry. You can  move kinesthetically. You experience people through the channel of relationship. You contact the world through synchronicity. You remember most dreams through the medium of visualization.The activities and signals of one channel are coupled, or connected together. Hence, you may have a stomach ache, feel your stomach to be like a rock, go to sleep and dream of a rock on the ground. The proprioceptive experience of the weight in the stomach was coupled to the dream rock. And vice versa. You can dream of a volcano and have a ‘splitting’ headache the next day.However, you cannot assume that if you give someone aspirin the stomach ache will go away. It frequently gets better, but because of the coupled effect, that is, because of the dreambody or the psychosomatic situation, the dream of the stone is still present and will appear again in the stomach, or in another organ. You can temporarily relieve a symptom but cannot get rid of the gestalt or archetype behind it. If the individual needs to be heavier or more like a stone, then this experience is going to try to reach consciousness in every way possible.*20\227\8*