A Cardiovascular Argument for Eating Whole Grains

It is hard to escape the message that whole grains are good for you. But few Americans put it into practice.
By some estimates, fewer than 1 in 10 adults eat three servings of whole grains a day. And about 4 out of 10 eat none.
Now a new study adds strength to the argument that a better diet can lead directly to better health. Writing in the online edition of the journal Nutrition, Metabolism and Cardiovascular Diseases, researchers say they have confirmed a clear connection between whole-grain intake and the risk of cardiovascular disease.
"In light of this evidence," write the authors, led by Dr. Philip B. Mellen of Wake Forest University, "policy makers, scientists and clinicians should redouble efforts to incorporate clear messages on the beneficial effects of whole grains into public health and clinical practice endeavors."
The researchers based their findings on a review of seven earlier studies that followed people's diets and health over time. In all, more than 285,000 people were involved.
The new study found that on average, people who ate two and a half servings of whole grains a day had a 21 percent lower risk of developing cardiovascular disease than those who ate a fifth of a serving. Whole grains can come from numerous sources, including whole-wheat flour, oatmeal and popcorn. (AP)

Psoriasis Guttate

Psoriasis Guttate (GUH-tate) adalah salah satu bentuk dari psoriasis yang mulai timbul sejak waktu anak-anak atau remaja. kata guttate berasal dari bahasa Latin yang berarti “jatuh”.(drop).
Bentuk psoriasis ini menyerupai bintik-bintik merah kecil di kulit. bercak (lesions) guttate biasanya timbul pada badan dan kaki.
Bintik-bintik ini biasanya tidak setebal atau bersisik seperti bercak-bercak (lesions) pada psoriasis plak.

Psoriasis Guttate kadang-kadang timbul secara tiba-tiba. berbagai kondisi diketahui menjadi pencetus timbulnya psoriasis guttate, termasuk infeksi saluran pernafasan atas, infeksi streptococcal, amandel, stress, luka pada kulit dan penggunaan obat-obatan tertentu (termasuk anti-malaria dan beta-bloker) .

Infeksi streptococcal pada tenggorokan (strep throat) biasanya merupakan salah satu pencetus psoriasis guttate.
Strep throat bisa terjadi tanpa gejala dan tetap bisa menimbulkan psoriasis guttate. berkonsultasilah dengan dokter anda untuk menjalani pemeriksaan strep guna mengetahui apakah anda terserang infeksi strep atau tidak.

Psoriasis Guttate masih bisa tetap ada, walaupun infeksi strep telah hilang.
Sebagian dokter memberikan antibiotik untuk membantu mencegah timbulnya kembali infeksi yang dapat memicu timbulnya psoriasis guttate.

Bentuk psoriasis ini dapat hilang dengan sendirinya, kadang-kadang penderita akan sembuh untuk selamanya, atau sembuh untuk sementara waktu kemudian kambuh kembali sebagai pecahan dari psoriasis plak. kadang-kadang psoriasis guttate bisa timbul pada masa anak-anak dan terbawa sampai dewasa.

Kasus-kasus psoriasis guttate dapat diobati dengan moisturizer ( lotion pelembab) atau obat oles yang lebih kuat. Lotion pelembab seperti Eucerin, Cetaphil atau petroleum jelly, merupakan bentuk pengobatan yang diminati, pada awal-awal permulaan timbulnya bintik-bintik gejala penyakit psoriasis guttate.

Penderita psoriasis guttate kadang-kadang merasa jemu untuk memberi salep/krem oles pada bintik-bintik yang banyak di kulit mereka. Pengobatan dengan penyinaran sinar ultraviolet B (UVB) atau PUVA (obat psoriasis light-sentizing ditambah sinar ultraviolet A) sangat efektif untuk psoriasis guttate.

Hanya pada kasus-kasus yang parah, dokter akan memberikan obat minum (pengobatan yang mengenai seluruh badan) untuk tipe psoriasis ini, walaupun kadang-kadang untuk jangka pendek pemakaian obat-obatan ini memberikan hasil yang cepat dan remisi yang panjang.

Obat injeksi (yang bekerja pada system immunisasi untuk memblok penyakit ini) bisa efektif untuk pengobatan psoriasis guttate. untuk obat injeksi yang telah dipelajari untuk pengobatan psoriasis plak yang kronis, dan diakui setelah diberitakan sukses pada pengobatan berbagai macam tipe psoriasis.

Vaccine and Immunization

Kids' Vaccine Ingredient Not Likely Linked to Neurological Problems CDC study finds no clear association between thimerosal, mental woes.

WEDNESDAY, Sept. 26 (HealthDay News)
The latest study on thimerosal, a preservative used in childhood immunizations, should provide parents with reassurance that exposure to the agent will not cause neuropsychological problems later on, experts say.

"We found no consistent pattern between increasing mercury exposure from birth to seven months and performance on neuropsychological tests," concluded the study's authors in the Sept. 27 New England Journal of Medicine.

Widely used before 2000, thimerosal has been the center of controversy for some years now. Some parents of autistic children believe that the mercury contained in the preservative is responsible for their children's autism.

However, the U.S. Centers for Disease Control and Prevention (CDC) maintains there is no scientific evidence of such an association. And this latest CDC study did not specifically look at links between thimerosal exposure and autism. According to the study authors, a separate CDC case-control study focused on autism and mercury exposure, is currently under way.

In 1999, the U.S Food and Drug Administration (FDA) concluded that children who were vaccinated according to the recommended childhood immunization schedule could be exposed to levels of mercury from the thimerosal contained in those vaccines that were higher than the maximum levels considered safe by the FDA.

In response, the CDC and the American Academy of Pediatrics (AAP) asked vaccine manufacturers to remove thimerosal from vaccines. That move, not surprisingly, concerned many parents who wondered if the preservative was being removed because it was harmful.

In an effort to allay some of those fears, the current CDC study looked at more than 1,000 children between the ages of 7 and 10. They compared the youngsters' neuropsychological functioning with their level of thimerosal exposure.

Using information from a three-hour neuropsychological assessment or information provided by parents and teachers, the researchers measured 42 neuropsychological outcomes, including speech, language, verbal memory, fine motor coordination, achievement, behavior regulation,
tics and general intellect.

They then compared those findings to levels of thimerosal exposure, based on the child's vaccination exposure prenatally, in the first month of life, and in the first seven months of life.

"Our study does not support a causal association between early exposure to mercury from thimerosal-containi ng vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years," concluded the study's authors.

That conclusion, however, seems to contradict some of the study's findings.

For example, the researchers found that boys with the highest levels of thimerosal exposure had about twice the risk of evaluator-observed tics compared to boys with the lowest exposure.

While these findings may seem disparate with this conclusion, Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, said some of the findings are likely due to chance, because such a high number of statistical comparisons were done. She was not involved in the study, which was led by William Thompson of the CDC's influenza division.

According to Schuchat, who spoke at a special CDC teleconference held Wednesday, the researchers completed 42 tests of neuropsychological functioning and completed 378 statistical comparisons from those tests.

"By chance alone, 19 of the 378 statistical tests we ran would be abnormal," she said, noting that 19 is the exact number of tests that resulted in abnormal findings.

However, 12 of those 19 tests suggested a positive outcome from higher thimerosal exposure, and seven, including the tic finding, suggested a negative outcome.

"Each test doesn't tell us as much individually, " she said. "Chance alone probably explained these findings. The totality of the results are quite reassuring."

Additionally, Schuchat said there was no increase in the incidence of parent-reported tics in children with the highest thimerosal exposure, so the tics observed by the evaluators may have been transient in nature.

But several other studies have found a possible link between thimerosal exposure and tics. Because of that, the CDC feels the finding should be further explored to ensure that it was due to chance finding and not an actual effect of the preservative.

"This is what happens when you try to sub-stratify data," said Dr. Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia. "What's important is if you add up all the studies, do you find greater problems from thimerosal?" And, he said that study after study has shown that thimerosal does not cause harm.

"Parents should feel enormously reassured that another study has found that the levels of thimerosal contained in vaccines before 2001 are not harmful," said Offit, who also wrote one of two accompanying perspective pieces in the journal. Both pieces offered details on the legal history and the public health implications of the autism-vaccine controversy, even though that was not addressed in the actual study itself.

Thimerosal has already been removed from all but one vaccine, according to Schuchat. Some versions of the influenza vaccine still contain thimerosal, though thimerosal-free versions are also available, she said.

"Parents shouldn't take a theoretical risk and elevate it above the real risk of influenza. There's nothing theoretical about the dangers of influenza," Offit explained, adding that even healthy children can be at risk of serious flu complications.

"Vaccines are safe and effective. They prevent 33,000 deaths and 14 million infections annually," Schuchat said.

HealthDay

Coke vs Mentos

A little boy died in Brazil after eating MENTOS and drinking Coca-Cola / PEPSI together. One year before the same accident happened with another boy in Brazil . Please check the experiment that has been done by mixing Coca-Cola (or Coca-Cola Light) with MENTOS .
So be careful with your self eating MENTOS (POLO's) and drinking COCA-COLA or PEPSI together.

CHECK THIS OUT...

PLZ PASS THIS INFORMATION TO AS MANY PEOPLE AS POSSIBLE SPECIALLY TO THE CHILDREN, BECAUSE IN OUR COUNTRY MENTOS AND COCA-COLA BOTH ARE VERY POPULAR AMONGST THE CHILDREN.

Starting the Good Life in the Womb

Pregnant women who eat right, watch their weight and stay active can actually improve their unborn babies' chances of growing into healthy adults.
Most pregnant women know they can hurt their babies by smoking, drinking alcohol and taking drugs that can cause birth defects. But they also may be able to "program" the baby in the womb to be a healthier adult. New research suggests that mothers-to-be can reduce the risk that their babies will develop obesity, high blood pressure, heart disease and diabetes by monitoring their own diet, exercise and weight.
The science behind this is relatively new and still somewhat controversial. In the late 1980s, a British physician and epidemiologist named David Barker noticed that a group of Englishmen who were born small had a higher incidence of heart disease. Studies showed that rates of obesity, high blood pressure and diabetes-illnesses that often are associated with heart disease-are higher in men born small. Barker proposed that poor nutrition in the womb may have "programmed" the men to develop illness 50 years or more later.
The "Barker Hypothesis" is still hotly debated, but it is gaining acceptance as the evidence builds. Because organs develop at different times, it appears that the effects of too little food during pregnancy vary by trimester. One example comes from study of the Dutch Hunger Winter, a brief but severe famine that occurred during World War II. Pregnant women who didn't get enough to eat in their first trimester had babies who were more likely to develop heart disease. If they were in their second trimester, their babies were at risk for kidney disease. A poor diet in the last three months led to babies who had problems with insulin regulation, a precursor of diabetes.
More-recent research has focused on the negative effects of too much food during pregnancy. Women who gain excessive weight during pregnancy are more likely to have babies who are born large for their age and who become overweight in childhood. A recent study from the National Birth Defect Prevention Study found that obesity in pregnancy also increases a baby's
risk for birth defects, including those of the spinal cord, heart and limbs.
A mother's nutrition and exercise patterns during pregnancy influence the long-term health of the baby by shaping her baby's metabolism. "Metabolism" includes everything that allows your body to turn food into energy-from the organ systems that process food and waste to the energy-producing chemical reactions that take place inside every cell. It is the collective engine
that keeps you alive.
A mother's body may influence her baby's metabolism on many levels: the way organs develop, how appetite signals get released in the brain, how genes are activated, even the metabolic chemistry inside the baby's cells.
Research now shows that the environment of the womb helps determine how a baby's metabolism is put together, or "programs" it for later health. The science of fetal programming is still new; it will be a long time before we have all the answers, since these health effects emerge over a lifetime. But several principles already are clear for a pregnant woman.
The first is to get healthy before pregnancy. Weighing too little or too much not only hampers fertility but can set the stage for metabolic problems in pregnancy. Doctors used to think of body fat as nothing more than inert insulation, but they know now that fat is an active tissue that releases hormones and plays a key role in keeping the metabolism running. Women should also eat a balanced diet and take prenatal vitamins before pregnancy to ensure that their bodies provide a good environment from the beginning.
The amount of weight gain is also critical. Women who gain too little weight during pregnancy are more likely to give birth to small babies, while women who gain too much weight are likely to have large babies. Paradoxically, both situations can predispose a child to metabolic disease. The weight gain should come slowly at first-about two to eight pounds in the first trimester, and one pound per week after that for normal-weight women. Obese women (with a body-mass index, or BMI, higher than 29) should gain no more than 15 pounds.
During pregnancy, women are already more susceptible to metabolic problems such as gestational diabetes and preeclampsia (high blood pressure), so choosing foods that help your metabolism run smoothly is important. Eating whole grains and foods rich in protein and fiber while avoiding foods high in sugar can help even out rises and falls in blood sugar. Pregnant women should eat about 300 extra calories per day while they're pregnant. But, as always, the quality of the calories matters even more. It's important to eat a diet rich in nutrients, since a lack of specific nutrients in the womb can hamper a baby's long-term health. A clear example is folic acid, without which the brain and spinal cord do not develop properly. But new research is
uncovering other nutrients that may have subtler but long-lasting effects on health.
Studies suggest that women could benefit from taking omega-3 fatty-acid supplements, particularly those containing docosahexaenoic acid (DHA, for short), a type of fat that has been shown to help prevent prematurity and contribute to healthy brain development. A recent study found that women with more vitamin D in their bodies have children with stronger bones;
adequate vitamin D is also needed for organ development.
Women may have different nutrient needs because of genetic differences, but to be safe every woman should take a daily prenatal vitamin before and during pregnancy. But supplements, whether in the form of a pill, a fortified shake or energy bar, don't replace the nutrients found in fruits, vegetables, low-fat meats, whole grains and other foods.
The energy you expend is as important as what you take in. Regular activity helps keep a woman's metabolism running smoothly and offsets problems of pregnancy like varicose veins, leg cramps and lower back pain. Pregnant women should avoid high-impact activities, especially late in their pregnancies.
All this may sound daunting, but most of the changes are simple ones that will improve a mother's long-term health as well as her children's.
[NW]

Poisoning

Poisoning is the harmful effect that occurs when a toxic substance is swallowed, is inhaled, or comes in contact with the skin, eyes, or mucous membranes, such as those of the mouth or nose.
Poisoning is the most common cause of nonfatal accidents in the home. More than 2 million people suffer some type of poisoning each year.
Drugs-prescription, nonprescription, and illegal-are the most common source of serious poisonings and poisoning-related deaths. Other common poisons include gases, household products, agricultural products, plants, industrial chemicals, vitamins, and foods (particularly certain species of mushrooms and fish). However, almost any substance ingested in sufficiently large quantities can be toxic.
Young children are particularly vulnerable to accidental poisoning in the home, as are older people, often from confusion about their drugs. Also vulnerable to accidental poisoning are hospitalized people (from drug errors) and industrial workers (from exposure to toxic chemicals). Poisoning may also be a deliberate attempt to commit murder or suicide. Most adults attempting suicide by poisoning take more than one drug and also consume alcohol.
The damage caused by poisoning depends on the poison, the amount taken, and the age and underlying health of the person who takes it. Some poisons are not very potent and cause problems only with prolonged exposure or repeated ingestion of large amounts. Other poisons are so potent that just a drop on the skin can cause severe damage.
Some poisons produce symptoms within seconds, whereas others produce symptoms only after hours or even days. Some poisons produce few obvious symptoms until they have damaged vital organs-such as the kidneys or liver-sometimes permanently.

First Aid & Prevention
Anyone exposed to a toxic gas should be removed from the source quickly, preferably out into fresh air. In chemical spills, all contaminated clothing should be removed immediately. The skin should be thoroughly washed with soap and water. If the eyes have been exposed, they should be thoroughly flushed with water. Rescuers must be careful to avoid contaminating themselves.
If the person appears very sick, emergency medical assistance should be called. Bystanders should perform cardiopulmonary resuscitation (CPR) if needed. If the person does not appear very sick, family members or coworkers can contact the nearest poison center for advice. If the caller knows the identity of the poison and the amount ingested, treatment can often be managed at home.
Containers of the poisons or the drugs taken should be saved and given to the family doctor. If the poisoning could be serious, the person must be treated as soon as possible. The poison center may recommend giving activated charcoal at home and, occasionally, may recommend giving syrup of ipecac to induce vomiting, particularly if the person must travel far to reach the hospital. To prevent accidental poisoning, drugs should be kept in their original child-resistant containers. Expired drugs should be flushed down the toilet. In addition, drugs and poisonous substances should be kept out of sight and beyond a child's reach, preferably in a locked cabinet. All labels should be read before taking or giving any drugs.

Diagnosis & Treatment
Identifying the poison is crucial to successful treatment. Labels on bottles and other information from the person, family members, or coworkers best enables the family doctor or the poison center to identify poisons. Urine and blood tests may help in identification as well. Sometimes, blood tests can reveal how serious the poisoning is.
Many people who have been poisoned must be hospitalized. The principles for the treatment of all poisoning are the same: prevent additional absorption; increase elimination of the poison; give specific antidotes (substances that eliminate, inactivate, or counteract the effects of the poison), if available; and prevent reexposure. With prompt medical care, most people recover fully. The usual goal of hospital treatment is to keep the person alive until the poison disappears or is inactivated. Eventually, most poisons are inactivated by the liver or are passed into the urine.
Stomach emptying may be attempted if an unusually dangerous poison is involved or if the person appears very sick. In this procedure, a tube is inserted through the mouth or nose into the stomach. Water is poured into the stomach through the tube and is then drained out (gastric lavage). This procedure is repeated several times.
For many swallowed poisons, hospital emergency departments usually give activated charcoal. Activated charcoal binds to the poison that is still in the digestive tract, preventing its absorption into the blood. Charcoal is usually taken by mouth but may have to be given through a tube that is inserted through the nose into the stomach. Sometimes family doctors give charcoal every several hours to help cleanse the body of the poison.
If a poisoning remains life threatening despite the use of charcoal and antidotes, more complicated treatments may be needed. The most common involve filtering poisons directly from the bloodstream- hemodialysis (which uses an artificial kidney [dialyzer] to filter the poisons) or charcoal hemoperfusion (which uses charcoal to help eliminate the poisons). For either of these methods, small tubes (catheters) are inserted into blood vessels, one to drain blood from an artery and another to return blood to a vein. The blood is passed through special filters that remove the toxic substance before being returned to the body.
Poisoning often requires additional treatment. For example, a person who becomes very drowsy or comatose may need a breathing tube inserted into the windpipe. The tube is then attached to a ventilator, which mechanically supports the person's breathing. The tube prevents vomit from entering the lungs, and the ventilator ensures adequate breathing. Treatment also may be needed to control seizures, abnormal heart rhythms, low blood pressure, high blood pressure, fever, or vomiting.
If the kidneys stop working, hemodialysis is necessary. If liver damage is extensive, treatment for liver failure may be necessary. If the liver or kidneys sustain permanent, severe damage, organ transplantation may be needed.
People who attempt suicide by poisoning need mental health evaluation and appropriate treatment.
[Merck]

Tips for Improving Your Health by Nutrition

Good nutrition is one of the keys to good health. This means making sure you regularly eat foods that have a lot of vitamins and minerals in them, as well as foods that are not high in fat.

Do I need to change what I eat?
If you answer yes to any of the following questions, you may need to talk about nutrition with your family doctor:
Has your family doctor talked with you about a medical problem or a risk factor, such as high blood pressure or high cholesterol?
Did your family doctor tell you that this condition could be improved by better nutrition?
Do diabetes, cancer, heart disease or osteoporosis run in your family?
Are you overweight, or have you gained weight over the years?
Do you have questions about what kinds of foods you should eat or whether you should take vitamins?
Won't it be hard to change my eating habits?
Probably, but even very small changes can improve your health considerably. The key is to keep trying to eat the right foods and stay in touch with your family doctor, to let them know how you're doing.
Here are a few suggestions to help you improve your eating habits:
Find the strong points and weak points in your current diet.
Do you eat 5 to 7 servings of fruits and vegetables every day?
Do you get enough calcium?
Do you eat whole-grain, high-fiber foods regularly?
If so, good! You're on the right track. Keep it up. If not, you can learn the changes you need to make. Make small, slow changes, instead of trying to make large, fast changes. Small changes will be easier to make and stick with. Keep track of your food intake by writing down what you eat and drink every day. Use this record to help you see if you need to eat more from any food groups, such as fruits, vegetables or dairy products.
Think about asking for help from your family doctor if you haven't already done so -- especially if you have a medical problem that requires you to follow a special diet.

Can I trust nutrition information I get from newspapers and magazines?
Nutrition tips from different sources can sometimes conflict with each other. You should always check with your family doctor first. Also, keep in mind this advice:
There is no "magic bullet" when it comes to nutrition. Short-term diets may help you lose weight, but they are difficult to keep up and may even be unhealthy in the long run.
Good nutrition doesn't come in a vitamin pill. With a family doctor's recommendation, a vitamin pill can help you get enough vitamins and minerals, but your body benefits the most from eating healthy foods. Eating a variety of foods is best for your body. Learn to try new foods. Stories from people who have used a diet program or product, especially in commercials and infomercials, are advertisements. Remember, regained weight or other problems that come up after someone has completed the program are never talked about in those ads.

What changes can I make now in my diet?
Almost everyone can benefit from cutting back on fat. If you currently eat a lot of fat, try just one or two of the following changes, or those suggested in our handout on healthy food choices:
If you eat meat, eat it baked, grilled and broiled rather than fried. Take the skin off before eating chicken. Eat fish at least once a week. Cut back on extra fat, such as butter or margarine on bread, sour cream on baked potatoes, and salad dressings.
Eat plenty of fruits and vegetables with your meals and as snacks. When eating away from home, watch out for "hidden" fats (such as that in salad dressing and desserts) and larger portion sizes. Read the nutrition labels on foods before you buy them. If you need help reading the labels, ask your family doctor.
Drink no- or low-calorie beverages, such as water, unsweetened tea and diet soda.
Balanced nutrition and regular exercise are good for your health even if your weight never changes. So try to set goals you have a good chance of reaching, such as making one of the small changes listed above or walking one more day per week.
[AAFP]

Final note comes early for rockers: They're twice as likely to die at a young age, a study finds.

Shari Roan

"And as the flames climbed high into the night
To light the sacrificial rite,
I saw Satan laughing with delight
The day the music died."
- Don McLean, "American Pie"

Since the dawn of rock 'n' roll, death has been a recurring theme. But for many young musicians, lyrics that dwell on mortality are prophetic.
A new study has found that rock and pop stars are more than twice as likely to die at a young age than the rest of the population -- and more than three times as likely to die within five years of becoming famous. The unhealthful behavior that leads to such untimely deaths harms more than musicians, the researchers said. It also sets a bad example for the millions of people who
emulate them.
"Like any industry, the music industry should see the health of its participants as a priority as well as the wide effect it may have on consumers of its products," said Mark A. Bellis, the study's lead author and director of the Centre for Public Health at Liverpool John Moores University, in an interview conducted by e-mail. "It is, after all, a music industry, not a promotional tour for alcohol and drugs."
Bellis says his research team undertook the study, which claims to be the first to quantify the effect of pop music stars' live-fast-die- young culture, because the death rates in the pop industry have not been well studied and because pop stars have tremendous influence on others.
Although the researchers expected to find that musicians die younger -- after all, that is the common perception -- they were surprised to see how many of those deaths occurred near the peak of fame and that the death rate remained double that of the normal population even 25 years after the musicians became famous.
It is a rare example of a group of mostly wealthy people who do not have better health outcomes than people of lower socioeconomic status, he said. The study, published last week in the Journal of Epidemiology and Community Health, was based on more than 1,050 North American and European musicians and singers who achieved fame between 1956 and 1999. All the musicians were featured in the "All-Time Top 1000 Albums," selected in 2000. They represented a range of genres, including rock, pop, punk, rap, R&B, electronica and new age.
For each pop star, the researchers calculated total years of survival and compared the numbers with their expected survival based on a general population of people similar in gender, nationality and ethnicity.
Of the 100 pop stars who had died, the average age of death was 35 for European musicians and 42 for American stars. The study does not prove that being a pop star causes an early death, but
it's clear that elements of the lifestyle are unhealthful, says Anton H. Hart, a psychologist and psychoanalyst in New York City who counts many professional musicians among his clients.
For example, Hart says, previous research suggests a bitter downside to fame that may lead to depression, anxiety, substance abuse, risky sexual behavior and general carelessness.
"Fame fulfills grandiose wishes to be known by everyone and loved by everyone," he says. "But it's a high you keep needing again and again, and you develop a tolerance for it. It turns out to be an empty high. It's exhilarating but gives way to a sense that fame is not as fulfilling as it was assumed to be. That is a very difficult and depressing thing."
The public -- and the music industry -- reinforces the high-risk lifestyles of pop stars, Hart suggests. We want them to act outrageously -- and they try to live up to that expectation.
"Part of their role is to act out and play out what most of us are simply too inhibited to do in our own lives," he says. "That's why we love them. They can get up and move and dance and flaunt themselves and act sexual in ways we would love to do. We need these icons to live out these things that we can't live out ourselves."
Pop stars also adhere to a tradition of rejecting conformity and remaining true to themselves. Standard health advice -- limiting alcohol intake, getting an annual flu shot and exercising at least three times a week -- may fit poorly with a pop star's self-image.
"They worry about authenticity, having street cred, being real rather than a sellout," Hart says. "High-risk behavior and drugs and alcohol play into this. Looking at risk and mortality, they may say, 'To hell with it. I'm just going to live, be in the moment.' "
Other celebrity-dependent industries, such as acting and professional sports, are sensitive to how their stars are viewed as role models, Bellis said. And almost every industry adheres to laws protecting workers from job-related hazards. Pop musicians are the exception, he said. "Cultural change in any industry or population can be difficult," he said. "But it is likely that everyone would accept some measures to at least reduce deaths once the risk has been clearly identified."
Such a goal is laudable, but it wouldn't be simple, Hart says. Although the leading cause of death in Bellis' study was drug and alcohol abuse -- accounting for one in four deaths -- cancer, accidents and cardiovascular disease also ranked high, he noted.
Mamas and Papas singer Cass Elliott, for example, died of a heart attack, but obesity was probably the root cause of her early demise. Elvis Presley, dead at age 42, also had a heart attack but misused drugs and had several other health problems. Rastafarian Bob Marley was diagnosed with malignant melanoma in his toe but refused, because of his religious beliefs, to have an operation that might have cured him. The cancer spread, and the reggae icon died of it.
And there are plenty of examples of musicians who cling to the edge and live to tell about it. Rolling Stones guitarist Keith Richards, 63, has defied the odds, surviving decades of hard partying, touring and even a reported fall from a tree last year.
Others see the error of their ways. Shock rocker Alice Cooper, 59, once drank prodigious amounts of alcohol and celebrated violence at his concerts. Now he attends church, plays golf, does commercials for an office supply store -- and, one would hope, gets an annual physical.
[LAT]

A Probiotic Recipe for Good Health

It sounds downright risky, but snacking on billions of live bacteria can actually improve digestion, support the immune system and bolster overall health.
Called probiotics, these "friendly" microbes with health benefits are found naturally in breast milk and fermented foods such as yogurt, fermented milk drinks, aged cheese, miso and certain pickles and sauerkraut. They work by keeping intestinal flora balanced and preventing not-so-friendly bacteria from taking over and causing disease.
But during the last 50 years, the increased use of antibiotics and a changing diet low in soluble fibre and high in refined carbohydrates have produced an "invisible epidemic of insufficient probiotics," said Gary Huffnagle, professor of internal medicine and microbiology at the University of Michigan Medical School. "We're not getting what we used to (through diet), and we're destroying what's there," he said. "As a result, the balance of our intestinal microbe population has changed, sometimes with disastrous effects on our immune system.''
Research on the topic is exploding. The US National Institutes of Health recently announced that it will explore how bacteria in the body can promote health, and the food, and cosmetics industries aren't about to be left behind.
The helpful bacteria and yeasts are being added to beverages, cereals, wellness bars, pet foods, infant formula and even personal-care products. The worldwide probiotic yogurt category alone is expected to increase in sales to $US500 million from $US294 million by 2010, according to the market research firm Euromonitor International.
But finding the correct type of probiotic food can be daunting for consumers, especially because research is evolving, and many functional foods make unproven claims.
Only a few bacteria (members of the lactobacillus and bifidobacterium genuses) have been studied extensively, and scientists are still trying to figure out which bacterial strains are most effective for particular problems.
While the strain Lactobacillus rhamnosus GR-1 has been shown to help with vaginal yeast or urinary-tract infections, Sacharomyces boulardii lyo has a positive effect on diarrhoea and inflammatory bowel disease.
Another research focus is "figuring how we detect an 'imbalance' in a single human being," Huffnagle said. "When we look at groups of people, we can make generalisations, but for any single person, the generalisation may not hold true."
Meanwhile, the marketplace is a free-for-all. All products labeled "probiotic" should contain "live" material, but some don't; others don't contain enough.
When the testing service Consumerlab. com looked at 13 products, they found that only eight contained at least 1 billion organisms in a daily serving, the generally recommended minimum dose. But even the proper minimum dose isn't really known. Some products have been shown to be effective at 100 million live cells, other show positive results at 1 trillion.
Still, "the potential of probiotics to improve health rivals drugs in terms of impact," said Huffnagle, author of The Probiotics Revolution, who says probiotics are more than beneficial; they're essential and deserve their own food group.
"We have more than a kilo of microbes inside us," he said. "The medical revelation is that when they cooperate and work together, they function in our body like an organ. Microbes in our digestive tract have profound effects on our health."
One of the most promising treatments uses probiotics to replenish the "good" bacteria and prevent or ease the symptoms of antibiotic-caused diarrhoea, a growing problem for hospitals because of antibiotic resistance. Although antibiotics can be lifesaving drugs, they work by killing many bacteria in our microflora, including the beneficial ones. Failure to restore the good bacteria can cause side effects. But mounting research, including a recent study published in the British Medical Journal that looked at the strains used in a probiotic milk drink, have shown that probiotics can counter the side effects. "This has the potential to decrease morbidity, health-care costs and mortality if used routinely in patients aged over 50," the researchers wrote in the BMJ.
Though not a routine practice in most hospitals, the National Jewish Medical and Research Centre gives probiotics to almost all of the infectious-disease patients who receive antibiotics.
For the last two years, Helen DeVos Children's Hospital in Grand Rapids, Michigan, has used them to improve the intestinal health of premature infants. And paediatricians are increasingly recommending them for their young patients.
"They worked well," said Chicago's Wendy Burgess, whose 2-year-old son, Henry, had diarrhoea after a round of antibiotics for an ear infection. Burgess' doctor suggested Florastor, which contains the probiotic yeast Saccharomyces boulardii lyo. "I didn't know what probiotics were, but if he were to go back on antibiotics, I'd start them to be proactive," she said.
"The one time it makes sense to (use probiotics) is after antibiotics, " said Katherine Knight, chair of the department of microbiology and immunology at Loyola University Chicago Stritch School of Medicine, who believes a diet strong in fruits, vegetable and dairy is a better way to build good intestinal bacteria.
Time will tell whether probiotics can help with other conditions. Though they're safe, and good evidence shows certain strains can help with antibiotic-related diarrhoea, colitis and H pylori ulcers, the data is less definitive for obesity, lactose intolerance, cancer prevention, dental cavities, common colds and allergic diseases.
"At this point, it seems the enthusiasm for probiotics use in most medical conditions has certainly outpaced the scientific evidence," said Yehuda Ringel, an assistant professor of gastroenterology at the University of North Carolina School of Medicine who recently published a paper calling them a "safe" but unproven treatment for irritable-bowel syndrome. Huffnagle, however, who has spent the last two decades studying the immune system, is hopeful. A longtime allergy and asthma sufferer, he started incorporating a probiotic, yogurt, fresh fruits, vegetables and whole grains into his diet. Within a month, he realised his allergies no longer affected his daily life, and asthma attacks rarely occurred.
He credits his newfound bacterial friends. "Modern medicine now appreciates that not all microbes are harmful," he wrote. "Some are our silent partners.''
[SMH]

Tennis Elbow

What is tennis elbow?
Tennis elbow is an injury to a tendon in your elbow called the lateral epicondyle (ep-i-KON-dile) . This tendon helps you move your wrist and fingers. If you use it too much, you can tear the tendon.
A common symptom is pain when you grip something (for example, when you give a handshake or open doors). Most people with tennis elbow don't have swelling, bruising, or numbness.

What causes tennis elbow?
It can be caused by using your arm the same way over and over. This can happen when you paint, use a hammer, or play racquet sports or golf. Doing an activity incorrectly (for example, using a racquet that isn't strung right or that has a grip that is too small) can also cause tennis
elbow.

How can my family doctor tell if I have tennis elbow?
Your family doctor usually can tell if you have tennis elbow by examining you. Your family doctor may take an x-ray, but it usually isn't needed.
Your family doctor may examine your elbow and shoulder to make sure you don't have another problem, such as arthritis or pinched nerves.

How is tennis elbow treated?
Your family doctor may wait to see if your pain gets better without treatment.
Medicine, an elbow brace, or physical therapy can help with pain, but it may take weeks or months for the pain to go away completely. Some patients with tennis elbow need surgery.

How can I prevent tennis elbow?
To lower the chances of getting tennis elbow, try to cut down on activities that cause it, and make sure you are doing these activities correctly. Do exercises to stretch and strengthen your arms.
[AAFP]

Memory Matters

Larissa Hirsch

Remember that great summer vacation you took last year? When you think back on it, you might see flashes of a day you spent swimming or a night spent watching fireworks explode high in the sky. But how do you store those images, so you can enjoy them later? It's your memory - and it's part of your complex and multitalented brain.

What is Memory?
When an event happens, when you learn something, or when you meet someone, your brain determines whether that information needs to be saved. If your brain judges the information important, it places it in your memory "files." You probably know your brain has different parts. Some of them are important for memory. The hippocampus (say: hih-puh-kam- pus) is one of the more important parts of the brain that processes memories. Old information and new information, or memories, are thought to be processed and stored away in different areas of the cerebral cortex, or the "gray matter" of the brain - the largest, outermost part of the brain.

What Can Go Wrong with Memory?
As wonderful as memory is, it isn't always perfect. It's normal to occasionally forget the name of somebody you just met or where you put your shoes. And of course, everyone has forgotten an answer on a test. Darn! You knew that one, too!
It's also typical for people to forget more things as they grow older. Your parents or grandparents might joke about having a "senior moment." That's when they forget something.
But some memory problems are serious, such as when a person has Alzheimer's disease. Strokes, which also affect older people, are another medical problem that can affect someone's memory. A stroke is when blood doesn't get to all the parts of the brain, either because there is a blockage in the pathway, or because a blood vessel (which carries the blood) bursts.

Brain Injuries Affect Memory
And, at any age, an injury to the head and brain can cause trouble with a person's memory. Some people who recover from brain injuries need to learn old things all over again, like how to talk or tie their shoes. That's why it's so important to protect your head by wearing your seat belt in the car and wearing a helmet when you skate, play football, ride your bike, skateboard, or wear roller sneakers.
You may have heard about a memory problem called amnesia (say: am-nee-zhuh) . This is when someone can't remember things that happened a short time ago. This happens sometimes, but it's not usually like you see on TV or in the movies. People rarely forget their own names and they usually get better slowly, instead of all at once because something dramatic happens - like getting kissed by a dreamy prince or princess!
The most common cause of amnesia is a traumatic brain injury (TBI). A TBI is caused by a severe hit to the head. Traumatic brain injuries can happen in a lot of ways and can be severe enough to cause a coma (prolonged unconsciousness) , or a person may just be stunned without even being knocked out (like in some concussions) .
Car accidents, bike accidents, and falls can cause TBIs. If you've ever seen someone take a hit to the head in a National Football League game, you may have seen the player being questioned on the sidelines. The family doctor may ask the person some basic questions - like what happened, where they are, and what team they're playing. Not knowing the correct answers could be the first sign of a brain inury.
Abusing alcohol or using illegal drugs is another way to injure the brain and cause memory problems. Hallucinogens (like LSD or PCP) can alter certain chemicals in the brain that actually make memories harder to recall.

Signs of a Memory Problem
A person might - or might not - be able to notice signs of his or her own memory problem. If a person has suffered a brain injury, doctors, nurses, and family members will be on the alert for signs of trouble. If someone has a memory problem, he or she will be unable to remember important things for varying lengths of time. The more severe the injury, the longer the memory loss is likely to last. Some people forget just the moments right before and after the injury, which is not unusual with a concussion. Sometimes, these memories come back. More significant problems with memory may make it hard to remember what happened days, weeks, months, or even years ago, and it can be difficult to learn and remember new things.

What Will the Family Doctor Do?
Any time a person has been hit in the head, it's important to see a family doctor. A family doctor will test the person's ability to recall events, names, or places by asking lots of questions. In the case of a brain injury, a family doctor may also want to take a picture of the patient's brain and skull using something called a CT scan.
If the person has memory loss from a head injury, the family doctor will design a treatment plan to help the brain heal and, if necessary, to help the person relearn things that have been forgotten. If the memory problem is due to a person using drugs or alcohol, the person needs to stop abusing these substances before his or her memory will improve.
With strokes, memory can return but it depends on severity and location of the stroke in the brain. With Alzheimer's, lost memory cannot be restored, but scientists are working on medicines they hope someday will prevent this kind of memory loss.
Most memory problems affect older people, so what can you do for your memory if you're 8, not 88? In addition to remembering to wear your helmet, use your brain! By doing challenging activities, like reading and doing puzzles, you can exercise your mind so you'll be remembering great memories for many years to come!
[AAFP]

PREVENTIVE MEDICINE

Western medicine has spent a great deal of time and effort reducing the risk of infectious diseases throughout the world through vaccines and antibiotics, which have saved millions of lives.

There have also been thousands of scientists and billions of research dollars put into the effort of slowing the progression of heart disease – the number one cause of death in essentially every industrialized nation in the world. Billions of dollars have also gone into reducing the risk of many chronic diseases, such as, cancer, diabetes, etc.
Unfortunately, this tremendous amount of work is commonly overlooked by the average patient in a Western physician’s office because of the economic and insurance pressures placed upon the physician.

Since insurance companies pay doctors based upon diagnoses and not nearly as much for preventive work, the focus of most Western physicians has been to primarily treat disease processes.

Eastern medical practitioners, who have not had the same financial encumbrances, have traditionally spent a lot of time with their patients focusing on disease prevention through balance in all areas of their lives.

They have also used herbs to treat disease processes, which are in effect their form of medicine or pharmaceuticals. Unfortunately, Eastern medicine has not applied rigorous, randomly selected, doubleblind studies to these herbs and subsequently, many have been found to be toxic or lethal even when given at traditional dosage strengths.

Surgical and diagnostic technology has lagged very far behind the West and a great deal of Eastern medicine is based upon spiritual practices (not nlike the Incas of Peru or tribal practitioners of Africa) that have been widely accepted without significant scientific review and analysis. Both Western and Eastern medicine traditions have their strengths and weaknesses and neither tradition should be completely avoided or completely accepted.

Preventive medicine is an exciting blend of the two that seeks to bridge the gap. It takes the best of the Eastern preventive approach and herbal support while applying tough scientific standards of Western medicine and utilizing Western diagnostics, medicines and procedures only when necessary.

Its emphasis is on balanced nutrition, exercise and appropriate lifestyle which if followed correctly will dramatically reduce the need of procedures and medicines. Even the insurance companies in the West are beginning to realize the tremendous economic benefit of reducing, preventing or delaying disease and have begun to provide money to support this effort.

We are embarking on a new journey in preventive medicine which I’m honored to be a part of these last 17 years. The future of preventing or slowing the development of chronic disease looks very bright.

In conclusion, let’s participate in the best the Western and Eastern medical traditions have to offer through preventive medicine. Before you begin an exercise program, check with your doctor to make sure you are healthy enough to begin. Eat a well balanced, calorie controlled diet rich in fruits and vegetables and supported with fish sources. Reduce your risk factors for chronic disease (see “The Impact of Lifestyle and Diet Upon the Body”) and consider supplementation to fill nutritional gaps and for special needs. Take these steps and you will be well down the road to “Optimum Health”. We are excited for you and look forward to hearing about your progress.

By Dr Duke Johnson M.D.

What You Can Do to Treat Your Ulcer

What is an ulcer?
Ulcers are sores on the lining of your digestive tract. Your digestive tract consists of the esophagus, stomach, duodenum (the first part of the intestines) and intestines. Most ulcers are located in the duodenum. These ulcers are called duodenal ulcers. Ulcers located in the stomach are called gastric ulcers. Ulcers in the esophagus are called esophageal ulcers.

What causes ulcers?
A type of bacteria called Helicobacter pylori (H. pylori) causes many ulcers. Acid and other juices made by the stomach can contribute to ulcers by burning the lining of your digestive tract. This can happen if your body makes too much acid or if the lining of your digestive tract is damaged in some way. Physical or emotional stress may not necessarily cause an ulcer, but it can aggravate an ulcer if you have one.
Ulcers can also be caused by anti-inflammatory medicines. Although most people take these medicines without problems, long-term use may damage the stomach lining and cause ulcers. Anti-inflammatory drugs include aspirin, ibuprofen, naproxen, ketoprofen and some prescription drugs for arthritis.

How can my doctor tell if I have an ulcer?
Your doctor will ask about your symptoms and may start you on some medicine before doing tests. This is because ulcers usually feel better within a week or so of treatment. You may not need tests if you're getting better.
If you don't get better, your doctor may do an endoscopy or a special x-ray to study your digestive tract. During an endoscopy, your doctor looks into your stomach through a thin tube. He or she may take a biopsy (a sample of
the stomach lining) to test for H. pylori. Blood and breath tests can also be used to test for H. pylori.

Possible signs of an ulcer
Feel better when you eat or drink and then worse 1 or 2 hours later (duodenal ulcer)
Feel worse when you eat or drink (gastric ulcer)
Stomach pain that wakes you up at night
Feel full fast
Heavy feeling, bloating, burning or dull pain in your stomach
Vomiting
Unexpected weight loss

How can ulcers be treated?
One way to treat ulcers is to get rid of the H. pylori bacteria. Treatment may also be aimed at lowering the amount of acid that your stomach makes, neutralizing the acid and protecting the injured area so it can heal. It's also very important to stop doing things, such as smoking and drinking alcohol, that damage the lining of your digestive tract.

What is triple therapy?
Triple therapy is a treatment to eliminate H. pylori. It is a combination of 2 antibiotics and bismuth subsalicylate. Other combinations may also be effective. This treatment may be used with medicine that reduces the amount of acid your stomach makes.

What about other medicines?
Several other medicines can be used to help treat ulcers. Two types of medicines (H2 blockers and proton pump inhibitors) reduce the amount of acid that your stomach makes. They usually help people start to feel better
within 3 days.
Antacids neutralize acid that the stomach makes. A medicine called sucralfate coats the ulcer to protect it from the acid so it has time to heal.
Another medicine, misoprostol, reduces the amount of acid and protects the lining of the stomach. It is usually used to prevent gastric ulcers in people who need to take anti-inflammatory drugs and who have had stomach irritation or ulcers in the past.

How long will I have to take medicine?
Treatment to get rid of H. pylori usually takes about 2 to 3 weeks. Your doctor may want you to take medicine that lowers the stomach acid for up to 8 weeks. Most ulcers heal within this time.
If your symptoms come back after you stop taking medicine, your doctor may want you to take a different medicine or take a low dose of medicine even when you're not having symptoms to keep the ulcer from coming back.

Tips on healing your ulcer
Don't smoke.
Avoid anti-inflammatory drugs such as aspirin and ibuprofen.
Avoid caffeine and alcohol (or have them only in small amounts and on a full stomach).
Avoid spicy foods if they cause heartburn.

Does what I eat affect my ulcer?
It may. But this isn't true for everyone. Certain foods and drinks may be more likely to make your pain worse. These include both regular and decaffeinated coffee, tea, chocolate, meat extracts, alcohol, black pepper, chili powder, mustard seed and nutmeg. You may want to avoid these things if they bother you. But keep your diet balanced. Try eating small, frequent meals when you're having pain.

Are ulcers serious?
Not usually. Ulcers sometimes can lead to other problems. These problems include bleeding, perforation (the ulcer eats through the wall of the digestive tract) or obstruction (the digestive tract is blocked and food can't leave the stomach).

Warning signs that your ulcer is getting worse
You vomit blood.
You vomit food eaten hours or days before.
You feel cold or clammy.
You feel unusually weak or dizzy.
You have blood in your stools (blood may make your stools look black or like tar).
You have ongoing nausea or repeated vomiting.
You have sudden, severe pain.
You keep losing weight.
Your pain doesn't go away when you take your medicine.
Your pain reaches to your back.

[AAFP]

Kidney Stones

What are kidney stones?
Kidney stones are hard lumps that your body makes from waste products in your urine. If these lumps are big enough, they can get stuck in your bladder or urinary tract. This can be very painful.

Who gets kidney stones and why?
Kidney stones are more common in men, but women also can get them. Most people who get them are between 30 and 50 years old. Kidney stones usually are caused by not drinking enough water and eating too much meat or salty foods. You are more likely to get kidney stones if someone in your family has had them. Kidney stones also can be caused by urinary tract infections.

How do I know if I have a kidney stone?
Kidney stones usually cause bad crampy pain in your side. The pain can move toward your groin. You may feel sick to your stomach or have blood in your urine. You also may have a fever. Your family doctor can take x-rays or do a urine test to see if you have kidney stones.

How are kidney stones treated?
You might be able to pass the stone in your urine if it is small enough. Your family doctor can give you medicine to help with the pain. If the stone is too big, your family doctor can use a special machine that breaks the stone into smaller pieces. Your family doctor also can put a very thin telescope into your urethra to find the stone. Then he or she can pull it out or break it into smaller pieces. If your family doctor does this, he or she will give you medicine to numb the area first. Sometimes surgery is the only way to get rid of kidney stones.

What can I do to keep from getting another kidney stone?
Most people with kidney stones have a 50-50 chance of getting another one within 10 years. But there are things you can do to lower your risk:

• Drink enough fluids to make 2 liters of urine per day (about 2 quarts).
• Do not eat more than 1,500 mg of salt per day (about 1 teaspoon). This includes salt in prepackaged food. Check nutrition labels to see how much salt (sodium) is in your food.
• Do not eat more than two servings of meat per day. Each serving should be about 6 to 8 ounces (the size of a deck of cards).
• Eat a moderate amount of foods with calcium, such as milk, cheese, and other dairy foods. If your kidney stones are made from calcium, you do not have to stop eating dairy foods. One or two servings per day is okay.
  

If you have had more than one kidney stone, your family doctor might send you to a specialist to find the exact cause of your stones. Some people need medicine to keep from getting another kidney stone.
[AAFP]

===============
Forget the lemonade stand-bring on the orange juice! Research published in the Clinical Journal of the American Society of Nephrology suggests that orange juice helps prevent the formation of kidney stones better than other citrus fruit juices such as lemonade. Four patients with a history of kidney stones and nine healthy control patients were given orange juice, lemonade, or distilled water while on a low-calcium, low-oxalate diet.
After analyzing the participants' urine samples, researchers found that orange juice had greater alkalinizing and citraturic effects than lemonade, despite comparable citrate content. Orange juice also raised the levels of citrate in the urine and reduced the crystallization of calcium oxalate and uric acid.
(J Am Soc Nephrol)

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Cataract

A cataract is a clouding (opacity) of the lens of the eye that causes a progressive, painless loss of vision. Cataracts are the leading cause of blindness worldwide. Cataracts are common where they affect mostly older adults. Almost one in five people between the ages of 65 and 74 develop cataracts severe enough to reduce vision, and almost one in two people older than 75 have them.

Symptoms & Diagnosis
Because all light entering the eye passes through the lens, any clouding of the lens that blocks, distorts, or diffuses light can cause poor vision. The first symptom of a cataract is usually blurred vision. Glare and halos and, less commonly, double vision can also be early symptoms of cataracts. A person may also notice that colors seem more yellow and less vibrant. Reading may become more difficult because of a worsening ability to distinguish between the light and dark of printed letters on a page. How much vision is changed by a cataract depends on the intensity of light entering the eye and on the location of the cataract. In bright light, the pupil constricts and narrows the pathway through which light enters the eye, and light cannot easily pass around a cataract that is centrally located (nuclear cataract). In dim light, the pupil dilates; bright lights, such as oncoming headlights, are scattered by the edge of the cataract, causing halos and glare, which may be especially disturbing during night driving.
People with cataracts who take drugs that constrict their pupils (certain glaucoma eye drops, for example) may also have greater vision loss. In normal light, however, a nuclear cataract may at first improve vision without eyeglasses for farsighted people. The cataract acts as a stronger lens, thus refocusing light, improving vision for objects close to the eye (near vision). Older people, who generally have trouble seeing things that are close without eyeglasses, may discover that they can read again without eyeglasses, a phenomenon often described as gaining second sight.
Unfortunately, a nuclear cataract eventually blocks and blurs light entering the eye and impairs vision. A cataract at the back of the lens (posterior subcapsular cataract) affects vision more than a cataract in another location because the clouding is at the point where light rays are focused in a narrow beam. This type of cataract impairs vision more in bright light and is more likely to cause glare and halos.
Although cataracts almost never cause pain, rarely they can swell and increase the pressure in the eye (glaucoma), which can be painful. A doctor can usually detect a cataract while examining the eye with an ophthalmoscope (a handheld instrument used to view the inside of the eye). Using an instrument called a slit lamp that allows examination of the eye in more detail, a doctor can identify the exact location of the cataract and the extent to which it blocks light.

Prevention
There are several things people can do to try to prevent cataracts. Consistent use of sunglasses with a coating to filter ultraviolet (UV) light will protect the eyes from bright sunlight and may help. Not smoking is useful and has other health advantages. People with diabetes should work with their doctor to be sure the level of sugar in their blood is well controlled. A diet high in vitamin C, vitamin A, and substances known as carotenoids (contained in vegetables such as spinach and kale) may protect against cataracts. Estrogen use by women after menopause may also be protective, but estrogen should not be used solely for this purpose. Finally, people who are taking corticosteroids for extended periods might discuss with their doctor the possibility of using a different drug.

Treatment
Until vision is significantly impaired, eyeglasses and contact lenses may improve a person's vision. Wearing sunglasses in bright light and using lamps that provide over-the-shoulder lighting may decrease glare and aid vision. Rarely, drugs that keep the pupil dilated may be used to help vision if the cataract is located in the center of the lens.
The only treatment that provides a cure for cataracts is surgery; there are no eye drops or drugs that will make cataracts go away. Occasionally, cataracts will cause changes (such as swelling of the cataract or glaucoma) that lead doctors to recommend the cataract be removed quickly. However, most times people should have surgery only when their vision is so impaired by cataracts that they feel unsafe, uncomfortable, or unable to perform daily tasks. There is no advantage to having cataracts removed before then.
Cataract surgery can be performed on a person of any age and is generally safe even for people with illnesses such as heart disease and diabetes. Usually, the doctor makes a small incision in the eye and removes the cataract by breaking it up with ultrasound and taking out the pieces (phacoemulsificatio n). When all the cataract pieces have been removed, the surgeon replaces the cataract with an artificial lens (intraocular lens). The intraocular lens cannot always be safely placed, however; when this is the case, people must wear thick eyeglasses or contact lenses after the cataract has been removed.
Surgery to remove cataracts is almost always performed under local anesthesia, in which the eye surface is numbed with an injection or eye drops. Rarely, children or adults who cannot hold still during surgery require general anesthesia. The procedure normally takes about 30 minutes, and the person can go home the same day. No sutures are usually needed, because the incision into the eye is small and can seal itself.
People should make arrangements in advance to get extra help at home for a few days after surgery because activity may be restricted (for example, bending over and heavy lifting may be prohibited) and vision changes, such as blurred vision and discomfort with bright light, may occur for a short time after surgery. For a few weeks after surgery, eye drops or ointments are used to prevent infection, reduce inflammation, and promote healing. A person is given eyeglasses or a metal shield to wear to protect the eye from injury until healing is complete, usually a few weeks. The person visits the doctor the day after surgery and then typically one week and one month later. If a person has cataracts in both eyes, many doctors wait several months after the first eye has healed to remove a cataract from the other eye.
Many people notice improved distance vision within a few weeks after cataract surgery. Almost everyone will need eyeglasses for reading, and some people will need eyeglasses to obtain the best possible distance vision as well. The doctor makes calculations before the surgery to decide how powerful the artificial lens should be. Thus, it is possible to go from wearing very thick eyeglasses before the surgery to wearing much thinner eyeglasses after it.
Complications after cataract surgery are rare. A person may develop an infection or serious bleeding in the eye, which can lead to a loss of vision. Eye pressure may become too high, which if left untreated, leads to glaucoma, or the implant can become displaced. The back of the eye (retina) can become swollen or detached. Rarely, people with retinal disorders, such as diabetic retinopathy, may notice their vision worsen after the operation. Proper follow-up with the doctor can lead to early detection and treatment of these unusual complications.
Sometimes people develop a haziness of the tissue (capsule) left behind in the eye when the original lens was removed (secondary cataract). This occurs in about one in four people who have had cataract surgery, months or even years after an artificial lens is implanted. Typically, it is treated by using a laser to make a small opening in the hazy capsule to let light through.
Cataracts usually develop without any apparent cause; however, they can result from injury to the eye, prolonged exposure to certain drugs (such as corticosteroids) or to x-rays (such as with radiation therapy to the eye), inflammatory and infectious eye diseases, and as a complication of diseases such as diabetes. Cataracts also seem to be more common in people with dark eyes, those who have had prolonged exposure to direct sunlight, those with poor nutrition, and smokers. People who have had a cataract in one eye are more likely to develop one later in the other eye. Sometimes cataracts can develop in both eyes at the same time. Babies can be born with them (congenital cataracts), and children can also develop cataracts, usually as a result of injury or illness.
[Merck]

Nausea & Vomiting

Nausea is an unpleasant feeling that may include dizziness, vague discomfort in the abdomen, an unwillingness to eat, and a sensation of needing to vomit. Vomiting is the forceful contraction of the stomach that propels its contents up the esophagus and out through the mouth. Vomiting serves to empty the stomach of its contents and often makes a person with nausea feel considerably better, at least temporarily. Vomiting is not the same as regurgitation, which is the spitting up of stomach contents without forceful abdominal contractions and nausea.
Vomitus-the material that is vomited up-usually reflects what was recently eaten. Sometimes it contains chunks of food. When blood is vomited, the vomitus is usually bright red (hematemesis) . When bile is present, the vomitus is green.
Even normal vomiting can be violent. A person who is vomiting typically doubles over and makes considerable noise. Severe vomiting can project food many feet (projectile vomiting). Vomiting greatly increases pressure within the esophagus, and severe vomiting can tear or even rupture the lining of the esophagus. People who are unconscious can inhale their vomitus. The acidic nature of the vomitus can severely irritate the lungs. Frequent vomiting can cause dehydration and electrolyte abnormalities; newborns and infants are particularly susceptible to these complications.

Causes
Nausea and vomiting result when the vomiting center in the brain is activated. These symptoms commonly occur with any dysfunction of the digestive tract but are particularly common with gastroenteritis and bowel obstruction. Obstruction of the intestine causes vomiting because food and fluids back up into the stomach from the blockage. The vomiting center also can be activated by certain brain disorders, including infections (such as meningitis and encephalitis) , brain tumors, and migraines. The balance organs of the inner ear (vestibular apparatus) are connected to the vomiting center. This connection is why some people become nauseated by the movement of a boat, car, or airplane and by certain disorders of the inner ear (such as labyrinthitis and positional vertigo). Nausea and vomiting may also occur during pregnancy, particularly during the early weeks and especially in the morning. Many drugs, including opioid analgesics, such as morphine, and chemotherapy drugs, can cause nausea. Psychologic problems also can cause nausea and vomiting (known as functional, or psychogenic, vomiting). Such vomiting may be intentional- for instance, a person who has bulimia vomits to lose weight. Or it may be unintentional- a conditioned response to address psychologic distress, such as to avoid going to school.

Evaluation
Otherwise healthy adults and older children who have only a few episodes of vomiting (with or without diarrhea) and no other symptoms may not require evaluation. Young children and older people, and those in whom vomiting lasts more than 1 day or who have any other symptoms, particularly abdominal pain, headache, weakness, or confusion, are evaluated by the doctor. If the person's symptoms and physical examination show no signs of dehydration or serious underlying illness, doctors may not perform any testing. Women of childbearing age may receive a pregnancy test. In others, blood tests may be obtained to look for signs of dehydration or abnormal electrolyte levels. If bowel obstruction is suspected, x-rays are obtained.

Treatment
Specific conditions are treated. If there is no serious underlying disorder and the person is not dehydrated, small amounts of clear liquids may be given an hour or so after the last bout of vomiting. If these liquids are tolerated, the amounts are increased gradually. When these increases are tolerated, the person may resume eating normal foods. If the person is
dehydrated and can tolerate some liquids by mouth, doctors usually recommend oral rehydration solutions. Those with significant dehydration or electrolyte abnormalities and those who cannot tolerate liquids by mouth usually require intravenous fluids.
For some adults and adolescents, doctors use anti-nausea drugs such as metoclopramide or prochlorperazine. For people whose vomiting is caused by chemotherapy, doctors usually use stronger drugs such as odansetron or granisetron.

[Merck]

Vaginal Discharge 2

Is vaginal discharge normal?
Yes. Glands inside your vagina and cervix make small amounts of fluid. This fluid flows out of the vagina each day, carrying out old cells that have lined the vagina. This is your body's way of keeping your vagina healthy and clean. The discharge is usually clear or milky and doesn't smell bad. The color and thickness of the discharge change with your monthly cycle. The discharge is thicker when you ovulate (when one of your ovaries releases an egg), when you breastfeed or when you're sexually excited.

What changes may be a sign of a problem?
Changes that may signal a problem include an increase in the amount of discharge, a change in the color or smell of the discharge, and irritation, itchiness or burning in or around your vagina. This is called vaginitis. A discharge that's stained with blood when you're not having your period could also be a sign of a problem. If you have any of these signs, you should talk to your family doctor.

Tips on preventing vaginitis
After using the toilet, always wipe from front to back. This may help prevent getting bacteria from your rectal area into your vagina. Wear cotton underpants during the day. Cotton allows your genital area to "breathe." Don't wear underpants at night.
Avoid wearing tight pants, pantyhose, swimming suits, biking shorts or leotards for long periods.
Change your laundry detergent or fabric softener if you think it may be irritating your genital area. The latex in condoms and diaphragms and the sperm-killing gels that are used for birth control can be irritating for some women. If you think one of these things is a problem for you, talk to your family doctor about other types of birth control.

Avoid hot tubs.
Bathe or shower daily and pat your genital area dry.
Don't douche.
Avoid feminine hygiene sprays, colored or perfumed toilet paper, deodorant pads or tampons, and bubble bath.

What can cause these changes?
These changes can occur if the normal balance of healthy germs in your vagina is upset. Many things can disturb the balance of a healthy vagina, including douching, feminine hygiene sprays, certain soaps or bubble baths, antibiotics, diabetes, pregnancy or infections.

How can douching be harmful?
The chemicals in douches may irritate your vagina and change the normal balance of germs in your vagina. Douching can also spread an infection into the uterus, increasing your risk of getting pelvic inflammatory disease (PID). PID is an infection of the fallopian tubes that can cause you to be unable to have children.
Douching isn't necessary to keep your body clean. Smells you may notice usually come from outside the vagina (vulva). Keeping this area clean with gentle soap and water can prevent smells.

What is a yeast infection?
Small amounts of yeast fungus are often found in a healthy vagina. But if too much grows, it can cause a yeast infection. Possible signs of yeast infections are listed below.
Yeast infections usually aren't caught from a sex partner. You may be more likely to get a yeast infection if you are using antibiotics, are pregnant, have diabetes, or stay hot and sweaty for long periods. Some women get frequent yeast infections for no obvious reason.

Signs of yeast infections
White, cottage cheese-like discharge
Swelling and pain around the vulva
Intense itching
Painful sexual intercourse

How are yeast infections treated?
Yeast infections are usually treated with a medicine you put into your vagina. Yeast infections can also be treated with oral medicine. If you have yeast infections often, your family doctor may suggest you use a medicine you can buy without a prescription. But if you have any questions about what's causing your vaginitis, you should call your family doctor. Many other things besides a yeast infection can cause vaginitis. Yeast infections are usually treated with a medicine you put into your vagina. Yeast infections can also be treated with oral medicine. If you have yeast infections often, your family doctor may suggest you use a medicine you can buy without a prescription. But if you have any questions about what's causing your vaginitis, you should call your family doctor. Many other things besides a yeast infection can cause vaginitis.

What is bacterial vaginosis?
Bacterial vaginosis is usually caused by Gardnerella vaginalis bacteria. Why some women get this infection isn't clear. It's probably not caught from a sex partner. Possible signs are listed below. Bacterial vaginosis is treated with antibiotic medicine, usually a pill. Signs of bacterial vaginosis A white, gray or yellowish vaginal discharge A fishy odor that is strongest after sex or after washing with soap Itching or burning Slight redness and swelling of the vagina or vulva

What is trichomoniasis?
Trichomoniasis is caused by an organism called Trichomonas vaginalis. You can be infected but have no signs for a long time. Possible signs of trichomoniasis are listed below.
Trichomoniasis is usually caught by having sex without a condom with someone who is infected. It's usually treated with antibiotic pills.

Signs of trichomoniasis
A watery, yellowish or greenish bubbly discharge
An unpleasant odor
Pain and itching when urinating
Most apparent after your period

What about other infections?
Two sexually transmitted diseases, chlamydia and gonorrhea, can also cause vaginal discharge. These are infections of the cervix caused by bacteria. Sometimes the only symptom may be an increase of vaginal discharge. Both of these infections can be treated with antibiotic shots or pills.

Should my sex partner be treated?
Sometimes. Talk to your family doctor if you're sexually active. You may also need to avoid having sex or use condoms until you've been treated.
[AAFP]

Vaginal Discharge

Vaginal discharge is normal and varies during your menstrual cycle. Before ovulation (the release of the egg), there is a lot of mucous produced, up to 30X more than after ovulation. It is also more watery and elastic during that phase of your cycle. You may want to wear panty liners during that time.
The things to be worried about include if the discharge has a yellow or green color, is clumpy like cottage cheese, or has a bad odor. If worried, see your family doctor.

Different Types of Discharge
White: Thick, white discharge is common at the beginning and end of your cycle. Normal white discharge is not accompanied by itching. If itching is present, thick white discharge can indicate a yeast infection.
Clear and stretchy: This is "fertile" mucous and means you are ovulating.
Clear and watery: This occurs at different times of your cycle and can be particularly heavy after exercising.
Yellow or Green: May indicate an infection, especially if thick or clumpy like cottage cheese or has a foul odor.
Brown: May happen right after periods, and is just "cleaning out" your vagina. Old blood looks brown.
Spotting Blood/Brown Discharge: This may occur when you are ovulating/mid- cycle. Sometimes early in pregnancy you may have spotting or a brownish discharge at the time your period would normally come. If you have spotting at the time of your normal period rather than your usual amount of flow, and you have had sex without using birth control, you should check a
pregnancy test.

Is this normal?
One of the challenges to answering questions is making sure that the person asking the question seeks the advice and care from her family doctor when appropriate. There is often information not given that can really change the answer.
For instance:
* How old are you (really)?
* Are you on medications or do you take herbs or vitamins?
* Do you have pain or itching?
* Are you pregnant?
* Do you have other health problems (like diabetes)?

An important question is sexual activity. Sometimes it isn't accurate to simply say yes or no. Symptoms can depend on the number of sexual partners, kind of sexual partners, birth control, birth control failure, kind of sex you are having and if abuse is involved. I think you can see, it can get pretty complicated to get all the information needed to give the best answer possible.
With that said, here is my best answer to the common question of vaginal discharge.
A normal vaginal discharge consists of about a teaspoon (4ml) a day that is white or transparent, thick to thin, and odorless. This is formed by the normal bacteria and fluids the vaginal cells put off. The discharge can be more noticeable at different times of the month depending on ovulation, menstrual flow, sexual activity and birth control.
It is not uncommon for the normal discharge to be dark, brown or discolored a day or two following the menstrual period. If you are having any of the symptoms below see your family doctor.
* Pain
* Itching
* Discomfort
* Rash or sores alone or with a vaginal discharge

[PAMC]

Pharyngitis

Pharyngitis is infection of the throat (pharynx) and sometimes the tonsils. Most pharyngitis is caused by the same viruses that cause the common cold. Like the common cold, viral pharyngitis gets better by itself and is a problem only because it makes children miserable and causes them to miss school. Streptococcus bacteria are a less common but more serious cause of pharyngitis ("strep throat"); strep throat is unusual in children younger than 2 years. Pharyngitis is also rarely caused by unusual infections, such as infectious mononucleosis or-in countries with low vaccination rates-diphtheria.
The tonsils (patches of lymphoid tissue at the back of the throat) also can become infected in children with pharyngitis. A doctor may use the term tonsillitis when the tonsils are particularly enlarged. Occasionally, the tonsils remain infected, inflamed, or enlarged (chronic tonsillitis) after an episode of pharyngitis.
Bacterial pharyngitis can cause persistent inflammation, infection, and enlargement of the tonsils (chronic tonsillitis) ; pus within folds of the tonsils (cryptic tonsillitis) ; and abscesses in the tissues to the side of the pharynx (lateral pharyngeal abscesses), behind the pharynx (retropharyngeal abscesses), or around the tonsils (peritonsillar abscesses). Some rare complications of streptococcal pharyngitis include rheumatic fever, glomerulonephritis, or life-threatening infection of the tissues (necrotizing fasciitis) and bloodstream (toxic shock syndrome).

Symptoms
All children with pharyngitis have sore throats and some degree of pain when swallowing. Ear pain may occur because the throat and ears share the same nerves. The back of the throat and tonsils are typically red, and the tonsils may be enlarged or coated with white discharge. Children with pharyngitis as part of a head cold have a runny nose, cough, and slight fever. Children with pharyngitis caused by strep throat may have tender, enlarged lymph nodes in the neck and a high fever. Occasionally, a child with strep throat has symptoms of scarlet fever, which include bright white or red changes of the tongue ("strawberry tongue") and a distinctive red skin rash (scarlatiniform rash). Children with chronic tonsillitis may have a sore throat or discomfort or pain with swallowing.

Diagnosis and Treatment
Doctors suspect pharyngitis when they see redness and white discharge or pus in the back of the throat and when the lymph nodes in the neck are enlarged. If doctors suspect strep throat, they may take a swab from the back of the throat and send it for two tests: rapid antigen testing and a bacterial culture. Rapid antigen testing can detect strep throat within minutes. If the result of a rapid test is positive, the bacterial culture is not needed.
However, if the result of the rapid test is negative, most doctors perform a culture, which takes about 1 to 2 days for results. Strep throat is usually treated with penicillin, either in a single injection or over 10 days by mouth. If the child is allergic to penicillin, the doctor may give erythromycin or another antibiotic. Treatment of strep throat and viral pharyngitis includes giving ibuprofen or paracetamol for pain and fever and encouraging the child to drink fluids. Providing soup is a good way to keep the child well hydrated and nourished when swallowing is painful and before the appetite has returned. Gargling with salt water or using an anesthetic throat spray may also help to temporarily relieve pain.
[Merck]