Mens Health Blog. Medical Blog

Interferons are natural glycoproteins that are produced by cells in response to viral infections, and they possess intrinsic antiviral activity. Initially, interferon-alfa was the only therapy available for the treatment of chronic HCV, and the drug needed to be given by intradermal injection three times per week. Administration of interferon-alfa resulted in a sustained virologic response (defined as complete HCV suppression 24 weeks after cessation of therapy) in only 15% to 20% of patients after 48 weeks of treatment. Subsequently, two large randomized trials demonstrated that the combination of interferon-alfa and the nucleoside analogue ribavirin was more effective than interferon alone, resulting in a sustained virologic response in 38% to 43% of patients after 48 weeks of therapy. Histologic improvement was noted in patients treated with combination therapy. Both studies also showed that patients with genotypes 2 or 3 had a higher sustained virologic response (64-69%) and required only 24 weeks to achieve this outcome, whereas those with genotype 1 had a much lower rate of sustained virologic response (28-31%) and required a full 48 weeks of therapy.The attachment of polyethylene glycol (PEG) to interferon results in a compound that has a much longer half-life than unmodified interferon, requiring only one intradermal injection per week. Two types of pegylated interferons (peginterferon alfa-2a and 2b), which differ in their pharmacokinetic and chemical properties, have been developed. Subsequently, randomized trials showed that once-weekly treatment with peginterferon alfa-2a had a higher rate of sustained virologic response (44-69%) than conventional interferon alfa-2a given three times per week (14-28%) after 48 weeks of therapy. In addition, peginterferon alfa-2b plus ribavirin was shown to produce a higher rate of sustained virologic response (54%) compared with interferon alfa-2b plus ribavirin (47%) after 48 weeks of therapy. Recently, peginterferon alfa-2a plus ribavirin was found to produce significant improvements in the rates of sustained virologic response (56%) compared with interferon alfa-2b plus ribavirin (44%) or peginterferon alfa-2a alone (29%) after 48 weeks of therapy.*85/348/5*

Comments (0) Apr 15 2011

Travel provides an opportunity to review and update routine vaccinations in adults. Routine childhood vaccinations should be reviewed for all persons, and boosters should be administered as necessary.

Tetanus and Diphtheria
Outbreaks of diphtheria have occurred throughout Eastern Europe and the former Soviet Union during the past decade, and tetanus remains endemic throughout the world. Previously immunized adults and children older than 7 years of age should receive a tetanus-diphtheria (Td, Aventis Pasteur) toxoid booster every 10 years. Travelers to remote areas, where post-exposure tetanus immunization might be unavailable, should consider receiving a booster dose prior to departure if 5 or more years have elapsed since their last vaccination.

Measles, Mumps, and Rubella
The measles-mumps-rubella vaccine (MMR, Merck) is a combined vaccine that is usually administered at 12 to 15 months of age. Since up to 5% of vaccine recipients fail to respond to primary immunization, a second dose of MMR vaccine is given at the time of school entry. Measles, in particular, is endemic in many developing nations, so immunity to the disease should be confirmed if a traveler’s itinerary includes one or more of these countries. Rubella is primarily a concern for women of childbearing age without documented immunity. People can be considered immune to measles, mumps, or rubella if they were born before 1957 (exposure is assumed), have a documented history of these diseases, received two doses each of monovalent measles, mumps, and rubella vaccines or two doses of MMR vaccine, or have serum antibody titers against these diseases. A booster of MMR vaccine is warranted for any person born after 1956 who does not have immunity. The vaccine rarely causes transient arthralgias, especially in non-immune women of childbearing age. Vaccination with this live attenuated viral vaccine is (Ontraindicated in women who are pregnant or anticipate pregnancy within 2 to 3 months.

Polio
Cases of poliomyelitis are still identified within developing countries of Africa, Asia, and Eastern Europe. Wild-type poliomyelitis has been eliminated from the Western Hemisphere. However, there was a recent outbreak in the Dominican Republic and Haiti in 2000. Travelers to Haiti, the Dominican Republic, Africa, Asia, and eastern Europe are advised to receive a single booster of inactivated polio vaccine (IPOL, Aventis Pasteur) if the primary series have already been administered. For those with an incomplete primary immunization series, three doses of inactivated polio vaccine should be given prior to departure.
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Comments (0) Mar 30 2011

The last two weeks of the menstrual cycle see rapid changes in the levels of progesterone and oestrogen. Each of these sex hormones has potent effects on the mind and bodies of women. As the levels fluctuate and finally fall before the periods commence their combined effects can lead to a complicated picture of female misery and despair.
Many women become bloated and overweight. They suffer from headaches, acne, greasy hair, elation or even the reverse in the form of depression. Lack of libido and shortness of temper can lead to a deterioration of family relationships; which sometimes ends in divorce.
Accepting that such problems really do exist is easier by far than to acknowledge that medical science has anything to offer in the form of a cure. So many remedies flourish in the management of premenstrual tension testifies mightily to the fact that none of these remedies are very effective.
Without embarking upon a mind and body altering search for the ideal form of oral contraceptive pill, many ways exist to tackle the recurring symptoms of premenstrual tension. A range of nutritional products and advice may be helpful. Foremost amongst them are Vitamin В 6, Vitamins A, D, E and Vitamin C. Many nutrients are often combined and sold over the counter as patent premenstrual tension remedies. In most cases it can do no harm to try them. Take the fat soluble vitamins with care. Vitamins А, К, Е and D can all cause death in overdose. The over consumption of refined carbohydrates and fat is now thought to contribute to the severity of premenstrual tension. Foods rich in linoleic acid such as sunflower seeds may be beneficial. In view of the fluid retention during premenstrual tension, a low salt intake is also advised.

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Comments (0) Mar 23 2011

The interest in exercise is now much greater than many years ago, as it makes one feel better physically, mentally, gives one a feeling of accomplishment, discipline, helps with weight control and generally a lower rate of cardiovascular disease, and those that are inactive, have a higher rate. Exercise has a direct effect not only on ones weight but also on hypertension, blood levels of total cholesterol, HDL cholesterol and triglycerides.
There are mainly two types of exercises. Aerobic takes oxygen from the atmosphere to contract the muscles, e.g., brisk walking, running, swimming, cycling, etc.
Anaerobic takes energy from the stored energy sources-short-term exercises like sprinting, weight lifting, pushups, sit ups. These exercises end too quickly to benefit the cardiovascular system and therefore aerobic exercises are recommended.

Beneficial Effects of Exercises
1. Helps in weight reduction.
2. Gives more stamina for physical work.
3. One can perform work over a long period of time.
4. Heart rate and breathing rate comes down.
5. Coronary risk profile improves.
6. Reduction in blood lipid levels, blood sugar, blood pressure and body weight.
7. One feels and looks better, producing a positive change in attitude.
Exercises can make a big difference in one’s weight.
For example, if one exercises for 30 minutes four times a week, one will burn 1200 extra calories/week, about 4800 calories/month, i.e., 62,400 calories/year. If one continues to eat the same number of calories as before, one will lose approximately 18 lb in a year.
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Comments (0) Mar 16 2011

Guidance and counseling, commonly used as synonymous terms, have somewhat different connotations to us. Guidance is something one person provides to another. It implies, to us at least, something actively given and passively received. Counseling, on the other hand, implies something done together and requires active participation by both parties. We believe this distinction is important.
Physicians often speak of patients as compliant or non-compliant, meaning they have or haven’t followed their instructions. Implied in the word compliant is a sense of submissiveness. We often assume that a person with seizures should do exactly what we tell them to. We forget that it is the patient who experiences the seizures, who is encumbered by the stigma of epilepsy, and who may experience side effects from medication we prescribe. We forget that the disorder is the patient’s and, therefore, that the patient must ultimately exercise his own control. However, in a more positive sense, compliance is not submissiveness but reflects a partnership in which the patient agrees with a therapy we recommend and will follow it.
If the patient or, in the case of young children, the family is to exercise the control, then they must be educated to become active partners in the decision-making processes. They must be informed about their condition or their child’s condition and about the likely future. The patient— or the parents of a young child—must assume the responsibility for that future. They must determine their own goals and aspirations. Some use terms like “owning your own disease” or “empowering the consumer.”
We prefer to talk in terms of a partnership and counseling. Then the physician and his team are in the more appropriate position of teachers, counselors, and supporters on this road to seizure control and to medical as well as psycho-social well-being.
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Comments (0) Feb 23 2011

Immunizations should be recommended according to the risk of travel-related diseases and not solely on geographic destination. However, determining vaccine recommendations based on health risk factors can be a major challenge for the health care practitioner. To properly assess a traveler’s risk of illness, the health care provider must first consider the details of the planned journey. Questions must be asked about the following:
-    Exact itinerary, including all geographic destinations and possible stopovers
-    Duration of stay in each location
-    Style of travel (for example, business versus backpacking)
-    Type of lodging (urban versus rural; hotel versus tent)
-    Planned activities (possible animal contact, fresh water exposure, eating habits, and sexual activity)
-    Purpose of the visit
-    Time of year of the trip (seasonal risks)
-    Level of anticipated contact with local residents (missionary, health care worker, Peace Corps volunteer)
Providers should then review the status of the traveler’s general health, paying close attention to underlying diseases (particularly diabetes mellitus, transplantation, human immunodeficiency virus, chronic lung disease, renal insufficiency) that can have substantial implications for
health during the trip and affect the immunogenicity of vaccines. In some health conditions, such as pregnancy or a compromised immune system, live vaccines are relatively contraindicated. This may influence a traveler’s plans. Live viral vaccines include measles, mumps, rubella, yellow fever, oral polio, and varicella. The main live bacterial vaccine is the oral typhoid formulation. Past medical history, previous immunizations, allergies to medications and vaccine components (for example, eggs), and current medications should also be reviewed. Special
effort should be made to identify travelers who are at particularly high risk for travel-related illness, since such travelers are more likely to acquire serious illnesses.
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Comments (0) Feb 16 2011

As many physical disorders are related to stress, it is necessary to work on this angle in order to induce general healing. As one develops a freedom from tension, it is easier for us to be more aware of our lifestyle and the frustrations and causes which have led to our symptoms. We all have a part in our bodies which holds a weak point, and for many of us the digestive tract is the part that suffers. At the first sign of stress, our diaphragm tightens, immediately restricting our normal breathing pattern, causing us to feel tense and anxious. This in turn releases the mechanisms which come into play as our ‘fight or flight’ response. During this process, large amounts of adrenaline are released into our circulatory system. Adrenaline is a chemical which is released into our bloodstream at times of stress, in order to increase energy levels into our muscles to give us the strength to run away from a fearful situation, or to stay and attack. If we do not do either, our muscles tend to stay in this state of tension as the process is repeated, and this in turn evokes other responses. The nerves in our digestive tract become exposed to our anxieties and behave in a disorderly manner. This causes pain, loss of appetite and digestive upsets, which in turn lead to more anxiety. The food we eat may not be fully absorbed, we feel bloated and uncomfortable, and again the tension increases.
The vicious cycle, once established, is difficult to break, unless we do something to help our bodies to relax, and recognize what we can do to help ourselves. As a natural health care practitioner, I instruct my patients how to achieve full body relaxation, which allows each individual to learn to control this build up of tension. Relaxation therapy, combined with aromatherapy treatments, and a back up of self-help at home, is a useful aid in helping the body to respond to the demands of stress.
A qualified aromatherapist will begin a consultation by taking a case history from the patient they are treating. The person’s lifestyle and full medical history are taken into account in order to select the correct oils suitable for an individual treatment. The most important factor to be considered, as there are many oils to choose from in
most cases, is that the person being treated appreciates and enjoys the fragrance being used. Essential oils are volatile substances, and during the evaporation process are absorbed by our sense of smell to reach various parts of the brain. This triggers off a chemical reaction in glands and organs throughout the body. Fragrances can evoke memories and produce emotional waves that nurture and calm our basic instincts.
Although treatment by a qualified therapist is obviously most beneficial, there is no reason why we cannot treat ourselves, or find a partner to help. Providing the technique used is simple and relaxing, intuitive massage by another caring person can help considerably.
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Comments (0) Feb 10 2011

Get an engaged notice to hang on the outside of bathroom and lavatory doors instead of locking them.
Baths are a potential hazard for anyone who has seizures. Showers are safer. When baths are taken, always run in cold water first, then add hot, so that the water never reaches a dangerously hot temperature. Bathwater should be kept shallow: about six inches is safest.
A regular routine with regular meals and plenty of sleep is important for any child, but especially so for the child who has epilepsy.
Do not leave your child alone after a seizure. They may be confused and need comfort and reassurance. If the seizure seems worse or different from usual, contact your doctor immediately.
Make sure the child always carries something (a Medic-Alert bracelet, for example) with their name and address and the information that they have epilepsy.
FEBRILE CONVULSIONS
Children’s brains are more excitable, and therefore more seizure-prone than adults. Between three and six per cent of children sometimes have convulsions when running a high temperature. These febrile convulsions tend to run in families. They usually last only a few seconds or, at the most, a minute or two, and take the form of a grand mal seizure. Febrile convulsions are nearly always harmless for the child, though frightening to watch. Most children grow out of them by the time they are two or three years old.
However, children run a greater risk than adults of developing status epilepticus (prolonged or repeated convulsions) during a fit. This is dangerous, and may cause permanent brain damage and even, occasionally, be fatal. About five per cent of children who have febrile convulsions go on to develop epilepsy later in life. This is probably because during severe febrile convulsions the brain has been damaged through a partial deprivation of oxygen. The damaged area is usually the temporal lobe, which is the part of the brain most vulnerable to lack of oxygen. There is some recent evidence to suggest that a few children are born with an abnormality in this part of the brain which causes them to have severe febrile convulsions. But whatever the cause, the result is that after a severe febrile convulsion these children are left with an area of damage in the temporal lobe which later acts as a focus for seizures.
It is therefore important that febrile convulsions should be treated quickly; always call your doctor or an ambulance if your child develops a convulsion during a fever. Once your child has had one febrile convulsion, your GP will want to take steps to ensure they do not have another. Some years ago most doctors believed that children who have a tendency to febrile convulsions should be given regular anticonvulsant medication, usually Epilim (sodium valproate), to prevent fits until they have outgrown the tendency. The view now is more flexible, and practice varies quite widely. It is most likely that your doctor will not give regular medication after a first febrile convulsion unless it was very prolonged and led to the child being kept in hospital for a day or two. Some doctors will not even give medication after a second or third febrile convulsion, but wait for a trend to be established before giving regular anticonvulsants.
When your doctor makes the decision, one of the most important guiding factors will be whether there is a strong family history of febrile convulsions which have not led to the development of epilepsy. A strong family history is usually seen as a sign of a child being likely to outgrow the convulsions without permanent damage, and so the need for medication is less.
In addition, your doctor will probably suggest that if your child has had a fit in the past, you should give them paracetamol whenever they start to run a temperature, and sponge them with tepid water to help bring the temperature down. The fact that your child has a tendency to have febrile convulsions and may even have to take an anticonvulsant drug does not mean that they have epilepsy; the treatment is just to prevent further convulsions which might eventually cause epilepsy.
A few children may have a short-lived paralysis down one side of the body after a severe febrile convulsion. If this happens, it is worthwhile noting and remembering which side of the body is affected. Some of these children may later go on to develop temporal lobe epilepsy; if they do, and if it is thought they might benefit from surgery, it can be very helpful to the doctor to know which side was paralysed at the time of that early seizure. The side of the paralysis is a very good indication of the side of the brain in which the seizure focus is likely to lie.
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Comments (0) Jan 26 2011

I know that you suffer from feeling unwanted. You are the identified patient of a troubled world family. We contribute to making you believe that you are a useless failure and I, know that you secretly feel that life is not for you. You are partially correct when in your altered states you perceive that this world is in trouble and that you are in order. Your life could show us the dreaming element in the world yet we dwell upon categorizing you. While we maintain the threads of history, you thieves, bag ladies, gods and holy people spin the eternal present.
Your living demon frightens us and we try in vain to turn away. For when we see your unthinkable visage we remember that part of ourselves which is connected to the wonder of life. Why don’t you realize that we are both inflexible; both think the other is crazy, both feel unrelated to and incapable of relating. Both feel despised. Both of us are asleep. Who will wake up first?
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Comments (0) Jan 19 2011

“What is the worst that can happen if my child continues taking the medication?”
If your child has been free of seizures for two years and is tolerating his medication well, then probably not much will happen if he continues to take medication. However, if he continues to take medicines for a long time, chronic effects occur that vary with the medicine. In addition, if your child is a girl, eventually she may want to have children. While the risks of any medication on the fetus are small, they are many times greater than no medication at all. If a woman doesn’t need medication to control seizures, the baby will be better off not being exposed to these drugs. Also, you’ll never know how much better your child will function without medication unless your physician discontinues it.
“What is the worst that can happen if we decide to discontinue my child’s medicine?”
Medication should never be stopped suddenly since this could cause status epilepticus. It should only be stopped under your physician’s direction. When the medication is decreased slowly, the worst thing that can happen is that your child will have another seizure. The consequences of another seizure vary with the individual’s age and circumstances. You and your child will have to determine how much weight to give this matter. When people stop taking medication under their doctor’s direction, they tend to worry about having another seizure. In our experience, this concern diminishes over time and is usually negligible after about a year.
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Comments (0) Jan 11 2011