Information on popular complementary and alternative medical topics

HIV: MEDICAL TREATMENTS-TRADITIONAL MEDICINE: SIDE EFFECTS OF THE DRUGS

admin — Fri, 22 Jul 2011 11:19:44 +0000

Many of these drugs have side effects, referred to by physicians as adverse drug reactions, ADRs for short. The ADRs of most drugs are well known and well defined, based on the experience of thousands of people who took the drug during its clinical trials, and on the experience of everyone who took the drug once it was on the market. Although anyone can develop ADRs, for some reason ADRs are more common in people with HIV infection. For instance, trimethoprim-sulfamethoxazole (Bactrim or Septra) causes ADRs in 10 percent of the people without HIV infection and 50 percent of those with HIV infection. ADRs are classified as either allergic or toxic. Allergic reactions mean that the cells of the immune system have recognized the drug as foreign and have responded by causing a rash, a fever, or both—like the rashes that penicillin causes in some people. In allergic reactions, the dose of the drug is unimportant: the immune system will respond similarly regardless of the dose. Serious allergic reactions often imply that neither that drug nor any related drugs should be taken again. Toxic reactions are caused, not by the immune system, but directly by the drug itself. An example is the drowsiness caused by Dramamine or other antihistamines or the kidney damage and anemia caused by amphotericin B. Toxic reactions are usually dose-related; lowering the dose will relieve the symptoms. People usually develop ADRs after they have been taking the drug for one or two weeks. Some people, however, will have a serious ADR after one dose; others will have no ADRs until after they have taken the drug for months or years; some develop ADRs after repeated courses of the same drug. Therefore, ADRs are unpredictable: because a drug was taken once and tolerated does not mean that it can be taken later and cause no ADR. Sorting out and controlling ADRs will be done by a physician. The physician will either give the person with a suspected ADR what is called a drug holiday—discontinuation of all drugs—or will stop drugs one at a time, starting with those that are most likely to cause ADRs and those that are most dispensable.*180\191\2*

COPING WITH EPILEPSY: COUNSELING THE YOUNGER CHILD – THE DIALOG

admin — Mon, 11 Jul 2011 11:07:53 +0000

“Too often doctors and even counselors get caught up with the parents’ concerns about their child’s epilepsy and the child’s own concerns about his seizures. We forget the brothers and sisters. Epilepsy is a family problem. It touches everybody. It’s important to let brothers and sisters express their concerns. It’s important to help them to ask questions that they can’t articulate easily. In our experience virtually every brother or sister has fears, misunderstandings, and resentments. It’s imperative that they talk about them and be part of the family’s acceptance of epilepsy.”When it was time to discontinue medication, Jeb was the one who was allowed to make the final decision. It was discussed with him and his mom. He went home to think about it and discuss it with the family. Even at seven, he understood that there was a risk of having more seizures and that he might have to restart medicine. I strongly believe that it is important to be honest with people, especially with children.”When he was scheduled to come back and tell us his decision, I was out of town, so Jeb changed his appointment because he wanted me to be there, too. He said that I was a part of all of this, and he wanted me to hear his decision.”I guess the important thing I want people to understand about counseling is that it is not a routine thing. It has to be individualized for each child, for each adult, for each family, and for each problem. Education about epilepsy underlies much of it, but understanding kids and family dynamics is probably the largest part. There is also a large element of common sense.”*230\208\8*

BDD IN CHILDREN AND ADOLESCENTS: JOHNIE’S CASE HISTORY

admin — Wed, 06 Jul 2011 09:59:44 +0000

“Johnnie, your hair looks so nice today!” the receptionist exclaimed as he walked by. “Oh, Johnnie, your hair looks wonderful!” one of the secretaries echoed. When Johnnie entered the psychiatrist’s office, instead of sitting in a chair as asked, he crouched down and intently peered at himself in a thin strip of chrome on the chair. “What are you doing, Johnnie?” the doctor asked him. Johnnie didn’t answer. Instead, he tilted his head, examining his hair from different angles, patting it and smoothing it out. He also grinned at himself, examining and touching his teeth.Johnnie was excessively worried about his hair, which he thought “wasn’t right” or flat enough. He was also obsessed with his teeth, which he thought weren’t white or straight enough, and his “pot” belly. He frequently checked mirrors and excessively brushed his teeth. He often touched and groomed his hair, using special hair creams. If he couldn’t get his hair to look right, Johnnie cried, dunked his head in water, and started his grooming routine all over again. “I wish the whole world was bald,” he said, “including me, so I wouldn’t have to worry about my hair!”Over and over again, Johnnie asked his parents, “Is my hair okay?” “Am I fat?” His mother estimated that he spent at least three hours a day focused on his appearance and asking for reassurance. Johnnie was only five years old.*152\204\8*

HIV INFECTION AND ITS EFFECTS ON THE EMOTIONS: FEAR AND REALISM

admin — Tue, 21 Jun 2011 08:27:44 +0000

Alan Madison: I’m scared as hell at different periods. I have little sores on my skin, and my leg tingles. I’m going to be crazy until I see the doctor. I wake up at night and cry a little. People fear what they do not understand and cannot control. Like Alan, they worry about symptoms that may or may not be serious. They fear being a patient in a hospital, or undergoing painful medical tests and procedures. They fear dependency: “My husband had a tremendous fear of being bedridden and me caring for him,” said Lisa. They fear rejection: Alan was afraid that people would treat him as though he had leprosy; Helen said she was fearful of telling her sons. People with HIV infection are afraid they will give someone else the virus. Caregivers fear contagion. People with HIV fear what the infection might do to them: they fear becoming blind, or losing their cognitive abilities. They fear dying. They say they fear not death, but the way death comes. “I could handle dying,” said Alan, “if I knew how I might die. My biggest fear is what the end will be like.” When June goes with her son to the hospital, she feels fear: “It is hard for me to see his friends who are also in the hospital. I think, what’s the last time going to be like for him? It’s so frightening. You can drive yourself crazy thinking these things. And you’re also crazy if you don’t think these things. You are faced with that ultimate fear all the time.” People fear the future. All these fears are realistic responses to a situation that in fact includes the possibility of sickness, pain, dependency, rejection, and death. Sometimes, however, people feel not fear, but anxiety. That is, they have feelings of fear that are unrealistic. People who are anxious say they feel as if something terrible were about to happen. They cannot say what exactly they fear, only that they have a sense of underlying uneasiness. They feel restless and uncomfortable wherever they are. They are irritable, tense, and preoccupied with their bodies. They have trouble breathing, are nauseated, break out into cold sweats, have racing pulses. Some have periods of feeling panicky. People whose feelings of anxiety persist too long or are too severe should see a mental health professional or a doctor who might in turn recommend a visit to a psychiatrist. Persistent anxiety takes a tremendous amount of energy, and it is often curable. Psychiatrists can prescribe medication to relieve anxiety. Mental health professionals can teach techniques that help you relax. Physical relaxation usually makes people feel calmer and more themselves again.
*74\191\2*

LIVING WITH SPINAL CORD INJURY

admin — Fri, 17 Jun 2011 08:15:20 +0000

For some people, adjustment to spinal cord injury is relatively smooth and easy. Others can resume a stable and productive life only after a period of emotional upheaval and economic or social struggle. The difficulties presented by a spinal cord injury often stimulate a period of soul-searching and spark a person’s capacity for creative problem-solving. These processes can lead to a renewed sense of personal strength, transcendence of loss, and development of a more meaningful “way of being in the world.”Our experience in working with people with spinal cord injury tells us that recovery and successful living after injury go more smoothly when people know what to expect during physical and emotional recovery. Being able to recognize and cope with medical and emotional difficulties, and having an idea of how to deal with changes in social relationships, really does help. In our current health care climate, priority is given to providing basic medical care and physical rehabilitation. Sometimes, not enough time and attention are given to helping people learn psychological, sexual, social, and vocational coping skills. A person may leave the hospital with the physical equipment for a changed way of life but unprepared for the emotional and social upheavals that lie ahead.Learning to live successfully with a spinal cord injury and its associated disability is a long and challenging process. Unlike most acute medical crises, such as a broken leg or appendicitis, spinal cord injury cannot be “fixed” and its consequences do not go away once the immediate medical crisis is over. In almost all cases, even with the best medical or surgical intervention, a spinal cord injury results in some enduring physical disability that affects one’s life in many ways. The process of adapting to a spinal cord injury continues throughout life.Spinal cord injury has a tremendous impact on physical, psychological, social, and economic aspects of life. After the injury, most people spend a significant period of time in the hospital, undergoing emergency treatment, acute medical care, and rehabilitation.To a great extent, self-image and identity are intertwined with the experiences of the body. Spinal cord injury interferes with these experiences by disrupting normal movement, sensation, and sexual function, and sometimes by causing pain. Spinal cord injury can make your favorite activities impossible, limit your choices, and increase your physical dependence on others.The disruptions and limitations caused by spinal cord injury can affect the sense of self, personal relationships, and social roles.The road to recovery has many pitfalls. Losses and changes brought about by the injury can produce lowered self-esteem, depression, family conflicts, and social isolation. Passivity, self-pity, self-neglect, and substance abuse are some of the problems that may derail your progress. Social stigma and prejudice, environmental and social barriers, and problems with the delivery of health care and economic benefits compound the emotional and physical struggles and create further obstacles to living successfully.Spinal cord injury, like any major life crisis, can be a catalyst for positive change. You’ll find that it can shake up old ways of thinking and doing and inspire a reassessment of your values, goals, and relationships. It can sharpen the appreciation of your mind, spirituality, and emotional connections to others. It can bring a family closer together. A spinal cord injury challenges you to find new and creative channels for self-expression and to discover new pathways to a full and satisfying life.
*1/156/5*

WHAT’S HAPPENING TO OUR BABY GIRLS? (INTRODUCTION)

admin — Thu, 02 Jun 2011 07:49:06 +0000

We usually think of life in the watery womb experience as a blissful time. Held within a protected bubble, the fetus floats in it’s own universe, growing and developing along the humanoid evolutionary pathway. We think of the womb as a haven, an impermeable, all-protecting nirvana that shields new life from the dangers existing in a more tumultuous and toxic outside world. At least for a time, it is believed that the developing child is perfectly safe.The protective placenta is a truly amazing organ. It surrounds the fetus and attaches to the mother, controlling metabolic changes. By month three of pregnancy, a human placenta is two inches in diameter. The attached umbilical cord is about four inches long. It will eventually grow into a curly twenty-two-inch-long and a half-inch wide rope. The placenta will expand into a disc that is eight inches wide and an inch thick, that weighs slightly more than a pound. The placenta is expelled with the fetus during birth.*1/165/1*

FREQUENCY OF OCCURRENCE AND TRANSCULTURAL PSYCHIATRY

admin — Thu, 12 May 2011 07:33:56 +0000

The term ‘extreme states’ indicates a certain infrequency of occurrence for a given observer. A volcano for an inhabitant of Hawaii will not be an extreme condition, for a New Yorker or Zuricher, it will be. Hence, what is sick or extreme for one culture will not be for another. By using terms like ‘extreme states’ and ‘process work,’ we have the chance of developing a transcultural psychiatry which deals with relative deviations from the norm and which is independent of the specific cultural definitions of illness.The western world differentiates its extreme states according to the way people in these states do or do not communicate. About one half of the people in our mental hospitals are said to suffer from what is diagnosed as schizophrenia, the rest are a mixture of severely depressed or suicidal people, the aged and senile, people in manic states, chronic alcoholics, heroin addicts, people with organic brain damage, the so-called criminally insane, those laboring under subnormal intelligence, and a large category entitled ‘mixed psychoses,’ those with a mixture of the above, or the ‘generally handicapped.’ These categories vary from one hospital and community to the next.*12\227\8*

CLINICAL FEATURES OF COMMUNITY-ACQUIRED PNEUMONIA

admin — Mon, 02 May 2011 15:34:00 +0000

The usual clinical features of community-acquired pneumonia are very familiar. Symptoms include fever, cough (usually productive of purulent sputum), shortness of breath, and chest pain (often described as pleuritic). Symptoms are typically rapid in onset, with most patients presenting within the first few days of symptoms. Patients may experience chills or rigors. Nonspecific symptoms are also common, such as headache, fatigue, myalgias, and occasionally abdominal pain.Clinical signs of pneumonia include fever, tachycardia, tachypnea, and abnormal breath sounds. Focal crackles, egophony, increased tactile fremitus, and wheezes are the most common physical examination findings associated with pneumonia.Although these signs and symptoms are identified in most patients, atypical presentations occur, especially in elderly or immunosuppressed patients. Among these patients, pneumonia may occur without signs or symptoms localizing to the chest and without fever. Elderly patients may be found with mental status changes, failure to thrive, abdominal Pain, or exacerbation of underlying chronic diseases. Tachypnea (respiratory rate exceeding 26 breaths/minute) may suggest pneumonia in the elderly patient without other obvious clinical features of pneumonia, and this may be the only clinical clue to the diagnosis.*40/348/5*

SKIN IN CHILDHOOD: TREATING ECZEMA

admin — Thu, 21 Apr 2011 15:04:01 +0000

The treatment of eczema is complex and involves a total management programme. There is no one cream or treatment that will cure the problem. Prevention constitutes the most important aspect of eczema therapy, especially the avoidance of aggravating factors as mentioned above.
Moisturizing creams Moisturizing creams are the mainstay of treatment for children with eczema. It is important that children are bathed daily in a bath containing oil, for example Aveeno Bath Oil, Hamilton’s Bath Oil or QV Bath Oil, and that this is followed by the use of a good moisturizing cream. Over-the-counter moisturizing creams such as Aquatain, E45 cream, QV cream, 10% glycerol in sorbolene cream, 5% peanut oil in aqueous cream and 10% olive oil in sorbolene cream are just a few of the excellent preparations available.
Anti-itch creams Over-the-counter anti-itch creams should be avoided as they do not treat the underlying eczema and often cause severe allergic reactions. These include topical anesthetic and topical antihistamine creams.
Topical cortisone creams Topical cortisone creams are essential in the management of active eczema. Unfortunately, they have acquired an undeservedly bad reputation, yet cause very few problems or side effects. Topical cortisone creams are not absorbed into the circulation in significant amounts.Strong topical cortisone creams should not be applied to the face as they can lead to thinning of the skin, but they may be used intermittently on other parts of the body. Mild cortisone creams, such as hydrocortisone cream, can be safely used on the face and body.Cortisone creams are often used too sparingly and infrequently to be very effective. This can result in the eczema actually becoming more uncomfortable and itchy. Secondary infection may then develop from constant scratching.
Tar creams Although tar-based creams are still used in mild cases of eczema, they have largely been superseded by topical cortisone preparations. The effectiveness of tar creams varies enormously, depending on the source of the particular batch of tar. Their effect is therefore difficult to predict.
*9/150/5*

STRESS AND PMS: CLARE’S STORY’

admin — Tue, 12 Apr 2011 12:55:50 +0000

I was the typical ’90s superwoman or thought I was,’ says Clare, 39, who runs a public relations business near Bristol in western Britain. I’d spent years building up my business and we’d got to the stage where things were doing well. I had four staff and a good portfolio of clients. So I decided to have a baby.I went back to work when Gemma was six weeks old because I felt I couldn’t leave the business any longer. From then on things went downhill.I was working really long hours. My diet was terrible because I didn’t have the energy to cook properly in the evenings. On top of that I hardly ever had a good night’s sleep because Gemma was very unsettled at night.’PMS sort of crept up on me. I felt exhausted, which I thought was due to Gemma. I was so snappy and bad-tempered that I must have been impossible to live with. Nothing anyone did was right. I also used to get such a bloated abdomen that I couldn’t do up my skirt buttons.’My family doctor was really sympathetic. She inspired me to change my diet and to sort out my life so that I wasn’t putting in so many hours at work and at home. She said I needed to take time for myself so 1 joined a yoga class at my local health club.’It took quite a while for things to start improving. But I realized that I’d been heading towards a breakdown and PMS was just a warning signal. Now I take a much more relaxed approach to things and I actually think that I am more effective at work because of it.’My PMS has not totally disappeared but it’s manageable and it doesn’t cause the chaos it used to’.*37\120\4*