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ALZHEIMER’S DISEASE: INVOLUNTARY INCONTINENCE OF URINE

admin — Thu, 16 Sep 2010 14:17:41 +0000

The most common cause of this, especially in elderly women, is an infection in the urine. Severe or repeated infection may mean that the infection goes further up the urinary tract (to the bladder or kidneys) or that there is some abnormality (stones or tumour) in the bladder or kidneys themselves.

Many women suffer from stress or urge incontinence. This is often the result of childbirth, where the muscles around the bladder have been stretched and so cannot keep the opening tightly closed. Usually this means that the person wets himself if they cough, laugh or strain (and overcome the muscles trying to keep the bladder opening closed). Some women however have muscles so weak that they wet themselves soon after they stand up. The same weakness can cause a prolapse, where in its most severe form the womb drops down and can be seen. Usually the prolapse is not so bad, but still causes incontinence.

When constipation is a problem the hard motions in the back passage can push against the bladder and make it pass water. If the bulk of the motions is very big, then the pressure can stop the bladder emptying at all and the bladder fills up (retention). This can happen acutely and be very painful and needs the obstruction removing quickly. Occasionally it happens more slowly and the full bladder keeps going by emptying a little all the time, i.e. the person leaks urine almost continuously. This is a big problem in men because the prostate gland sits at the bottom of the bladder and it commonly gets bigger as men get older. A stage is reached where it begins to cause symptoms (passing small amounts of water frequently and with difficulty) and then it can block off the exit to the bladder in the same way as being very constipated can – indeed constipation and a large prostate gland in men is asking for trouble.

A woman’s vagina (front passage) and the tube (urethra) leading up to and just into the bladder is covered by a delicate lining that needs female hormones to keep it moist and supple. In some women after the menopause (change of life) the hormone levels drop so low that the lining becomes dry and painful and more liable to infections. The bladder opening is also affected and the woman can then become incontinent of urine. The application of hormone creams or the taking of hormone tablets relieves this condition.

Another common cause of incontinence of urine is known as the unstable bladder. As described before, our bladders fill up with urine and as they do so we receive messages telling us how full it is. Within limits, only when we are ready do all the openings relax and the bladder contracts, pushing out the urine. All these actions take place because the nerves around the bladder, etc., use chemical messengers to tell the muscles to relax and contract. In the unstable bladder these chemicals are at fault and the bladder begins to contract when it has only a smallish quantity of urine in it and before it has told the brain it is ready – indeed, before the person is ready. The condition appears to occur more commonly in those suffering from dementia but can occur in anyone (women more than men). The classic tale is of a carer taking someone to the toilet, where they remain quite a while, then on the way out or just back in the living room the person is incontinent. It appears willful, but is not. The condition can be diagnosed from the history and the absence of other causes, but usually a cystometrogram is done. In this test a small catheter (tube) is passed into the bladder and another one into the back passage. The bladder is filled with water and in the unstable bladder contractions of the bladder can be seen occurring too soon. Some exercises and drugs appear to help a lot, but mainly in the unconfused group who need to be able to cooperate with the treatment.

Drugs, as mentioned before, can put a great strain on the bladder. Diuretics (water tablets) especially are the main culprits. They can be either strong or weak; the most common include:

• Strong diuretics

frusemide/Frumil/Frusene

bumetamide/Burinex, Burinex К

• Weak diuretics

bendrofluazide/Aprinox, Berkozide, Centyl

Dyazide, Moduretic

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EYE CARE: TIPS FOR CONTACT LENS WEARERS

admin — Thu, 16 Sep 2010 14:16:16 +0000

Here are some miscellaneous tips for contact lens wearers:

1. Wait a half hour after awakening before inserting your lenses to give your sleep-swollen corneas a chance to return to normal.

2. A short nap with lenses in place won’t be harmful, but remember not to go to bed for the night with your contacts on.

3. Insert lenses prior to putting on face or eye makeup. Water-soluble eye makeup is best for lens wearers.

4. Wash your hands before putting in a lens to avoid introducing irritating substances into the eyes.

5. Never touch the inner surface of the lens, which rests against the cornea.

6. If you must use aerosol deodorants and hair sprays (and for the sake of the environment it’s recommended that you do not), apply them before installing your contact lenses.

7. Have new lenses rechecked after ten days and again in a month to be sure they are not damaging the eyes. Repeat such examination once a year.

8. See an ophthalmologist if you develop lasting irritation, redness, pain, blurred vision, or any other eye abnormality, whether or not directly connected to your wearing of contact lenses.

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YOU AND YOUR CHILD: STRATEGIES FOR MANAGING BEHAVIOUR PROBLEMS IN YOUNG CHILDREN

admin — Thu, 21 May 2009 07:01:50 +0000

Maintain a sense of humour. While many behaviour problems really are serious and a cause of considerable stress for parents, keeping things in perspective is important. The fact that the child utters a profanity, or breaks a vase, isn’t necessarily the calamity that it appears to be at the time. Of course, it is still important to employ the strategies outlined below but the ability to laugh, and not to take it all too seriously, is one of the more important things to keep in mind as a parent. Give your child a choice where possible, but set limits on this. Often there is a blow-up in the morning, when you are in a hurry, and your toddler is holding everyone to ransom by refusing to wear the yellow shirt. A limited choice — ‘Which shirt would you like to wear, the yellow one or the red one?’ — will give your child a sense of control as well, and often avoids setting up a confrontation. Observe the two fundamental rules of behaviour modification: reinforce wanted behaviour, and ignore unwanted behaviour. Most parents generally do not pay enough attention to children when they are good, that is, they do not sufficiently reward and reinforce desirable behaviour. Try to catch your child being good, and let him know how pleased you are about it. Praise him verbally, or with a light touch on the shoulder, a cuddle, or even an unexpected reward, such as an icecream. Similarly, wherever possible and appropriate try to ignore undesirable behaviour (see Temper tantrums, p. 144). Obviously, there will be times when this is not appropriate. In these circumstances, use the ‘time-out’ technique which is described below.

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HEADACHE — CLUSTER – DIAGNOSIS

admin — Fri, 15 May 2009 09:10:36 +0000

As well, the eye may water and the nostril on that side become blocked, then run with discharge.

The pain rarely lasts beyond three hours and is often as short as 30 minutes. Attacks may occur several times a day and often go on for days or weeks, then disappear.

During an attack, alcohol seems to precipitate the headache, or make it worse. In between attacks, alcohol has no effect.

Many sufferers seem to share a characteristic appearance. Their facial features are described as leonine (lionlike).

Once diagnosed, treatment lies more in prevention than using drugs to relieve the acute pain.

Drugs used in the management of migraine such as methysergide, pizotifen and ergotamine taken regularly, singly or in combination, can abort and prevent attacks.

Cortisone, used in a short burst, is also of considerable value. The betablocker drugs, originally introduced for use in treating heart disorders and high blood pressure, can be of benefit in preventing these attacks.

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MENOPAUSE – TREATMENT

admin — Fri, 15 May 2009 07:19:29 +0000

It was suggested that hysterectomy should be carried out on all women beginning oestrogen replacement therapy so as to “keep young” … this operation is not a minor procedure and such advice did not find favor in this country.

Sometimes oestrogen may be given in cream or pessary form to deal with local changes in the genital area.

Oestrogens may cause bleeding and this can be a worry as the doctor may be uncertain whether the bleeding is due to the tablets or to a cancer. For this reason, all cases of post-menopausal bleeding need to be properly investigated.

A woman’s change of life should be accepted as part of existence and as an entry into a different world. No longer is there the fear of becoming pregnant and she should retain or increase her interest in sex.

Those who understand what is happening to their bodies have more chance of having a smooth and trouble-free climacteric.

Hormone replacement therapy is an important and now, relatively safe, form of treatment for menopausal symptoms. The oestrogen is combined with the other female hormone, progesterone, and is usually given in a cyclical fashion.

This does result in regular bleeding, like a period, but by getting rid of the lining of the womb with this bleeding, the risk of getting cancer of the womb is greatly reduced.

This treatment will prevent the development of osteoporosis and may also be protective for cancer of the breast.

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BABY AND CHILDHOOD RESPIRATORY DISORDERS: LARYNGEAL STRIDOR (STRANGE HARSH BREATHING NOISES)

admin — Fri, 08 May 2009 08:37:36 +0000

Some babies from birth make a strange rasping noise when they breathe. It may be more noticeable when they cry. There are many causes, and the doctor will try to discover the underlying reason, and have this corrected if possible.

Infections of the voice box are the commonest cause. (In serious cases this may develop into croup, as previously described.) Foreign bodies the infant has inhaled, or structural abnormalities that occurred during baby’s development, all may play a part.

Noisy breathing is the key symptom. The parent may notice that when the infant breathes, the area between the ribs seems to suck in. Hoarseness, breathing difficulty, and a ‘laryngeal crow’ (this is a strange crowing noise when baby breathes) may be present.

Treatment

If any of these symptoms are present, they need a full check by the doctor. When the cause has been found, the doctor will work out the necessary treatment. It will vary with the individual; and as treatment varies with cause, it is a matter of tailoring the therapy for the young patient.

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BABY AND CHILDHOOD ILLNESSES: TICS

admin — Fri, 08 May 2009 08:28:18 +0000

Tics commonly occur between the ages of five and ten years. They are repetitive, purposeless, involuntary movements. Often they commence for a reason, such as a sore eye, but then their automatic nature takes over. Winking the eye, tossing the head, shrugging the shoulders or jerking an arm or hand are common movements. Nearly always these have an emotional basis. The well-adjusted, normal child will rarely have persisting tics.

Treatment

An effort to find an emotional cause is often worthwhile, for most cases have a nervous origin. Strict parental domination, with no available outlet for emotional stresses, is a common cause. Stressful situations at home, or at school, or with peers, may often provide causes for this outward manifestation. Frequently, if the cause is found and relief can be offered (by correcting the problem), the condition may be resolved. Sometimes tics persist into adult life.

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NOSEBLEEDS

admin — Wed, 29 Apr 2009 09:54:39 +0000

(Epistaxis)

Nosebleeds have a variety of causes, most of which are minor. Most nosebleeds are caused by the rupture of small blood vessels in the anterior section of the nasal septum. There are often obvious causes like a blow to the nose, irritation from a foreign body, excessive nose-blowing during a cold or sinusitis and nose-picking. Nosebleeds can also occur during menstruation. Some people suffer more from nosebleeds than others.

Occasionally nosebleeds are related to more serious illnesses and injuries such as the presence of polyps or other growths in the nose, high blood pressure, allergies to certain foods, vitamin deficiencies and conditions like haemophilia. Arteriosclerosis, or hardening of the arteries, can cause nosebleeds in old people, while in children they are sometimes a symptom of rheumatic fever.

When bleeding from the nose cannot be sourced to a blood vessel inside the nose, it may indicate an internal injury. The blood may be caused by a skull fracture or injury to the stomach or lungs. If the nose bleeds regularly or excessively, or if the bleeding is difficult to stop, medical advice should be sought. Persistent bleeding may require cauterisation of the blood vessel.

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CYSTIC FIBROSIS IN CHILDREN

admin — Tue, 28 Apr 2009 09:26:55 +0000

Cystic fibrosis is a chronic (lifelong), inherited disease. It affects the lungs, pancreas, sweat glands, and sometimes the liver and other organs.

Cystic fibrosis (CF) is passed from parents to child through a particular gene. Genes are the parts of the body’s cells that determine inherited characteristics (such as hair color, eye color, and size, as well as inherited diseases). To have cystic fibrosis, a child must inherit the particular gene from both parents. A child who has the CF gene from only one parent will not have the disease. A person who carries the gene but does not have the disease is known as a “healthy carrier.” When both parents are healthy carriers, only about 25 percent of their children receive the gene from both parents and develop the disease.

CF may appear at birth as an obstruction or blocking of the intestines. Symptoms may also appear during infancy or childhood and sometimes as late as adolescence.

Signs and symptoms

Some common symptoms of cystic fibrosis are frequent respiratory infections, including bronchitis and pneumonia; chronic cough; failure to gain adequate weight; constipation or diarrhea with foul-smelling stools; protrusion of the rectum; and clubbing (broadening) of the fingertips and toes. Almost all persons with cystic fibrosis have unusually salty sweat. A very salty taste to a child’s skin when kissed is sometimes a sign of CF.

Home care

If you have any reason to suspect your child has CF, see your doctor. If CF is diagnosed, home treatment will be directed by your doctor. Treatment at home may include taking antibiotics, following a special diet, taking pancreatic enzymes by mouth, inhaling vapor and medications, and postural drainage.

(Postural drainage, conducted in a home setting, involves positioning the child over the bed with the head pillowed on the floor. The child’s chest is tapped soundly to allow excess fluids to drain from the lungs. Your doctor will give specific instructions for performing postural drainage.)

Precautions

• If your child shows any CF symptoms, a sweat test should be done. A sweat test is a painless, harmless, inexpensive, and generally reliable test for cystic fibrosis.

• If there is any history of CF in the family, a sweat test should be considered for all children, even if they appear to be healthy.

• The sweat test is not reliable before age one month and is not as reliable during adolescence.

Medical treatment

The doctor will perform an inexpensive test for CF called the sweat test. The doctor may also order a chest X ray. If cystic fibrosis is diagnosed, your doctor will refer you to a medical center where there are specialists in treating CF.

The outlook for prolonged life of a child with CF who is in relatively good health is better now than in the past, but a cure for CF is still being sought. The earlier the diagnosis is made and treatment started, the better the outcome.

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FOOD FOR LIFE: FISH AND TOFU

admin — Thu, 23 Apr 2009 06:11:56 +0000

Believe this fish story.

Some fish have a good type of fat called omega-3 fatty acids, and salmon is one of the richer sources of that element. Our bodies use omega-3 fatty acids to make hormone-like substances called eicosanoids, which help regulate processes such as inflammation, blood clotting, and constriction of blood vessels.

Omega-3′s appear to assure the orderly inflow of calcium, sodium, and other charged particles into each heart cell, which helps ensure a nice, steady, strong thump-bump, thump-bump.

And talk about capable: Fish like salmon, anchovies, and herring, which are all rich in Omega-3′s, reel in one of the shadiest characters implicated in rheumatoid arthritis inflammation, leukotriene B4. Scientists can measure a significant drop in leukotriene when fish oil is added to the diet.

Omega-3′s don’t stop there. They also soothe the effects of Crohn’s disease (a serious inflammation of the small intestine), may lessen your sweetheart’s severe menstrual cramping, and are thought to help stave off depression.

Need more convincing of this fishy health benefactor? One study showed that people who ate the equivalent of just one serving of salmon weekly had half the risk of cardiac arrest as those who ate no omega-3′s.

How much, how often? A single 3-ounce serving of baked salmon provides 10 times the amount of omega-3′s the typical American gets in a week. Eat at least one serving weekly, experts say.

Tofu.

So it sounds a bit like an invective. Too many of us have shunned it as though it were. But this simple, palatable, easy-to-use, and oh-so-versatile soybean derivative is nothing short of a super-food when it comes to our health.

Cultivating a taste for tofu is easy; it can be added to just about anything without changing the taste. Tofu is mild and light-bodied and represents “one of our very best food choices,” Dr. Anderson says.

What can you do with tofu? Blend it in a shake or smoothie. Crumble it on a salad. Chuck chunks into soups, stews, chili, marinara sauce. Slice it for a sandwich to replace cheese. Blend it into dips, dressings, custards, puddings. Slip it into stir-fries.

The potential health benefits of soy are sweeping, says Dr. Anderson. Topping the list: major heart protection. Add to that preliminary but encouraging studies suggesting reversal of osteoporosis, and other studies suggesting reduction in the risk of kidney disease and a lower risk of prostate and colon cancers. You begin to see why Dr. Anderson is soy excited.

Researchers haven’t determined precisely how soy manages its heart-healing magic, but they’re thinking that compounds in soy might function as antioxidants.

In addition, emerging research suggests that isoflavones (another plant version of estrogen) in soybeans may actually repair damaged, sluggish blood vessels, restoring their youthful flexibility – something that’s important for healthy blood flow, says Dr. Anderson.

The isoflavones’ estrogen-like and estrogen-altering activities may be key to the reductions in risks of prostate and breast cancers. These activities may also be why the isoflavones are credited with preserving bone and actually promoting new bone mass. Isoflavones are also known kidney-protectors.

How much should you eat? It depends on what you want. For general health, Dr. Anderson recommends 30 to 40 milligrams of isoflavones per day. (A 1/2-cup serving of tofu has 35 milligrams of isoflavones, 1 cup regular soy milk has 30 milligrams, and 2 tablespoons roasted soy butter has 17 milligrams.) To tap tofu’s help in reversing heart disease and osteoporosis, Dr. Anderson recommends that you triple your daily dose.

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