April 15th 2011 · Read More · Comments Off
Complex partial seizures may not produce changes in behavior or function before alterations in consciousness occur. The child may start with a blank stare without any warning or aura, then wander around the room, pick at his clothes, do repetitive movements, and so on. Such seizures, with sudden impairment of consciousness, are likely to originate in the frontal lobe.Distinguishing between these two types of complex partial seizures—with simple partial onset and with loss of consciousness at onset—may be difficult or impossible. It may require careful analysis of a video-EEG where the instantaneous correlation of changes in the EEG and changes in behavior recorded by the video can be seen. The correct differentiation between these two subtypes is not important unless surgery is being considered.Again, before a physician can classify a seizure, she must be sure that a child is actually having seizures. Therefore, diagnosis and classification go hand in hand.One of the most confusing areas of classification both for physicians and for parents is differentiation between absence seizures and complex partial seizures. This differentiation may be important since it may determine which medications should be used to treat your child. Further confusion comes when you try to differentiate either of these staring spells from normal daydreaming. Let us give you an example of how we try to differentiate daydreaming from seizures.*72\208\8*
April 5th 2011 · Read More · Comments Off
RAlthough fiber has been downplayed in the past year as a possible protective agent against colon and other forms of cancer, don’t throw out that oatmeal and bran muffin just yet. A recent study of more than 68,000 women found that dietary fiber – particularly from breakfast cereals – can significantly decrease the risk of heart attacks by improving cholesterol levels, lowering blood sugar, boosting sensitivity to insulin, and lowering the risk of blood clotting. A previous study of men had similar results. Also, despite the controversy over some recent studies, which seem to indicate that fiber isn’t as beneficial for cancer prevention as once thought, many experts question whether these studies should outweigh all of the previous studies that indicate it does indeed reduce risk. In short, the scientific community is unsure of the fiber-cancer link but quite sure that the benefits in other areas should more than justify a healthy high-fiber, low-fat diet.*16/277/5*
March 30th 2011 · Read More · No Comments
Give details of treatment to any new doctor consulted.
Should the child need any kind of medical attention which may or may not be related to asthma or allergies, from a doctor who is not familiar with his case, it is vital that parents should be able to tell the doctor as much as possible about the child’s treatment. If the child is being treated with the steroid drugs or has taken them in the previous year, it is essential to let the doctor know about them, particularly if the child is going to need a surgery and/ or anaesthesia. This also applies to dental operations.
Don’t stop treatment suddenly. Unless you are told otherwise by the usual doctor, it is unwise to stop any medicine suddenly. Generally, medicines are tapered off over a period of a few days on doctor’s advice. This is a medical decision, and parents should rely on expert advice.
Know what to do for an attack. Even if the child’s asthma is well under control, parents should ask the doctor the procedure if it gets worse or a severe attack develops. Usually, this will mean increasing the regular medicines. Parents should be sure how to do this safely and effectively. In some cases it will mean adding stand-by medicines to the usual treatment for a few days.
Know when to call the doctor. There is no doubt that some of the most difficult attacks occur in the children of the most capable parents because they tend to continue to treat the child for too long before calling the doctor. If the child is not improving over a few hours despite the recommended treatment, it is usually worth speaking to the doctor.
Don’t take advice except from the doctor. There are a great many old wive’s tales about asthma which are at best useless and at worst dangerous. It is unwise for parents to seek or take advice from anyone other than a qualified doctor. This applies particularly to anyone offering to ‘cure’ the child by any means of faith healing, hypnotism etc.
*119\260\8*
March 24th 2011 · Read More · No Comments
Narcotics Anonymous, which is made up of thousands of recovering addicts from all over the world, started in July 1953
when a bunch of addicts got together to help each other come off drugs and stay clean, in order to lead happy lives again.
In fact, it grew out of the experience of Alcoholics Anonymous, the self-help organisation for alcoholics which has been flourishing since 1935. AA discovered a secret which has revolutionised the treatment of alcoholism – the best person to help a drinking alcoholic is an alcoholic who has discovered how to stay sober.
In the same way, the best person to help an addict in the grip of chemical dependence is another addict who has discovered how to stay off drugs.
Narcotics Anonymous has no clinics or hospitals. It has no counsellors, no social workers, no policemen, no clergymen, no doctors or authority figures telling you what to do.
Narcotics Anonymous is just a bunch of ex-junkies and ex-pillheads helping each other stay off drugs. (Of course, there are social workers, policemen, clergymen and doctors in NA. But they are there because they too are addicts staying well.) It’s just the same in Alcoholics Anonymous.
*59\116\2*
March 16th 2011 · Read More · No Comments
Both alcohol and drugs can damage the body as well as the mind and the emotions. But physically most young addicts and alcoholics recover very quickly, even when their drug-use has been severe. Older addicts and alcoholics may face a longer period of physical recovery.
For most people, it is a good idea to get back to normal living as soon as possible. An active and fulfilled life is far better protection against relapse than a life empty of interests.
Taking care of the body by getting proper food, rest and recreation is part of recovery.
Drug-using addicts are quite often impervious to their body’s needs, failing to eat and to take proper rest. If you still fail to do this now that you are clean, it’s clear that you have not altered your attitudes sufficiently.
So eat proper meals, with plenty of fresh fruit and vegetables. Give yourself enough rest. The mind and body are interconnected. If your body is unwell, it will translate that unwellness to your mind and you will probably start feeling depressed or over-anxious.
It’s just like running a car. If you never have it serviced or properly maintained, you are increasing your chance of a breakdown. In the same way, regular petrol and oil are needed, otherwise it will just stop going.
*104\116\2*
February 24th 2011 · Read More · No Comments
A given paradigm determines the observational methods and treatments of the patients. Basic to medicine in all cultures, including ours, is the assumption that people who do not function in a given society are ill; they are not in order and require change. Thus, if we assume that people are sick, we shall find its cause and eradicate it. Our observations focus upon the symptoms which correspond to our definition of a given illness. Curing a patient means, then, eradicating his symptoms so that he corresponds to our definition of normalcy.
My conclusion from supervising psychiatrists and psychologists working with psychotic patients is that when the above paradigm does not produce the desired results, the reason for failure is not always due to a given therapist’s inability to apply the medical model. A core difficulty in dealing with psychotic states is frequently traceable to insufficient training in observing the actual details of the patient’s behavior. Thus, the detailed behavior of the individual patient is frequently glossed over. For example, a patient who is very passive and involved in his treatment is obviously going to be more responsive to medication than another patient who considers herself a revolutionary and finds it necessary to despise authority. In the process paradigm, to be presented briefly in the next chapter, the client is not considered, a priori, to be sick. We do not assume that his brain is functioning improperly, or that he is conscious or unconscious. Rather, the exact nature and content of his utterances and body signals are studied with the idea in mind that appreciating these details will help him best. We assume that if the signals and goals of altered and normal states are followed, life is going to be more worthwhile to him afterwards than if we only attempted to get him back on his feet and function again.
*2\227\8*
February 16th 2011 · Read More · No Comments
Wisdom is the good news. Wisdom has been associated with advanced age in the popular lore of all societies and through history. Wisdom is the precious gift of aging. But can wisdom withstand the assault of neuroerosion, and for how long?
This raises a question about the nature of wisdom. In our culture we use the word frequently and reverently. But has wisdom ever been sufficiently defined? Its neural basis understood? Can the phenomenon of wisdom be understood in principle in biological and neurological terms, or is it too elusive and multifaceted to be tackled with any degree of scientific precision?
Without claiming any particular wisdom of my own, I believe I can contribute to this understanding by enlarging on my earlier introspections, which help elucidate the nature of wisdom, or at least one important aspect thereof. The train of thought and the argument developed in this book will flow from this introspection and this insight.
With age, the number of real-life cognitive tasks requiring a painfully effortful, deliberate creation of new mental constructs seems to be diminishing. Instead, problem-solving (in the broadest sense) takes increasingly the form of pattern recognition. This means that with age we accumulate an increasing number of cognitive templates. Consequently, a growing number of future cognitive challenges is increasingly likely to be relatively readily covered by a preexisting template, or will require only a slight modification of a previously formed mental template. Increasingly, decision-making takes the form of pattern recognition rather than of problem-solving. As the work by Herbert Simon and others has shown, pattern recognition is the most powerful mechanism of successful cognition.
Evolution has resulted in a multilayered brain design, consisting of old subcortical structures and a relatively young cortex with a particularly young subdivision appropriately called the neocortex. The cortex of the brain is in turn divided into two hemispheres: right and left. The passage from problem-solving to pattern recognition changes the way these different parts of the brain contribute to the process. Firstly, cognition becomes more exclusively neocortical in nature and increasingly independent of subcortical machinery and of the machinery contained in the old cortex. Secondly, the balance of our use of the two hemispheres of the brain shifts. As I will show, in neural terms this probably means a decreasing reliance on the right hemisphere of the brain and an increasing reliance on the left cerebral hemisphere.
In neuroscientific literature, the cognitive templates that enable us to engage in pattern recognition are often called attractors. An attractor is a concise constellation of neurons (nerve cells critical for processing information in the brain) with strong connections among them. A unique property of an attractor is. that a very broad range of inputs will activate the same neural constellation, the attractor, automatically and easily. In a nutshell, this is the mechanism of pattern recognition.
I believe that those of us who have been able to form a large number of such cognitive templates, each capturing the essence of a large number of pertinent experiences, have acquired “wisdom,” or at least a certain crucial ingredient thereof. (As I write this, I hear the indignant howling of critics from various corners of science, humanities, and social activism, accusing me of scandalously gross oversimplification, so I am hedging my bets).
By the very nature of the neural processes involved, “wisdom” (at least in my admittedly narrow definition of it) pays dividends in old age by allowing relatively effortless decision-making requiring only modest neural resources. That is, modest as long as the templates have been preserved as neural entities. Up to a point, wisdom and its kin qualities, competence and expertise, may be impermeable to neuroerosion.
But before we delve into the brain mechanisms of the cognitive gains in aging, we need to dispense with several preliminaries. We need to examine the nature of wisdom as a psychological and social phenomenon. We need to establish to our satisfaction, whether it is truly the case that a powerful mind may persevere and, to a point, prevail and triumph, even in the face of neuroerosion.
*2\302\2*
February 10th 2011 · Read More · No Comments
Enteroviruses remain the most common cause of aseptic meningitis in those cases in which a diagnosis is made. Approximately two thirds of all culture-negative CSF from patients with aseptic meningitis will be positive for enteroviruses by polymerase chain reaction (PCR). The most common enteroviruses causing meningitis include coxsackieviruses A and B, echovirus, and enteroviruses 68 to 71. Poliovirus is also classified as an enterovirus, but its incidence has declined greatly since vaccination. Enteroviruses are transmitted by a fecal-oral route. In temperate climates, disease is most common in the summer and early fall months, although it may occur throughout the year. Symptoms generally include nonspecific flu-like symptoms, along with fever, headache, nausea, vomiting, and meningismus. A maculopapular rash may also be seen. Focal neurologic signs are rare in the adult population.
The CSF leukocyte count is usually less than 500 cells/mm3 but may be higher. There is classically a predominance of lymphocytes, but early in the illness there may be a predominance of neutrophils. The CSF protein level may be mildly elevated, and hypoglycorrhachia, a low CSF glucose, is usually mild if present. Enterovirus may be grown in culture, but PCR can make the diagnosis more rapidly and may shorten hospitalization and courses of empiric antibiotics.
Although the clinical course in adults is usually self-limited, morbidity may still be high. In a 1998 study of the clinical course of aseptic meningitis in adults, 82% of patients were hospitalized, with an average duration of stay of 4 days and 9 days of missed work. The treatment of aseptic meningitis is primarily supportive. However, trials involving the use of antiviral agents are ongoing. One drug, pleconaril, has been shown to be effective for compassionate use and continues to be investigated in ongoing trials.
*10/348/5*
January 26th 2011 · Read More · No Comments
If the ovary is not functioning following the time when the girl reaches adolescence, as may occur when there is a necessity for surgical removal or when cysts form in the ovary and destroy the ovarian tissue, a number of significant conditions may appear. One of the most important is development of irregularity of the usual rhythmic flow, sometimes culminating in complete absence of the flow. With this there is a tendency to put on too much weight, to grow extra hair and to develop a pasty skin.
Occasionally the menopause comes on in a woman long before she is forty-eight years of age. This is definitely abnormal. Such an occurrence should lead to an immediate medical examination because it may be associated with social and psychological difficulties. The doctor who is called to study such a patient can bring relief in many instances by prescribing the necessary hormones, according to the condition in each patient.
The menopause may occur quite suddenly. When it does, a number of serious symptoms may develop, including excessive flow and what are commonly called “hot flashes” with drenching sweats, the development of a ravenous appetite and a rapid gain in weight. There are also sometimes changes in the bones and joints, giving rise to the condition known as “menopausal arthritis.” Obviously such symptoms are serious, affecting the entire life of the women concerned. They should be an indication for a complete and careful study of the case and for the administration of such hormones as might be considered by the physician to be desirable.
For the arthritis of the menopause, the use of Cortisone or ACTH has already been shown to be helpful in bringing about relief.
The physician always remembers that the glands are an interlocking chain and the source for disturbance may be not only the sex gland itself, but quite as often the pituitary gland or, occasionally, the thyroid gland. In any event, the psychological aspects must be studied.
*3/318/5*
January 19th 2011 · Read More · No Comments
A number of chemical reactions are involved in turning glucose into energy instead of fat. These are controlled by enzymes, which are themselves dependent on certain vitamins and minerals in the body. If these are deficient, you will lack energy and feel low. So while it is important to identify any allergies and to eat well, you can also help yourself by making sure that you are taking a good balance of vitamins and minerals. While you are restricting your food to check on the allergies it can be a good idea to take some supplements to ensure that you have a good balance of nutrients.
The В vitamins are important, especially vitamins B3 and B6, and the minerals zinc and chromium. They help to supply fuel to cells ready for burning to give you energy. Vitamin B6 is especially important because it is needed for the production of pancreatic enzymes which help effective digestion. Together with zinc, B6 is needed to make the enzyme that digests food.
Zinc is an important mineral in appetite control and a deficiency of zinc can cause a loss of taste and smell so that we crave and seek stronger tasting foods. Chromium is needed for the metabolism of sugar. Without it insulin is less effective in controlling blood sugar levels. Chromium also helps to control levels of fat and cholesterol in the blood.
Vitamin С can play a role in weight control too. It helps to lower cholesterol and is involved in the conversion of glucose to energy in the cells.
Co-enzyme Q10 is important for energy production. It’s found in all the tissues and organs of our bodies but as we get older we may become deficient. Any deficiency of co-enzyme Q10 results in a reduction of energy and a slowing down of the life-giving process. It has been used to help heart problems, high blood pressure, gum disease and immune deficiencies. A study showed that people on a low-fat diet doubled their weight loss when supplemented with Q10 compared to those who did not have the extra Q10.
Garcinia cambogia, a small tropical fruit from Central Asia where the rind is used in Thai and Indian cooking, can also help with weight loss. The garcinia contains HCA (hydroxy-citric acid) which can enable carbohydrates to be turned into usable energy instead of being deposited as fat. The HCA in this fruit seems to curb appetite, reduce food intake and inhibit the formation of fat and cholesterol; though this has yet to be proven scientifically. Garcinia cambogia is usually marketed under the brand Citrimax.
Eating, of course, is not a purely mechanistic biochemical process. Food is and should be enjoyable, appealing to our senses. Constant dieting can distort our emotional relationship with food. Not eating the right food at the right time can also affect our moods and emotions, sabotaging our efforts to establish a healthy eating pattern that will result in weight loss.
*3/101/5*