Saturday, September 5, 2009

Types of Fitness Training


Types of Fitness Training
One of the best and most used types of fitness training is aerobics. Because aerobics caters to the needs of most people, a lot of individuals prefer having aerobic workouts as a training ground for heavier exercises later on. Aerobics provides for a healthy heart by increasing the cardiac output that an individual can achieve through its many forms of exercise. An increased heart rate would lead to better circulation which is needed by all organs in your body. If blood flows freely in the circulation, your organs and muscles would receive the right amount of oxygen that is needed during an exercise. Exercises that are started with aerobics are healthier for an individual as it prepares the heart for heavier workload during the later course of the program.
Types Of Fitness Training: Muscle Building
Perhaps the most popular types of fitness training programs today are those which involve muscle building. These exercises provide for core stability and stretching workouts as well. The types of fitness training under muscle building provide the body of a leaner muscle mass and stronger large group muscles as well. The work of the exercises under muscle building is to contract the muscle, flex the bones and joints, and strengthen every core part of your body. Among the many types of fitness training, muscle building proves to be the best in keeping a well-trimmed and finely figured body.
Types Of Fitness Training: Weight Reduction
Weight reduction programs are one of the types of fitness training that would enable you to lose weight at a much faster pace. Those who desire to shed some pounds off should enroll on a weigh reduction program so that a healthier and leaner body can be achieved. The types of fitness training under weight reduction would include cardio exercises, fat burning workouts and toning exercises that would help trim your body into the figure that you want.

Health Benefits of Drinking Tea


Health Benefits of Drinking Tea
White tea is made from buds and young leaves picked in the springtime, shortly before the buds have fully opened. It is called white tea because the soft silver down that still covers the bud turns white when the tea is dried. (The best and most expensive white tea is made entirely from buds.) These are then steamed and dried, undergoing the minimum of processing. This means the tea retains greater levels of powerful antioxidants than in green or black teas. Antioxidants help to reduce and also repair the damage done to cells in the body.
Green Tea
Green tea is made from more mature tea leaves further along the branch, which then undergo a little more processing. In 1994 the American Journal of the National Cancer Institute published the results of a study showing that drinking green tea reduced the risk of esophageal cancer in Chinese men and women by almost 60 percent. The University of Purdue, Indiana, more recently concluded that a compound in green tea does contribute to preventing cancer by inhibitting the growth of cancer cells. Green tea has been used for many years in traditional Chinese and Indian medicine to improve heart health.
Rooibos or Red Tea
Strictly defined, tea is from Camellia Sinensis, and Rooibos is not a tea, but a shrub from the legume family, found only in the South African Cedarberg Mountains. Caffeine free, it has a low tannin content, which means that it does not have the astringent taste associated with tea and will not become bitter, even after standing or being reheated. This makes it a good alternative for pregnant or breastfeeding women; or for those who have digestive problems. It also contains antioxidants, and has other health benefits :
* It eases irritability, headaches, nervous tension and insomnia.
* It acts as an anti-spasmodic agent, to relieve stomach cramps and colic in infants.
* It boosts the immune system
Black Tea
Usually from China or India, black tea is often named after the region where it is grown, such as Darjeeling. Last year, public health nutritionist Dr Carrie Ruxton and colleagues at Kings College London, England, looked at published studies on the health benefits of drinking ordinary tea. Dr Ruxton said: "Drinking (hot) tea is actually better for you than drinking water. Water is essentially replacing fluid. Tea replaces fluids and contains antioxidants, so it's got two things going for it.

Treatment of Lymphoma


Treatment of Lymphoma
To someone newly diagnosed with lymphoma, treatment options may be difficult to understand. Lymphoma can be treated in many ways - with chemotherapy, radiation, monoclonal antibodies or a combination of these. There are nearly 30 types of lymphoma, and often there are multiple treatment options for a single disease. Here is a guide to understanding lymphoma treatment.
1. The Pre-Treatment Assessment
2. Understanding the Types of Lymphoma Treatment
3. Treatment of Hodgkin's Lymphoma
4. Treatment of non-Hodgkin's lymphoma (NHL)
The Pre-Treatment Assessment
After the diagnosis of lymphoma and finding out the exact type of Hodgkin's or non-Hodgkin's lymphoma, a number of tests are carried out to find out the extent of disease (the stage of lymphoma) and other factors that determine the prognosis. When all these investigations are complete, the oncologist counsels the patient regarding the best treatment options available.
* Tests after lymphoma diagnosis
* Understanding lymphoma stages
* What are prognostic factors?
Understanding the Types of Lymphoma Treatment
There are four main types of treatment for lymphomas - chemotherapy, radiation therapy, antibody therapy (or biological therapy) and bone-marrow or stem cell transplantation. They may be used alone or in combination to fight a particular type of lymphoma. Do you know how these treatments work?
* How does chemotherapy work?
* How does radiotherapy work?
* What is monoclonal antibody treatment?
* Understanding bone marrow and stem cell transplants
Treatment of Hodgkin's Lymphoma
Hodgkin’s lymphoma is usually treated with chemotherapy and radiotherapy. Treatment options are based on the stage of lymphoma and some prognostic factors. Nearly all patients receive chemotherapy. Radiation is used when required usually after chemotherapy or occasionally as the only treatment in very early stage disease.
* Treatment options for Hodgkin's lymphoma
* ABVD chemotherapy
* BEACOPP Chemotherapy
* Extended field radiation therapy (EFRT)
* Involved field radiation therapy (IFRT)
Treatment of non-Hodgkin's lymphoma (NHL)
There are nearly 25 different types of non-Hodgkin’s lymphoma. Some of them behave very differently from others. The treatment of all NHL is not the same but depends on the type and behavior of the particular type. Chemotherapy is usually the main treatment. Radiation or monoclonal antibody therapy may be added to chemotherapy in some situations for added benefit.

Stem Cell Treatments


Stem Cell Treatments
Tiantan Puhua hospital uses the newest neurological approaches to provide effective and safe stem cell treatments to a wide range of neurological disorders. We Use the latest knowledge of stem cells behavior in the human body within an individually tailored medical plan according to the patient's condition. Using stem cell transplantation, intensive physiotherapy and medicines, this combination of therapies has so far proved itself to be most efficient in bringing high level of recovery to our patients.
What are stem cells?
Stem cells are the master cells of the human body. What define stem cells from other cells is their ability to self-generate themselves and the ability to differentiate into other cell types.
Stem cells are at the center of a new field of science called regenerative medicine. All stem cells, regardless of their source, have three general properties: they are capable of dividing and renewing themselves for long periods; they are unspecialized; and they can give rise to specialized cell types.
Self-regeneration is the ability of stem cells to divide and produce more stem cells. During early development, the cell division is symmetrical i.e. each cell divides to gives rise to daughter cells each with the same potential. Later in development, the cell divides asymmetrically with one of the daughter cells produced also a stem cell and the other a more differentiated cell (such as brain cell, blood cell, etc.)
When stem cells are being transplanted into the body and arrive (through migration or through direct injection) into the injured part of the brain being targeted for tissue regeneration, the stem cells are coming into contact with growth chemicals in the body. These chemicals program the stem cells to grow into the tissue surrounding it.
Stem cells can typically be broken into four types:
Embryonic stem cells - Stem cells taken from human embryos
Fetal stem cells- Stem cells taken from aborted fetal tissue
Umbilical stem cells - Stem cells taken from umbilical cords
Adult stem cells - Stem cells taken from adult tissue
The Type of stem cells we use
At Tiantan Puhua hospital 3 main types of stem cells are being used:
Neural Stem Cells (derived from fetal stem cells) used for: Cerebral Palsy, Brain Injury, Stroke, Degenerative Diseases, and other neurological disorders.
hRPE Stem Cells (Adult Retinal Stem Cells) Used for: Parkinson's Disease
Bone Marrow Stem cells (Adult Bone Marrow stem cells extracted from the patient's own bone marrow) Recommended for young patients with a weak immune system.
What are Neural Stem Cells?
Neural Stem cells are self-regenerating, multipotent cells, found in the human brain which have the potential to differentiate into three major cell types: nerve cells (neurons), astrocytes and oligodendrocytes, and to self renew sufficiently to provide adequate number of cells in the brain.
When brain cells are damaged or are dying, due to a disease or an injury, fetal stem cells are the best known source for human neural stem cells.
Since most brain injuries, stroke, degenerative diseases and Demyelinating disorders affect several areas in the brain and not only one, the most effective and safe procedure to deliver neural stem cell into the brain is via a Lumbar Puncture (also called Spinal Tap): a spinal injection in the lumbar area (lower back) into the CSF (Cerebral Spinal Fluid).
Lumbar Puncture
During a lumbar puncture, a needle is carefully inserted into the spinal canal low in the back. A small amount of CSF is collected, then mixed with the stem cell fluid and injected back into the CSF.
The CSF circulation (Cerebral Spinal Fluid) goes in and around the brain, separated from the blood circulation by the Blood Brain Barrier. One cycle of the CSF circulation takes between 6-7 hours. Within this time frame the stem cells will flow through the CSF into the brain.

Brain Tumor Facts


Brain Tumor Facts
* A brain tumor is a cluster of abnormal cells growing in the brain.
* There are more than 120 different types of brain tumors; some are malignant (cancer), many are benign (non-cancerous).
* An estimated 52, 200 new cases of primary brain tumors are expected to be diagnosed in 2008.
* Primary brain tumors are those that begin in the brain and tend to stay in the brain. Metastatic brain tumors begin as a cancer elsewhere in the body and migrate, or metastasize, to the brain.
* Brain tumorbrain tumor facts prevalence refers to the total number of people who have a brain tumor. It is estimated that 359,000 people in the United States are living with the diagnosis of a primary brain tumor.
* Brain tumors are difficult to diagnose; their symptoms often mimic other diseases.
* Brain tumors are the leading cause of solid tumor cancer death in children under the age of 20.
* Benign or malignant, primary or metastatic, brain tumors are treatable.
* Standard treatments include surgery, radiation and chemotherapy.
* The cause of brain tumors is unknown.
* More knowledge about brain tumors has been gained in the last ten years than in the past hundred years.

Primary Brain Tumor


Primary Brain Tumor
A primary brain tumor should have prompt treatment. Early treatment improves the chance of a good outcome for many tumors.
Treatment varies with the size and type of the tumor and the general health of the person. The goals of treatment may be cure of the disorder, relief of symptoms and improvement of function or comfort.
Surgery is indicated for most primary brain tumors. Some may be completely excised (removed). Tumors that are deep or that infiltrate brain tissue, may be debulked (removal of much of the mass of the tumor to reduce its size) rather than removed.
Surgery may reduce intracranial pressure and relieve symptoms in cases when the tumor cannot be removed. Stereotactic (guided by CT) surgery may be helpful in removing deep tumors.
Radiation therapy may be advised for tumors that are sensitive to this treatment. Anticancer medications (chemotherapy) may be recommended.
Other medications may include the following:
* Corticosteroids such as dexamethasone to reduce brain swelling
* Osmotic diuretics such as urea or mannitol to reduce brain swelling (and associated increased intracranial pressure)
* Anticonvulsants such as phenytoin to reduce seizures
* Analgesics to control pain
* Antacids or histamine blockers to control stress ulcers
Comfort measures, safety measures, physical therapy, occupational therapy and other such steps may be required to improve quality of life. Counseling, support groups and similar measures may be needed to help in coping with the disorder.
Legal advice may be helpful in formulating advanced directives, such as power of attorney, in cases where continued physical or intellectual decline is likely.

Friday, September 4, 2009

Brain Tumor Treatments


Brain Tumor Treatments
Treatment
Treatment for brain tumors depends on a number of factors including the type, location and size of the tumor as well as the patient's age and general health. Treatment methods and schedules differ for children and adults.
Brain tumors are treated with surgery, radiation therapy and chemotherapy. Our doctors also are studying a vaccine for treating a recurrent cancer of the central nervous system that occurs primarily in the brain, known as glioma.
Depending on your needs, several methods may be used. Our team includes neurosurgeons, medical oncologists, radiation oncologists, nurses, a dietitian and a social worker, who work together to provide the best possible care.
Before treatment begins, most patients are given steroids, drugs that relieve swelling or edema. Your may receive anticonvulsant medicine to prevent or control seizures. If hydrocephalus is present, you may need a shunt to drain cerebrospinal fluid. A shunt is a long, thin tube placed in a ventricle of the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a drainpipe. Excess fluid is carried away from the brain and is absorbed in the abdomen. In some cases, the fluid is drained into the heart.
Surgery
Surgery is the usual treatment for most brain tumors. To remove a brain tumor, a neurosurgeon makes an opening in the skull. This operation is called a craniotomy. Whenever possible, the surgeon attempts to remove the entire tumor. If the tumor cannot be completely removed without damaging vital brain tissue, your doctor may remove as much of the tumor as possible. Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumor to be treated by radiation therapy or chemotherapy.
Some tumors cannot be removed. In such cases, your doctor may do only a biopsy. A small piece of the tumor is removed so that a pathologist can examine it under a microscope to determine the type of cells it contains. This helps your doctor decide which treatment to use.
Sometimes, a biopsy is done with a needle. Doctors use a special head frame (like a halo) and ) CT scans or MRI to pinpoint the exact location of the tumor. The surgeon makes a small hole in the skull and then guides a needle to the tumor. Using this technique to do a biopsy or for treatment is called stereotaxis. Other advanced techniques during surgery include brain mapping to find functional pathways near tumors, endoscopy to perform biopsies and open spinal fluid pathways through a small scope and advanced frameless stereotaxic computer assisted tumor resections. Intraoperative MRI also is available to help maximize tumor removal.
Radiation therapy
Radiation therapy, also called radiotherapy, is the use of high-powered rays to damage cancer cells and stop them from growing. It is often used to destroy tumor tissue that cannot be removed with surgery or to kill cancer cells that may remain after surgery. Radiation therapy also is used when surgery is not possible.
Radiation therapy may be given in two ways. External radiation comes from a large machine. Generally, external radiation treatments are given five days a week for several weeks. The treatment schedule depends on the type and size of the tumor and your age. Giving the total dose of radiation over an extended period helps to protect healthy tissue in the area of the tumor.
External radiation may be directed just to the tumor, the surrounding tissue or the entire brain. (Sometimes the radiation is also directed to the spinal cord. When the whole brain is treated, the patient often receives an extra dose of radiation to the area of the tumor. This boost can come from external radiation or from an implant.
Radiation also can come from radioactive material placed directly in the tumor, or implant radiation therapy. Depending on the material used, the implant may be left in the brain for a short time or permanently. Implants lose a little radioactivity each day. The patient stays in the hospital for several days while the radiation is most active.
The Gamma Knife, or stereotactic radiosurgery, is another way to treat brain tumors. The Gamma Knife isn't actually a knife, but a radiation therapy technique that delivers a single, finely focused, high dose of radiation precisely to its target. Treatment is given in just one session. High-energy rays are aimed at the tumor from many angles. In this way, a high dose of radiation reaches the tumor without damaging other brain tissue.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. The doctor may use just one drug or a combination, usually giving the drugs orally or by injection into a blood vessel or muscle. Intrathecal chemotherapy involves injecting the drugs into the cerebrospinal fluid.
Chemotherapy is usually given in cycles. A treatment period is followed by a recovery period, then another treatment period and so on. Patients often don't need to stay in the hospital for treatment and most drugs can be given in the doctor's office or clinic. However, depending on the drugs used, the way they are given and the patient's general health, a short hospital stay may be necessary.
Advances in chemotherapy include direct placement into the tumor cavity using a new technique called convection enhanced delivery.

Progesterone Women

Progesterone Women
Progesterone is one of your sex hormones and is made in your ovaries before menopause. After menopause, some progesterone’s made in your adrenal glands. As we age, we lose our hormones, and progesterone is one of the first to go. In women, progesterone declines first, then estrogen. You could suffer from progesterone loss for 15 years before you lose your period.
In our 40’s, we usually start to experience progesterone decline. Symptoms of decreased progesterone include anxiety, depression, irritability, mood swings, insomnia, pain and inflammation, osteoporosis, decreased HDL, weight gain, and excessive menstruation. Why do we gain weight with low progesterone? Estrogen is a building up hormone, and if you do not have enough progesterone to balance the estrogen you have, then you will gain weight. Estrogen without progesterone equals gaining about 10 pounds.
Causes of low progesterone levels are peri-menopause, impaired production, low luteinizing hormone (LH), increased prolactin production, stress, sugar, and saturated fat, deficiency of vitamins A, B6, C, zinc, and decreased thyroid hormone.
Be aware that progestin is not bioidentical progesterone. I have spoken to doctors and nurses who did not know the important difference. Synthetic non-bioidentical progesterone is called progestin. It is very different from natural bioidentical progesterone since it does not have the same chemical structure nor the same effects as the progesterone that your body makes on its own. Natural bioidentical progesterone is biologically identical to what you produce. Also, progestins do not reproduce the actions of natural progesterone. Progestins are contained in birth control pills, Provera, and Prempro. Don’t be fooled by the similarities in names. Medroxyprogesterone is a progestin, not progesterone.
What’s the difference? It could be your life. To start, progestins have many side effects. The side effects of progestins (synthetic progesterone) that do not occur with natural bioidentical progesterone include: increased appetite, weight gain, fluid retention, irritability, depression, headache, decreased energy, bloating, breast tenderness, decreased sexual interest, rash, acne, hair loss, nausea, insomnia, breakthrough bleeding/spotting. Progestins interfere with your body‘s own production of progesterone and do not help balance estrogen. They remain in your body longer and can cause spasm of your coronary (heart) arteries. Progestins stop the protective effects estrogen has on your heart, attaches to many of your body‘s receptor sites not just your progesterone receptors (long-term affects of this are unknown), and may make the symptoms of progesterone loss worse. Progestins increases LDL (bad cholesterol) and decreases HDL (good cholesterol). Progestins counteract many of the positive effects of estrogen on serotonin and may cause depression.
Here’s the life-threatening part: a recent study has shown that the use of synthetic progesterone or progestin increases the risk of breast cancer by 800% as compared with the use of estrogen alone. Another study showed that women taking natural bioidentical progesterone had a 10% lower rate of cancer than the general population.
Natural bioidentical progesterone helps balance estrogen, leaves your body quickly, helps you sleep, has a natural calming effect1, lowers high blood pressure, helps your body use and eliminate fats, lowers cholesterol, may protect against breast cancer , increases scalp hair, normalizes libido, helps balance fluids in the cells, and increases the beneficial effects of estrogens on blood vessel dilation in atheroscelerotic plaques (hardening of the arteries), has an anti-proliferative effect (decreases the rate of cancer) on all progesterone receptors not just the ones in the uterus, does not change the good effect estrogen has on blood flow, increases metabolic rate, is a natural diuretic and a natural antidepressant.
Natural bioidentical progesterone offers a safer approach to hormone replacement therapy than synthetic progesterone (progestin). It is very important that you have your levels of progesterone
measured before you begin bioidentical hormone replacement and then on a regular basis to confirm that you are on an optimal dose for you.
If you have had a complete hysterectomy you still need natural progesterone since it has the many positive affects on your body discussed above. Progesterone can be prescribed as a pill or a topical cream. A compounding pharmacist would fill your prescription. It is made from an extract of soy beans or yams with an enzyme added to convert the diosgenin in the yam into bioidentical progesterone. Over-the counter progesterone frequently does not contain this enzyme. If one of your main symptoms is insomnia, then choose the pill form which affects the GABA receptors in your brain, having a calming effect which allows you to sleep.
If you think you have progesterone changes, consult with a doctor who has experience with peri-menopausal hormone changes and bioidentical hormone replacement.

Low Birth Weight Infants

Low Birth Weight Infants
New Jersey is one of the richest states in the nation. One of its health indicators, low birth weight, places it in the same category as poor, impoverished countries. What is low birth weight? Why is it a concern? What can you do to prevent it?
Most infants are born at around 36 weeks and weigh about 3400 grams, or 7 lbs. Low birth weight infants are those who weigh 2500 or less grams, or about 5 ½ lbs. Very low birth weight infants weigh 1500 grams, or about 3.3 lbs. Extremely low birth weight infants weigh 1000 grams or less, or about 2.2 lbs. The low birth weight (LBW), very low birth weight (VLBW) or extremely low birth weight (ELBW) babies are generally born between 23 and 32 weeks and spend time in a Neo-natal Intensive Care Unit (NICU) after delivery. In New Jersey, 7.7% of infants are born with low birth weight; in the African American community it is 13.1%.
With modern technology, even infants that weigh only a pound can be sustained and grow and develop. The lifetime 'cost' to them and their parents, however, can be enormous: seeing their baby tied up to machines in the NICU, or the infant not going home with the mother after delivery can be extremely stressful on the entire extended family. The financial cost to the community is also high: despite being a small fraction of live births (7.7% in New Jersey), low birth weight infants account for more than one-third of all dollars spent on health care for babies.
The infants that weigh less than 2500 grams or less are at a greater risk of death within the first month of life, as well as increased risk for developmental disabilities and illness throughout their life. Lifelong problems include chronic lung disease, adult-onset diabetes, coronary heart disease, high blood pressure, intellectual, physical and sensory disabilities, and psychological and emotional distress. Very low birth weight infants are also at higher risk for SIDS, or Sudden Infant Death Syndrome.
What can a mom do to prevent low birth weight? There is general agreement among pediatricians, the March of Dimes, American Heart Association, and local and state health professionals that drinking, smoking and using drugs during pregnancy negatively impact the size and health of a newborn. Lack of pre-natal care and poor pre-natal nutritional habits also play a role. Some studies have also shown that having a previous low birth weight baby or multiple births, or unplanned pregnancy, and a mother being over 35 can contribute to having a low birth weight infant. There is also concern that environmental factors, stress, racism and poverty contribute to the terribly high rate, of 13.1% low birth weight infants, among African American mothers.
The goal of Healthy People 2010, the Centers for Disease Control and Prevention's (CDC) guide to the best health for the nation, is 5% low birth weight infants within the total number of infants born every year. It is currently 11.6% in the United States, but there are at least three things every expectant mom can do to help reduce the numbers:
No drinking, smoking or using drugs during pregnancy
Healthy food during pregnancy
Regular pre-natal check-ups
Other ways of getting the best possible outcome for you and your infant are avoiding stress, developing relaxation techniques, and maintaining a health weight. An important element of pre-pregnancy is taking a multivitamin with 400 mcg of folic acid every day, to avoid neural tube defects in your baby.
A pediatrician and former NJ Deputy Commissioner of Health, Dr. Leah Z. Ziskin, said, prevention is the best form of 'cure.'" Preventing your baby from being low birth weight is the one thing you can do so that both you and your infant are healthy and happy.

Haemophilia B

Haemophilia B
Hemophilia B is characterized by deficiency in factor IX clotting activity that results in prolonged oozing after injuries, tooth extractions, or surgery, and delayed or recurrent bleeding prior to complete wound healing. The age of diagnosis and frequency of bleeding episodes are related to the level of factor IX clotting activity. In severe hemophilia B, spontaneous joint or deep muscle bleeding is the most frequent symptom. Individuals with severe hemophilia B are usually diagnosed during the first year of life; without prophylactic treatment, they have an average of two to five spontaneous bleeding episodes each month. Individuals with moderately severe hemophilia B seldom have spontaneous bleeding; however, they do have prolonged or delayed oozing after relatively minor trauma and are usually diagnosed before age five to six years; the frequency of bleeding episodes varies from once a month to once a year. Individuals with mild hemophilia B do not have spontaneous bleeding; however, without preventive treatment, abnormal bleeding occurs with surgery, tooth extraction, and major injuries; the frequency of bleeding may vary from once a year to once every ten years. Individuals with mild hemophilia B are often not diagnosed until later in life. In any individual with hemophilia B, bleeding episodes may be more frequent in childhood and adolescence than in adulthood. Approximately 10% of carrier females are at risk for bleeding (even if the affected family member has mild hemophilia B) and are thus symptomatic carriers, although symptoms are usually mild.
Diagnosis/testing. The diagnosis of hemophilia B is established in individuals with low factor IX clotting activity. Molecular genetic testing of F9, the gene encoding factor IX, identifies disease-causing mutations in more than 99% of individuals with hemophilia B. Such testing is available clinically.
Management. Treatment of manifestations: referral to one of the approximately 140 federally funded hemophilia treatment centers (HTCs) for assessment, education, and genetic counseling; for those with severe disease, intravenous infusion of plasma-derived or recombinant factor IX concentrate within one hour of onset of bleeding. Training and home treatment with parental- followed by self-infusion are critical components of comprehensive care. Prevention of primary manifestations: For those with severe disease, prophylactic infusions of factor IX concentrate two to three times a week usually maintain factor IX clotting activity higher than 1% and prevent spontaneous bleeding. Prevention of secondary complications: reduction of chronic joint disease by prompt effective treatment of bleeding, including home therapy. Surveillance: For individuals with severe or moderately severe hemophilia B, annual assessments at an HTC are recommended; for individuals with mild hemophilia B, every two to three years; monitor carrier mothers for delayed bleeding post partum unless it is known that their baseline factor IX clotting activity is normal. Agents/circumstances to avoid: circumcision of at-risk males until hemophilia B is either excluded or treated with factor IX concentrate regardless of severity; intramuscular injections; activities with a high risk of trauma, particularly head injury; aspirin and all aspirin-containing products. Testing of relatives at risk: to clarify genetic status of females at risk before pregnancy or early in pregnancy, to facilitate management. Other: Vitamin K does not prevent or control bleeding in hemophilia B; no clinical trials for gene therapy in hemophilia B are currently in progress although several improved approaches are in pre-clinical testing.

Haemophilia A

Haemophilia A
Haemophilia A is caused by a deficiency of a protein in the blood; Factor VIII. The level of factor VIII in the blood determines the severity of haemophilia. Factor levels of less than 1-2% are found in people with severe Haemophilia A, they experience spontaneous bleeds into joints or muscles. Moderate haemophilia is found in people with Factor levels of 2-5% and they may experience spontaneous bleeds. Or those with mild haemophilia, who have factor levels of between 5-50%, usually only experience bleeds following trauma or surgery.
Children with severe Haemophilia A often begin to show increased bruising around the age of one year. It may present earlier, if the child under goes surgery, or after minor trauma, including immunisations.
The major problem in severe Haemophilia A is painful bleeding into joints, mainly the knees, ankles and elbows. These bleeds may occur spontaneously. If not treated treated promptly the bleeds may result in permanent arthritis and disability.
Most children and adolescents with severe Haemophilia A receive preventative treatment (prophylaxis) with an intravenous infusion of Factor VIII, 2-3 times a week. This is to prevent spontaneous joint and muscle bleeds.
Most person with Factor VIII deficiency requiring treatments will have a synthetic type of Factor VIII called Recobinant Factor VIII. A plasma derived Factor VIII will be available if required. Those with mild Haemophilia may be treated with DDAVP.
With appropriate management and factor replacement children and adults with inherited bleeding disorders can lead active and normal lives.

Turner Syndromes


Turner Syndromes
What is it?
Turner syndrome is a genetic disorder in girls caused by a missing or defective X (female) chromosome. It occurs in 1 of 2,000-2,500 live female births.
What are the symptoms?
There are many different physical features associated with Turner syndrome. Not all girls have all symptoms, and in many cases the signs are hard to detect. Girls with Turner syndrome may have:
* short stature (affects almost all girls with Turner, to different degrees)
* failure of ovaries to develop (90-95% of girls)
* webbed neck (25%) or short neck (40%)
* abnormal fingernails and toenails (70%)
* low hairline at neck (40%)
* heart defect (30%)
* kidney or urinary tract defect (30%)
* hearing disorders (50-90%)
* frequent ear infections in childhood (75%)
* shortening of bones in the hands (35%)
* lower jaw smaller than normal (60%)
* drooping eyelids (ptosis), wandering eyes (strasbismus)
Girls and women with Turner syndrome have normal intelligence but often have learning problems that lead to difficulty with math and spatial relationships between objects.
How is it diagnosed?
If a physician suspects a girl may have Turner syndrome because she is not growing at a normal rate, and perhaps has one or more of the other signs of the syndrome, a chromosome analysis will be done. Finding the specific chromosome problem of the syndrome is the only definitive diagnosis.
How is it treated?
There are two main medications given to girls with Turner syndrome. One is human growth hormone, used to increase the girl's growth rate and help her be taller. The other medication is estrogen, a female hormone, to replace the estrogen which would normally have been produced by the ovaries. Another female hormone, progesterone, is also given when the girl grows older, to help her have a normal monthly menstrual cycle.
Since a girl with Turner syndrome usually does not have ovaries, she cannot produce eggs and become pregnant when she grows up. However, some women with Turner syndrome can use in vitro fertilization to become pregnant, using donated eggs. Other women choose to adopt children in order to have a family.
Early diagnosis important
The signs and symptoms of Turner syndrome may be hard to recognize. However, it is important for girls with the syndrome to be identified as soon as possible so that hormone treatments can offer the most benefits possible. Early diagnosis and treatment will help prevent some of the chronic health problems that can occur in women with the syndrome, such as osteoporosis and diabetes.

Brain Encephalopathy


Brain Encephalopathy
Toxic what? Encephalopathy (en sef al ah' pathy) simply means something wrong with the brain. and toxic encephalopathy means a brain that is toxic or poisoned and does not function properly because of some environmental toxin or chemical.
Toxic encephalopathy is just the medical word for the under recognized, under-diagnosed brain fog. This classic symptom is often erroneously chalked up to normal aging, stress, poor memory, or a bad personality. Many people do not know that there is a cause and a cure for brain fog or toxic encephalopathy. But unfortunately, many do not know that they even have it, for there is a silent epidemic of toxic encephalopathy.
What are the symptoms of brain fog? Dopey, dizzy, spacy, can't think clearly, "feel like there's a bag over my head," can't concentrate, poor memory, depressed for no reason, fatigue for no reason, or unexplained mood swings out of proportion to the trigger.
And the causes of brain fog? For many they are the everyday chemicals found in furnishings, bedding, building construction materials, cosmetics, toiletries, traffic exhaust, office supplies, pesticides, and much more." [and the toxins in wood smoke from heating with wood and burning wood and charcoal and forest fires, burn barrels and field burning. Ed. Burning Issues.
It might seem like a flight into fantasy to think that seemingly harmless everyday chemicals can affect the brain. But actually it is the number one target organ affected.
For these chemicals can diffuse through the nose and lung membranes right into the blood stream and brain rather rapidly. And once there, if the person is low in any vitamins or minerals in the pathways to rapidly detoxify the chemical, the the undetoxified amount back up and starts to do its damage, producing these bizarre symptoms.
One danger lies in the fact that this erratic function of the brain can lead to accidents. For example, the inhalation of exhaust fumes has been the cause of some auto accidents and pilot error. Not knowing you have brain fog considerably jeopardizes personal relationships too, especially when it suddenly provokes mood swings. Or it can cause a child to be erroneously labeled as learning disabled or attention deficit disorder or poor achiever. It can lead to poor work performance, depression and the need for antidepressants, and is in part responsible for our current Prozac epidemic. And it can even lead to criminal acts.
Physician who are not knowledgeable in environmental medicine will vehemently deny the existence of brain fog or toxic encephalopathy, or erroneously refer the patient for psychiatric care.
Thanks to a recent article by Dr. Edward L. Baker, Director of Public Health Practice Program office at the Centers for Disease Control and Prevention in Atlanta, Georgia, we understand that it is not a figment of our imaginations. ..(Baker EL, A Review of Recent Research on Health Effects of Human Occupational Exposure to Organic Solvents. A Critical Review, Journal of Occupational Medicine 36:10 1079-1092 Oct. 1994) Wood smoke has organic solvents ( or PAH). Ed.
To paraphrase physical effects: " When the brain is unable to detoxify some of these chemicals, it actually manufactures chloral hydrate in the brain, better known as the old "Mickey Finn" or knock-out symptoms."
Sherry A Rogers, M.D. a Diplomat of the American Board of Family Practice, a Fellow of the American College of Allergy and Immunology and a Diplomat of the American Academy of Environmental Medicine, has been in private practice for over 26 years.
She is a lecturer of yearly original scientific material, as well as advanced courses for physicians. She was the keynote speaker for the international symposium Indoor Air Quality 86 in which she described the office method for testing chemical sensitivities.
She developed the Formaldehyde Spot Test and published her mold research in three volumes of the ANNALS Of ALLERGY. She has published chemical testing methods in the National Institutes of Health journal, ENVIRONMENTAL HEALTH PERSPECTIVES. She has published 17 scientific articles, 10 books, and was the environmental medicine editor for INTERNAL MEDICINE WORLD REPORT.
She has lectured throughout China, Sweden, England, Canada, and Europe, as well as the United States in indoor air symposia to physicians and the public. She has appeared on numerous television and radio programs and writes monthly articles for health magazines, plus her own and other newsletters covering all aspects of environmental illness.
Man has neglected one fundamental biological rule; to check and see if the organism is adapting to its new environment. She says we are the first generation to be exposed to such an unprecedented number of chemicals. The work of detoxifying these causes serious deficiencies. This maladaptation in turn has resulted in chronic disease. But disease is not a drug deficiency. The common goal of her current research projects is that of helping people adapt naturally to the 21 st century and reverse chronic disease.

Encephalopathy Treatment

Encephalopathy Treatment
TREATMENT OF PRECIPITATING CAUSES It is important to recognize that hepatic encephalopathy, acute and chronic, is reversible and that a precipitating cause rather than worsening of hepatocellular function can be identified in the majority of patients. In one classic study, over 80 percent of 100 cases were attributable to such factors as gastrointestinal bleeding, increased protein intake, hypokalemic alkalosis, infection, and constipation (all of which increase arterial ammonia levels), or to hypoxia and the use of sedatives and tranquilizers (show table 3) [3]. Patients with advanced cirrhosis may be particularly sensitive to benzodiazepines because of an increased concentration of benzodiazepine receptor ligands in the brain (see Treatments based upon the GABA hypothesis" below).
Treatment of precipitating events is typically associated with a prompt and permanent improvement of hepatic encephalopathy. As a result, every attempt should be made to identify such precipitating events while instituting therapy with the specific agents described below
TREATMENTS BASED UPON THE AMMONIA HYPOTHESIS The gastrointestinal tract is the primary source of ammonia, which enters the circulation via the portal vein. Ammonia is produced by enterocytes from glutamine and by colonic bacterial catabolism of nitrogenous sources such as ingested protein and secreted urea. The intact liver clears almost all of the portal vein ammonia, converting it into glutamine and preventing entry into the systemic circulation. Elevations of ammonia are detected in 60 to 80 percent of patients with hepatic encephalopathy and therapy aimed at reduction of the circulating ammonia level usually results in resolution of the encephalopathy. (See "Pathogenesis of hepatic encephalopathy"). Treatment is aimed at either reducing or inhibiting intestinal ammonia production or increasing the removal of ammonia.

Liver Encephalopathy

Liver Encephalopathy
Definition
Liver encephalopathy is a potentially life-threatening disease in which toxic substances accumulate in the blood. Also known as hepatic encephalopathy or hepatic coma, this condition can cause confusion, disorientation, abnormal neurological signs, loss of consciousness, and death.
Description
A normally functioning liver metabolizes and detoxifies substances formed in the body during the digestive process. Impaired liver function allows substances like ammonia (formed when the body digests protein), some fatty acids, phenol, and mercaptans to escape into the bloodstream. From there, they may penetrate the blood-brain barrier, affect the central nervous system (CNS), and lead to hepatic coma.
Hepatic coma is most common in patients with chronic liver disease. It occurs in 50-70% of all those with cirrhosis.
Causes and symptoms
The cause of hepatic coma is unknown, but the condition is frequently associated with the following conditions:
* acute or chronic liver disease
* gastrointestinal bleeding
* azotemia, the accumulation of nitrogen-containing compounds (such as urea) in the blood
* inherited disorders that disrupt the process by which nitrogen is decomposed and excreted
* the use of shunts (devices implanted in the body to redirect the flow of fluid from one vessel to another)
* electrolyte imbalances, including low levels of potassium (hypokalemia) and abnormally alkaline blood pH (alkalosis). These imbalances may result from the overuse of sedatives, analgesics, or diuretics; reduced levels of oxygen (hypoxia), or withdrawal of excessive amounts of body fluid (hypovolemia)
* constipation, which may increase the body's nitrogen load
* surgery
* infection
* acute liver disease
Binge drinking and acute infection are common causes of hepatic coma in patients with long standing liver disease.
Symptoms of hepatic encephalopathy range from almost unnoticeable changes in personality, energy levels, and thinking patterns to deep coma.
Inability to reproduce a star or other simple design (apraxia) and deterioration of handwriting are common symptoms of early encephalopathy. Decreased brain function can also cause inappropriate behavior, lack of interest in personal grooming, mood swings, and uncharacteristically poor judgment.
The patient may be less alert than usual and develop new sleep patterns. Movement and speech may be slow and labored.
As the disease progresses, patients become confused, drowsy, and disoriented. The breath and urine acquires a sweet, musky odor. The hands shake, the outstretched arms flap (asterixis or "liver flap"), and the patient may lapse into unconsciousness. As coma deepens, reflexes may be heightened (hyperreflexia). The toes sometimes splay when the sole of the foot is stroked (Babinski reflex).
Agitation occasionally occurs in children and in adults who suddenly develop severe symptoms. Seizures are uncommon.

Gene Linkage

Gene Linkage
First let's go through what linkage means. Ignoring for a moment chromosomes and DNA, the concept of a gene is simply a unit of inheritance. Most higher organisms are diploid, meaning that we all carry two copies of each gene (each with its own trait), only one of which is passed on to our children. Under normal conditions, if you take a complete collection of genes, called a genome, and randomly divide the copies of the genes into new genomes, then for any given trait, the probability of also getting another trait is around 50%, i.e. for any trait the probability of being passed on to the new genome is 50%. In an absolute sense, if two genes are "linked", it means that if a trait for one gene is passed on, then a specific trait for the other gene will be passed on 100% of the time, i.e. the genes are physically linked together: inseparable. In reality, two genes are "linked" if the probability of inheriting both traits is significantly greater than 50% there actually no 100% linkages, unless the two traits are from the same gene. To address the second part of your question, here's a little history.
While working as an undergraduate student in Thomas Morgan's lab, Alfred Sturtevant realized that the linkages his boss had been cataloguing could be rearranged to form a "linkage map" giving the positions of the genes along a chromosome. To make the map, Sturtevant defined the distance between two genes that would recombine once in every hundred matings (i.e. a 1% recombination frequency) as a centiMorgan (cM), now more commonly referred to as a genetic map unit.
Put more simply, if we assume that recombinations occur randomly during meiosis, then genes that are closer together on the chromosome should be less likely to be separated than genes that are far apart. Some of this goes back to Gregor Mendel, who noticed that some of the traits he was studying were mutually independent (i.e. having one trait didn't affect the appearance of the other trait), while other traits were linked (i.e. having one trait determined the appearance of the other trait). Actually, Mendel fudged his data (gasp!) to suggest that linkage was absolute and without recombination - something about proving the immutability of nature. Instead, later geneticists began cataloguing the extent of linkage between traits, and grouped the genes into linkage pools even before anyone had figured out what chromosomes were for. With the identification of chromosomes as the physical manifestations of the genome, it became important to apply the linkage pools to the chromosomes.

Huntington's Disease Information

Huntington's Disease Information
What is Huntington's Disease?
Huntington's disease (HD) results from genetically programmed degeneration of brain cells, called neurons, in certain areas of the brain. This degeneration causes uncontrolled movements, loss of intellectual faculties, and emotional disturbance. HD is a familial disease, passed from parent to child through a mutation in the normal gene. Each child of an HD parent has a 50-50 chance of inheriting the HD gene. If a child does not inherit the HD gene, he or she will not develop the disease and cannot pass it to subsequent generations. A person who inherits the HD gene will sooner or later develop the disease. Whether one child inherits the gene has no bearing on whether others will or will not inherit the gene. Some early symptoms of HD are mood swings, depression, irritability or trouble driving, learning new things, remembering a fact, or making a decision. As the disease progresses, concentration on intellectual tasks becomes increasingly difficult and the patient may have difficulty feeding himself or herself and swallowing. The rate of disease progression and the age of onset vary from person to person. A genetic test, coupled with a complete medical history and neurological and laboratory tests, helps physicians diagnose HD. Presymptomic testing is available for individuals who are at risk for carrying the HD gene. In 1 to 3 percent of individuals with HD, no family history of HD can be found.
Is there any treatment?
Physicians prescribe a number of medications to help control emotional and movement problems associated with HD. In August 2008 the U.S. Food and Drug Administration approved tetrabenazine to treat Huntington’s chorea (the involuntary writhing movements), making it the first drug approved for use in the United States to treat the disease. Most drugs used to treat the symptoms of HD have side effects such as fatigue, restlessness, or hyperexcitability. It is extremely important for people with HD to maintain physical fitness as much as possible, as individuals who exercise and keep active tend to do better than those who do not.
What is the prognosis?
At this time, there is no way to stop or reverse the course of HD. Now that the HD gene has been located, investigators are continuing to study the HD gene with an eye toward understanding how it causes disease in the human body.
What research is being done?
Scientific investigations using electronic and other technologies enable scientists to see what the defective gene does to various structures in the brain and how it affects the body's chemistry and metabolism. Laboratory animals are being bred in the hope of duplicating the clinical features of HD so that researchers can learn more about the symptoms and progression of HD. Investigators are implanting fetal tissue in rodents and nonhuman primates with the hope of understanding, restoring, or replacing functions typically lost by neuronal degeneration in individuals with HD. Related areas of investigation include excitotoxicity (over-stimulation of cells by natural chemicals found in the brain), defective energy metabolism (a defect in the mitochondria), oxidative stress (normal metabolic activity in the brain that produces toxic compounds called free radicals), tropic factors (natural chemical substances found in the human body that may protect against cell death).

Huntington's Disease Treatment

Huntington's Disease Treatment
Treatment
There is no cure for Huntington's disease. Treatment focuses on reducing symptoms, preventing complications, and providing support and assistance to the patient and those close to him or her.
Medication
Physicians often prescribe various medications to help control emotional and movement problems.
* Antipsychotics (hallucinations, delusions, violent outbursts): haloperidol, chlorpromazine, olanzapine (contraindicated if patient has dystonia)
* Antidepressants (depression, obsessive-compulsive behavior): fluoxetine, sertraline hydrochloride, nortriptyline
* Tranquilizers (anxiety, chorea): benzodiazepines, paroxetine, venlafaxin, beta-blockers
* Mood-stabilizers (mania, bipolar disorder): lithium, valproate, carbamazepine
* Botulinum toxin (dystonia, jaw clenching)
Because most drugs used to treat the symptoms of HD can produce undesirable side effects, ranging from fatigue to restlessness and hyperexcitability, physicians often prescribe the lowest possible dose.
Nutrition and Eating
Some Huntington's disease patients need a lot of time for meals because the loss of coordinated movement can make it difficult for them to swallow or feed themselves. These difficulties put them at risk for choking.
Food can be cut into small pieces, softened, or pureed to make swallowing easier. Swallowing therapy can help if started before there is serious difficulty. Dairy products should be avoided because they tend to increase the secretion of mucus, which can increase the risk for choking.
It is important for the patient to consume enough calories to maintain adequate body weight. The number of daily meals may have to be increased and vitamins and nutritional supplements may be recommended. If eating and dietary problems become severe, families and caregivers may need to consider the use of a feeding tube.
HD patients require large quantities of fluids, especially during hot weather, to avoid dehydration. Bendable straws can make drinking easier. In cases where the patient's muscular capability is severely weakened, water may have to be thickened with additives to the consistency of syrup before drinking is possible.
Complications such as constipation and incontinence can develop as a result of diet and lack of physical activity. A physician can provide dietary advice and information about how to cope with these problems.
Physical Activity
It is important for Huntington's disease patients to be as physically fit as their condition permits. Daily exercise promotes physical and mental well-being. Patients should walk as much as possible, even if assistance is necessary.
Because falls are always a risk, caregivers should keep the patient's surroundings free of hard, sharp objects. Wearing special padding during walks can help protect against injury from falls. Small weights worn around the ankles and sturdy, well-fitting shoes that slip on and off easily can help improve a patient's stability.
Social Activity
Unless and until the disease's progression prohibits it, people with HD should participate in outside activities, socialize, and pursue hobbies and interests. These activities also give family members and caregivers valuable time for themselves.
Prognosis
Huntington's disease usually runs its full terminal course in 10 to 30 years. It has been observed that the earlier in life the symptoms of HD appear, the faster the disease progresses. The bedridden patient in the final stages of Huntington's disease often dies from complications such as heart failure or pneumonia.

Treatment For Tension Headaches

Treatment For Tension Headaches
What's the treatment for tension headache?
Nonprescription painkillers such as aspirin, acetaminophen or ibuprofen most commonly relieve tension headaches. When severe muscle contraction is present, more powerful prescription drugs may be needed to get relief. Because these drugs may cause drowsiness and slow the reflexes, caution must be taken to avoid injury or accident when they are taken. Most physicians recommend only using prescription medications for short periods of time, usually no more than a few days.
Learn and practice stress management strategies. Some people find relaxation exercises or meditation helpful. Biofeedback (a means of providing information about certain body functions) may enhance relaxation exercises and may be helpful for chronic tension headache.
Other preventive measures may include keeping warm if the headache is associated with cold, using a different pillow, or sleeping position or similar changes. Use good posture when reading, working, or doing other activities that may cause headache. Exercise the neck and shoulders frequently when typing, working on computers, or doing close work.
Adequate sleep and rest or massage of sore muscles can help reduce the chance that a headache will occur. Hot or cold showers or baths may relieve a headache for some people.
Over-the-counter analgesics such as aspirin, ibruprofen, or acetominophen may relieve pain if the above measures are ineffective. An antidepressant or other medication may be advised for chronic headache. A nonsedating muscle relaxant like Skelaxin helps some patients.
A headache diary can help you identify the source of chronic headaches. When a headache occurs, write down the date and time the headache began. Note what you ate for the preceding 24 hours, sleep pattern and amount of sleep, what was being experienced immediately before the headache, unusual stress or other circumstances, how long the headache lasted, and what made it stop.
Lifestyle changes may be required for chronic tension headaches. This may include adequate rest and exercise, change in job or recreational habits, or other changes.

Causes of Tension Headache


Causes of Tension Headache
What causes tension headache?
The exact cause of tension headaches is still unknown. It has long been believed that they are caused by muscle tension around the head and neck. However although muscle tension may be involved, there are many forms of tension headaches and some scientists now believe there is not one single cause for this type of headache. One of the theories is that the pain may be caused by a malfunctioning pain filter which is located in the brain stem. The view is that the brain misinterprets information, for example from the temporal muscle or other muscles, and interprets this signal as pain.
One of the main molecules which is probably involved is serotonin. Evidence for this theory comes from the fact that tension headaches may be successfully treated with certain antidepressants. Another theory says that the main cause for tension type headaches and migraine is teeth clenching which causes a chronic contraction of the temporalis muscle.
Like migraines, tension headaches seem to be more common in women than in men. Unlike migraines, which often make their initial appearance during adolescence, tension headaches usually begin in middle age. As such, their onset often is equated with the development of adult stresses, anxieties and depression that can characterize mid-life. The name "tension headache" therefore can be said to describe a response by the body to emotional strains and pressures, rather than to excessive muscular tightness and resultant constriction of the scalp arteries, as was once widely presumed. In many such cases, researchers have found that patients complaining of frequent headaches, which are generally not migraines, also exhibit varying degrees of depression, anxiety and worry.
Despite these findings, many physicians and researchers still believe strongly that stress-induced muscular tension in the head, neck and shoulders can bring on tension headaches. This is supported by evidence of muscular tenderness in areas of the neck, the base of the skull, scalp, forehead, face, jaw, shoulders or upper arms in many tension-type headache sufferers. Others show signs of pronounced clenching of the teeth, suggesting that problems related to the temporomandibular joint (TMJ) are causative factors, along with cervical disorders, such as arthritis or degenerative disease of the neck and/or spine, leading to chronic muscular contraction.
Tension headaches result from the contraction of neck and scalp muscles. One cause of this muscle contraction is a response to stress, depression or anxiety. Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or use of computers, fine work with the hands, and use of a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position can also trigger this type of headache.
Other causes include eye strain, fatigue, alcohol use, excessive smoking, excessive caffeine use, sinus infection, nasal congestion, overexertion, colds, and influenza. Tension headaches are not associated with structural lesions in the brain.

Thursday, September 3, 2009

Human Skeleton

Human Skeleton
The human skeleton consists of 206 bones. We are actually born with more bones (about 300), but many fuse together as a child grows up. These bones support your body and allow you to move. Bones contain a lot of calcium (an element found in milk, broccoli, and other foods). Bones manufacture blood cells and store important minerals.
The longest bone in our bodies is the femur (thigh bone). The smallest bone is the stirrup bone inside the ear. Each hand has 26 bones in it. Your nose and ears are not made of bone; they are made of cartilage, a flexible substance that is not as hard as bone.
Joints: Bones are connected to other bones at joints. There are many different types of joints, including: fixed joints (such as in the skull, which consists of many bones), hinged joints (such as in the fingers and toes), and ball-and-socket joints (such as the shoulders and hips).
Differences in males and females: Males and females have slightly different skeletons, including a different elbow angle. Males have slightly thicker and longer legs and arms; females have a wider pelvis and a larger space within the pelvis, through which babies travel when they are born.

Tennis Elbow Treatment

Tennis Elbow Treatment
There are several available treatments for tennis elbow. These usually start off conservatively and work up to more involved treatments. Non-surgical treatment is successful in over 90 percent of patients.
Lifestyle Modification
Lifestyle modification is important if tennis elbow does not resolve or if it recurs. With athletes, often an improvement in technique (see below) can resolve the problem.
Changing Stroke Mechanics & Racquet
Tennis racquets should be sized properly. Higher stringing tensions may contribute to tennis elbow. Playing on harder surfaces also increases the risk of developing tennis elbow. Stroke mechanics should be evaluated to ensure patients are hitting the ball in the center of the racquet; players should not lead the racquet with a flexed elbow. See a tennis pro/instructor for a swing and racquet evaluation.
Anti-inflammatory Medications Anti-inflammatory medications are often used to help control pain and inflammation. The oral forms of these medications are easy to take and often help control inflammation and manage pain.
Cortisone Injections
If these conservative measures fail, a steroid (cortisone) injection is a reasonable option. If a person has tried more than two cortisone injections without relief, it is unlikely that additional injections will benefit the patient.
Elbow Brace and Exercises
An elbow orthosis, called an elbow clasp, can be worn. The theory behind using an elbow clasp is that the brace will redirect the pull of misaligned muscles. Patients often find relief of pain when using the clasp during activities.
Some simple exercises can also be helpful in controlling the symptoms of tennis elbow. These exercises should not cause pain, and those that do should not be done until pain resolves. By strengthening the muscles and tendons involved with tennis elbow, you can help prevent the problem from returning.
Surgery
There are several possible surgical treatments that have been successful. These include removing a portion of the damaged tendon or releasing the attachment of the affected tendon. A repair of the healthy portion of tendon is sometimes carried out as well.
Surgery to release the damaged tendon is usually successful, but rarely needed; about 95 percent of patients with tennis elbow can be treated without surgery. A variety of conservation treatments should be tried prior to opting for surgery.
Possible New Treatments
Extracorporeal Shock Wave Therapy
Shockwave therapy is a controversial treatment option for tennis elbow. The idea behind shockwave therapy is to use sound waves to induce so-called 'microtrauma' to tissues. This microtrauma initiates a healing response and helps to decrease inflammation. Shockwave therapy is also used in the treatment of heel spurs and kneecap tendonitis.
Results of studies investigating this treatment have been mixed. There is no strong evidence that this is a better treatment than other conservative options. One of the better designed studies found there was no benefit from using shockwave therapy for tennis elbow. Some insurance companies will not pay for this treatment either.
Autologous Blood Injection
An article in the Journal of Hand Surgery reported the results of a small group of patients who underwent injection of their own blood into the location of lateral epicondylitis. The idea proposed by the authors is that the blood injection supplies the necessary healing components to help cure the problem.
The study fails to compare this treatment to more standard treatments, and the number of patients investigated is quite small. That said, the authors report good results. This may become a more standard treatment option, but more investigation is needed.

Tennis Elbow Injury

Tennis Elbow Injury
Doctors first described tennis elbow (lateral epicondylitis) more than 100 years ago. Almost half of all tennis players will eventually get tennis elbow but less than 5 percent of all cases result from playing tennis. Golfer’s Elbow & Bursitis are 2 related conditions, which are sometimes mistaken for tennis elbow. How are these three conditions similar?
With tennis elbow the pain comes on gradually and is experienced as tenderness on or below the outside of the elbow. Gripping, lifting and carrying objects becomes painful. Golfers Elbow has similar causes and pain but the tenderness is felt on the inside of the elbow where the bone seems to jut out from the joint. Bursitis affects the back of the joint where the pain is and there is sometimes a visible lump. Bursitis is caused by either a fall or a blow directly to the tip of the elbow. Excessive leaning on the joint can also cause it.
Tennis elbow is a form of tendonitis. When the muscles and bones of the elbow joint are involved, then the condition is called epicondylitis. If the pain is felt directly on the back of your elbow joint, and not on the outside of your arm, you could have bursitis, which is caused by inflamed lubricating sacs in the joint. There should not be any swelling associated with tennis elbow. If there is swelling then it's probably not tennis elbow but another condition, such as arthritis, infection, gout or a tumor.
The Symptoms
Victims of tennis elbow will experience recurring pain on the outside of the upper forearm just below the bend of the elbow. Sometimes the pain radiates down the arm all the way to the wrist. Lifting with or bending the arm or even holding a light object like a cup will cause pain. Sufferers will have problems fully extending their forearm because of inflamed muscles, tendons and ligaments. The pain typically lasts for six to twelve weeks and there can be discomfort for anywhere from 3 weeks to several years.
The actual damage that tennis elbow causes is very small tears in a part of the tendon and in the muscle coverings. Once the original injury heals, these areas often tear again which leads to hemorrhaging and the forming of calcium deposits and development of some rough tissue around the injury and in surrounding tissues. Collagen can leak out from around the injured areas and cause inflammation. The pressure from this blocks the blood flow and pinches the radial nerve, which controls the muscles in the arm and hand.
Tendons do not heal as quickly as muscles do and some cases of tennis elbow can last for years. The inflammation usually goes down in 6 to 12 weeks.
Treatment
The best way to treat tennis elbow is to stop doing the things that irritate your arm. This is not a problem for the recreational tennis player, but creates a dilemma for a laborer, office worker or professional athlete. The most effective treatments for tennis elbow involve resting the arm until the pain disappears, massage to relieve muscle stress and tension, and strengthening exercises to prevent reinjury. If you have to go back to the activity that caused the problem, a 5 to 10 minute period of warm-up stretching and movement before starting that activity will help. It also helps to take breaks frequently.
Medicine offers different treatments for tennis elbow, from injections to surgery, but the pain will continue unless you stop stressing the joint. The tennis elbow will return if the joint is not given adequate rest. For mild and moderate cases aspirin or ibuprofen will help reduce the inflammation and the pain while you are resting the injury. Later you can get exercise and massage to accelerate the healing process.
For stubborn cases of tennis elbow your doctor may prescribe corticosteroid injections. These injections will reduce the inflammation, but they cannot be used long-term because of the risk of detrimental side effects. Topical ointments are another option for many sufferers, especially those who would rather not take medications.
If rest, medication, and a stretching routine fail to cure your tennis elbow, surgery may be advised. Less than 3 percent of patients require an operation. One surgical procedure cuts the tendon loose from the epicondyle, the round bump at the end of the bone. This eliminates the stress on the tendon but leaves the muscle useless. Another technique removing granulated tissue in the tendon and repairing the tears. After you have seemingly overcome a case of tennis elbow, continue to baby your arm. Always warm up your arm for 5 to 10 minutes before starting any activity that involves your elbow. If you develop severe pain after the activity anyway, pack your arm in ice and call your doctor.
Prevention
To prevent tennis elbow, try these techniques:
When lifting something, do it with your palm facing your body. Do some strengthening exercises with hand weights. Before beginning a possibly stressful activity stretch the relevant muscles by pulling the top part of your fingers gently but firmly back toward your body while keeping your arm fully extended and your palm facing outward.
To prevent a relapse, discontinue or change the action that is causing the strain on your elbow. Be sure to warm up for at least 10 minutes before performing any activity involving your arm and apply ice to it after. Take a break as often as you can.
It might help to strap a band around your forearm just below the elbow. The support should help you lift heavy objects. These bands can impede circulation and slow down the healing, so they should only be used after the symptoms of tennis elbow have disappeared.
If the pain lasts for more than a few days, chronic inflammation of the tendons can lead to permanent disability. If the elbow joint begins to swell, you may have another condition such as arthritis, gout, infection or even a tumor.

Beta Lactam Antibiotics

Beta Lactam Antibiotics
INTRODUCTION Beta-lactam antibiotics are among the most commonly prescribed drugs, grouped together based upon a shared structural feature, the beta-lactam ring. Beta-lactam antibiotics include:
* Penicillins
* Cephalosporins
* Cephamycins
* Carbapenems
* Monobactams
* Beta-lactamase inhibitors
Since this category of antibiotics is so broad, it is important to subdivide these drugs into functional drug groups to facilitate understanding and prescribing practices. It is not necessary for clinicians to know every drug within each of these groups. The grouping of these agents can be based upon spectrum of activity, for choice of agents for an antibiotic formulary, for therapeutic use or for routine susceptibility testing. Within each functional group, differences between antibiotics in pharmacokinetics, safety, duration of the clinical experience with their use, and cost allow reasonable choices to be made in selecting an individual drug as representative of that group.
The mechanisms of action and resistance and major adverse reactions to these antibiotics will be reviewed here. The penicillins, cephalosporins, and novel beta-lactam drugs are discussed separately. (See related topics).
MECHANISM OF ACTION Beta lactam antibiotics inhibit the growth of sensitive bacteria by inactivating enzymes located in the bacterial cell membrane, which are involved in the third stage of cell wall synthesis. It is during this stage that linear strands of peptidoglycan are cross-linked into a fishnet-like polymer that surrounds the bacterial cell and confers osmotic stability in the hypertonic milieu of the infected patient. Beta-lactams inhibit not just a single enzyme involved in cell wall synthesis, but a family of related enzymes (four to eight in different bacteria), each involved in different aspects of cell wall synthesis. These enzymes can be detected by their covalent binding of radioactively-labeled penicillin (or other beta-lactams) and hence have been called penicillin binding proteins (PBPs).
Different PBPs appear to serve different functions for the bacterial cell. As an example, PBP2 in Escherichia coli is important in maintaining the rod-like shape of the bacillus, while PBP3 is involved in septation during cell division [1]. Different beta-lactam antibiotics may preferentially bind to and inhibit certain PBPs more than others. Thus, different agents may produce characteristic effects on bacterial morphology and have different efficacies in inhibiting bacterial growth or killing the organism.

Beta Lactam Resistance

Beta Lactam Resistance
ß-lactams belong to a family of antibiotics which is characterized by a ß-lactam ring. Penicillins, cephalosporins, clavams (or oxapenams), cephamycins and carbapenems are members of this family. The integrity of the ß-lactam ring is necessary for the activity which results in the inactivation of a set of transpeptidases that catalyze the final cross-linking reactions of peptidoglycan synthesis.
Resistance to ß-lactams in clinical isolates is primarily due to the hydrolysis of the antibiotic by a ß-lactamase. Mutational events resulting in the modification of PBPs (penicillin binding proteins) or cellular permeability can also lead to ß-lactam resistance.
ß-lactamases constitute a heterogenous group of enzymes. Several classification schemes have been proposed according to their hydrolytic spectrum, susceptibility to inhibitors, genetic localisation (plasmidic or chromosomal), gene or amino-acid protein sequence. The functional classification scheme of ß-lactamases proposed by Bush, Jacoby and Medeiros (1995) defines four groups according to their substrate and inhibitor profiles. Group 1 are cephalosporinases that are not well inhibited by clavulanic acid; group 2 penicillinases, cephalosporinases, and broad-spectrum ß-lactamases that are generally inhibited by active site-directed ß-lactamase inhibitors; group 3 metallo-ß-lactamases that hydrolyze penicillins, cephalosporins, and carbapenems and that are poorly inhibited by almost all ß-lactam-containing molecules; group 4 penicillinases that are not well inhibited by clavulanic acid. Subgroups were also defined according to rates of hydrolysis of carbenicillin or cloxacillin (oxacillin) by group 2 penicillinases. The classification initially introduced by Ambler (1980) and based on the amino-acid sequence recognizes four molecular classes designated A to D. Classes A, C, and D gather evolutionarily distinct groups of serine enzymes, and class B the zinc-dependent ("EDTA-inhibited") enzymes.