SKIN CANCER: MELANOMA
KEY POINTS: SCOPE AND IMPACT OF DIABETES IN THE U.S.
Prevalence of diagnosed diabetes has risen from 4.9% in 1990 to 7.3% in 2000.
There are approximately 12-14 million adults with known diabetes. Prevalence rises with increasing age.
An additional 6-7 million adults have diabetes but do not know it. When people with IGT are included, over 25% of the adult population in the U.S. has abnormal glucose metabolism.
Type 1 diabetes is present in less than 1 million people in the U.S. In 1997, expenditures attributable to diabetes were $98 billion.
Total medical expenditures by people with diabetes in 1997 were in excess of $10,000/year, about 4 times the expenditures for people without diabetes.
People with diabetes lose about 8.3 days from work each year, 5 times the days lost by those without diabetes.
A shift from hospital to outpatient-based care resulted in a decrease in direct costs for diabetes between 1992 and 1997, despite increased prevalence of the disease.
Major cardiovascular risk factors are usually present in excess before the diagnosis of type 2 diabetes as well as during the course of the disease.
Major advances in preventive measures directed at the complications of micro and macrovascular disease will lead to reduced costs of diabetes in the future, if translated into usual diabetes care.
*14\357\8*
COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: BRONCHODILATORY DRUGS – SIDE EFFECTS OF XANTHINES OR THEOPHYLLINE DRUGS
Generally, xanthines do not cause serious long-term side effects. However, there can be acute side effects if the dosage is high. These side effects mainly involve the stomach and the nervous system. The effects on the stomach include nausea, vomiting, loss of appetite, stomach aches and cramps. The effects on the nervous system include irritability, dizziness, tremors, insomnia and headaches. Some children may become hyperactive, and in rare cases, develop learning problems. Parents should look out for these symptoms.
Sometimes the stomach or the intestines may become sensitive in which case theophylline or other xanthine drugs can be taken with milk, biscuits or other foods.
Precautions. These medicines should be taken exactly as prescribed, which is usually at equally spaced intervals spread over a 24-hour period. It is important to maintain their level in the blood stream within the therapeutic range at all times. The medicine should therefore be continued even when the child is well and shows no apparent signs of asthma. Any adverse or side effects should be reported to the doctor so that he can regulate the dosage to minimise or avoid undesirable side effects. The doctor should be informed if the child is taking any antibiotics. If so, the dose may need to be adjusted to keep the level of the drugs in the therapeutic range.
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ALLERGIES: HISTORY, MANAGEMENT AND TREATMENT
The word allergy is fairly young but the signs and symptoms have been noted for centuries. Of course Hippocrates referred to it long before Christ. Four centuries ago a cardinal was said to have been forced to withdraw every year at the time the roses were in bloom. Thomas Willis is well known to us doctors for describing some little blood vessels at the base of the brain which occasionally force themselves on our attention by rupturing. About the time that Charles II was living his riotous life, and our austere ancestors were developing our eastern seaboard, Willis described asthma. Only in the last century has “hay fever” been recognized. The English in particular have continued to be hay-fever minded, while we in America are more disturbed by other plants.
The man who really told us something was Dr. Morrill Wyman, of Harvard Medical School, who eighty years or so ago wrote a book on Autumnal Catarrh. He was the one who put a finger on that wicked, wicked villain, ragweed. Somewhat before his time there was a pretty strong opinion that asthma was a nervous affliction. One man whom I cannot identify told of “an asthmatic little boy who would say to his father, ‘Don’t scold me or I will have the asthma,’ and so he did: his fears were as correct as they were convenient.” We all recognize now that both nervous and physical effects play a part.
There certainly is no routine way to dodge allergy, whether or not your equanimity and peace of mind are catered to. I have a fortunate friend who is fond of the mountains and at the proper time he takes his vacation in the White Mountains, where he is free from the pollen and happy. Such travel is worth while. It is a different story when home life is broken up to seek some distant location where bodily reactions will be no longer vile. There are pollens and molds practically everywhere. Often at first there is temporary improvement, but too often it is short lived. But always if a move is tried it should first be on a temporary basis. Do not burn your bridges behind you. Arrange it so that a return may be made to the scenes, friends, and associates of a lifetime if permanent relief is not found in the new place. Perhaps your psyche will come to your aid with your final return to your familiar and formerly loved surroundings.
The identification, regulation, and treatment of a case of allergy is a time-consuming, difficult job. Here is a rough outline of the manner in which it is usually done.
1. An exhaustive survey is made of clues and possible causes.
2. A general physical examination is made to appraise the patient as a whole.
3. Such tests as are called for to verify or disprove the clues obtained are now performed.
4. The non-essential items to which the patient is allergic or sensitive are eliminated. Common examples of these are pets, egg, lobster, feathers.
5. Injections are given to immunize against those things which cannot be eliminated from the environment. Examples: pollens, molds, and dust.
Successful management of allergic problems demands not only tests but the survey of the patient as a whole and the employment of previous experience of like cases. All possible approaches should be used. Patience on the part of the doctor and the patient is essential. Trial and error are often necessary and that takes time.
There is a tremendous amount of enthusiastic study of allergy going on at the present time. Several of my friends attend frequently what they call their Sneeze, Wheeze, and Itch Club. I should think that they would need a little of this jocosity to brighten up their work which to an onlooker would seem to be long and difficult, often baffling, and with many discouraging setbacks. Yet its rewards are great.
Few things not lethal that happen to the human body are more distressing than the manifestations of allergy. To restore to comfort a child covered with itching eczema, or an older person gasping and fighting day and night for barely enough air to keep alive, is indeed a rewarding experience. Diligent study by devoted physicians and the discovery of numerous new agents are bringing this about with increasing frequency.
*2/276/5*
STROKE: AVOIDING; A BRAIN BREAKDOWN
How common: Stroke is the third leading cause of death for people in the United States. About 550,000 people suffer a stroke each year, most of them men. About 150,000 of those people die each year, roughly 60,000 of whom are men.
Risk factors: Involuntary: age, gender, race (Blacks are more at risk), diabetes, previous stroke, heredity, previous heart attack. Voluntary: high cholesterol, high blood pressure, diet, being overweight, smoking, heavy drinking, lack of exercise.
Age group affected: Men over age 55 are at an increased risk, and their chance for stroke doubles every decade thereafter.
Gender gap: Men are 30 percent more likely to have a stroke than women, but less likely to die.
Who to see: Emergency room physician ASAP, then a neurologist.
Actor Raul, Julia will always be remembered as the vigorous, sensuous Gomez Addams from the Addams Family movies. He danced with reckless abandon and brandished his fencing rapier with lightning speed. Yet, at only 54 years of age, Raul Julia died from the complications of a stroke.
Julia’s death was a shock. But that he died of a stroke is not. Stroke is the third leading cause of death in the United States, preceded only by heart disease and cancer.
Think of stroke as a heart attack of the brain—a “brain attack,” as the experts say. Like a heart attack, a stroke is quick, unexpected and often deadly. As a man, your chance of getting a stroke is 30 percent greater than that of a woman. Only 40 percent of men who suffer a stroke die, however, compared to 60 percent of women.
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LUNG CANCER: THE BIG THREE
A number of factors play a role in the onset of lung cancer, but three preventive steps stand out.
Stop smoking. “By far the most important thing you can do is to not smoke,” says Dr. Munzer. Overall, smokers are ten times more likely to die from lung cancer than nonsmokers. Once you stop, however, the lungs immediately begin to nurture themselves back to health, slowly but surely. Ten years after quitting, a smoker’s risk of lung cancer drops to 30 to 50 percent that of other smokers who continued their habit. After 15 to 20 years risk becomes similar to that of someone who never smoked at all. By one estimate, taking the “Don’t smoke” advice saves 434,000 lives a year.
Don’t get it secondhand. Studies have consistently found that breathing other people’s smoke is almost as bad as smoking yourself, which is why smokers are increasingly being booted out of public buildings, offices, restaurants and shopping malls. In 1993 the Environmental Protection Agency (EPA) declared secondhand smoke a cancer-causing substance and held it responsible for 3,000 lung cancer deaths in nonsmokers each year. By some estimates, having close contact with a smoker raises your risk of lung cancer by 30 to 70 percent, depending on how heavily the other person smokes. In short, if you don’t smoke, other people who do smoke provide a major risk factor for lung cancer.
Vent the cellar. It comes from beneath the earth, undetectable by smell, sight, taste or touch. It’s radon, a natural radioactive gas formed by the breakdown of uranium in rocks and soil. In the open air it’s harmless, but when trapped in airtight houses, it can build to dangerous levels. According to the EPA, radon is the leading cause of lung cancer after smoking. It’s a controversial point: Many studies have failed to find strong links between radon exposure and lung cancer, but many others have/including long-term studies in Sweden that find high exposures over time boost the risk of lung cancer by 30 to 80 percent, depending on the amount of radon exposure. Smoking multiplies the danger.
To get rid of radon, first get a test kit from your local hardware store to determine household levels. If they’re high, one solution is to have a contractor install a simple system of venting pipes and fans to suck air from beneath your basement and release it above the house. In the meantime open a window: Even a small draft can cut radon concentration by half or more.
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BACH FLOWER REMEDIES: PINE REMEDY
Self-reproach; blames himself for not only his faults but for the faults of others also. Guilt feeling. Despondency. Pine relates to the soul qualities of regret and forgiveness.
In the positive state, the Pine person is frank to admit his own fault; expresses his sincere regrets for his failings, but having done so there is no trace of guilt left on his mind, and he does not brood over his past mistakes. True, he takes his lessons from the past mistakes and does not repeat them in future, but does not waste time in thinking of them again and again, or feeling despondent over them. He can easily forgive himself or forgive others for their past mistakes and helps them to overcome any feelings of guilt complex and despondency by offering them his sage advice, and meaningful help. But in the negative state the “Pine’ person makes himself a self-condemning machine. He is always out to blame himself for any undesirable happening. If he arrives late in the office because of an accident to the bus in which he was travelling he would muse “Why did not I start earlier in another bus? It is my fault, in any case.”
If he is driving his scooter on his own side and a rash driver strikes him from behind, he would still blame himself for the accident. He would argue thus, “this is a busy street and I know there are rash drivers who ply their vehicles on this street. I should have taken care to drive to the extreme left, or I should not have used this street”.
If his office peon is reprimanded by the superior officer for dereliction of duty, he would still blame himself for not having guided him properly about his duties.
If his building falls in an earthquake, he would still blame himself for not having constructed it in a quake-proof design.
If he cannot find any justification for taking any blame on himself for such tragedies as cloud burst, earthquake or tempests, his guilt complex attributes such mishappenings to his bad ‘Karma’ in the previous life.
*155\308\8*
ECONOMICS OF BACH FLOWER REMEDIES
As already stated Bach Flower Remedies are available from the BACH FLOWER REMEDIES Ltd, THE BACH CENTRE England in stock bottles in complete sets of all 38 Remedies and also RESCUE Remedy. They are also available separately.
They are available in 2 sizes:
1/3 oz (10 ml) = Approx 140 drops, sufficient for 60 medicine bottles of 30 ml. each.
1 oz (30 ml) = Approx 420 drops, sufficient for 180 medicine bottles of 30 ml. each.
Under normal storage conditions the contents of the stock bottles will keep indefinitely.
Rescue Remedy is also available in the form of cream about 1 oz. packing or 27 grm tube.
Assuming that the cost of the complete set of 38 stock bottles of 30 ml. packing is Rs 6000/- then the cost per 30 ml. works out to 6000/38 = say Rs 160/- i.e., the cost of Flower Remedy ( 2 drops in 30 ml bottle ) = 160/180 i.e., less than Rs 1 / – per 30 ml medicine bottle.
The cost of other contents in the medicine bottle i.e., spring water and brandy and the 30 ml. glass or plastic container bottle may be added to Rs 1/- to arrive at the manufacturing cost of Bach Flower Remedy.
*10\308\8*
ARTHRITIS: PENICILLIN CAN’T HELP
No specific germ has ever been isolated that is responsible for either osteo- or rheumatoid arthritis. So, unfortunately, the popular germ-killer known as penicillin is of no aid to arthritis.
In penicillin there is not one drop of oil to arrest a squeaking joint. It would be wonderful if arthritics could walk into a doctor’s office, receive a beneficial injection of 100,000 units of penicillin, and stay cured, but it’s impossible. With penicillin, or any other antibiotic on the market today.
There are, and probably always will be, a few doctors who will try injecting vaccine. The vaccines themselves are of two kinds, autogenous and stock synthesised. Autogenous means self-originating. Autogenous vaccines are vaccines made from bacteria already inside the patient’s body during fevers or inflammation. Stock vaccines are created in laboratory test-tubes. The theory is that if you inject bacteria from one disease (like typhoid) and cause an abnormally high fever, when the fever recedes it may take away your arthritis, too.
Doctors begin by giving small doses of 10,000,000 micro-organisms, then lead up to 2,000,000,000 organisms. A violent body reaction results. Some of the better-known vaccines are Coley’s, Crome’s typhoid, a non-specific protein vaccine like sulphur, and a bee-venom preparation named apiolan. Even the doctors who used vaccine therapy soon saw its limitations. The fever caused was sometimes worse than the arthritis.
Still another injection experiment involved arsenic salts. Today we hear little of arsenic being used as a drug in the treatment of arthritis. Yet, because a limited number of arthritics thought they felt better temporarily, arsenic was known and used for a time as a blood stimulator. We could delve into a dozen other drugs like strychnine, quinine, nitrates and bromides. All have been tried out on the arthritic and all have failed.
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