• PREVENTIVE MEDECINE: DRUG ABUSE

    No Comments
    23 Apr 2009 /  General health

    Drug abuse is a condition in which an individual, often a youngster, takes drugs of addiction which he or she then cannot do without.

    ‘Drugs’ can include all sorts of substances-from prescribed medications to alcohol, cigarettes and glue-but here we will talk about the drugs that are used illegally. This includes LSD, heroin, cocaine, amphetamines, barbiturates and cannabis.

    Drug-taking starts young, often in the teens. Most youngsters start on drugs in much the same way as they start to smoke-to keep in with their friends. Some like the risks involved and others probably do it as part of their general adolescent rebellion against their parents. Others take drugs because they are depressed, unhappy at home, bored, don’t like school, and so on. Sometimes starting on drugs is a cry for help or attention from parents who seem to have no time or inclination to care. It is not easy to tell whether or not your child is taking drugs but here are a few signs that might help. Remember that just because a youngster shows any or even most of these signs it does not necessarily mean that he or she is taking drugs.

    • Sudden mood changes.

    • Irritability or aggression.

    • Poor appetite.

    • No interests in hobbies, friends or school.

    • Drowsiness and sleepiness.

    • Telling lies.

    • Shifty and furtive behaviour.

    • Unusual smells, stains or marks on the body or clothes.

    • The disappearance of money or belongings from around the home (to pay for the drugs).

    None of these things is particularly hazardous, of course, but drug abuse can lead to three which are. First, accidental overdose is an ever present problem with any form of drug addiction, and can lead to unconsciousness and even death. Many users of illegal drugs mix them and this can render the dosage totally unpredictable. Drug overdose is now a major cause of death in the under 25s in New York State and there are signs that things are going the same way in the UK. The second hazard of drug abuse is the increased risk of accident. Accidents of all kinds are more common in those taking illegal drugs. Some, such as road accidents, can easily be fatal to the drug-taker or to an innocent party.

    Finally, addiction or dependence is the most worrying problem for parents because they see their child trapped in a habit that is extremely difficult to get out of.

    On a day-to-day basis drugs can make the youngster confused and have hallucinations, and can cause serious emotional and psychological disturbances. First-time heroin users may be sick, and regular users become constipated. Girls stop having periods. Eventually more serious emotional and physical disorders set in.

    The injection of drugs can cause hepatitis (a potentially lethal infection of the liver), sores, abscesses, blood poisoning and jaundice. The social consequences are equally horrifying as the individual becomes desperate for the next fix and steals and resorts to all kinds of other crimes to fund the habit.

    *143/72/5*

    Tags:

  • ARTHRITIS TREATMENT: ABOUT DRUGS AND THEIR REGISTRATION

    No Comments
    23 Apr 2009 /  Arthritis

    Drugs and therapeutic substances

    A therapeutic substance is something that has a therapeutic effect on the body. This means that it has a healing or remedying effect. It does not mean that it is a drug.

    A drug is a type or class of substance that has been defined as such by a statutory body. Thus, the word ‘drug’ is a defined term; it has no bearing on the therapeutic value of a material. In order for a substance to be defined as a drug it usually has to meet certain criteria. We are referring, of course, to drugs usually used in the field of medicine. There are many valuable therapeutic materials which are not classified as drugs. In fact, at one time, substances such as insulin, penicillin and acetyl salicylic acid (now aspirin) were not drugs. What, then, is the purpose of a drug, and why are some therapeutic preparations classed as drugs and others not? The answer to these questions involves two factors. One is advertising; the other is government subsidy.

    Whilst there are other reasons for therapeutic substances being registered as ‘drugs’ by the appropriate governmental authorities, the main ones concern the two conditions above, which, in turn, concern money. In order to explain what is meant by this it will be necessary to generalize, otherwise we will become involved in a lengthy discussion involving the laws relating to the sale of foods and drugs.

    Registration of drugs

    Under the appropriate laws of most countries the advertising of therapeutic properties of any substances which are not registered as drugs is prohibited. Thus, in effect, it is illegal to claim that ‘an apple a day keeps the doctor away’ because this is making a therapeutic claim for apples, which are not classified as a drug. If apples were to be put through the trial procedures and production requirements which would satisfy the drug licensing authorities, then it would become legal to make the claim as written. Obviously, this is a far-fetched example, but it is quite pertinent. This is the advertising factor. Basically, it means that unless a product is registered as a drug it cannot be advertised for its beneficial properties and thus its commercial potential is considerably hampered.

    On the aspect of subsidy, drugs are eligible for inclusion on prescription lists. This means that they can be prescribed by practicing physicians and the cost of them will be subsidized

    ó the government. Not all countries have this system of prescription drug subsidy, but where it is available only registered drugs are usually allowed to be treated this way. Therefore, we can have the situation of a valuable therapeutic substance that doctors cannot prescribe because it is not a classified ‘drug’. The doctor can, of course, recommend a patient to use this particular substance, but the patient must pay for it himself. If this is the case, why not have all therapeutic substances registered as drugs? The answer involves an explanation of the requirements for drug registration.

    These requirements are such that valuable therapeutic materials do not qualify for drug registry because of some particular feature. This does not mean that they are not effective or safe. It might simply be that the material is of natural origin and that its absolute composition cannot be defined. Alternatively, the active part of the material may not have been identified or isolated and thus the criteria required in drug registry are not satisfied.

    *31/48/5*

    Tags:

  • BREAST RECONSTRUCTION: PEDICLED SKIN AND MUSCLE FLAPS

    No Comments
    23 Apr 2009 /  Cancer

    Otherwise known as autogenous tissue reconstruction, the creation of a pedicled flap involves taking skin and muscle from another part of the body and placing it on the chest wall to replace the tissue removed during a mastectomy. The tissue transported to create a pedicled flap remains attached at some point – either via a section of the tissue itself or via blood vessels – to the site from which it is taken.

    One of the commonly used procedures to create a flap following a mastectomy involves using the large muscle on the back -the latissimus dorsi muscle – and its overlying skin. A section of the skin and muscle is separated from the back, with some of its blood vessels still attached, and is then tunneled beneath the skin to the front of the chest. If this skin and muscle alone are not enough to augment the chest to match the size of the other breast, a small silicone prosthesis may be placed within the space thus created to provide symmetry.

    This method of reconstruction is useful when tissue expansion is not possible, for example after radiotherapy or when a single-stage prosthetic reconstruction is required. In some cases, the extra muscle cover it provides for a prosthesis is also important.

    Although the loss of part of the large muscle from the back does not usually have any significant functional effect, its removal leaves an obvious scar, which can stretch.

    The imported skin will be – to some degree – a different colour from, and will therefore contrast with, the remaining breast skin, although this tends to improve with time.

    Another type of autogenous tissue reconstruction involves the use of the rectus abdominis muscle together with a large flap of overlying skin and subcutaneous tissue from the lower abdomen. (Once the skin has been removed from the lower abdomen, the navel is re-sited.) This is known as a transverse rectus abdominis myocutaneous (TRAM) flap. It is usually large enough to create a good-sized breast with natural droop and texture, and an artificial prosthesis is not required.

    Removal of the excess abdominal tissue in this operation has a similar effect to a ‘tummy tuck’ operation. The abdominal muscles can occasionally be left weakened, although not usually significantly so.

    Some of the blood vessels remain attached to the skin and muscle as it is transported from the abdomen to the chest, and these can form new attachments to blood vessels within the chest. However, the normal blood supply to the skin is altered during this operation, and healing can therefore be slow. Wound dressings may thus be required for a week or two longer than normal. Occasionally, significant portions of the transferred tissue can die, and further minor surgery may then be necessary to allow healing to take place.

    Microvascular tissue transfer

    Reconstruction of a breast using this technique involves transferring tissue from one site in the body, usually the lower abdomen, separating it from its normal blood supply, and reattaching it on the chest wall by microsurgery. Small sections of some blood vessels remain attached to the transferred tissue, and very fine surgical techniques are used, as well as high-powered magnification, to join the severed ends of these blood vessels to veins and arteries in the chest or axilla region.

    This technique gives the best-shaped and most natural-looking of all the breast reconstructions. It involves the removal of less muscle from the abdomen than does the pedicled TRAM flap, and as the blood supply is more secure, healing is usually quicker. However, the operation itself is complex, and takes longer than the pedicled TRAM flap, thus involving a longer anesthetic time. It may fail completely in up to 10 per cent of cases, and is most suited to young, fit women who do not smoke and are not obese.

    *58/39/5*

    Tags:

  • HORMONAL DRUGS TO TREAT ENDOMETRIOSIS: DÅÐÎ – PROVERA

    No Comments
    23 Apr 2009 /  Women's Health

    Depo-Provera is the long-acting injection form of Provera, also manufactured by Upjohn, which is sometimes used in the treatment of endometriosis. It is also used to treat endometrial cancer (cancer of the uterus), breast cancer and, in some countries, is used as a contraceptive agent.

    An injection of Depo-Provera consists of thousands of very small crystals of the drug suspended in a solution of water. When the drug is injected into the body the crystals are slowly released into the bloodstream over a period of weeks or months. The time that the drug remains in the body depends on how fast it releases the crystals and how fast the body removes the drug from the bloodstream.

    There has been considerable controversy over the last decade regarding the unapproved use of Depo-Provera for contraceptive purposes. However, Depo-Provera has long been approved in this country for the treatment of endometriosis.

    How Depo-Provera works

    Depo-Provera presumably eradicates endometrial implants in the same way as Provera.

    Dosages of Depo-Provera generally used

    Dosages vary. Some gynecologists recommend one injection every two weeks for the first two to three months followed by one injection every month for the rest of the course of treatment. Others recommend one injection every two weeks throughout the course of treatment. The recommended length of treatment may vary from six months to a year.

    It is important to remember that because Depo-Provera is a long-acting injection, any side effects will persist until all the crystals of the drug have been removed from the body. There is no way to remove the drug from your body once you have had an injection and there is no antidote.

    Some gynecologists suggest that you try taking a short-term course of Provera tablets before you embark on a long-term course of Depo-Provera as this should enable you to find out how your body responds to the drug and whether or not the side effects are likely to cause problems.

    Side effects of Depo-Provera

    Side effects of Depo-Provera include vaginal bleeding, weight gain, depression, headaches, nausea, lethargy and tiredness, decreased libido, acne, abdominal discomfort and breast tenderness.

    Vaginal bleeding is common and may be troublesome. The bleeding may be heavy and prolonged, or erratic with episodes of light bleeding or spotting. The bleeding may sometimes persist after the course of treatment has finished.

    Weight gain is also common — usually only about two or three kilograms but sometimes more.

    Most women will start ovulating and menstruating again within several months of their last injection. Depo-Provera sometimes causes a prolonged delay in the return of menstruation and a few women will not menstruate for more than a year following their last injection. Depo-Provera is not recommended for women who may wish to become pregnant soon after their treatment has ceased.

    How effective is Depo-Provera

    Studies indicate that Depo-Provera relieves the symptoms of endometriosis in 60% to 80% of women and that approximately 50% of women desiring pregnancy will conceive. There are no figures on the rate of recurrence of endometriosis following treatment.

    Depo-Provera, pregnancy and breastfeeding

    The manufacturers state that Depo-Provera should not be used if there is any possibility that you may be pregnant, as progestogens may cause abnormalities in the developing foetus. However, some gynecologists believe that Depo-Provera causes no risks to the foetus.

    The use of Depo-Provera while breastfeeding is probably safe.

    Interaction with other drugs, alcohol or foods

    There are no known interactions of Depo-Provera with any foods, alcohol or other drugs.

    *41/41/5*

    Tags:

  • DRUG THERAPY FOR ANOREXIA NERVOSA: ANTIDEPRESSANT MEDICATIONS

    No Comments
    23 Apr 2009 /  Weight Loss

    Unfortunately, the few good studies on the use of antidepressants in treating self-starvation have produced nothing like the results seen in bulimia. The specific antidepressants studied so far include clomipramine and amitriptyline. Clomipramine, recently approved for use in this country and sold under the brand name Anafranil, is used to treat obsessive-compulsive disorder, which has some features in common with anorexia. The theory was that the same drug might prove effective in both. So far, however, results have been inconclusive. We need more studies, especially ones looking at the use of clomipramine in higher doses.

    If we can one day find the right antidepressant, we may help anorexics in two ways. First, these medications can improve depressed mood. When that happens, the patient’s attitudes may improve not just about eating but about life in general. Second, such drugs may correct the underlying biological malfunctions that produce the symptoms of the disorder.

    Depression by itself can cause weight loss. Conversely, weight loss can lead to depression. If her mood improves, fine; no medication is needed. If not, I will think about using an antidepressant. In certain circumstances I may try these products before the patient regains weight if her mood disturbance is severe, or if she engages in compulsive rituals that interfere with her ability to function.

    Even so, antidepressants pose risks, such as lowered blood pressure or problems with the way electric signals travel through the heart. One common side effect may be weight gain. As you might expect, an anorexic who is aware of this may resist taking her medication.

    Studies on lithium carbonate haven’t shown that it is of much use in treating anorexia. Some reports state that patients gained a little weight and experienced better moods. However, the weight gain may have resulted from salt and water retention, a known side effect of lithium. I wouldn’t use this drug on an anorexic unless she also happened to suffer from manic-depressive illness.

    *65/35/5*

    Tags:

  • WIN THE FAT WAR: REFLECTING ON WEIGHT-LOSS SUCCESS

    No Comments
    23 Apr 2009 /  Weight Loss

    When Adrienne Sussman’s sister-in-law lost weight, it was the proverbial straw that broke the camel’s back. “I had always been thinner and fitter than she was,” explains the 52-year-old mom from Silver Spring, Maryland. “Now, she looked better than me.”

    Envious of her sister-in-law’s success, Adrienne was determined to get back her former shapely figure. A svelte 103 pounds for most of her life, she began to gain after giving birth to her son in 1984. Once he started nursery school at age 2, Adrienne turned to food to make her feel better. “I missed my son so much and felt so guilty for sending him to school that I started eating just to calm my nerves,” she recalls. “I went to the bakery every day to buy a pastry for myself, one for my husband, and one for my son, Then, I’d eat all three.”

    Within a year and a half, Adrienne’s weight rose to 139 pounds.”At that point, my self-esteem had hit rock bottom,” she explains. “I looked in the mirror, and I really didn’t like what I saw.” Ironically, that mirror would later become a critical component of Adrienne’s I ^ weight-loss program.

    Determined to get rid of her excess baggage, Adrienne signed up for Weight Watchers. “My sister-in-law had joined, and I figured that if she could do it, I could do it,” she explains. But it wasn’t easy at first. “I didn’t want to go to the weekly meetings, because I felt really self-conscious,” she says. “So I wrote ‘doctor’s appointment’ on my calendar to fool myself into attending.” Eventually, she started looking forward to the meetings, where she learned to use a combination of portion control, exercise, and behavior modification to slim down.

    To monitor her progress, every couple of weeks she’d stand in front of the mirror completely naked and do a head-to-toe body check. Over the course of a few months, she saw her body changing. That’s what kept her motivated. “I stopped looking in the mirror and telling myself that I was destined to be overweight forever,” she says. “I accepted that whatever was broken, I had the power to fix.”

    With this new, positive attitude, Adrienne was able to shed 30 pounds. She has maintained her weight at a healthy 109 pounds for 8 years.

    These days, Adrienne serves as a program leader for Weight Watchers. She constandy reminds people in her group to stop obsessing about the number on the scale. “The most important questions you should ask yourself are, Are you happy with what you look like? Do you like the way you perceive yourself? And do you like the way you carry yourself?’ she says. “It’s what you think when you look in the mirror—not the number on the scale—that matters.”

    WINNING ACTION

    Let your mirror be your friend. Self-acceptance—even when you’re naked—is an important first step of any weight-loss program. Once you feel comfortable with yourself, you’ll have the confidence and patience to achieve lasting weight-loss success. Try the same strategy that worked for Adrienne: Every 2 weeks or so, take off your clothes and stand in front of a mirror completely nude. At first, you may not like what you see. But find one part that you do like, even if it’s your elbows! Over time, as your body changes, you’ll find more to like, and you’ll continue your weight-loss efforts.

    *119\89\8*

    Tags:

Related Posts: