May 8th 2009 · Read More · No Comments
Summary of main points.
• Accurate measurements of body fat, mass and distribution require a variety of techniques and there is no one entirely satisfactory measure.
• A combination of measures is usually necessary to determine health risk.
• Validity, reliability and sensitivity of measures are an important indication of their worth.
• BMI is a good measure of body mass; waist circumference of fat distribution; skinfolds are useful measurements in the hands of experienced operators and with thon severely obese.
• New measures of central fat, such as abdominal diameter, may have important uses in the future.
Typically, the most commonly used measure of body fatness has been body weight. This is then compared with a table of ‘ideal weights’ prepared by life insurance companies on the basis of actuarial data, relating weight to the risk of an early death or to average weights in the population, and some measure of overweight calculated on the basis of population figures.
The advantage of weight is that it is a simple, accurate and reliable measurement. For individuals, significant changes in weight over the long term usually reflect significant changes in body composition. However, weight is often not a true reflection of obesity—particularly in those in the population (e.g. athletic males) who might have high body density due to muscular structure—nor a good indication of health risk, because measures of weight (in contrast to body fat distribution) do not correlate highly with illness risk. Height is, of course, a confounding factor and hence the calculation of body mass index, or BMI, which corrects for height, has become the norm.
More recently, it has been realised that BMI is also not always a good representation of fatness, again because of the bias against those with a high body density (i.e. those with a high fat free mass to fat mass ratio, FFM:FM). Hence there has been a recent move towards new measures of total body fat and fat distribution, including the better use of simple anthropometric measures such as height, weight and circumference measures. There has also been a move to develop cost-effective machines which accurately measure fat, in contrast to body mass.
*56\186\4*
May 8th 2009 · Read More · No Comments
This occurs when a young baby (usually under the age of six months) which is apparently healthy, suddenly dies for no obvious reason while peacefully sleeping in its cot at night.
It is now more often referred to as ‘Sudden infant death syndrome’ or ‘Sudden and unexpected deaths in children syndrome’.
The cause is still in dispute, although many theories have been put forward, and each week medical journals offer more ideas. Viral infections, the baby drowning in its own carbon dioxide (seems more common if the cot sides are covered in), lack of vitamin E, immunodeficiency, immunization, diabetes, aerosols, the house dust mite sensitivity, cows’ milk that is too strong, cardiac changes, allergies, over-heating, pressure from a dummy, head colds, inhaled milk from a burp when the stomach is full, a reduction in the mucosal defence of the respiratory system, body cooling, and lack of magnesium have all been incriminated at some time. There may be many causes, and some or none of the above may finally prove to play a part.
At present, it is repeated, the cause is still unknown. It appears to be less common in breast-fed babies which may indicate that there is some deficiency in the baby’s resistance factors. Most autopsies do not offer any reason for the unexpected happening. They are often put down to a sudden unexplained infection. Most health departments are now carrying out fuller investigations in the hope that a cause and cure may be discovered.
*80\87\2*
May 8th 2009 · Read More · No Comments
Jealousy implies a sense of insecurity combined with a desire to monopolize; within the family circle, there can be many such combinations, none of which leads to happiness. It is more common with a first child, particularly when the second baby arrives, and it may be aggravated if parents make individious comparisons. It may readily be worsened if there are personal feuds between the parents, if there is a show of favouritism for one, or if one is disciplined to the benefit of the other.
Often jealousy leads to direct physical violence with the rival. But frequently there are other low-key methods that are adopted more subtly. A child may revert to some former childhood behaviour, such as bed-wetting, thumb sucking, or clinging to a particular parent, may withdraw from the family circle, develop anti-social attitudes to others, especially at school, where it may act as an attention-getter.
Treatment
Ideally parents will prepare child if there is to be an addition to the family in the near future. Playing it cool and not overdoing this is important, otherwise the child may suspect something sinister. Avoiding obvious parental favouritism is important. All efforts must be made to let all the children in a family know they are loved and wanted and will always remain secure in their parents’ affection.
*31\87\2*
April 29th 2009 · Read More · No Comments
The volatile oil of the peppermint is listed by some as the most important of all essential oils. Containing cooling menthol, this pungently aromatic oil is an antispasmodic, used to ease painful conditions of the alimentary canal, including flatulence, colic, and abdominal cramps. Like all volatile oils, however, it should not be administered to babies without the supervision of a qualified health practitioner.
Peppermint oil, applied to the temples or inhaled, will ease the symptoms of a head cold, including a cold-related headache. It acts as a mild diaphoretic, meaning that it promotes perspiration.
Peppermint leaves steeped as a tea bring relief from indigestion and all kinds of nausea, including morning sickness. A common ingredient in toothpastes and chewing gum, peppermint conquers bad breath and the oil or leaves can be used in the preparation of a refreshing mouthwash. The essential oil of peppermint, applied to the temples, will improve concentration.
Similar therapeutic properties are found in other species of mint, including spearmint.
*30\69\2*
April 29th 2009 · Read More · No Comments
What would you do if you came home one day to find that your wife had left you, had taken your two children with her and had cleared all the furniture out of the house? This is the state of affairs that confronted Matthew one day when he returned home from his job as a security officer. There had been some difficulties in the marriage, but nothing that made Matthew suspect that it was almost over. ‘She was so nice to me the night before she left,’ he mused wistfully ‘it was as though she was giving me a going-away present.’ In fact, his wife had met another man and moved away to live with him, taking the two children with her.
For Matthew the loss was devastating. He had always been a sensitive person. Even as a young boy he had always been ‘thin-skinned’, feeling more stung than most by ordinary taunts from other boys in the playground. Later, when it came time to date girls, he was always painfully aware when he did not have a girlfriend while others did. ‘I was always crushed by rejections,’ he recalls ‘and would often be disinclined to try things because of fear of failure.’ He wondered whether his extreme sensitivity was somehow related to his pale sun-sensitive skin which went along with his ginger hair.
Being abandoned by his wife was one of the biggest blows of Matthew’s life. He felt like a failure as a husband and a father and went into a profound depression that was to last six years. During this time he felt like a bad person – if that were not the case, he reasoned, why would his wife have left him for another man? He couldn’t sleep at night as his mind ‘would race to places I wouldn’t want it to go – back to the memories of being abandoned and betrayed by my wife’. During the day, on the other hand, a cloud of exhaustion would overwhelm him when he was at work and should have been attending to the security of the business for which he worked. He recalls how his eyelids ‘weighed 1000 pounds each’ and he could barely stay awake. He craved junk foods – sweets, donuts, chocolate ice-cream and cakes. His blood sugar became elevated and he needed medications to lower it.
Things became so bad that he felt as though he no longer had any reason to live. Life seemed to lose its meaning and he would ask himself, ‘What is this all for?’ He went to the doctor for help, mindful that he had proven to be hypersensitive to almost all medications he had been given in the past. The doctor recommended Lustral, but Matthew suffered a serious allergic reaction after only a single dose. His eyes swelled shut, his heart ‘raced 100 miles per hour’ and he had nightmares and hallucinations.
Shortly after this experience, his mother saw a television programme in which the benefits of St John’s Wort were discussed. She suggested that he might try it. Recognizing his sensitivity to medications, Matthew began by taking 300 mg of St John’s Wort per day. He felt some relief from the very first day and the improvement continued over the subsequent two months, by which time his depression had lifted completely. His sleep improved and even though he was sleeping fewer hours than he had been, he ‘seemed to get more out of it’ and felt more rested and alert during the day. His energy level ‘was boosted back to its normal level’.
Matthew has returned to his old passion, music, and has begun to play his guitar again. He finds himself walking around the house, singing and dancing. For a long time he’d forgotten that music even existed. Now he is overjoyed to have rediscovered it and will literally burst out into song. He has returned to church again, visiting different denominations to discuss religious ideas with different people. Along with his improved mental condition, Matthew’s physical health is also better. Remarkably, given his sensitivity to medicines of all types, Matthew has experienced no side-effects whatsoever on St John’s Wort.
Even though his depression is over, Matthew recognizes that he is now faced with having to rebuild his life. ‘I am just beginning to see the light at the end of the tunnel,’ he observes, ‘but I’m not there yet.’ He plans to go to the gym and enrol in classes so that he can get a better job. He is even contemplating beginning to date again ‘without the old defeated attitude’. He has begun to chat with an old sweetheart from his school days and is thinking of buying some new clothes and taking her out dancing.
He sums up his experiences with St John’s Wort as follows:
‘After six years of solid depression, of feeling crippled and at the edge of a cliff, ready to jump … all my ailments have subsided.
I no longer feel any need for a medical professional. My faith has been restored. It’s a miracle.’
No doctors involved. No side-effects. Complete remission of a chronic and disabling depression. Small wonder, therefore, that Matthew regards St John’s Wort as a miracle herb that has given him back his life.
*6\75\2*
April 28th 2009 · Read More · No Comments
The previous two cases illustrated a chemical- and a food-susceptibility problem, respectively. The case of ten-year-old Paul Rossi demonstrates the more common instance in which both food and chemical susceptibilities combine to create a serious illness.
Paul was an extreme case of hyperactivity. The examining physician in the Ecology Unit could not complete the admission interview, since Paul kicked, pushed, and shoved everybody around him, including his mother who was to stay with him.
Paul’s temper tantrums had begun when he was thirteen months old. He appeared to be learning well, however, until his seventeenth month, when he suddenly started forgetting the words he had already learned. He seemed distant and unable to relate emotionally to those around him. When he reached school age, his parents attempted to place him in a public school, but to no avail. He could not learn, and was transferred from one school to another. He was finally placed in a school for problem children, a sheltered environment, where he was kept on tranquilizers most of the time. Occasionally his behavior became so uncontrollable that he had to be placed in a straitjacket.
Watching this boy race around the examination room, overturning furniture and tearing papers, one could not help but feel sorry for this tortured child and his frustrated, agonized parents.
Paul had been diagnosed as “autistic.” Autism is a strange disease in which the child, in effect, dreams his life away, seemingly unaware of external reality. He cannot form meaningful relationships, and has difficulty in learning or even speaking. Other doctors had suggested as treatment drugs, vitamins, or institutionalization. Before coming to the Ecology Unit, Mrs. Rossi had put Paul on the Feingold Diet, a mass-applicable approach which cautions against artificially-colored or -flavored items, as well as certain other types of food.3 The Feingold Diet, which eliminates some, but hardly all, of the synthetic pollutants in food, was useful, and Paul benefitted. Encouraged, Mrs. Rossi sought a more complete, personalized approach.
Paul’s history revealed a tendency toward addiction to foods containing beet sugar, milk, corn, and oranges. These seemed to result in flare-ups of his behavior problems when he ate them in excess. He also appeared to be highly susceptible to environmental chemicals. When he was exposed to perfume, nail polish, or similar cosmetics he would frequently scream, kick, and bite for a few minutes, as if in a seizure.
Abstention from food for five days, in a chemically less contaminated environment, led to a marked improvement in his behavior. When he was given beef, and corn mush sprinkled with corn sugar, however, he threw a temper tantrum which was quite convincing as a test of food allergy to those around him. He also reacted to apricot, raisins, grape juice, yeast, beets and beet sugar, honey, lamb, and other foods. His mother had said that hot dogs seemed to bring on his symptoms at home. Most hot dogs contain beef, corn, and other foods identified as troublesome in the deliberate food tests.
We next took some of the organic foods to which Paul had not reacted in his food tests (such as honeydew, broccoli, and peas) and fed them to him for six successive meals in their commercial form—the type of food that he, and millions of other children and adults, eat every day. By the end of the sixth meal, there was a marked increase in his hyperactivity and irritability, and the symptoms of autism were also increased.
Paul turned out to be one of those people who must have truly organic food in order to stay well. If he does not get it he suffers from problems so severe that he becomes impossible for his parents to cope with. With it, despite the supposedly “incurable” nature of his problems, specifically autism, he is able to lead a normal life.
*59\110\2*
April 28th 2009 · Read More · No Comments
Closely related to the drug problem is that posed by cosmetics. In fact, as far as the majority of chemically susceptible persons are concerned, the scent of cosmetics is one of the most troublesome features of this problem.
One patient found that she had difficulty riding in elevators or dining out in many restaurants because of her great susceptibility to scents. Sometimes it is only particular perfumes which the susceptible person finds annoying or even suffocating. The safest thing, however, is for such individuals to avoid all perfumes, either on themselves or when worn by others. (The same advice applies to after-shave lotions and colognes, which can be equally irritating to certain individuals.)
Another possible solution is to use only cosmetics and ointments made up entirely of natural ingredients, without artificial colors, scents, and preservatives. Such preparations are more widely available now than they were a decade ago, although use of the word hypoallergenic is no guarantee that the product will not cause adverse reactions. Some genuinely nonallergenic products must be refrigerated, since they contain no artificial preservatives.
Reactions to cosmetics, it should be emphasized, usually occur in the presence of an overall susceptibility to the chemical environment. The inability to tolerate these agents alone is rare.
The overall question of drug and cosmetic sensitivity is one which has received far too little publicity in recent years. In fact, it has required a struggle even to get the facts about acute drug side effects to the public. Yet the question of chronic, disguised, long-term harm may be more important than the more dramatic short-term problems caused by these agents.
Since the drug side of this problem is largely caused by the medical profession, supported by the pharmaceutical manufacturers, it is a highly controversial question. And since it involves multiple symptoms, based on an individual’s unique reactions to his overall chemical (and food) intake, it is not given to mass-applicable solutions. The existence of this drug susceptibility problem highlights the pressing need for a thoroughly new orientation in medical care, employing more individualized approaches to chronic illness.
*29\110\2*
April 28th 2009 · Read More · No Comments
Dizziness (vertigo) is the sensation that the person is spinning around or that the environment is turning around the person. It is a sense of rotating and can be experienced normally by twirling rapidly in one spot until the room reels. Dizziness makes it difficult for a person to keep balanced. If dizziness continues, it may cause nausea and vomiting.
If possible, it is important to find out exactly what a child means when complaining of dizziness. Children often use the word “dizzy” to describe faintness, light-headedness, nausea, and vision problems. Any of these problems can have many causes.
True dizziness has few causes. The most common cause is infection of the inner ear (semicircular canals), sometimes from a virus (Meniere’s syndrome). This disease usually is harmless and clears up without treatment, but it may last for weeks.
Dizziness may also accompany middle ear infections, concussions, and fractures of the base of the skull. Dizziness occurs with tumours that involve the eighth cranial nerve or the cerebellum of the brain. It may also occur in cases of meningitis and encephalitis.
Signs and symptoms
If your child complains about feeling dizzy, ask the child to try to describe the feeling as clearly as possible. Be sure the child is describing a spinning sensation and not some other sensation (faintness, lightheadedness, nausea, or vision problems). Look at the child to see if there is a loss of balance. Also look for jerking motions of the eyes when they are turned to one side or the other; this is another sign of dizziness. A long period of dizziness may cause nausea and vomiting.
Home care
Have a dizzy child sit or lie down to rest. Raise the feet higher than the head to relieve symptoms of faintness or lightheadedness. If the dizziness was caused simply by turning or spinning during play, the dizziness will quickly disappear. If rest does not relieve the dizziness, the cause must be determined by a doctor for proper treatment.
Precautions
• Try to be sure the child is describing a sense of rotation before reporting the condition to your doctor.
• See your doctor if dizziness occurs often or if dizziness lasts more than a short period (one or two hours).
Medical treatment
The doctor will perform careful physical and neurological (nervous system) examinations. X rays of the skull and a blood count may be required. An ear, nose, and throat specialist may be asked to test the functioning of the inner ear, as well as the child’s hearing. Your doctor may also consult a neurologist (a specialist in diseases of the nervous system). A CAT (computerized axial tomography) scan and an electroencephalogram may be necessary.
*54/84/5*
April 23rd 2009 · Read More · No Comments
Tuberculosis test: You should have a tuberculin skin test every three to five years throughout your life, Dr. Goldberg suggests. Tuberculosis has gone from the history books to the newspaper headlines. And today’s strains are harder to fight with traditional medications, making early detection essential. Men are twice as likely to get tuberculosis as women. You are particularly vulnerable if you live in crowded conditions or work in the teaching or health-care professions.
Cholesterol screening: You should have your cholesterol-or lipid profile-screened every three years until your 40th birthday; then switch to every two years, suggests Dr. Goldberg. Cholesterol screenings will tell you several things: Your level of “bad” low-density lipoprotein (LDL) cholesterol, which is known to form plaque on artery walls; your level of “good” high-density lipoprotein (HDL) cholesterol, which appears to prevent plaque buildup; and the triglycerides in your blood, which are body fats that, when present at high levels, can contribute to heart disease risk. Ideally, you should aim for total cholesterol of no more than 200 milligrams per deciliter and LDL cholesterol of no more than 130 milligrams per deciliter. HDL should be at least 35 milligrams per deciliter, but more is better. Triglyceride levels should register under 200 milligrams per deciliter.
Eye exam: You should have your vision checked every three years until you reach 40 and then every two years thereafter, just to be sure that you’re seeing as clearly as possible, says Dr. Coulehan.
Testicular self-exam: If you’re younger than 40, you should check your testicles every month, but it doesn’t hurt to keep checking them monthly even after you are 40. “Testicular cancer is the most common solid cancer in men younger than 35,” Dr. Goldberg says.
Electrocardiogram: You should get a baseline electrocardiogram done at every decade throughout your life, says Dr. Goldberg. This test uses electrodes on your wrists and ankles and chest to determine the electrical activity of your heart. Any abnormalities will alert your doctor that there may be some form of heart disease in progress and that he should perform further tests.
HIV test: While not recommended as part of routine screening tests, if you feel that you are at risk for HIV because of your sexual practices or intravenous drug use, you should be tested regularly. “But having a clean AIDS test is not a license to act irresponsibly,” warns Dr. Coulehan. “A negative test does not mean that you are invulnerable to future infection. Obviously, you will need to practice safe sex.”
*61/36/5*
April 22nd 2009 · Read More · No Comments
The more radical operation is increasingly less used. As already stated, it can be deforming. In addition to the removal of the cancer and an ellipse of skin around the breast, the whole breast is removed as in a simple total mastectomy, and the auxiliary lymph nodes are stripped to the apex of the armpit. To achieve this fully, the chest wall muscles also need to be excised, usually the pectoralis major and pectoralis minor muscles which contribute to the shape of the chest wall in men and women. A slightly less disfiguring operation involves the removal of the pectoralis minor muscle (as for a complete auxiliary lymph node clearance described above). This does not cause disfigurement and allows good access to the armpit to remove all the nodes that may be there.
The whole breast is removed from the underside of the remaining skin and then dissected off the underlying muscles. Two-thirds of the muscle underneath the breast is pectoralis major, and one-third is the serratus anterior. The breast is swung outwards and then the tail of the breast is dissected up to whatever level is considered necessary. Level 1 involves dissection of the lowest part of the auxiliary tail and lymph nodes, up to the lower border of the pectoralis minor. Levels 2 and 3 go beyond this, along the auxiliary vein to the apex of the armpit, and require either removal of the pectoralis minor or, in the more radical operation, of the pectoralis major.
Radical mastectomy is certainly beset with more complications than a simple mastectomy and is more painful and more disfiguring. It is claimed, however, that a mastectomy in which the pectoralis minor muscle is removed causes no more morbidity or mortality than a simple mastectomy with an appropriate auxiliary dissection.
At the end of the operation, the skin is usually closed with a subcuticular stitch of absorbable or non-absorbable material. Drains are commonly used after mastectomy to minimize the risk of a bruise developing underneath the skin flaps. The drains usually stay in place for at least 2 to 3 days. Their removal is not a painful procedure, being only a little more uncomfortable than having the stitch removed.
The even more radical operations in which some rib or sternum may be removed are no longer performed.
*40/39/5*