Ebola And Symptoms And Effects

Ebola virus is a relatively recently discovered virus, that when it infects humans, caries with it a 50-90% fatality rate. Symptoms of this deadly virus include Sudden Fever, Weakness, Muscle Pain, Headache, Sore Throat, Vomiting, Diarrhea, Rash. Internal results include Limited Kidney Function, Limited Liver Function, and Internal and External Bleeding. The incubation period for the Ebola virus ranges from 2 to 21 days, depending upon the method of infection. A direct inoculation of the virus into the bloodstream of a human will bring about symptoms markedly faster than other forms of less direct ontact.

The virus is present in the male’s reproductive fluids, and can be transmitted through sexual contact for up to 7 weeks after clinical recovery from the Ebola virus. The Ebola virus can be diagnosed with laboratory testing of blood specimens under maximum containment conditions – because of the high risk of infection to those handling infected blood. There is currently no treatment or vaccination available for the Ebola virus. Transmission of the Ebola virus occurs by direct contact with the bodily fluids of patients infected with the virus.

The handling of chimpanzees that are either ill or have died from the Ebola virus can also transmit the virus. Any suspicion of infection with the Ebola virus should be treated with extreme caution: immediate isolation from other patients and strict barrier nursing techniques must be practiced. All instruments, clothing, or biological matter must be either disposed of or thoroughly disinfected immediately. The initial outbreaks of the Ebola virus occurred in 1976. Springing forth from unknown origins, this virus held the nations of Zaire in fear as it quickly claimed the lives f many of it’s citizens.

As this was the first recorded outbreak of the Ebola virus, the medical community was unsure of how to handle Ebola. The level of care in Zaire during this outbreak was very low, and as a result of the many infected victims congregated in public areas, the virus continued to spread among the denizens of Zaire. The intervening years have slowly produced scientific data on the nature of the virus – yet treatment is still unavailable for those infected. The first outbreak, as stated earlier, occurred in Zaire in 1976.

This first outbreak as followed by one in western Sudan, also in 1976. In total, these two outbreaks have been traced to the deaths of 340 people – resulting from the 550 plus cases that were identified in these two nations. After lying dormant for several years the Ebola virus once again made it’s presence known in 1979. Once again, no cause was identified as 34 cases of Ebola were identified in Sudan. This occurrence brought the deaths of 22 patients – showing a fatality rate of more than 60%, just as in the 1976 outbreaks.

The next instance of humans contracting the Ebola virus occurred in 1995. The Ebola Zaire strain was discovered once again on April 10, 1995 when a patient hospitalized for what was believed to be Malaria infected the surgical team during an operation. Those involved with the operation developed symptoms indicating a viral haemorrhagic fever disease. This outbreak occurred in the city of Kikwit, Zaire. Although the virus was spreading at a rapid rate, a coordinated effort of international health services was able to contain the outbreak.

Present in this coalition of health organizations was the Centers for Disease Control and Prevention (the CDC) and the World Health Organization aided by members of the medical community from France, Belgium, and several southern African nations. In this most recent epidemic (defined as all cases occurring from 1 July 1995), approximately 233 deaths have been caused, and 293 cases identified as Ebola – bringing the fatality rate to nearly 80% in the outbreak of 1995) Ebola was also detected in the United States in 1989, but this strain of the virus, known as Ebola Reston, is not harmful to the Homo Sapien population.

In 1989 a shipment of African Green and Rhesus Monkeys arrived in Reston, Virginia from the Philippines. These monkeys were infected with the Ebola virus, yet no human cases were documented. 149 workers came into contact with these monkeys in Reston, Virginia and not one became ill – although two did develop antibodies for Ebola Reston. A recent outbreak of the Ebola Virus occurred in November of 1995. There had been a rash of deaths in the population of chimpanzees living within the Tai Forest.

On 24 November 1995, a Swiss researcher on the Cote d’Ivore of West Africa contracted the disease from an infected chimpanzee in the Tai Forest. The researcher was rushed to a Swiss hospital where she recovered. After an autopsy of the chimpanzee indicated that it was showing effects similar to those visible in human patients, a search began for the locale the virus is indigenous to. However, the Tai Forest comprises over 4200 square kilometers, and field researchers were unable to locate the virus.

The Ebola virus has not been very researchable. Part of the difficulty is that the virus is so communicable, research must be conducted in very strictly controlled settings requiring safeguards and equipment that are beyond the reach of many laboratories. Also, because of the Ebola virus’ very lethal tendencies, it is xtraordinarily difficult to obtain a specimen for research. The most concentrated research efforts to date have been performed by the World Health Organization and the Centers for Disease Control and Prevention.

Although some understanding of the virus has occurred, much of the information needed to develop a treatment and vaccine still remains elusive to researchers. Research has led to a better understanding of the pattern of symptoms which the Ebola virus causes in humans. Most patients arrive overtly ill, dehydrated, apathetic, and disoriented – further medical investigation quickly shows other ymptoms indicating an infection with the Ebola virus. The Ebola virus is best known for the extraordinary amount of bleeding, both internal and external, that it causes in it’s victims.

The death of the patient usually occurs within 7 to 16 days, with the specific cause being shock – often accompanied with severe blood loss. As early as 10-14 days after infection with either the Marburg or Ebola viruses, an immune response can be detected. The primary response of the immune system is to produce antibodies against the surface glycoproteins. This response is relatively neffective in that the Ebola still flourishes within the human body and is fatal to most infected persons. There is also little known about the cell-mediated response to these viruses.

The pathology of the Ebola virus produces lesions found in liver, spleen, and kidney. They are characterized by focal hepatic necrosis and by follicular necrosis of the lymph nodes and spleen. As the disease progress into it’s later stages, hemorrhage occurs in the gastrointestinal track, pleural, pericardinal, and peritoneal spaces. Abnormalities in the coagulation occur(blood), suggesting that disseminated oagulation is a terminal event. Research also points out that macrophages and fibroblasts appear to be the initial and also preferred site of replication by Ebola.

Experimental treatments have included human interferon, human convalescent plasma and anticoagulation therapy. These treatments, however, have met with mixed results and any success is quite controversial. The only effective preventative measure currently known is to crate a physical barrier of some sort – surgical masks, quarantine wards, et cetera – that is capable of blocking the transmission of the virus to currently uninfected patients. As stated previously, past research has been significantly slowed as a result of the extreme pathogenicity of the Ebola virus, as well as the Marburg virus.

Recombinant DNA technology holds hope in that the molecular structure of the virus is beginning to be understood. This type of research will also lead to an understanding of the way in which this virus replicates itself and the interactions that occur between virus and host. The goal is to gain an understanding of the frequency, ways in which it is transmitted, and also to identify where in nature the Ebola virus naturally resides – to identify it’s initial host organism.

Legal Issues Surrounding First Aid

First aid is the initial care given to a sick or injured person before more formal medical assistance is applied. The goal of first aid is to intervene actively to prevent further damage, to provide life support, and to begin effective treatment of the victim’s condition, to minimize injury and prevent death. Although first aid is not a substitute for medical care, those trained in first aid are able to assess the nature and the extent of an emergency and determine the best course of action to take until professional medical help arrives.

The need for training in first aid is evident, considering that injury is the fourth leading ause of death. Falls are the most common cause of injury, but motor vehicle accidents are the most lethal, accounting for 22 percent of injury deaths. An important thing to know when dealing with a first aid situation is to be up to date as far as procedures are concerned. Procedures like slapping a choking person on the back, putting iodine on a wound, cutting an X on a snake bite, putting ointment on burns, or using a tourniquet to stop bleeding are old, out dated procedures and have been replaced by new ones from the Red Cross association.

If you decide to administer first aid, be sure ou are familiar with current procedures. First aid begins with a scene survey. Before approaching a victim, a survey of the area is necessary to determine if conditions surrounding the incident may place the victim and the rescuer in danger. Next, the primary survey will determine if lifesaving procedures must be immediately performed to save the victim’s life. The primary survey involves checking the ABC’s: A: Is the airway opened and the victim’s neck stabilized? B: Is the patient breathing? C: Is the victim’s blood circulating?

Is there a pulse? Or is there active bleeding? Lifesaving procedures include cardiopulmonary resuscitation , which may be needed to provide basic life support when a victim has no pulse and is not breathing. The Heimlich maneuver aids choking victims by forcing ejection of obstructing material from the windpipe. The severity of spinal cord injuries has decreased 30-45 percent due to awareness that the neck must be stabilized before moving the accident victim. External bleeding is controlled by direct pressure and elevation of the bleeding site.

The secondary survey is a total body examination, a pulse check, respiration count, and bservation of skin conditions. The only outward sign of severe medical problems, such as cardiac diseases, stroke, or internal bleeding, may be shock. Those in shock will have pale, cool, and clammy skin, a rapid and weak pulse, more than 20 respirations per minute, weakness, and confused behavior. Treatment involves minimizing body heat loss, elevating the legs without disturbing the rest of the body, and getting help as quickly as possible.

No one is required to render first aid under normal circumstances. Even a physician could ignore a stranger suffering a heart attack if he chose to do so. Exceptions include ituations where a person’s employment designates the rendering of first aid as a part of described job duties. Examples include lifeguards, law enforcement officers, park rangers and safety officers in industry. A duty to provide first aid also exists where an individual has presumed responsibility for another person’s safety, as in the case of a parent-child or a driver-passenger relationship.

While in most cases there is no legal responsibility to provide first aid care to another person, there is a very clear responsibility to continue care once you start. You cannot start first aid and then stop nless the victim no longer needs your attention, other first aiders take over the responsibility from you or you are physically unable to continue care. In every instance where first aid is to be provided, the victim’s consent is required. It should be obtained from every conscious, mentally-competent adult. The consent may be either oral or written.

Permission to render first aid to an unconscious victim is implied and a first aider should not hesitate to treat an unconscious victim. Consent of a parent or guardian is required to treat a child, however emergency first aid necessary to maintain ife may be provided without such consent. Some well-meaning people hesitate to perform first aid because they are concerned about being sued. Legislators in almost every state in the country have passed Good Samaritan Laws which are intended to protect good people who offer first aid help to others.

Most of the Good Samaritan Acts are very similar in their content and usually provide two basic requirements which must be met in order for the first aider to be protected by their provisions: the first aider must not deliberately cause harm to the victim and the first aider must provide the level and type of care expected of a reasonable erson with the same amount of training and in similar circumstances. If there is a situation that is due to the defendant’s own negligence, then it imposes on him a duty to make a reasonable effort to give assistance. In most states there is a statute to this effect in reference to automobile accidents.

It states that the driver of a vehicle involved in an accident resulting in injury to or death of any person shall render to any person injured in such an accident reasonable assistance, including the carrying or making arrangements for the carrying of such person to a physician, surgeon, or hospital or medical or surgical treatment, if it is apparent that such treatment is necessary, and if such carrying is requested by the injured party. In most state Drivers’ manuals directions are given for behavior required after an accident among them being a part devoted to care of persons injured in an accident.

The directions specify that the injured person is not to be moved unless necessary, keep the victim lying down, still, and warm, and send for an ambulance, doctor, and police. So we see that for an omission to act there is no liability unless there is some definite elation between the parties which is regarded as imposing a duty to act. The law has not recognized any general duty to aid a person who is in peril, but if the defendant enters upon an affirmative course of conduct affecting the interests of another, he is regarded as assuming a duty to act and will thereafter be liable for negligent acts or omissions.

It is quite clear then, that we are not required by law to give aid to a person in danger or injured except under conditions of the statute stated above, but if we do take it upon ourselves to help the injured then we must give reasonable care or we may find ourselves iable for our actions. However, it would appear to me that it would be very hard for a court to define what is or isn’t reasonable care, and the outcome of any such case would quite likely be in favor of the defendant. The purpose of this paper is to provide some basic guidelines as to what the laws state in some approaches in first aid situations.

With these guidelines it is hoped you can more readily see and appreciate probable legal implications and also that you will discover that the law is not engaged in searching for legal wrongdoing. Specific rules of onduct for your own work should be formulated after proper consultation with your own legal counsel. The law recognizes that there are various degrees of skill. There are few problems for people who stay in their own area. The right and duty to engage in radical procedures, such as external heart massage and tracheotomies, are necessarily governed by the circumstances.

When communication is good and transportation swift, it is generally wise to leave such procedures to physicians. The function of para-medical people is to get the patient to a physician for diagnosis and treatment in as good condition as possible, ot to act as a physician. In times of great disaster or in the absence of transportation and communication, it may be necessary and appropriate for all medical personnel to be upgraded. Such promotions must be made with caution and after careful consideration of the genuine need.

It is not the purpose of the law nor this discussion to alarm you that you do not perform your duty. Legal complications have been extremely rare in this area and they will continue to be most unusual so long as common sense and advance planning and thought are applied. Your participation in first aid is evidence of your desire to achieve the roper level of skill and training. The careful use of this skill and training will not only enhance the physical welfare of the persons you care for but will also enhance your own legal welfare.

On a closing note, here is a copy of Indiana’s Good Samaritan Law as an example of almost every other states Good Samaritan Law. “From and after the effective date of this act, no civil action can be brought against a person licensed to practice the healing arts in the state of Indiana, who has gratuitously rendered first aid or emergency care at the scene of an accident, casualty or disaster to a erson injured therein, for the recovery of civil damages as a result of any act or omission by the said person rendering such first aid or emergency care in the rendering of such first aid or emergency care.

This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton misconduct. ” As you can see, there is essentially nothing to lose if you administer first aid as long as you try your best to help and know what you are doing. Keep in mind that helping someone in a life and death matter is a very big commitment, so make sure you are willing to do so before you act.

Ovarian Cancer

Ovarian Cancer Of all gynecologic malignancies, ovarian cancer continues to have the highest mortality and is the most difficult to diagnose. In the United States female population, ovarian cancer ranks fifth in absolute mortality among cancer related deaths (13,000/yr). In most reported cases, ovarian cancer, when first diagnosed is in stages III or IV in about 60 to 70% of patients which further complicates treatment of the disease (Barber, 3).

Early detection in ovarian cancer is hampered by the lack of appropriate tumor markers and clinically, most patients fail to develop significant symptoms until they reach advanced stage disease. The characteristics of ovarian cancer have been studied in primary tumors and in established ovarian tumor cell lines which provide a reproducible source of tumor material. Among the major clinical problems of ovarian cancer, malignant progression, rapid emergence of drug resistance, and associated cross-resistance remain unresolved.

Ovarian cancer has a high frequency of metastasis yet generally remains localized within the peritoneal cavity. Tumor development has been associated with aberrant, dysfunctional expression and/or mutation of various genes. This can include oncogene overexpression, amplification or mutation, aberrant tumor suppressor expression or mutation. Also, subversion of host antitumor immune responses may play a role in the pathogenesis of cancer (Sharp, 77). Ovarian clear cell adenocarcinoma was first described by Peham in 1899 as “hypernephroma of the ovary” because of its resemblance to renal cell carcinoma.

By 1939, Schiller noted a histologic similarity to mesonephric tubules and classified these tumors as “mesonephromas. ” In 1944, Saphir and Lackner described two cases of “hypernephroid carcinoma of the ovary” and proposed “clear cell” adenocarcinoma as an alternative term. Clear cell tumors of the ovary are now generally considered to be of mullerian and in the genital tract of mullerian origin. A number of examples of clear cell adenocarcinoma have been reported to arise from the epithelium of an endometriotic cyst (Yoonessi, 289).

Occasionally, a renal cell carcinoma metastasizes to the ovary and may be confused with a primary clear cell adenocarcinoma. Ovarian clear cell adenocarcinoma (OCCA) has been recognized as a distinct histologic entity in the World Health Organization (WHO) classification of ovarian tumors since 1973 and is the most lethal ovarian neoplasm with an overall five year survival of only 34% (Kennedy, 342). Clear cell adenocarcinoma, like most ovarian cancers, originates from the ovarian epithelium which is a single layer of cells found on the surface of the ovary.

Patients with ovarian clear cell adenocarcinoma are typically above the age of 30 with a median of 54 which is similar to that of ovarian epithelial cancer in general. OCCA represents approximately 6% of ovarian cancers and bilateral ovarian involvement occurs in less that 50% of patients even in advanced cases. The association of OCCA and endometriosis is well documented (De La Cuesta, 243). This was confirmed by Kennedy et al who encountered histologic or intraoperative evidence of endometriosis in 45% of their study patients.

Transformation from endometriosis to clear cell adenocarcinoma has been previously demonstrated in sporadic cases but was not observed by Kennedy et al. Hypercalcemia occurs in a significant percentage of patients with OCCA. Patients with advanced disease are more typically affected than patients with nonmetastatic disease. Patients with OCCA are also more likely to have Stage I disease than are patients with ovarian epithelial cancer in general (Kennedy, 348). Histologic grade has been useful as an initial prognostic determinant in some studies of epithelial cancers of the ovary.

The grading of ovarian clear cell adenocarcinoma has been problematic and is complicated by the multiplicity of histologic patterns found in the same tumor. Similar problems have been found in attempted grading of clear cell adenocarcinoma of the endometrium (Disaia, 176). Despite these problems, tumor grading has been attempted but has failed to demonstrate prognostic significance. However, collected data suggest that low mitotic activity and a predominance of clear cells may be favorable histologic features (Piver, 136).

Risk factors for OCCA and ovarian cancer in general are much less clear than for other genital tumors with general agreement on two risk factors: nulliparity and family history. There is a higher frequency of carcinoma in unmarried women and in married women with low parity. Gonadal dysgenesis in children is associated with a higher risk of developing ovarian cancer while oral contraceptives are associated with a decreased risk. Genetic and candidate host genes may be altered in susceptible families. Among those currently under investigation is BRCA1 which has been associated with an increased susceptibility to breast cancer.

Approximately 30% of ovarian adenocarcinomas express high levels of HER-2/neu oncogene which correlates with a poor prognosis (Altcheck, 375-376). Mutations in host tumor suppresser gene p53 are found in 50% of ovarian carcinomas. There also appears to be a racial predilection, as the vast majority of cases are seen in Caucasians (Yoonessi, 295). Considerable variation exists in the gross appearance of ovarian clear cell adenocarcinomas and they are generally indistinguishable from other epithelial ovarian carcinomas.

They could be cystic, solid, soft, or rubbery, and may also contain hemorrhagic and mucinous areas (O’Donnell, 250). Microscopically, clear cell carcinomas are characterized by the presence of variable proportions of clear and hobnail cells. The former contain abundant clear cytoplasm with often centrally located nuclei, while the latter show clear or pink cytoplasm and bizarre basal nuclei with atypical cytoplasmic intraluminal projections. The cellular arrangement may be tubulo acinar, papillary, or solid, with the great majority displaying a mixture of these patterns.

The hobnail and clear cells predominate with tubular and solid forms, respectively (Barber, 214). Clear cell adenocarcinoma tissue fixed with alcohol shows a high cytoplasmic glycogen content which can be shown by means of special staining techniques. Abundant extracellular and rare intracellular neutral mucin mixed with sulfate and carboxyl group is usually present. The clear cells are recognized histochemically and ultrastructurally (short and blunt microvilli, intercellular tight junctions and desmosomes, free ribosomes, and lamellar endoplasmic reticulum).

The ultrastructure of hobnail and clear cells resemble those of the similar cells seen in clear cell carcinomas of the remainder of the female genital tract (O’Brien, 254). A variation in patterns of histology is seen among these tumors and frequently within the same one. Whether both tubular components with hobnail cells and the solid part with clear cells are required to establish a diagnosis or the presence of just one of the patterns is sufficient has not been clearly established. Fortunately, most tumors exhibit a mixture of these components.

Benign and borderline counterparts of clear cell ovarian adenocarcinomas are theoretical possibilities. Yoonessi et al reported that nodal metastases could be found even when the disease appears to be grossly limited to the pelvis (Yoonessi, 296). Examination of retroperitoneal nodes is essential to allow for more factual staging and carefully planned adjuvant therapy. Surgery remains the backbone of treatment and generally consists of removal of the uterus, tubes and ovaries, possible partial omentectomy, and nodal biopsies. The effectiveness and value of adjuvant radiotherapy and chemotherapy has not been clearly demonstrated.

Therefore, in patients with unilateral encapsulated lesions and histologically proven uninvolvement of the contralateral ovary, omentum, and biopsied nodes, a case can be made for (a)no adjuvant therapy after complete surgical removal and (b) removal of only the diseased ovary in an occasional patient who may be young and desirous of preserving her reproductive capacity (Altchek, 97). In the more adv- anced stages, removal of the uterus, ovaries, omentum, and as much tumor as possible followed by pelvic radiotherapy (if residual disease is limited to the pelvis) or chemotherapy must be considered.

The chemotherapeutic regimens generally involve adriamycin, alkylating agents, and cisPlatinum containing combinations (Barber, 442). OCCA is of epithelial origin and often contains mixtures of other epithelial tumors such as serous, mucinous, and endometrioid. Clear cell adenocarcinoma is characterized by large epithelial cells with abundant cytoplasm. Because these tumors sometimes occur in association with endometriosis or endometrioid carcinoma of the ovary and resemble clear cell carcinoma of the endometrium, they are now thought to be of mullerian duct origin and variants of endometrioid adenocarcinoma.

Clear cell tumors of the ovary can be predominantly solid or cystic. In the solid neoplasm, the clear cells are arranged in sheets or tubules. In the cystic form, the neoplastic cells line the spaces. Five-year survival is approximately 50% when these tumors are confined to the ovaries, but these tumors tend to be aggressive and spread beyond the ovary which tends to make 5-year survival highly unlikely (Altchek, 416). Some debate continues as to whether clear cell or mesonephroid carcinoma is a separate clinicopathological entity with its own distinctive biologic behavior and natural history or a histologic variant of endometrioid carcinoma.

In an effort to characterize clear cell adenocarcinoma, Jenison et al compared these tumors to the most common of the epithelial malignancies, the serous adenocarcinoma (SA). Histologically determined endometriosis was strikingly more common among patients with OCCA than with SA. Other observations by Jenison et al suggest that the biologic behavior of clear cell adenocarcinoma differs from that of SA. They found Stage I tumors in 50% of the observed patient population as well as a lower incidence of bilaterality in OCCA (Jenison, 67-69).

Additionally, it appears that OCCA is characteristically larger than SA, possibly explaining the greater frequency of symptoms and signs at presentation. Risk Factors There is controversy regarding talc use causing ovarian cancer. Until recently, most talc powders were contaminated with asbestos. Conceptually, talcum powder on the perineum could reach the ovaries by absorption through the cervix or vagina. Since talcum powders are no longer contaminated with asbestos, the risk is probably no longer important (Barber, 200).

The high fat content of whole milk, butter, and meat products has been implicated with an increased risk for ovarian cancer in general. The Centers for Disease Control compared 546 women with ovarian cancer to 4,228 controls and reported that for women 20 to 54 years of age, the use of oral contraceptives reduced the risk of ovarian cancer by 40% and the risk of ovarian cancer decreased as the duration of oral contraceptive use increased. Even the use of oral contraceptives for three months decreased the risk. The protective effect of oral contraceptives is to reduce the relative risk to 0. r to decrease the incidence of disease by 40%.

There is a decreased risk as high as 40% for women who have had four or more children as compared to nulliparous women. There is an increase in the incidence of ovarian cancer among nulliparous women and a decrease with increasing parity. The “incessant ovulation theory” proposes that continuous ovulation causes repeated trauma to the ovary leading to the development of ovarian cancer. Incidentally, having two or more abortions compared to never having had an abortion decreases one’s risk of developing ovarian cancer by 30% (Coppleson, 25-28).

Etiology It is commonly accepted that cancer results from a series of genetic alterations that disrupt normal cellular growth and differentiation. It has been proposed that genetic changes causing cancer occur in two categories of normal cellular genes, proto- oncogenes and tumor suppressor genes. Genetic changes in proto-oncogenes facilitate the transformation of a normal cell to a malignant cell by production of an altered or overexpressed gene product. Such genetic changes include mutation, translocation, or amplification of proto-oncogenes Tumor suppressor genes are proposed to prevent cancer.

Inactivation or loss of these genes contributes to development of cancer by the lack of a functional gene product. This may require mutations in both alleles of a tumor suppressor gene. These genes function as regulatory inhibitors of cell proliferation, such as a DNA transcription factor, or a cell adhesion molecule. Loss of these functions could result in abnormal cell division or gene expression, or increased ability of cells in tissues to detach. Cancer such as OCCA most likely results from the dynamic interaction of several genetically altered proto-oncogenes and tumor suppressor genes (Piver, 64- 67).

Until recently, there was little evidence that the origin of ovarian was genetic. Before 1970, familial ovarian cancer had been reported in only five families. A familial cancer registry was established at Roswell Park Cancer Institute in 1981 to document the number of cases occurring in the United States and to study the mode of inheritance. If a genetic autosomal dominant transmission of the disease can be established, counseling for prophylactic oophorectomy at an appropriate age may lead to a decrease in the death rate from ovarian cancer in such families.

The registry at Roswell Park reported 201 cases of ovarian cancer in 94 families in 1984. From 1981 through 1991, 820 families and 2946 cases had been observed. Familial ovarian cancer is not a rare occurrence and may account for 2 to 5% of all cases of ovarian cancer. Three conditions that are associated with familial ovarian cancer are (1) site specific, the most common form, which is restricted to ovarian cancer, and (2) breast/ovarian cancer with clustering of ovarian and breast cases in extended pedigrees (Altchek, 229-230).

One characteristic of inherited ovarian cancer is that it occurs at a significantly younger age than the non-inherited form. Cytogenetic investigations of sporadic (non-inherited) ovarian tumors have revealed frequent alterations of chromosomes 1,3,6, and 11. Many proto-oncogenes have been mapped to these chromosomes, and deletions of segments of chromosomes (particularly 3p and 6q) in some tumors is consistent with a role for loss of tumor suppressor genes. Recently, a genetic linkage study of familial breast/ovary cancer suggested linkage of disease susceptibility with the RH blood group locus on chromosome 1p.

Allele loss involving chromosomes 3p and 6q as well as chromosomes 11p, 13q, and 17 have been frequently observed in ovarian cancers. Besides allele loss, point mutations have been identified in the tumor suppressor gene p53 located on chromosome17p13. Deletions of chromosome 17q have been reported in sporadic ovarian tumors suggesting a general involvement of this region in ovarian tumor biology. Allelic loss of MYB and ESR genes map on chromosome 6q near the provisional locus for FUCA2, the locus for a-L-fucosidase in serum. Low activity of a-L-fucosidase in serum is more prevalent in ovarian cancer patients.

This suggests that deficiency of a-L-fucosidase activity in serum may be a hereditary condition associated with increased risk for developing ovarian cancer. This together with cytogenetic data of losses of 6q and the allelic losses at 6q point to the potential importance of chromosome 6q in hereditary ovarian cancer (Altchek, 208-212). Activation of normal proto-oncogenes by either mutation, translocation, or gene amplification to produce altered or overexpressed products is believed to play an important role in the development of ovarian tumors.

Activation of several proto- oncogenes (particularly K-RAS, H-RAS, c-MYC, and HER-2/neu) occurs in ovarian tumors. However, the significance remains to be determined. It is controversial as to whether overexpression of the HER-2/neu gene in ovarian cancer is associated with poor prognosis. In addition to studying proto-oncogenes in tumors, it may be beneficial to investigate proto-oncogenes in germ-line DNA from members of families with histories of ovarian cancer (Barber, 323-324). It is questionable whether inheritance or rare alleles of the H-RAS proto-oncogene may be linked to susceptibility to ovarian cancers.

Diagnosis and Treatment The early diagnosis of ovarian cancer is a matter of chance and not a triumph of scientific approach. In most cases, the finding of a pelvic mass is the only available method of diagnosis, with the exception of functioning tumors which may manifest endocrine even with minimal ovarian enlargement. Symptomatology includes vague abdominal discomfort, dyspepsia, increased flatulence, sense of bloating, particularly after ingesting food, mild digestive disturbances, and pelvic unrest which may be present for several months before diagnosis (Sharp, 161-163).

There are a great number of imaging techniques that are available. Ultrasounds, particularly vaginal ultrasound, has increased the rate of pick-up of early lesions, particularly when the color Doppler method is used. Unfortunately, vaginal sonography and CA 125 have had an increasing number of false positive examinations. Pelvic findings are often minimal and not helpful in making a diagnosis. However, combined with a high index of suspicion, this may alert the physician to the diagnosis.

These pelvic signs include: Mass in the ovarian area Relative immobility due to fixation of adhesions Irregularity of the tumor Shotty consistency with increased firmness Tumors in the cul-de-sac described as a handful of knuckles Relative insensitivity of the mass Increasing size under observation Bilaterality (70% for ovarian carcinoma versus 5% for benign cases) (Barber, 136) Tumor markers have been particularly useful in monitoring treatment, however, the markers have and will probably always have a disadvantage in identifying an early tumor.

To date, only two, human gonadotropin (HCG) and alpha fetoprotein, are known to be sensitive and specific. The problem with tumor markers as a means of making a diagnosis is that a tumor marker is developed from a certain volume of tumor. By that time it is no longer an early but rather a biologically late tumor (Altchek, 292). Many reports have described murine monoclonal antibodies (MAbs) as potential tools for diagnosing malignant ovarian tumors. Yamada et al attempted to develop a MAb that can differentiate cells with early malignant change from adjacent benign tumor cells in cases of borderline malignancy.

They developed MAb 12C3 by immunizing mice with a cell line derived from a human ovarian tumor. The antibody reacted with human ovarian carcinomas rather than with germ cell tumors. MAb 12C3 stained 67. 7% of ovarian epithelial malignancies, but exhibited an extremely low reactivity with other malignancies. MAb 12C3 detected a novel antigen whose distribution in normal tissue is restricted. According to Yamada et al, MAb 12C3 will serve as a powerful new tool for the histologic detection of early malignant changes in borderline epithelial neoplasms.

MAb 12C3 may also be useful as a targeting agent for cancer chemotherapy (Yamada, 293-294). Currently there are several serum markers that are available to help make a diagnosis. These include CA 125, CEA, DNB/70K, LASA-P, and serum inhibin. Recently the urinary gonadotropin peptide (UCP) and the collagen-stimulating factor have been added. Although the tumor markers have a low specificity and sensitivity, they are often used in screening for ovarian cancer. A new tumor marker CA125-2 has greater specificity than CA125.

In general, tumor markers have a very limited role in screening for ovarian cancer. The common epithelial cancer of the ovary is unique in killing the patient while being, in the vast majority of the cases, enclosed in the anatomical area where it initially developed: the peritoneal cavity. Even with early localized cancer, lymph node metastases are not rare in the pelvic or aortic areas. In most of the cases, death is due to intraperitoneal proliferation, ascites, protein loss and cachexia. The concept of debulking or cytoreductive surgery is currently the dominant concept in treatment.

The first goal in debulking surgery is inhibition of debulking surgery is inhibition of the vicious cycle of malnutrition, nausea, vomiting, and dyspepsia commonly found in patients with mid to advanced stage disease. Cytoreductive surgery enhances the efficiency of chemotherapy as the survival curve of the patients whose largest residual mass size was, after surgery, below the 1. 5 cm limit is the same as the curve of the patients whose largest metastatic lesions were below the 1. 5 cm limit at the outset (Altchek, 422-424).

The aggressiveness of the debulking surgery is a key question surgeons must face when treating ovarian cancers. The debulking of very large metastatic masses makes no sense from the oncologic perspective. As for extrapelvic masses the debulking, even if more acceptable, remains full of danger and exposes the patient to a heavy handicap. For these reasons the extra-genital resections have to be limited to lymphadenectomy, omentectomy, pelvic abdominal peritoneal resections and rectosigmoid junction resection.

That means that stages IIB and IIC and stages IIIA and IIB are the only true indications for extrapelvic cytoreductive surgery. Colectomy, ileectomy, splenectomy, segmental hepatectomy are only exceptionally indicated if they allow one to perform a real optimal resection. The standard cytoreductive surgery is the total hysterectomy with bilateral salpingoophorectomy. This surgery may be done with aortic and pelvic lymph node sampling, omentectomy, and, if necessary, resection of the rectosigmoidal junction (Barber. 182-183).

The concept of administering drugs directly into the peritoneal cavity as therapy of ovarian cancer was attempted more than three decades ago. However, it has only been within the last ten years that a firm basis for this method of drug delivery has become established. The essential goal is to expose the tumor to higher concentrations of drug for longer periods of time than is possible with systemic drug delivery. Several agents have been examined for their efficacy, safety and pharmacokinetic advantage when administered via the peritoneal route.

Cisplatin has undergone the most extensive evaluation for regional delivery. Cisplatin reaches the systemic compartment in significant concentrations when it is administered intraperitoneally. The dose limiting toxicity of intraperitoneally administered cisplatin is nephrotoxicity, neurotoxicity and emesis. The depth of penetration of cisplatin into the peritoneal lining and tumor following regional delivery is only 1 to 2 mm from the surface which limits its efficacy. Thus, the only patients with ovarian cancer who would likely benefit would be those with very small residual tumor volumes.

Overall, approximately 30 to 40% of patients with small volume residual ovarian cancer have been shown to demonstrate an objective clinical response to cisplatin-based locally administered therapy with 20 to 30% of patients achieving a surgically documented complete response. As a general rule, patients whose tumors have demonstrated an inherent resistance to cisplatin following systemic therapy are not considered for treatment with platinum-based intraperitoneal therapy (Altchek, 444-446).

In patients with small volume residual disease at the time of second look laparotomy, who have demonstrated inherent resistance to platinum-based regimens, alternative intraperitoneal treatment programs can be considered. Other agents include mitoxantrone, and recombinant alpha-interpheron. Intraperitoneal mitoxanthone has been shown to have definite activity in small volume residual platinum-refractory ovarian cancer. Unfortunately, the dose limiting toxicity of the agent is abdominal pain and adhesion formation, possibly leading to bowel obstruction.

Recent data suggests the local toxicity of mitoxanthone can be decreased considerably by delivering the agent in microdoses. Ovarian tumors may have either intrinsic or acquired drug resistance. Many mechanisms of drug resistance have been described. Expression of the MDR1 gene that encodes the drug efflux protein known as p-glycoprotein, has been shown to confer the characteristic multi-drug resistance to clones of some cancers. The most widely considered definition of platinum response is response to first-line platinum treatment and disease free interval. Primary platinum resistance may be defined as any progression on treatment.

Secondary platinum resistance is the absence of progression on primary platinum-based therapy but progression at the time of platinum retreatment for relapse (Sharp, 205-207). Second-line chemotherapy for recurrent ovarian cancer is dependent on preferences of both the patient and physician. Retreatment with platinum therapy appears to offer significant opportunity for clinical response and palliation but relatively little hope for long-term cure. Paclitaxel (trade name: Taxol), a prototype of the taxanes, is cytotoxic to ovarian cancer. Approximately 20% of platinum failures respond to standard doses of paclitaxel.

Studies are in progress of dose intensification and intraperitoneal administration (Barber, 227-228). This class of drugs is now thought to represent an active addition to the platinum analogs, either as primary therapy, in combination with platinum, or as salvage therapy after failure of platinum. In advanced stages, there is suggestive evidence of partial responsiveness of OCCA to radiation as well as cchemotherapy, adriamycin, cytoxan, and cisPlatinum-containing combinations (Yoonessi, 295). Radiation techniques include intraperitoneal radioactive gold or chromium phosphate and external beam therapy to the abdomen and pelvis.

The role of radiation therapy in treatment of ovarian canver has diminished in prominence as the spread pattern of ovarian cancer and the normal tissue bed involved in the treatment of this neoplasm make effective radiation therapy difficult. When the residual disease after laparotomy is bulky, radiation therapy is particularly ineffective. If postoperative radiation is prescribed for a patient, it is important that theentire abdomen and pelvis are optimally treated to elicit a response from the tumor (Sharp, 278-280).

In the last few decades, the aggressive attempt to optimize the treatment of ovarian clear cell adenocarcinoma and ovarian cancer in general has seen remarkable improvements in the response rates of patients with advanced stage cancer without dramatically improving long-term survival. The promises of new drugs with activity when platinum agents fail is encouraging and fosters hope that, in the decades to come, the endeavors of surgical and pharmacoogical research will make ovarian cancer an easily treatable disease.

Hot Zone

Imagine walking into a tiny village in Africa, suffering and dying from some unknown virus. As you approach the huts you hear the wails of pure agony from the afflicted tribe members. Coming closer, you smell the stench of vomit mixed with the bitter smell of warm blood. People inside lay dying in pools of their own vital fluids, coughing and vomiting up their own liquefied internal organs; their faces emotionless masks loosely hanging from their skulls, the connective tissue and collagen in their bodies turned to mush.

Their skin bubbled up into a sea of tiny white blisters and spontaneous rips occurring at the slightest touch, pouring blood that refuses to coagulate. Hemmorging and massive clotting underneath the skin causing black and blue bruises all over the body. Their mouths bleeding around their teeth from hemorrhaging saliva glands and the sloughing off of their own tongues, throat lining, and wind pipe, crying tears of pure blood from hemorrhaging tear ducts and the disintegration of the eyeball lining and bleeding from every opening on the body.

You see the blood spattered room and pools of black vomit, expelled during the epileptic convulsions that accompany the last stages of death. Their hearts have bled into themselves, heart muscles softened and hemorrhaging , the brain clogged with dead blood cells (sludging of the brain), the liver bulging and yellow with deep cracks and the spleen a single hard blood clot. Babies with bloody noses born with red eyes lay dead from spontaneous abortions of affected mothers.

It is the human slate-wiper, the invisible ultimate death, the filovirus named Ebola. The theme of Richard Preston’s Hot Zone seems deal with man’s one predator, the invisible one, the one thing that man cannot seek out and conquer, the one that lurks unseen and undetected in the shadows waiting for a warm body to make its new breeding ground in, with total disregard for person, social class, or status.

We are “meat”, as the biologists at the USAMRIID Institute stated, no names, no faces, no “individuality”, the virus rips through our bodies with no thought, mechanical reproducers who sabotage our cells and used them as incubators until their “offspring” replicate to the point the cell wall bursts, releasing hundreds of new virus particles. Literally thousands of these “killers”, as humans see them can be held on the point of an ink pen. The question the book seems to raise later on, however, is who is the real impostor; the virus on the human race, or the human race on its home for the past millions of years, the rain forests.

Are Ebola, and the other filoviruses, antibodies against the “human virus” that is swiftly and thoughtlessly destroying Mother Earth? Are these viruses the “check” on the human K-species that we have been expecting? For the most part, the characters of this book have the utmost respect for all Level 4 viruses, especially the greatly feared and most deadly Ebola Zaire (killing 90% of those infected). Handling viral samples, infected animals and blood samples as if they were nuclear weapons, that if detonated, would ultimately result in total carnage.

They were all right in doing so, all having witnessed the gruesome effects on living organisms on one primate or another. Gene Johnson, the civilian virus hunter working for the army who specialized in Ebola, perhaps showed the most fear and total respect for its destructive capabilities and unpredictable nature. Having visited Africa, researching, studying, and actually staring the virus in the face, Gene knew the virus all to well. In the winter of 1989, the foreigner made its first appearance on the North American continent via an infected monkey who been shipped here from the Philippines.

An “unknown virus” was sweeping through a monkey house in West Virginia, first noticed by some runny noses and loss of appetite, ending a few days later with death; bloody noses, swollen livers, and enlarged spleens. First perceived to be Marburg, one of the filovirus sisters, it was later revealed to actually be the more lethal Ebola. An operation was organized to nuke the monkey house, to destroy the virus, along with every living thing inside; every monkey was assumed a carrier. Of all the people involved in the Reston operation, Gene Johnson was actually the most fearful; due to his in depth knowledge of the killer.

He knew the possibilities if the virus were to escape the monkey house, through an air duct or walk out inside the body of one of the animal caretakers. He knew that if the virus was airborne, which was what they were finding evidence of, the virus could circle the whole entire earth, wiping out large populations in a matter of days. He didn’t sleep for days during the operation, perhaps out of sheer terror of the idea of an outbreak right here in our own homeland (or in the human race at all for that matter).

The effects could rival those of the Bubonic plague if the virus were to go airborne. Dan Dalgard, the veterinarian at the Reston monkey house, however, was on the other end of the spectrum. Dalgard had perceived the virus he was witnessing in his monkeys to be Simian Fever, one harmless to humans. After getting the word from USAMRIID that he may actually be dealing with Marburg, a filovirus lethal in humans, Dalgard was a frightened. He’d heard about the effects of Marburg on the human body, not only would he loose his monkeys, but also he was putting himself and his employees at risk.

When he later received a call from the Institute stating that he may actually have a monkey house infected with Ebola, unlike Johnson, he knew nothing about this virus! He’d thought Ebola to be no more dangerous than Marburg. Dalgard did not fully realize the agent he was dealing with. He knew nothing of the “crashing and bleeding out”, or liquefying of the internal organs to the extent that the elder sister Ebola Zaire caused. Dalgard left his employees to carry on working in the environment, one perceived to be as “hot” as a Level 4 lab at the Institute by the Army unknowingly.

When the Army was in the process of nuking the building, wearing their space suits and air filtering devices, Dan walked in with nothing more than a surgeons mask on! Another character, however, who had had close contact (almost too close at one point) was Lieutenant Colonel Nancy Jaax. She, along with Peter Jharling (the codiscoverer of the new strain of Ebola in the Reston monkey house, which was actually found not to be damaging to humans)and Gene Johnson had worked in Level 4 labs at the Institute on numerous occasions.

Nancy, at first, seemed to be enthralled by the idea of holding a deadly agent in the palm of her hand. Only a few layers of rubber and latex separated the hot zone of the lab from the inner safety of her space suit. However, it wasn’t until the Reston incident that Nancy fully understood the potential biological disaster that unseen agent could cause. Nancy, and her husband Jerry, head over the 91-Tangos who were responsible for nuking the building, were so dedicated to preventing the leak of this killer into the outside world that she passed up being with her own father on his death bed.

She sacrificed being with her dying family member to potentially save the human race. Last, there was the character of Dr. Joseph B. McCormick, chief of the Special Pathogens Branch of the C. D. C. , who perhaps, in a sense, personifies the human race’s attitudes toward nature. McCormick, like Gene Johnson, had been to Africa and treated patients suffering from Ebola in Sudan. He had spent days on end inside the blood-spattered huts, breathing the smell of warm blood, blood infested with Ebola viruses and was never, himself, infected.

At one point, he had even been trying to give a woman a shot, and she convulsed, causing him to stick himself with a bloody needle. Lucky for him, however, she was only suffering from malaria. McCormick was a little boastful about the situation and informed everyone that Ebola was not as contagious as they had thought because, after all, he hadn’t caught it in his many days in the infected village. He gave the impression of invincibility, humans are superior maybe. He showed no respect for Nature’s destructiveness (and perhaps even her wrath).

Ebola, the human slatewiper as Johnson called it, was nothing more than dealing with any other virus to McCormick. It leaves one to think that Mother Nature will have her revenge on those who make a mockery of her as he does, perhaps the human race, as well, which is destroying the very loins that gave birth to us, the African rain forest. Ebola is a deadly virus to humans and primates, and its origin has yet to be uncovered. There is no cure for any of the Ebola sisters: Ebola Zaire, Ebola Sudan, Marburg, and the most recent Ebola Reston because of their mutation ability.

As for there being a solution to the problem, it may lay in the reduction in human interference in nature and destruction of our own universe or perhaps the end of the species that has become such a nuisance to Nature. Scientists, perhaps, should make developers and loggers aware of such consequences, before its too late. There is no Ebola epidemic at the moment, but as the book said, it hasn’t gone away, its just retreated into the shadows, lying dormantly there, for now.

Osteoporosis Report Essay

Twenty years ago osteoporosis was a word used mainly by researchers and physicians. Over the past few years, there has been an explosion of information about this condition that can cause severe pain and crippling. No cure is known yet, but ways to lessen your potential for osteoporosis have been identified. Today, one in three Americans are 50 or older. The baby boom generation will begin to enter their retirement shortly after the turn of the century that is rapidly approaching.

Thanks in part to medical advances and the emphasis on exercise and healthy diets, vast numbers of these baby boomers can expect to reach their eighties, nineties, and beyond. Yet, if present day trends unhealthy eating and lack of exercise continues, osteoporosis threatens to be one of the biggest public health dangers of modern times. Osteoporosis, literally meaning porous bone, is a disease of the skeleton in which the amount of calcium present slowly decreases to the point where the bones become extremely brittle and subject to fractures. The skeleton serves two functions.

It provides structural support for organs and muscles and also serves as a depository for the bodys calcium and other minerals, manly phosphorous and magnesium. The bone holds 99% of the bodys calcium. The other 1-% of remaining calcium is freed to circulate in the blood and is essential for crucial functions in the body such as blood clotting, muscle, contractions and nerve functions. Bones have two main sections. The outer section of the bone is the cortical bone. It is composed of a hard shell that serves to protect the other section of the bone, called the trabecular bone.

This part of the bone is an inner lacy, structural matrix of calcium that helps support the bone structure. Bone tissue is constantly being broken down and reformed to help the body cope with everyday stress and for maintaining a properly functioning body. The breakdown of the bones is called resorption and is performed by cells known as osteoclasts that did holes into the bone allowing calcium to be released into the body. Then, cells produced by the bone called osteoblasts help rebuild the bone.

The osteoblasts first fill in these holes left by the osteoclasts with collagen and then by laying down crystals of calcium and phosphorous. A complex mix of hormones and chemical factors controls this osteoclast-osteoblast balance. The trabecular and cortical parts of the bone both give off calcium to the body when it is needed, but as aging progresses the amount slowly declines. The rebuilding of bones makes them denser until about the age of 35 and peak period of bone mass building is somewhere between the ages of 25 to 35. After the age of 35, the body becomes slower and slower in replenishing bone as time goes on.

Osteoporosis develops when bone resorption occurs too quickly or if formation occurs too slowly. Because weakened bones, an increased susceptibility to fractures of the hip characterize osteoporosis, spine, and wrist are prevalent. Doctors have identified two types of osteoporosis that correlate with specific types of fractures. Type I osteoporosis, often referred to, as post enopausal osteoporosis, is most associated with wrist and spine fractures. Type II osteoporosis, also called senile osteoporosis, is generally attributed to reduced calcium by old age and causes mainly hip fractures.

There are more than 300,000 hip fractures, 300,000 wrist fractures, and over 700,000 spinal fractures in the US each year (Peck and Avioli 19). Osteoporosis causes more than 1. 5 million fractures each year and the cost to the healthcare system for these fractures is over 13. 8 billion dollars per year, greater than the cost for congestive heart failure and asthma. Of the individuals who fractured a hip, one-half will be permanently disabled, 20% will require long-term nursing care, and 20% of hip fracture victims die within a year, usually from complications caused by surgery.

Hip fractures are responsible for about 65,000 deaths per year in the United States. Hence, osteoporosis represents a major public health problem. There is no single cause of osteoporosis, and it seems that there are many factors that contribute to the disease. Some people are more prone to develop osteoporosis than others are. Factors that increase the likelihood of developing osteoporosis can be separated into controllable and uncontrollable factors. Uncontrollable factors include age, sex, body frame, and race.

The longer a person lives, the greater their chance is in developing osteoporosis. Osteoporosis is associated with age because bone mass begins to decline after it peaks at about the age of 35. The more years that passes the more loss of bone increases. Roughly estimating, people lose 10% of bone mass per year (24). As people grow older they also become less physically active, and this assist in bone loss. Also, other changes occur with age that can affect out ability to absorb calcium. The skin and kidney do not make Vitamin D with the same efficiency as they do in youth.

This affects the ability to absorb calcium from the diet or from supplements. A decline in stomach acid after the age of 60 may also affect the ability of the body to absorb calcium. Another risk factor for osteoporosis is sex. Women are four times as likely to develop osteoporosis than men are. One reason is that woman generally have thinner, lighter bones then men do. Also, the rapid loss of estrogen women experience after menopause can be contributed to osteoporosis. Estrogen protects the body against bone loss.

Women with regular menstrual periods are exposed to healthy levels of estrogen from puberty to menopause. Around the time of menopause though, the levels of estrogen sharply declines. Early menopause or surgically induced menopause, such as a hysterectomy, can increase a womans likelihood of developing osteoporosis because the protective effect of estrogen is lost. Another contribution of sex to osteoporosis is t women live longer then men do, which gives them more time to develop weaker bones. Race is also a risk factor of osteoporosis.

Caucasians and Asians have a higher risk of osteoporosis than African-Americans and Hispanics do. African-Americans in the US ave heavier and larger bones than Caucasians, although the reason for this is unknown. (33). Controllable risk factors for osteoporosis includes lack of calcium, lack of physical activity, cigarette smoking, and alcohol and caffeine intake. Lack of calcium is one of the great cause of osteoporisisCalcium is needed to build strong bones during childhood and early adult hood, and to prevent losses thereafter.

Studies have linked an inadequate amount of calcium intakes appear to be associated with low bone mass, rapid bone loss, and high fracture rates (Germano 99). Today, many people consume less than half of the amount of calcium recommended to build and maintain healthy bones. Calcium needs change during ones lifetime. The bodys demand for calcium is greater during childhood and adolescence when the skeleton is growing rapidly. Pregnant and lactating woman also need increased calcium, as do postmenoptusal woman and older men and women.

Good sources of calcium include low fat dairy products such as milk, cheese, and yogurt, dark green leafy vegetables like broccoli, collard greens, and spinach and other foods fortified with calcium like orange juice, cereals and bread. Lack of physical activity is another controllable factor. Bone is a living tissue that responds like muscles to exercise. Individuals who are inactive, immobilized, or bedridden for a long time are at higher risk. Weight bearing exercises such as walking, running, tennis, and other exercises that cause muscle to work against the force of gravity play an important role in preventing bone loss.

Therefore, resumption of physical activity is an important factor in building bone and preventing bone loss. Other risk factors are smoking, alcohol, and caffeine. A high intake of caffeine-containing foods, such as coffee, is thought to increase the amount of calcium eliminated in the urine (Bonnick 59). For individuals who have osteoporosis, a comprehensive treatment program includes a focus on nutrition, exercise, and safety issues to prevent falls that may result in fractures.

In addition, medications may be prescribed to slow or stop bone loss, or increase bone density. Currently the U. S. Food and Drug Administration for the treatment of postmenopausal osteoporosis approve estrogen, calcitonin, and alendronate. Estrogen, reloxifene and alendronate are approved for the prevention of the disease. While osteoporosis can be prevented and treated, there is, as of now, no cure. Prevention is the only way to avoid this disease and its debilitating consequences. Yet millions of Americans are not actively protecting themselves against osteoporosis.

Over the past decade, important information has slowly been uncovered about the causes of osteoporosis and the ways to prevent it. One of the most significant findings is that osteoporosis in not an inevitable part of growing older. One of the great myths associated with this disease is that as people age, they are all susceptible to suffering fractures or to becoming stooped over. This major misconception that causes individuals to overlook their risk and to avoid taking the necessary steps to prevent and treat osteoporosis.

Gonorrhea – infectious sexually transmitted disease

Gonorrhea is an infectious sexually transmitted disease. This disease involves the mucous membranes of the urogenital tract. Gonorrhea is much more obvious in males because they develop an acute discharge of pus from the urethra. Scarce when it starts, it becomes thicker and heavier and causes frequent urination. When urination takes place, there will be a burning sensation. If the prostate becomes infected, the passage of urine is partly obstructed. In females the infection occurs in the urethra, the vagina, or the cervix.

Although discharge and irritation of the vaginal mucous membranes may be severe. Nearly few or no early symptoms will appear. Gonorrhea is diagnosed by staining a smear of the discharge to expose the bacteria. Treatment in the early stages is usually effective. If the disease is untreated in the male, the early symptoms may subside, but the infection may spread to the testicles causing sterility. In the untreated female the infection usually spreads from the cervix into the uterus and fallopian tubes, causing pelvic inflammatory disease.

Severe pain may occur, or the infection may stay behind with few or no symptoms. While doing this, it will be gradually damaging the tubes and leaving the woman sterile. In both sexes the gonococcus may enter the bloodstream, resulting in arthritis, heart inflammation, or other diseases. Gonorrhea in pregnant women may be transmitted to the infant during birth and may, if untreated, cause a serious eye infection. Penicillin is commonly used against gonorrhea, although over the years an increasing number of penicillin resistant strains have been found.

Other effective antibiotics are tetracycline, spectinomycin, and the newer ones called cephalosporins. One antibiotic called ceftriaxone can cure uncomplicated gonorrhea, including infections resistant to penicillin, with a single injection. Gonorrhea increased greatly in the U. S. almost reaching epidemic proportions in adolescents and young adults. In most large cities clinics have been established where young people can get treatment. One of the most difficult tasks in controlling gonorrhea is locating all recent sexual contacts of an infected person in order to prevent further spread of the disease.

AIDS and HIV

The HIV virus poses one of the biggest viral threats to human society today. It is contracted through bodily fluids such as blood and semen, and sometimes even saliva and tears. AIDS kills 100% of its victims and puts them through agony before they die. It has been a threat for about 15 years, and it is not going to stop now. In fact, AIDS is just getting started: It consumes more people each year. There is no known treatment for it either, only antibiotics to slow the reproduction of the virus.

HIV is passed from one person to another by bodily fluids only. It is usually gotten through sexual intercourse or other ntimate contact, through the exchanging of unsterilized intravenous needles, or by the contact of HIV-infected bodily fluids and an open wound. It cannot permeate though intact skin, hence it cannot be spread through informal contact. AIDS has not been found to travel in insects or tame animals. In pregnant women, the virus only infects the infant near or at the time of birth.

The virus dies quickly without a host. AIDS (Acquired ImmunoDifficiency Syndrome) weakens the bodys immune system so it is sensitive to infection. The AIDS virus primarily attacks the T lymphocytes, which are a main part of the immune system. The virus is also incubated in cells called macrophages, where it is accidentally sent to other, healthy cells in the body like neurons and lymphatic cells. After HIV is contracted, the person looks and feels healthy for up to 20 years before symptoms start occurring.

During this time, the person can give the virus to another even though it cannot be detected by sight or smell. Usually, symptoms start developing within 1 to 2 years. Typical indications of the virus are fever, weariness, weight loss, skin rashes, a fungal mouth infection called thrush, lack of immunity to infection, and enlarged lymph nodes. When AIDS vertakes the body, the body becomes especially susceptible to tuberculosis, pneumonia, and a rare form of cancer called Kaposis Sarcoma. Once AIDS has fully taken hold, the body may suffer damage to the nerves and brain.

The life expectancy of an AIDS victim after the birth of symptoms is 1 to 5 years. AIDS was believed to have begun in Central Africa around 1979. Nearly all of the first AIDS patients were male homosexuals. However, after 1989 90% of all new cases of AIDS were from heterosexual intercourse. Public awareness rose as famous people began to die, like Rock Hudson, Perry Ellis, Michael Bennett, Robert Mapplethorpe, and Tony Richardson. Basketball star Magic Johnson also reported having AIDS.

The approximate number of AIDS cases in the U. S. lone is 65,000 and growing. So far, there is no treatment or vaccination for AIDS. With most viruses, the body produces antibodies that eventually destroy the virus. However, with HIV, natural antibodies are completely ineffective. Blood tests will not give accurate results of infection of HIV until between 2 weeks and 3 months after the initial infection. In 1987, the drug AZT (azidothymidine) had proved effective in slowing the growth of the virus, but it was lethal in large oses and some patients could not handle taking it at all.

There was a new HIV- fighting chemical scientists found called DDI (dideoxyinosine) that was not as harmful to the patient and could be used in AZTs place for more sensitive patients. In 1992 DDC (zalcitbine) was found to be useful for delaying the reproduction of HIV in patients with advanced AIDS, but only in conjunction with AZT. AIDS is one of an epidemic of super-deadly viruses like Ebola, Hanta Virus, and Dingae in Puerto Rico. In my opinion, this is natures way of fighting back from overpopulation. However, AIDS is a formidable disease and is a force to be reckoned with.

Sexual Transmitted Diseases Defined

A sexually transmitted disease is not the same as genital disease. Most genital diseases are not caused by sexually transmitted organisms. But most sexually transmitted infections do involve the genitals. Infection of the rectum, throat, and the eye are also common. Alot of sexually transmitted diseases spread from a single place and produce sores on parts of the body. At least a dozen diseases are sexually transmitted. Sexually transmitted diseases occur mainly in people 15 to 30 years of age. But sometimes people are born with it because of an infected mother.

People with a sexually transmitted Disease are usually at high risk for catching other diseases. There are more male infections reported than female cases. This is caused by prostitutes and homosexual contacts. 50 percent or more infections result from homosexual contacts. Other infections like syphilis, herpes, and HIV infection may be passed on to the fetus or during childbirth. The fetus or baby can suffer from the disease and can die from it. The helping of STDs has three parts: treatment, counseling, and following up.

Sometimes treatment is given in a single dose but in sometimes you have to take it more than once. A person can still be infected even if the symptoms go away. That is why a follow-up visit is important. To avoid spreading the infection the person should not have sex until the doctor says that it is cured. It can take up to fourteen days. This stops the Ping Pong effect. This infection is caused by the Herpes simplex virus. The symptoms are similar, and can result from either oral-to-genital or genital-to-genital contact.

The virus causes blisters on the genitals, similar to the cold sores that occur on the mouth. Cold sores on the mouth are also caused by the herpes virus. These infections are caused by viruses cures are not available. It has been estimated that approximately 1 in 6 people in Australia has had a history of genital herpes at some time. Not all people infected with the herpes virus will have symptoms. As many as 60-70% of people with herpes virus type 2 infection by a blood test have not had symptoms diagnosed as genital herpes.

Things occur most often on the penile shaft, glans or anal area and on the labia, clitoris,vagina or cervix. They also are around the mouth or on the throat after oral sex. . Genital herpes is usually more painful in women Vaginal and blisters may be so painful that women become unable to pass urine. It is important to get early treatment in order to prevent this from getting worse. Some symptoms happen for 1 to 3 weeks. Herpes lives in the body between symptoms.

Relapses can happen by emotional or physical stress, fever, trauma, hormonal changes, sunlight, alcohol. There are two different Infections Asymptomatic Infections and Neonatal Infections. Genital herpes can be passed on through most forms of sexual contact, genital-to-genital, oral-to-genital, and mutual masturbation. Many people are naware that cold sores may cause genital infection during oral sex. It is also possible for a person to transfer herpes from their own mouth to their genitals, and to their eyes. Condoms may further reduce spread between attacks.

Some treatments that can relieve discomfort: -Keeping sores clean and dry – Wrapping an ice-block in a towel -Bathing in salt water -Drinking plenty of water -If urination is painful, urinating in a hot bath or, for women, using both hands to separate -the lips of the vulva to achieve a free stream of urine, preventing urine from touching the lcers. -Wearing loose, cotton underpants and avoiding tight trousers – aspirin Anti-Herpes Drugs: Acyclovir The use of condoms during vaginal and anal intercourse reduces the risk of genital herpes, but protects only those areas in contact with the condom.

Because herpes can be transmitted from mouth-to-genitals condoms or dental dams may be used during oral sex. If  there are sores , it is important to avoid oral sex. Because herpes can be spread by the hands between people, it is important to wash your hands if they have come into contact with sores. The yeast like organisms that cause candidiasis are very common and normally are in the vagina as well as the mouth and in the intestines of most people. Candida is not an actual STD. It is seen in most sexually active people.

The presence of candida doesn’t usually have symptoms. There is a change in the pH of the vagina and may cause a problem in the balance of the normal flora. As a result, candidal overgrowth can occur and then cause symptoms. Some things that cause symptoms are heat, moisture, diabetes, steroid medications, cancer, chronic infection, and malnutrition . Men can also get candidiasis, which causes balanitis which causes inflammation of the glans penis. This usually happens to uncircumcised men who still have a foreskin which gives moist conditions for candidal overgrowth.

Some symptoms are itchiness in the anal and genital area, which intensifies at night, smooth to firm vaginal pus discharges, inflamed, split, and abraded skin and Inflammation of the glans penis. There is some treatment to change some of the factors that prevent the organism to spread. Minor vaginal candidiasis is treated with anti fungal agent n the form a capsule of nystatin which is inserted into the vagina, or a vaginal cream. Another way to treat this is natural yoghurt which can be inserted into the vagina or a vinegar and water douche.

Genital and oral antifungal therapy can be effective also, however, thrush can always recur because candida lives in the bowel. Candida cannot be permanently taken care of. Carefully washing and drying of the anal and genital area using soap helps somewhat. Chlamydia grows within cells. Chlamydia usually infects the cervix and fallopian tubes of women and the urethra of men. Chlamydial infections are said to be the most common of all STDs. It is also said that in a population of 15 million, there are up to 300,000 cases of chlamydia each year.

There are many undiagnosed cases of chlamydia in the community. It has been estimated that the true population of chlamydia in sexually active people may be in the order of 5% to 10%. Chlamydia often produces no symptoms. 60% of women and 40% of men have no symptoms. Infection of the cervix and fallopian tubes occurs more, and chlamydia can also cause urethral infection. Symptoms can include pain in rination, bladder infection, a thin vaginal discharge of pus and lower abdominal pain. Inflammation of the cervix with pus is very common.

Eye infections in infants born of infected mothers can also occur. In men, chlamydia may produce inflammation of the urethra similar to gonorrhoea. Symptoms for men may include discharges also. The most severe complication of chlamydia, is the risk of pelvic inflammatory disease (PID). As a result of infection to women it travels into the upper genital tract. Chlamydia can also lead tothe genital tract in men causing epididymitis,although this is much less ommon for men than for women. The risk of infection from person-to-person is alot like gonorrhoea.

It can also be passed to the eye by a hand moistened with infected fluids. Chlamydia can be transmitted during anal intercourse causing inflammation of the rectum. Chlamydial infections are treated the best with a drug doxycycline, taken orally for 10 days. Other infections, such as PID, require longer treatment. For  prevention, use of condoms during vaginal and anal intercourse works well. Because chlamydia can infect the eyes, care must be taken to avoid spreading sexual fluids into them.

Hypogravitational Osteoporosis Essay

Osteoporosis: a condition characterized by an absolute decrease in the amount of bone present to a level below which it is capable of maintaining the structural integrity of the skeleton. To state the obvious, Human beings have evolved under Earth’s gravity “1G”. Our musculoskeleton system have developed to help us navigate in this gravitational field, endowed with ability to adapt as needed under various stress, strains and available energy requirement.

The system consists of Bone a highly specialized and dynamic supporting tissue which provides the vertebrates its rigid infrastructure. It consists of pecialized connective tissue cells called osteocytes and a matrix consisting of organic fibers held together by an organic cement which gives bone its tenacity, elasticity and its resilience. It also has an inorganic component located in the cement between the fibers consisting of calcium phosphate [85%]; Calcium carbonate [10%] ; others [5%] which give it the hardness and rigidity.

Other than providing the rigid infrastructure, it protects vital organs like the brain], serves as a complex lever system, acts as a storage area for calcium which is vital for human metabolism, houses the bone marrow within its mid cavity and o top it all it is capable of changing its architecture and mass in response to outside and inner stress. It is this dynamic remodeling of bone which is of primary interest in microgravity.

To feel the impact of this dynamicity it should be noted that a bone remodeling unit [a coupled phenomena of bone reabsorption and bone formation] is initiated and another finished about every ten seconds in a healthy adult. This dynamic system responds to mechanical stress or lack of it by increasing the bone mass/density or decreasing it as per the demand on the system. eg; a person dealing with increased mechanical stress will respond with ncreased mass / density of the bone and a person who leads a sedentary life will have decreased mass/density of bone but the right amount to support his structure against the mechanical stresses she/she exists in. Hormones also play a major role as seen in postmenopausal females osteoporosis (lack of estrogens) in which the rate of bone reformation is usually normal with the rate of bone re-absorption increased.

In Skeletal system whose mass represent a dynamic homeostasis in 1g weight- bearing,when placed in microgravity for any extended period of time requiring practically no weight bearing, the regulatory system of bone/calcium reacts by ecreasing its mass. After all, why carry all that extra mass and use all that energy to maintain what is not needed? Logically the greatest loss -demineralization- occurs in the weight bearing bones of the leg [Os Calcis] and spine. Bone loss has been estimated by calcium-balance studies and excretion studies.

An increased urinary excretion of calcium , hydroxyproline & phosphorus has been noted in the first 8 to 10 days of microgravity suggestive of increased bone re-absorption. Rapid increase of urinary calcium has been noted after takeoff with a plateau reached by day 30. In contrast, there was a teady increase off mean fecal calcium throughout the stay in microgravity and was not reduced until day 20 of return to 1 G while urinary calcium content usually returned to preflight level by day 10 of return to 1G.

There is also significant evidence derived primarily from rodent studies that seem to suggest decreased bone formation as a factor in hypogravitational osteoporosis. Boy Frame,M. D a member of NASA’s LifeScience Advisory Committee [LSAC] postulated that “the initial pathologic event after the astronauts enter zero gravity occurs in the bone itself, and that changes in mineral homeostasis and the calcitropic ormones are secondary to this. It appears that zero gravity in some ways stimulate bone re-absorption, possibly through altered bioelectrical fields or altered distribution of tension and pressure on bone cells themselves.

It is possible that gravitational and muscular strains on the skeletal system cause friction between bone crystals which creates bioelectrical fields. This bioelectrical effect in some way may stimulate bone cells and affect bone remodeling. ” In the early missions, X-ray densitometry was used to measure the weight-bearing bones pre & post flight. In the later Apollo, Skylab and Spacelab issions Photon absorptiometry (a more sensitive indicator of bone mineral content) was utilized.

The results of these studies indicated that bone mass [mineral content] was in the range of 3. % to 8% on flight longer than two weeks and varying directly with the length of the stay in microgravity. The accuracy of these measurements have been questioned since the margin of error for these measurements is 3 to 7% a range being close to the estimated bone loss. Whatever the mechanism of Hypogravitational Osteoporosis, it is one of the more serious biomedical hazard of prolonged stay in microgravity. Many forms of weight loading xercises have been tried by the astronauts & cosmonauts to reduce the space related osteoporosis.

Although isometric exercises have not been effective, use of Bungee space suit have shown some results. However use of Bungee space suit [made in such a way that everybody motion is resisted by springs and elastic bands inducing stress and strain on muscles and skeletal system] for 6 to 8 hrs a day necessary to achieve the desired effect are cumbersome and require significant workload and reduces efficiency thereby impractical for long term use other than proving a theoretical principle in preventing hypogravitational osteoporosis.

Skylab experience has shown us that in spite of space related osteoporosis humans can function in microgravity for six to nine months and return to earth’s gravity. However since adults may rebuild only two-third of the skeletal mass lost, even 0. 3 % of calcium loss per month though small in relation to the total skeletal mass becomes significant when Mars mission of 18 months is contemplated. Since adults may rebuild only two-thirds of the skeletal mass lost in microgravity, even short durations can cause additive effects.

This problem becomes even greater in females who are already prone to hormonal osteoporosis on Earth. So far several tudies are under way with no significant results. Much study has yet to be done and multiple experiments were scheduled on the Spacelab Life Science [SLS] shuttle missions prior to the Challenger tragedy. Members of LSAC had recommended that bone biopsies need to be performed for essential studies of bone histomorphometric changes to understand hypogravitational osteoporosis.

In the past, astronauts with the Right Stuff had been resistant and distrustful of medical experiments but with scientific personnel with life science training we should be able to obtain valid hard data. [It is of interest that in the SLS mission, two of the mission pecialists were to have been physicians, one physiologist and one veterinarian. ] After all is said, the problem is easily resolved by creation of artificial gravity in rotating structures. However if the structure is not large enough the problem of Coriolis effect must be faced.

To put the problem of space related osteoporosis in perspective we should review our definition of Osteoporosis: a condition characterized by an absolute decrease in the amount of bone present to a level below which it is capable of maintaining the structural integrity of the skeleton. In microgravity where locomotion consists mostly of swimming actions with stress eing exerted on upper extremities than lower limbs resulting in reduction of weight bearing bones of lower extremities and spine which are NOT needed for maintaining the structural integrity of the skeleton.

So in microgravity the skeletal system adapts in a marvelous manner and problem arises only when this microgravity adapted person need to return to higher gravitational field. So the problem is really a problem of re-adaptation to Earth’s gravity. To the groups wanting to justify space related research: Medical expense due to osteoporosis in elderly women is close to 4 billion dollars a year and significant work in this field lone could justify all space life science work.

It is the opinion of many the problem of osteoporosis on earth and hypogravity will be solved or contained, and once large rotating structures are built the problem will become academic. For completeness sake: Dr. Graveline, at the School of Aerospace Medicine, raised a litter of mice on a animal centrifuge simulating 2G and compared them with a litter mates raised in 1G. “They were Herculean in their build, and unusually strong…. ” reported Dr. Graveline. Also X-ray studies showed the 2G mice to have a skeletal density to be far greater than their 1G litter mates.

Babies Killing Babies

Two teenagers entered a high school in Colorado and opened fire on their classmates. The young gunmen end their lives, but not before taking the lives of fifteen students, and injuring twenty, finalizing the tragedy. In recent years we have experienced a rampage of violence in our schools. Researchers have yet to pinpoint the answer to this plague of violent disorders. The National Institute of Mental Health, and The Office of the Surgeon General have focused their research to the areas of stages of violence development, prevention and intervention, and methods of identifying the most effective treatments.

Studies by the Office of the Surgeon General have concluded that there are two paths for the materialization of youth violence. One is identified at an early age of puberty, the other in the adolescent stage. The research shows that if there is violence demonstrated in the early childhood stage of a child, the degree of violence in the child rises, as the child grows older, concluding in severe violent behavior. The group that is said to be in the early-onset group, or before puberty, is said to have a greater and more serious number of violence incidents during the adolescent years.

This also leads to a determining factor for violent behavior during their adulthood, (see research by Stattin and Magnusson, 1996; and Tolan and Gorman-Smith, 1998). Research has shown that violence offenses committed by young men, between the ages of sixteen or seventeen, can be traced back to their puberty stage (DUnger et al. , 1998; Elliot et al. , 1996; Huzinga et al. , 1995; Nagin and Tremblay, 1999; Patterson and Yoerger, 1997; Stattin and Magnusson, 1996). This is proof that the majority of offenders began their violent behavior during the younger years.

However, the study also shows that those who began in the puberty stage did not commit the most serious and persistent acts of violence; moreover, by those whos violent behavior began during adolescence. The study also concludes that there is very little support to the claims that youth violence can be easily identified at an early age. We can see an example of this in the violent shootings that took place in Jonesboro, Arkansas; where two boys, ages eleven and thirteen years old, opened fire during a false fire alarm, killing four girls and one teacher.

On the other hand, most offenders have showed only minimum levels of childhood violence. It is obvious that there are different levels in which researchers have to evaluate violence in children. Further research programs are needed to target, puberty and adolescent, stages of childhood violence. Since 1997, we have experience such an explosion of school violence that parents, teachers, and community leaders are wondering whether or no is safe to send our children to school. The following are accounts of school violence as reported by ABC News:

In February 1996, in Moses Lake, Washington, a fourteen year old boy wearing a trench coat opens fire in classroom with a hunting rifle. He kills the teacher, two students, and injures one other. In February 1997, in Bethel, Alaska, a sixteen year old opens fire with a shotgun. He kills the principal and another student. Two others students are injured. The young man was sentenced to two ninety-nine year terms. In October 1997, in Pearl, Mississippi, another sixteen year-old shoots nine students, two of them die including the shooters ex-girlfriend.

The shooters mother is also found shot in her home. The youth is sentence to life in prison, and other students could be found guilty of accessory. In December 1997, in West Paducah, Kentucky, a fourteen-year-old is found guilty of shooting students in Heath High School. Three die and five others are wounded. The young offender is sentenced to life in prison. In March 1998, in Jonesborough, Arkansas, four students and one teacher are shot to death by and eleven and a thirteen year old boys. Ten others are injured during a false fire alarm.

They were staged in the woods near the evacuation area. They can be held in juvenile court until the age of twenty-one. In April 1998, in Edinboro, Pennsylvania, a fourteen-year-old student shoots a teacher to death during a graduation dance. In April 1998, in Pomona, California, a fourteen-year-old boy shoots and kills two other teenagers on an elementary school basketball court. In May 1998, in Fayetteville, Tennessee, an eighteen year-old honor roll student kills another teenager just days away from graduation. The teenager killed was dating the shooters ex-girlfriend.

In May 1998, in Houston, Texas, a fifteen year-old is shot and wounded after a gun misfires while it was inside the backpack of another seventeen year-old student. The student is charged with a third degree felony. In May 1998, in Onalaska, Washington, a fifteen year-old boy boards a bus with a gun and orders his girlfriend to get off the bus and took her to her home. He then dies from a self-inflicted headshot. In May 1998, in St. Charles, Montana, police intervene when information was found on three six-graders that had a hit list and plans to kill students on the last day of school during a false fire alarm.

In May 1998, in Springfield, Oregon, a fifteen-year-old student opens fire in the school cafeteria and kills two students. The shooters parents are also found dead in their home. All this happened the day after the shooter was expelled for bringing a gun to school. In June 1998, in Richmond, Virginia, a teacher and a guidance counselor are shot and wounded in the hallway. On April 1999, in Littleton, Colorado, the most serious of school shootings, two young men wearing black trench coats fire, killing fifteen students, including themselves, and injuring twenty.

On November 1999, in Deming, New Mexico, a twelve-year-old boy shoots and kills a young girl with a . 22 caliber handgun. On December 1999, in Fort Gibson, Oklahoma, five students were injured after a thirteen-year-old boy opens fire with his fathers 9mm pistol. According to the Office of the Surgeon, there are hundreds of researches conducted on youth violence, yet there is little to be known about their effects. It has also been found that the funding allotted to the prevention of programs for school violence has been spent on unproductive programs (Mendel, 2000).

However, there has been some advancement in information concerning youth violence. Some scientists have made progress in uncovering some of the causes and correlates of youth violence. Experts say that it had become difficult to identify effective programs. A recommendation is to use the resources of ineffective programs and allocate them to the programs that have been identified as affective. Another roadblock is the lack of cooperation between schools, communities, and juvenile justice authorities.

Because of the reputation that most programs give no positive results, organizations are wary of trying new programs. The focus should be centered in providing a healthy, non-violent environment for children. Doctor Scott Poland, one of the two educators invited to the White House to discuss solutions to school violence with President Clinton and Attorney General Janet Reno, was asked to comment on the recent wave of youth violence and its prevention he stated that we must reduce the violence in television, motion pictures, video games, and music.

We must put the mental health of children in America first, and provide the schools with the resources that they need. And we must restrict gun access to children. I am concerned at how our culture glamorizes violence, and portrays it as painless and guiltless. (Dr. Scott led the crisis response team in the Oklahoma City bombing incident in 1995) Scientists have two different methods of identifying school violence. These are a meta-analysis method, and an empirical method. The first is a statistical method in which results of various studies are combined in order to achieve an estimate.

The second is a review of the first in order to identify broad distinctiveness, and make recommendations on them. Statistics and the review of research is not the only practice in identifying the causes of youth violence. The National Institute of Mental Health has been studying a more scientific approach in the genetic research of brain development. Steven E. Hyman, Director of The NIMH states that An understanding of the timing of brain development, and the types of environments in which it can proceed in a healthy trajectory have important policy implications.

This awareness is a very important beginning in which we should built. For example, we know that brain development continues to throughout childhood and adolescence, but for success in school and life, we need t pay attention not only to cognitive development, but also to emotional development. The negative effects of neglect and abuse, poor adult supervision, and the influence of deviant peers and of exposure to violence are important, but have been well documented; less well understood are the emotional disorders of childhood that may lead to the violence that seems to come out of nowhere.

The causes of this violence; indeed the reasons for the frequency of depression and other emotional disturbances in our society are complex and not fully understood. A profound truth that we have learned about brain development and vulnerability to mental disorders is that as complex as the gene-gene interactions are providing to be, they do not explain everything; equally complex gene-environment interactions are also involved. The interactions of genes and environment permit the limited information in the genome to be read out in as way as to produce the human brain.

Our brains have been described as the most complex structure in the known universe, and complex they must be to confer on humanity its wonderful richness and diversity, and above all, to permit us to adapt to the many different environments and conditions in which human beings live. How might the environment cause our brains to develop in one possible way rather than another? Insofar as we experience it or interact with it, the environment produces biochemical changes in the nerve cells within our brains.

When such biochemical changes are of large enough magnitude, they turn gene on and off inside those cells as part of normal processes that go by the name of brain plasticity. These physical changes caused by experience within the brain are the basis of all long-term memory. During development, as these little tweaks add up, our brains get wired up one way or another. This has sometimes been described as sculpting the brain. This sculpting occurs, of course, by the regulation of genes by the environment, which not only builds new connections but also may eliminate connections that go unused.

There is enough evidence, according to the study made by NIMH, to relate that development in genetic activity should be researched further. It is not to say that the research in place should be abandoned, but that new research should be implemented with current research. Hyman also states that sometimes there is no reasonable explanation for such violent behavior among youths; and that sometimes there is no apparent negative experiences in the past of violent offenders. In these cases the questions of economic and social status, family relationship, peer influence, stability, and family history.

There is much more research needed in the field of youth violence. Students, parents, school staff and the community should have a sense of safety regarding our educational institutions. There must be a reform of research programs in order to combined those programs that are successful with new programs. The government should be more involved with the allocation of funding, and drop the grants from programs that have sown little or no effect on finding an answer to detecting, preventing, and treatment of youth violence. Only then can our kids feel secured in our schools.

The Anthrax Vaccination

The anthrax vaccination is the only known defense available for United States Troops against the deadly anthrax virus. Many experts have said it is not effective against inhalation anthrax. Studies have not been conclusive in their findings. The chance of living if you have received the anthrax vaccination seems better. More studies should be conducted outside the Department of Defense, with their cooperation, before the process to vaccinate troops continues. Anthrax is a disease normally associated with plant eating animals (sheep, goats, and cattle) caused by the bacterium Bacillius anthracis.

It is now controlled through vaccination programs throughout the world including the United States. Human infection with anthrax usually results from contact with infected animals or products. Anthrax was discovered by Robert Koch in 1876. An effective vaccine for animals was developed in 1881 by Louis Pasteur. In humans, the disease appears in both external and internal forms. The external form is contracted through cuts and breaks in the skin. The internal form is caught by inhaling anthrax spores, which invade the lungs and intestinal tract (Funk and Wagnalls New Encyclopedia, 1996).

Russian scientists have created a new form of the anthrax virus by genetic engineering. Col. Arthur Friedlander , chief of the bacteriology division at the U. S. Army Medical Research Institute states, The evidence that they presented suggested that it could be resistant to our vaccine (Riechman, Army Times 03-09-98). When anthrax is used as a biological weapon, people become infected by breathing the spores released in the air. Anthrax is 100,000 times deadlier than the deadliest chemical warfare agent. It is the preferred biological agent because it is easy to produce in bulk and the materials are low in cost.

B. D. Hawkins,Army Times) Dr. Jose Ramero Cruz, of the World Health Organization states,Because anthrax spores are resistant to dryness and heat, they are relatively easy to grind and store. U. S. officials say that as many as 12 countries including Russia, Iraq, and North Korea, have established capabilities to produce and load deadly anthrax spores into weapons (D. Funk, Army Times, 3-19-98). An anthrax loaded scud missile could kill 100,000 people in an urban area according to a 1993 study, Proliferation of Weapons of Mass Destruction: Assessing the Risks, (J. Erlich, Army Times, 9-8-97).

No country is known to have released the biological agent during wartime. Anthrax has the potential to cover large areas of the battlefield. It is not known what branch of service, front line, or rear area troops would be at greater risks. Defense Secretary William Cohen stated, Anthrax is the poor mans atomic bomb (D. Funk, Army Times,1-12-98). The anthrax vaccine is used to protect against anthrax. It contains only dead organisms. Human vaccination was developed in England and the United States in the 1950s and early 1960s.

The vaccination was licensed and approved by the United States Food and Drug Administration in 1970. The vaccination is produced by Michigan Biologic Products Institute located in Lansing, Michigan. It has been administered to veterinarians, laboratory workers, and livestock handlers safely for over twenty five years (D. Funk, Army Times, 8-31-98). The anthrax vaccination prevents illness by stimulating the bodys natural disease fighting abilities. It has not been proven whether the vaccination will work against inhaled anthrax. The informational insert that usually comes with the vaccine could not be obtained.

I did find that according to the Michigan Department of Public Health in Lansing, Michigan there are no references for using the vaccine for inhaled anthrax (Joyce, AGWVA). Chairman of the Joint Chiefs of Staff, General Henry H. Shelton says we have stockpiled a safe and effective vaccine to protect our forces against anthrax (DefenseLINK a. , 18June98). There are many views and arguments to this statement. One that may not be resolved until further research can be done or anthrax is used against roops who have received the vaccination.

Almost all cases of inhalation anthrax in which treatment was started after symptoms began, have resulted in death, regardless of treatment afterwards. Being vaccinated greatly increases your chances of surviving an exposure to anthrax. Without the vaccination or protection (MOPP gear) it has a ninety-nine percent death rate to unprotected persons (PROMED (03) PRO/AH). From this point of view, it would beneficial to receive the vaccination. Since 1970, there have been no known long term side effects associated with the anthrax vaccination.

Reported side effects to the vaccine are mostly limited to local reactions. They include, sore arm, redness, and slight swelling at the injection site in 30 percent of recipients. Severe local reactions such as swelling that may extend from the elbow to the forearm are rare (Arnot Ogden Medical Center, 1998). Minor adverse reactions can include, but are not limited to flu like symptoms. Out of 133,870 immunizations, only seven (. 005 percent) severe reaction cases have been reported. Six were found to be minor effects and all service members were returned to duty.

Only one service member had a more severe illness (Guillain-Barre Syndrome) that occurred after receiving his third dose of anthrax vaccination. He began recovery one month after onset of the illness (D. Funk, Army Times, 8-31-98). No studies have been conducted to determine if the anthrax vaccination causes cancer, induces genetic mutation, impairs fertility, or causes fetal harm ( Joyce, AGWVA). Service members have already begun the immunization process against anthrax. Phase I of the immunization process began with all service members expected to be going to a high threat area on August 16, 1998. Those already in Korea will begin September 9,1998.

Service members serving in the Persian Gulf began in early March of 1998. About 48,000 have begun the series. Phase II will be for units first to deploy (XVIII Airborne Corps and subordinate units) in the event of a military incident. It is scheduled to begin in fiscal year 2000. Phase III will include the remaining forces and new recruits by fiscal year 2003. All 2,400,000 active duty, reserve, and national guard members will be vaccinated (D. Funk, Army Times,8-31-98).

All service members will be required to take the vaccination as stated in Department of Defense Directive 6205. 3 unless medically deferred. Some examples of soldiers who will be deferred are pregnant soldiers, and soldiers who are HIV positive. Family members will not be required to receive the vaccination and there is no plan to vaccinate them at this time. Withdrawing them from the region will be the first resort ( DefenseLINK a. 18JUN98). The majority of service members that have been required to receive the vaccination have done it.

Sixteen service members, 14 Navy, and 2 Air Force have refused to ake the vaccination. Two sailors have been discharged and the rest have received disciplinary action. A Fort Stewart, Georgia soldier is facing a probable discharge after choosing to go AWOL rather than take the required series of shots. It is conceivable that the number of refusals could rise when the program spreads to troops who dont feel an immediate threat said Secretary of Defense William H. Cowan (D. Funk, Army Times, 8-31-98). A total of six vaccinations will be administered in order for the series to be complete.

Three vaccinations will be given 2 weeks apart from each other initially. It will be followed by 3 additional vaccinations given at 6, 12, and 18 months. A booster shot annually will be given afterwards (ProMED(03), PRO/AH). While the entire vaccination series is 6 shots, military officials think it is possible service members dont need that many shots. Research to determine that is continuing, said Rear Admiral Michael Cowan, deputy director of medical readiness for the Joint Staff. Until we know for certain that it is safer to give fewer shots, well go with standardization, approved series,he said (D. Funk, Army Times, 8-31-98).

The cost to immunize an estimated 2,400,000 military personnel will be approximately 130,000,000 million dollars(DefenseLINK News 8-14-98). The estimated 130,000,000 dollars needed to vaccinate all active duty, reserve, and national guard forces against anthrax is wasted money, said Victor Sidel, a physician at the Albert Einstein College of Medicine in New York and co-president of International Physicians for the Prevention of Nuclear War, which won the Noble Peace Prize. It is a snare and delusion, said Sidel of troops taking the vaccination.

Theres very kind of evidence that this material is ineffective against the strains that are likely to be used. And there is evidence that the material causes adverse reactions (D. Reichman, Army Times, 3-9-98). In conclusion, the best believed defense available to the United States military is the anthrax vaccination. Studies against the vaccination have not been conclusive enough to persuade me to trust this vaccination 100 percent. It should be handed down to an independent research team outside the Department of Defense for further study. If the choice was mine to make today, I would not take the vaccination.

Evolution of Immunity and the Invertebrates

The complex immune systems of humans and other mammals evolved over quite a long time – in some rather surprising ways. In 1982 a Russian zoologist named Elie Metchnikoff noticed a unique property of starfish larva. When he inserted a foreign object through it’s membrane, tiny cells would try to ingest the invader through the process of phagocytosis. It was already known that phagocytosis occurred in specialized mammal cells but never in something less complex like a starfish. This discovery led him to understand that phagocytosis layed a much broader role, it was a fundamental mechanism of protection in the animal kingdom.

Metchnikoff’s further studies showed that the host defense system of all animals today were present millions of years before when hey were just beginning to evolve. His studies opened up the new field of comparative immunology. Comparative immunologists studied the immune defenses of past and current creatures. They gained further insight into how immunity works. The most basic requirement of an immune system is to distinguish between one’s own cells and “non-self” cells. The second job is to eliminate the non- self cells. When a foreign object enters the body, several things happen.

Blood stops flowing, the immunity system begins to eliminate unwanted microbes with phagocytic white blood cells. This defensive mechanism is possessed by all animals with an innate system of immunity. Innate cellular immunity is believed to be the earliest form of immunity. Another form of innate immunity is complement, composed of 30 different proteins of the blood. If these mechanisms do not work to defeat an invader, vertebrates rely on another response: acquired immunity. Acquired immunity is mainly dealt by specialized white blood cells called lymphocytes.

Lymphocytes travel throughout the blood and lymph glands waiting to attack molecules called antigens. Lymphocytes are made of two classes: B and T. B lymphocytes release antibodies while T help produce antibodies and serve to recognize antigens. Acquired Immunity is highly effective but takes days to activate and succeed because of it’s complex nature. Despite this, acquired immunity offers one great feature: immunological memory. Immunological Memory allows the lymphocytes to recognize reviously encountered antigens making reaction time faster.

For this reason, we give immunizations or booster shots to children. So it has been established that current vertebrates have two defense mechanisms: innate and acquired, but what of older organisms ? Both mechanisms surprisingly enough can be found in almost all organisms (specifically phagocytosis). The relative similarities in invertebrate and vertebrate immune systems seem to suggest they had common precursors. The oldest form of life, Protozoan produce these two immune functions in just one cell. Protozoan phagocytosis is not uncommon to that of human phagocytic cells.

Another basic function of immunity, distinguishing self from non-self, is found in protozoan who live in large colonies and must be able to recognize each other. In the case of metazoan, Sponges, the oldest and simplest, are able to do this as well refusing grafts from other sponges. This process of refusing is not the same in vertebrates and invertebrates though. Because vertebrates have acquired immunologic memory they are able to reject things faster than invertebrates who ust constantly “re-learn” what is and is not self.

Complement and lymphocytes are also missing from invertebrates, but which offer an alternative yet similar response. In certain invertebrate phyla a response called the prophenoloxidase (proPO) system occurs. Like the complement system it is activated by enzymes. The proPO system has also been linked to blood coagulation and the killing of invading microbes. Invertebrates also have no lymphocytes, but have a system which suggests itself to be a precursor of the lymph system. For instance, invertebrates have olecules which behaving similarly to antibodies found in vertebrates.

These lectin molecules bind to sugar molecules causing them to clump to invading objects. Lectins have been found in plants, bacteria, and vertebrates as well as invertebrates which seems to suggest they entered the evolutionary process early on. This same process occurs in human innate immune systems with collections of proteins called collectins which cover microbes n a thin membrane to make them easier to distinguish by phagocytes. And although antibodies are not found in nvertebrates a similar and related molecule is.

Antibodies are members of a super family called immunoglobulin which is characterized by a structure called the Ig fold. It is believed that the Ig fold developed during the evolution of metazoan animals when it became important to distinguish different types of cells within one animal. Immunoglobulins such as Hemolin have been found in moths, grasshoppers, and flies, as well as lower vertebrates. This suggests that antibody-based defense systems, although only active in vertebrates, found their roots in the invertebrate immune system. Evolution seems to have also conserved many of the control signals for these defense mechanisms.

Work is currently being done to isolate invertebrate molecules similar to the cytokines of vertebrates. Cytokines are proteins that either stimulate or block out other cells of the immune system as well as affecting other organs. These proteins are critical for the regulation of vertebrate immunity. It is suspected that invertebrates will share common cytokines with vertebrates or at least a close replication. Proteins removed from starfish have been found to have the same physical, chemical, and iological properties of interleukins (IL-1, IL-6), a common cytokine of vertebrates.

This research has gone far enough to conclude that invertebrates possess similar molecules to the three major vertebrate cytokines. In the starfish, cells called coelomocytes were found to produce IL-1. The IL-1 stimulated these cells to engulf and destroy invaders. It is thus believed that invertebrate cytokines regulate much of their host’s defense response, much like the cytokines of vertebrate animals in innate immunity. Comparative Immunology has also found defense mechanisms first in nvertebrates only later to be discovered in vertebrates.

Invertebrates use key defensive molecules such as antibacterial peptides and proteins, namely lysozyme, to expose bacterial cell walls. Thus targeting the invader. This offers great potential for medicinal purposes, because lysozyme is also found in the innate immunity of humans in it’s defense of the oral cavity against bacteria. Peptides of the silk moth are currently being developed as antibacterial molecules for use in humans. Two peptides found in the skin of the African clawed frog actively fight bacteria, fungi, and protozoa.

Antibodies which bind to these two peptides also bind to the skin and intestinal lining of humans. The potential of these peptide antibiotics only now being discovered is a rather considerable thing to ponder. For that reason it is surprising that such little attention has been paid to invertebrate immune responses. In the end, the complexity of vertebrate immune systems can only be understood by studying the less complex systems of invertebrates. Further studies look to explain immunity evolution as well as aid in the solving of problems of human health.

In the Marketplace: Your Legal Rights

The expeditious augmentation of consumer product transactions taking place on the Internet have developed new risk for the public’s health and safety, especially with the rise of online self-prescription drug sites. Online Pharmacies have been created to benefit the consumer but pose many risks for credulous purchasers, increased health fraud, and unique challenges to regulators, law enforcement, and policymakers. With these latest technological advancements, former regulations utilized by the Food and Drug Administration (FDA) concerning the distribution of prescription and over the counter drugs have to some extent become obsolete.

This has required that the FDA along with the combined efforts of other organizations such as the Federal Trade Commission (FTC), create new regulations to protect consumers. The evolution of online prescription Internet sites has brought several advantages to consumers, allowing individuals to attain ever-increasing amounts of knowledge to improve their understanding of health issues and treatment options. “Last year alone more than 22 million Americans used the Internet to find medical information.

According to Investor’s Business Daily, 43% of web surfers access health care data online each year. Health concerns are the sixth most common reason people use the Internet, and according to the market research firm, Cyber Dialogue Inc. , this number is growing 70 percent a year. ” The leading attractions to purchasing consumer products online are speed, privacy, ease of choosing and ordering products, and reduction in possible prescription errors with the use of computer technology to transmit prescriptions from doctors to pharmacies.

Other benefits include: lower prices through increased competition among licensed sellers; greater availability of drugs for people with difficulties causing inability to get to the pharmacy or people who may live a great distance from the pharmacy; the ease of comparative shopping among many sites to find the best prices and products; and greater convenience and variety of products for all customers who prefer online ordering of drugs.

While there seems to be vast amounts of benefits with these online drug prescription sites for consumers, the public must remember that they are at risk from avaricious sites or individuals that run them, which do not have the best interests of the consumer in mind. Over approximately 200 domestic sites have been identified by the National Association of Boards of Pharmacy and the American Medical Association identified over 400 sites that both dispense and offer a prescribing service, half of which are located in foreign countries.

This sizeable variety of companies, which are expanding everyday, give rise to numerous concerns for the consumer and challenges for government at both state and federal levels. Such concerns include illegal sale of drugs not approved by the FDA, distribution of counterfeit drugs, prescription drugs dispensed without a valid prescription, fatal interactions between drugs that may occur because of sites only requiring one to fill out a questionnaire to obtain the prescribed drug without prior knowledge of medical history, and products marketed with fraudulent health claims.

The unique qualities of the Internet, including its broad reach, relative anonymity, and ease of creating new websites or removing old ones, pose new challenges for the enforcement of existing laws. ” The technological advancements of electronic commerce have outdated the establishment of the FDA and its system of drug regulation as it exists today. The FDA’s system of drug regulation reviews new drugs to assess their safety and efficacy.

In addition, it only permitted licensed health care professionals with the necessary education and training to administer prescription drugs, which reduced the risks that may occur from lack of knowledge by individuals without the proper credentials. The global nature of the Internet and the ability for websites to be made up of several related sites and links allows illegal transactions to occur readily thereby placing consumers health and safety at extreme peril.

The occurrence of illegal transactions from online pharmacies becomes possible because foreign sites can be accessed and used to obtain drug prescriptions. Foreign countries have different drug regulations than those in America and create a difference in the legality of all existing drugs. Permitting the purchase of drugs from foreign sites may allow individuals to purchase drugs legal in that country but illegal in America. Another factor pertaining to foreign drug purchases made from online pharmacies is that shipment of drugs from foreign countries into the U. S. is illegal.

To insure that the shipment of drugs from places out of jurisdiction do not occur the Drug Enforcement Administration has enforced laws that imposed the importation of controlled substances. This makes law enforcement increasingly complex and hinders investigations of sites that are breaking laws because companies can shut down the site just as fast as they can create a new site. When the Internet is used for an illegal sale, the FDA must establish the same elements of a case, bring the same charges, and take the same actions as it would if another medium, such as a storefront or a magazine, had been used.

Under the Federal Food, Drug, and Cosmetic (FD&C) Act unlawful conduct involving online drug sales that have been identified by the FDA, allows them to take legal action against: The importation, sale, or distribution of an adulterated or misbranded drug; The importation, sale, or distribution of an unapproved new drug; The sale or dispensing of a prescription drug without a valid prescription; and When an illegal site has been reported, the Office of Regulatory Affairs (ORA) and the Office of Compliance in the Center for Drug Evaluation and Research the primary organization within the FDA for regulating online drug sales is notified.

The FDA has already investigated and brought several cases for criminal prosecution and civil enforcement actions against some online sellers of drugs and other FDA regulated products, particularly the sellers of drugs not approved by the Agency. For example, in July of 1996, the Office of Criminal Investigations (OCL) was contacted by a womens health care provider to advise that several clients had directed her to an Internet site promoting an abortion kit. This kit proposed serious health risks to women when used without a doctor’s supervision because of possible side effects that caused heavy vaginal bleeding and death.

An anonymous purchase had been made on the OCL’s behalf and the company responded sending out an abortion kit. The OCL was able to trace the site Easy Life Labs in Columbia, South America, but this company temporarily went off-line. In March of 1997, the OCL was contacted once again that this same company was online again. The OCL notified the foreign Drug Company’s U. S. Internet Service Provider (ISP) and told them that one of their subscribers was criminally violating the FD&C Act and the service voluntarily removed violative ads.

As cases like the above example have increased with the widespread incorporation of online pharmacies into the consumer world, the FDA has contacted several agencies and States and initiated the address of the concerns brought on by these sites. Several new programs have been introduced to verify legitamacy of Internet sites dispensing prescription drugs. One new program announced by the National Association of Boards of Pharmacy (NABP), known as the Verification of Internet Pharmacy Practice Sites, or VIPPS, will provide a NABP “seal of approval” to sites meeting the organization’s standards.

The FDA also believes that by working with the States, that they will be able to regulate the domestic sale of both approved and unapproved drugs, as well as the sale of prescription drugs without a valid prescription thereby reducing health fraud. The FDA has also drafted and devised an action plan concerning online pharmacies. The FDA has identified five major areas of focus pertaining to the regulation of online drug sales which are to: Customize and expand the agency’s regulatory and criminal enforcement efforts: Identify when and with which Federal agencies FDA should partner in joint activities;

Partner with State bodies to address domestic Internet sales; Provide input to congress regarding legislation. Although many actions have been taken to curb health fraud and unsafe conditions for consumers, the public still remains at extreme risk by purchasing drugs from online pharmacies. Consumers are still subjected to risks involving factors such as the illegal sales of drugs because it is difficult to regulate foreign sites, health fraud, and counterfeit drugs that may be used in place of the perceived drug thought to have been purchased.

Regulating foreign sites is one of the most difficult tasks yet to be accomplished by the FDA. Regulation is hard to control because the FDA and other federal organizations have limited jurisdiction concerning sellers of prescription drug sales from other countries. They are working closely with the post offices to try and stop illegal drugs from crossing state borders but finding these packages is a task in itelf. Health fraud allows consumers to fall prey to health gimmicks.

These fraudulent health products manipulate consumers into spending billions of dollars a year. FDA shares federal oversight of health fraud products with the Federal Trade Commission. But because of limited resources, say Joel Anderson, team leader for the nontraditional drug compliance team in FDA’s Center for Drug Evaluation and Research, the agency’s regulation on health fraud products is based on a priority system that depends on whether a fraudulent product posses a direct or indirect risk.

The most extreme hazard that consumer’s are exposed to with the purchase of prescription drugs online are those which deal with the threat that the drug which they purchased could be counterfeit or tampered with and cause harm or serious complications. As a guide to consumers when purchasing drugs online the FDA has issued tips and warnings for consumers to be aware of which include: Purchasing a medication from an illegal Website puts you at risk . You may receive a contaminated or counterfeit product, the wrong product, an incorrect dose, or no product at all.

Taking an unsafe or inappropriate medication puts you at risk for dangerous drug interactions and other serious health consequences. Getting a prescription drug by filling out a questionnaire without seeing a doctor poses serious health risks. A questionnaire does not provide sufficient information for a health-care professional to determine if that drug is for you or safe to use, if another treatment is more appropriate, or if you have an underlying medical condition where using that drug may be harmful.

The American Medical Association has determined that this practice is generally substandard medical care. FDA agrees. The Internet generates a haven where numerous illegal transactions can be carried out with almost no detection by authorities. The development of online pharmacies, although seemingly bring advantages to patrons, ultimately creates an unprotected environment for consumers. While the FDA and other organizations take action to improve the out dated safety regulations for online pharmacy purchasing, these sites still pose threats to the public’s health and safety.

Schizophrenia – Mental Illness

Schizophrenia, severe mental illness characterized by a variety of symptoms, including loss of contact with reality, bizarre behavior, disorganized thinking and speech, decreased emotional expressiveness, and social withdrawal. Usually only some of these symptoms occur in any one person. The term schizophrenia comes from Greek words meaning “split mind.” However, contrary to common belief, schizophrenia does not refer to a person with a split personality or multiple personality. (For a description of a mental illness in which a person has multiple personalities, see Dissociative Identity Disorder.) To observers, schizophrenia may seem like madness or insanity.

Perhaps more than any other mental illness, schizophrenia has a debilitating effect on the lives of the people who suffer from it. A person with schizophrenia may have difficulty telling the difference between real and unreal experiences, logical and illogical thoughts, or appropriate and inappropriate behavior. Schizophrenia seriously impairs a person’s ability to work, go to school, enjoy relationships with others, or take care of oneself. In addition, people with schizophrenia frequently require hospitalization because they pose a danger to themselves. About 10 percent of people with schizophrenia commit suicide, and many others attempt suicide. Once people develop schizophrenia, they usually suffer from the illness for the rest of their lives. Although there is no cure, treatment can help many people with schizophrenia lead productive lives.

Schizophrenia also carries an enormous cost to society. People with schizophrenia occupy about one-third of all beds in psychiatric hospitals in the United States. In addition, people with schizophrenia account for at least 10 percent of the homeless population in the United States (see Homelessness). The National Institute of Mental Health has estimated that schizophrenia costs the United States tens of billions of dollars each year in direct treatment, social services, and lost productivity.

II Prevalence Print Preview of Section

Approximately 1 percent of people develop schizophrenia at some time during their lives. Experts estimate that about 1.8 million people in the United States have schizophrenia. The prevalence of schizophrenia is the same regardless of sex, race, and culture. Although women are just as likely as men to develop schizophrenia, women tend to experience the illness less severely, with fewer hospitalizations and better social functioning in the community.

III Symptoms Print Preview of Section

Schizophrenia usually develops in late adolescence or early adulthood, between the ages of 15 and 30. Much less commonly, schizophrenia develops later in life. The illness may begin abruptly, but it usually develops slowly over months or years. Mental health professionals diagnose schizophrenia based on an interview with the patient in which they determine whether the person has experienced specific symptoms of the illness.

Symptoms and functioning in people with schizophrenia tend to vary over time, sometimes worsening and other times improving. For many patients the symptoms gradually become less severe as they grow older. About 25 percent of people with schizophrenia become symptom-free later in their lives.

A variety of symptoms characterize schizophrenia. The most prominent include symptoms of psychosis-such as delusions and hallucinations-as well as bizarre behavior, strange movements, and disorganized thinking and speech. Many people with schizophrenia do not recognize that their mental functioning is disturbed.

A Delusions

Delusions are false beliefs that appear obviously untrue to other people. For example, a person with schizophrenia may believe that he is the king of England when he is not. People with schizophrenia may have delusions that others, such as the police or the FBI, are plotting against them or spying on them. They may believe that aliens are controlling their thoughts or that their own thoughts are being broadcast to the world so that other people can hear them.

B Hallucinations

People with schizophrenia may also experience hallucinations (false sensory perceptions). People with hallucinations see, hear, smell, feel, or taste things that are not really there. Auditory hallucinations, such as hearing voices when no one else is around, are especially common in schizophrenia. These hallucinations may include two or more voices conversing with each other, voices that continually comment on the person’s life, or voices that command the person to do something.

C Bizarre Behavior

People with schizophrenia often behave bizarrely. They may talk to themselves, walk backward, laugh suddenly without explanation, make funny faces, or masturbate in public. In rare cases, they maintain a rigid, bizarre pose for hours on end. Alternately, they may engage in constant random or repetitive movements.

D Disorganized Thinking and Speech

People with schizophrenia sometimes talk in incoherent or nonsensical ways, which suggests confused or disorganized thinking. In conversation they may jump from topic to topic or string together loosely associated phrases. They may combine words and phrases in meaningless ways or make up new words. In addition, they may show poverty of speech, in which they talk less and more slowly than other people, fail to answer questions or reply only briefly, or suddenly stop talking in the middle of speech.

E Social Withdrawal Advertisement

Another common characteristic of schizophrenia is social withdrawal. People with schizophrenia may avoid others or act as though others do not exist. They often show decreased emotional expressiveness. For example, they may talk in a low, monotonous voice, avoid eye contact with others, and display a blank facial expression. They may also have difficulties experiencing pleasure and may lack interest in participating in activities.

F Other Symptoms

Other symptoms of schizophrenia include difficulties with memory, attention span, abstract thinking, and planning ahead. People with schizophrenia commonly have problems with anxiety, depression, and suicidal thoughts. In addition, people with schizophrenia are much more likely to abuse or become dependent upon drugs or alcohol than other people. The use of alcohol and drugs often worsens the symptoms of schizophrenia, resulting in relapses and hospitalizations.

IV Causes Print Preview of Section

Schizophrenia appears to result not from a single cause, but from a variety of factors. Most scientists believe that schizophrenia is a biological disease caused by genetic factors, an imbalance of chemicals in the brain, structural brain abnormalities, or abnormalities in the prenatal environment. In addition, stressful life events may contribute to the development of schizophrenia in those who are predisposed to the illness.

A Genetic Factors

Research suggests that the genes one inherits strongly influence one’s risk of developing schizophrenia. Studies of families have shown that the more closely one is related to someone with schizophrenia, the greater the risk one has of developing the illness. For example, the children of one parent with schizophrenia have about a 13 percent chance of developing the illness, and children of two parents with schizophrenia have about a 46 percent chance of eventually developing schizophrenia. This increased risk occurs even when such children are adopted and raised by mentally healthy parents. In comparison, children in the general population have only about a 1 percent chance of developing schizophrenia.

B Chemical Imbalance

Some evidence suggests that schizophrenia may result from an imbalance of chemicals in the brain called neurotransmitters. These chemicals enable neurons (brain cells) to communicate with each other. Some scientists suggest that schizophrenia results from excess activity of the neurotransmitter dopamine in certain parts of the brain or from an abnormal sensitivity to dopamine. Support for this hypothesis comes from antipsychotic drugs, which reduce psychotic symptoms in schizophrenia by blocking brain receptors for dopamine. In addition, amphetamines, which increase dopamine activity, intensify psychotic symptoms in people with schizophrenia. Despite these findings, many experts believe that excess dopamine activity alone cannot account for schizophrenia. Other neurotransmitters, such as serotonin and norepinephrine, may play important roles as well.

C Structural Brain Abnormalities

Brain imaging techniques, such as magnetic resonance imaging and positron- emission tomography, have led researchers to discover specific structural abnormalities in the brains of people with schizophrenia. For example, people with chronic schizophrenia tend to have enlarged brain ventricles (cavities in the brain that contain cerebrospinal fluid). They also have a smaller overall volume of brain tissue compared to mentally healthy people. Other people with schizophrenia show abnormally low activity in the frontal lobe of the brain, which governs abstract thought, planning, and judgment. Research has identified possible abnormalities in many other parts of the brain, including the temporal lobes, basal ganglia, thalamus, hippocampus, and superior temporal gyrus. These defects may partially explain the abnormal thoughts, perceptions, and behaviors that characterize schizophrenia. D Factors Before and During Birth

Evidence suggests that factors in the prenatal environment and during birth can increase the risk of a person later developing schizophrenia. These events are believed to affect the brain development of the fetus during a critical period. For example, pregnant women who have been exposed to the influenza virus or who have poor nutrition have a slightly increased chance of giving birth to a child who later develops schizophrenia. In addition, obstetric complications during the birth of a child-for example, delivery with forceps-can slightly increase the chances of the child later developing schizophrenia.

E Stressful Events

Although scientists favor a biological cause of schizophrenia, stress in the environment may affect the onset and course of the illness. Stressful life circumstances-such as growing up and living in poverty, the death of a loved one, an important change in jobs or relationships, or chronic tension and hostility at home-can increase the chances of schizophrenia in a person biologically predisposed to the disease. In addition, stressful events can trigger a relapse of symptoms in a person who already has the illness. Individuals who have effective skills for managing stress may be less susceptible to its negative effects. Psychological and social rehabilitation can help patients develop more effective skills for dealing with stress.

V Treatment Print Preview of Section

Although there is no cure for schizophrenia, effective treatment exists that can improve the long-term course of the illness. With many years of treatment and rehabilitation, significant numbers of people with schizophrenia experience partial or full remission of their symptoms.

Treatment of schizophrenia usually involves a combination of medication, rehabilitation, and treatment of other problems the person may have. Antipsychotic drugs (also called neuroleptics) are the most frequently used medications for treatment of schizophrenia. Psychological and social rehabilitation programs may help people with schizophrenia function in the community and reduce stress related to their symptoms. Treatment of secondary problems, such as substance abuse and infectious diseases, is also an important part of an overall treatment program.

A Antipsychotic Drugs

Antipsychotic medications, developed in the mid-1950s, can dramatically improve the quality of life for people with schizophrenia. The drugs reduce or eliminate psychotic symptoms such as hallucinations and delusions. The medications can also help prevent these symptoms from returning. Common antipsychotic drugs include risperidone (Risperdal), olanzapine (Zyprexa), clozapine (Clozaril), quetiapine (Seroquel), haloperidol (Haldol), thioridazine (Mellaril), chlorpromazine (Thorazine), fluphenazine (Prolixin), and trifluoperazine (Stelazine). People with schizophrenia usually must take medication for the rest of their lives to control psychotic symptoms. Antipsychotic medications appear to be less effective at treating other symptoms of schizophrenia, such as social withdrawal and apathy.

Antipsychotic drugs help reduce symptoms in 80 to 90 percent of people with schizophrenia. However, those who benefit often stop taking medication because they do not understand that they are ill or because of unpleasant side effects. Minor side effects include weight gain, dry mouth, blurred vision, restlessness, constipation, dizziness, and drowsiness. Other side effects are more serious and debilitating. These may include muscle spasms or cramps, tremors, and tardive dyskinesia, an irreversible condition marked by uncontrollable movements of the lips, mouth, and tongue. Newer drugs, such as clozapine, olanzapine, risperidone, and quetiapine, tend to produce fewer of these side effects. However, clozapine can cause agranulocytosis, a significant reduction in white blood cells necessary to fight infections. This condition can be fatal if not detected early enough. For this reason, people taking clozapine must have weekly tests to monitor their blood.

B Psychological and Social Rehabilitation

Because many patients with schizophrenia continue to experience difficulties despite taking medication, psychological and social rehabilitation is often necessary. A variety of methods can be effective. Social skills training helps people with schizophrenia learn specific behaviors for functioning in society, such as making friends, purchasing items at a store, or initiating conversations. Behavioral training methods can also help them learn self-care skills such as personal hygiene, money management, and proper nutrition. In addition, cognitive-behavioral therapy, a type of psychotherapy, can help reduce persistent symptoms such as hallucinations, delusions, and social withdrawal.

Family intervention programs can also benefit people with schizophrenia. These programs focus on helping family members understand the nature and treatment of schizophrenia, how to monitor the illness, and how to help the patient make progress toward personal goals and greater independence. They can also lower the stress experienced by everyone in the family and help prevent the patient from relapsing or being rehospitalized.

Because many patients have difficulty obtaining or keeping jobs, supported employment programs that help patients find and maintain jobs are a helpful part of rehabilitation. In these programs, the patient works alongside people without disabilities and earns competitive wages. An employment specialist (or vocational specialist) helps the person maintain their job by, for example, training the person in specific skills, helping the employer accommodate the person, arranging transportation, and monitoring performance. These programs are most effective when the supported employment is closely integrated with other aspects of treatment, such as medication and monitoring of symptoms.

Some people with schizophrenia are vulnerable to frequent crises because they do not regularly go to mental health centers to receive the treatment they need. These individuals often relapse and face rehospitalization. To ensure that such patients take their medication and receive appropriate psychological and social rehabilitation, assertive community treatment (ACT) programs have been developed that deliver treatment to patients in natural settings, such as in their homes, in restaurants, or on the street.

C Associated Problems

People with schizophrenia often have other medical problems, so an effective treatment program must attend to these as well. One of the most common associated problems is substance abuse. Successful treatment of substance abuse in patients with schizophrenia requires careful coordination with their mental health care, so that the same clinicians are treating both disorders at the same time.

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The high rate of substance abuse in patients with schizophrenia contributes to a high prevalence of infectious diseases, including hepatitis B and C and the human immunodeficiency virus (HIV). Assessment, education, and treatment or management of these illnesses is critical for the long-term health of patients.

Other problems frequently associated with schizophrenia include housing instability and homelessness, legal problems, violence, trauma and post- traumatic stress disorder, anxiety, depression, and suicide attempts. Close monitoring and psychotherapeutic interventions are often helpful in addressing these problems.

Socio-economic development and health

There are a number of ways in which the increasing socio-economic development of a nation can help improve the health of the population.

1. There is a correlation between mortality rates in the developing countries, especially amongst children, and the level of education of the parents of the children. For example, in Morocco, a mother who has completed 4-6 years of schooling, their child is 45% less likely to have died by the age of 2, compared with child’s mother who has had no school (Book 3, Page 54). Education improves the overall knowledge of looking after oneself and others, but also enables people to gain higher income levels, and thus, acquire purchasing power to buy the goods (if available), which will help them improve their quality of life.

2. Food provisions are a necessity to maintaining a healthy population. There are many facets to food, mainly the distribution and supply of food, and the quality and nutritional ingredients of food. Food needs to be of good, sustainable quality so that it provides people with the basic supply of vitamins and minerals to live, and has to be easily accessible so that everyone in the nation can benefit.

Developed countries have pioneered the way of preserving food for longer (i.e. use of plastics), and developing countries have benefited from this, but the developed world has also introduced new fear factors regarding food such as contamination (BSE, Salmonella etc) and additives, and, the long term effects of such advancements is beginning to materialise (Book 3, Page 306-307). Developing nations need to maintain a balance of growth, by producing enough food for the nations own consumption, but also growing food for exportation, which will improve their GNP and their overall growth as a nation.

3. Reducing the gap between the social classes will provide a better overall health and wealth of a nation. Those living in the lower social classes have a lower life expectancy than those in higher social classes (Book 3, Page 216). There are many tools and precautions that may be used to bridge the gap. Occupations within the social classes tend to be more manual and risk-based occupations such as mining or engineering. In recent times, Acts of Law have been passed by Governments to protect employees, and as such limit the risk involved in the work practices. By reducing the risk, the Government can enable the employees to work in a safe environment thus providing a longer and healthier work and social life.

Hantavirus: A Four Corners Study

When a new virus appeared in the Four Corners region, American scientists were stumped. What was causing such a quick death to such healthy people? Was there a potential epidemic on their hands? No one knew, and when they finally determined that a strain hantavirus was involved, many were shocked. This had to be something completely new to the hantavirus family and that was somewhat overwhelming. Normally, the hantavirus only affects the kidneys, but this new virus dealt with the upper respiratory area. This paper takes an in depth look at the history of the hantavirus as well as its infectious nature and replication process.

Hantaviruses first came into existence through human eyes during the Korean War. Over 2000 U. S. soldiers were affected with this unknown virus that was quickly found to be carried through field mice. The natural territory of this virus included parts of Japan, Korea, northeastern China, and southeastern and central Russia. Between 1955 and 1977, this virus caused many more infections along with fatalities. Throughout the 1970s, eleven other strains of hantaviruses were found in Korea and Eurasia. In 1976, Hantaan virus was isolated from the Apodemus agreavius coreae mouse.

Using the microscope, one could see the round microbes that were stacked in rows along the epithelial lining of the lungs (CDC website 6). Each infection still involved mild kidney infections. The same type of rodent always carried the virus, and people came in contact with the microbes through skin exposure or inhalation of infected animal feces or urine. Research continued on this virus and in 1981, it was first cultured in human cells. Many people were worried that since the virus was so prevalent in Korea that it possibly could be spread easily from boat to new land through trade.

When rats were tested in various harbors throughout the United States, the Seoul virus, a form of hantavirus, was found. In 1982, a study in Baltimore tested local rats and found that every rat over the age of two had the virus in their system (Garrett 539). Then individuals from two STD clinical-hospitals were tested and four cases of the Korean Hantavirus were found. The researchers took it one step further by testing the blood of humans that were undergoing proteinuria blood chemistry analysis as well as kidney dialysis patients.

Amazingly they discovered that 6. of the patients on dialysis had serum that reacted with Seoul hantavirus antibodies indicating that there had been an infection at some point. Cases of hantavirus continued to pop up throughout the United States. A Mexican immigrant died of internal hemorrhaging and kidney failure, and the disease was tied to a new strain of hanta: the Leaky virus. Not only was the disease infecting southwestern U. S. , but also deep in America’s inner cities. With the increase of rats in the cities, that increased the likelihood of the hantavirus infecting people.

But on May 14, 1993 there was something new that was infecting Navajo Indians in the Four Corners Area. This disease struck people quickly and it left them behind with lungs so severely fluid-filled that they weighed twice as much as normal (Garrett 529). Symptoms generally started similar to the flu: fever, muscle aches, and headaches. After a few hours or up to two days, the symptoms escalated to coughing and irritation in the lungs. Then within a few hours, the patients would become so hypoxic that they would be unable to absorb oxygen.

Slowly, the heart would stop and death would follow either caused by cardiac failure or pulmonary edema. By May 14th, there was a list of five healthy people who had died from this disease. When the lab work returned it showed no signs of plague bacteria in the victim’s blood. Worried, the head scientist pushed people to look through the medical records of all the recent unexplained respiratory deaths. The scientists determined that a disease known as acute respiratory distress syndrome (ARDS) was infecting these people.

Normally, this infected the elderly and burn victims, but for the five individuals in this area there was no connection. When searching for a possible chemical that might cause these symptoms, Cheek came across something known as phosgene. Initially the Germans used it during World War I and it was known that this chemical could cause symptoms of ARDS. This chemical had been banned from the United States. However, a sister compound known as phosphene had been used legally to kill prairie dogs. With the increase in the number of prairie dogs that winter and spring, Cheek thought they had found their solution.

But when he searched for this chemical in trailers used to store equipment for extermination throughout the area he found nothing. After the local doctors and hospitals were notified of these strange occurrences, more cases surfaced. Of the 19 people with similar symptoms, 12 had already died. Working with the CDC, a group of scientists came up with a list of possible explanations: an unknown chemical toxin, a new virulent flu strain, a new coxiella bacterium, anthrax, Crimean-Congo hemorrhagic fever virus, Hantaan virus, or something completely new.

When the lab obtained samples from the people from Four Corners, it was suggested that the samples be tested against antibodies for every virus that was available. Finally, on June 3, antibodies against a family of viruses called hantaviruses, cross-reacted in test tubes with blood from the patients. And then patient blood injected into mice from the compound showed an even stronger reaction to the hantavirus reagents. That helped to prove that the virus could reproduce and multiply in mice. However, there was some doubt that hantavirus was the culprit. Never had a strain of hantavirus ever caused respiratory infections.

Usually it was only involved with kidney disease. There was one undeniable factor that was intriguing the scientists: it was noted that during this research and the year previous there had been a 10-fold increase in the number of deer mice in the area. Because people were unconvinced that hantavirus was the culprit, traps were set up that could handle larger animals such as raccoons as well as smaller animals like mice and prairie dogs. All the traps contained a variety of animals, but by far one particular mouse, Peromyscus maniculatus, was found the most.

It is a brown, big-eared mouse with a white belly and tail and huge, black eyes deep in the skull. When these mice were tested, it was determined that they carried a strain of hantavirus. And by the middle of June it was evident that the Four Corners strain of hantavirus was one previously undiscovered. Soon fears of an epidemic came into the spotlight. Other cases of ARDS caused by hantavirus were found in East Texas, Nevada, northern California, Oregon, and then Louisiana and Mississippi. While the initial infections did match the Four Corners strain, the case in Louisiana was unique.

The particular deer mouse was not a native inhabitant in Louisiana, and the strain in the patient did not match the Four Corners strain. Surges of Hantavirus infections were not only occurring in the United States. Outbreaks were occurring in Germany as well as France, Belgium, and the Netherlands. Some believed that the decreased efforts to keep rat and mouse populations low may have been the reason behind the increased infections. Early in 1994, the CDC reported that there had been a total of fifty-five ARDS cases in sixteen different states. Thirty-two of the infected people died.

And also in 1994, the new microbe was officially named Muerto Canyon, after a valley located inside the Navajo nation where the Four Corners virus fist appeared. Hantavirus is able to induce two different infections in a person’s body. Hemorrhagic fever with renal syndrome (HFRS) is responsible for the infections caused by the Hantaan, Seoul, Puumala, and Prospect Hill strains. HFRS is a generalized infection with fever, hemorrhages, and acute renal insufficiency. Approximately 150,000 to 200,000 cases of HFRS involving hospitalization are reported each year throughout the world, with more than half in China.

Death rates vary from 0. 1% for HFRS caused by Puumala to 5-10% from HFRS involved with HTN viruses (CDC 2). The clinical course of HFRS follows five overlapping stages: febrile, hypotensive, oliguric, diuretic, and convalescent. The course of action usually starts with a severe headache, backache, fever, and chills. When the febrile stage ends, hypotension can develop and last for hours up to days. This is where nausea and vomiting are most common. One-third of deaths occurs during this phase caused by vascular leakage and acute shock.

About one-half of the deaths occur in the oliguric stage because of hypervolemia. Those that survive those stages may progress to the diuretic phase and show improved renal function, but may still die of shock or pulmonary complications. The last stage can last for weeks to months before recovery is complete. Luckily, there is a somewhat effective treatment for HFRS. Unfortunately, it is only effective if used early in the course of the disease. The treatment known as Ribavirin is a broad-spectrum antiviral drug. It is effective against RNA viruses in vitro and in vivo.

This treatment has shown a reduced mortality when administered early enough (Care 1). However, the treatment is not effective when the disease is advanced. There is one adverse side effect of the treatment; a person can possibly develop of anemia. This side effect is reversible once a person stops taking the drugs. Scientists do not believe that this treatment is successful for the other type of infection caused by hantavirus: hantavirus pulmonary syndrome (HPS). Hantavirus pulmonary syndrome (HPS) was first detected in the United States in 1993.

Infection through HPS occurs at a much faster rate. Following a three-day prodromal period, patients quickly developed interstitial pulmonary edema and respiratory failure. The main histopathological features were seen primarily in the lung and spleen. The noncardiogenic pulmonary edema, which is associated with high mortality rate, has been attributed to an increased permeability of the pulmonary capillaries (Bhide 1). The single most common feature of this illness was a fever that occurred in 98% of the people infected in the Four Corners area.

In addition, myalgia, vomiting, weakness/fatigue, coughing, diarrhea, nausea, shortness of breath, and headaches also occurred in patients. The mortality rate of HPS is much higher than HFRS at 50% of people effected dying. Since the symptoms were so general, it is often easy to initially think that something else is the cause of the problems. In HPS, capillary leakage was largely localized in the lungs, rather than in the retroperitoneal space, and the kidneys are largely unaffected. The Sin Nombre (SN) virus has caused most of the cases in the United States.

In HPS, death occurs from shock and cardiac complications, even with adequate tissue oxygenation. Although there appears to be significant difference between the two types of infection, there are points when the two intermingle. For example, the Bayov virus and the Black Creek Canal virus, both cases of HPS can exhibit renal involvement similar to HFRS. And there have been several cases of HFRS that had pulmonary manifestations. Although there are many differences between the two, they do have something in common: pathogenetic features.

Both have capillary injury that can lead to hemorrhages and shock in HFRS or pulmonary edema and suffocation in HPS (Plyusnin 2677). Hantaviruses belong to the Bunyavirus family. In this family there are five genera: Bunyavirus, Phlebovirus, Nairovirus, Tospovirus, and Hantavirus. Unlike other members of Bunyavirus, which are arthropod-borne, the hantavirus is rodent-borne. Hantaviruses are negative-stranded RNA viruses with a tripartite genome that consists of a large (L), medium (M), and small (S) segment (Rodriguez 99). They are spherical and enveloped. The L protein acts as a replicase, transcriptase, and endonuclease.

The M and S code for two surface glycoproteins G1 and G2 and a nucleocapsid protein (N) respectively. The envelope glycoproteins are thought to be the major elements involved in induction of immunity to hantaviruses. Genomic RNA of hantavirus shows relatively few differences in length between the L and M segments. However, the S segment varies in length mainly in its 3′ noncoding region. The noncoding region specific to the S segment is made up of numerous imprecise repeats. Both the 3′ and 5′ ends of the hantavirus RNA are highly conserved and complementary and therefore are capable of forming panhandle structures.

The panhandles are about 17 bp long. In most types of hantaviruses 14 out of the 17 bases are identical in all three genome segments and the complementarity of the termini is incomplete, with a mismatch at position 9 and a pairing of U-G at position 10 (Kukkonen 2615). It is thought that the panhandle-like structures serve a role in the regulation of viral transcription and replication. The ends of the genome contain three nucleotide repeats which are suggested to be involved in the proposed prime-and-realign mechanism of replication resulting in 5′ ends containing only monophosphate.

The S segment 3′ NCR represents the most puzzling aspect of the hantavirus genome. Within a certain hantavirus type the length and sequence of this region does not change thereby leading to the conclusion that the S segment has a functional role. But between different hantavirus types, the 3′ NCR varies widely in length and in sequence. Some believe that the 3′ NCR participates in something like packaging, then there are two possible explanations for the differences.

First, there may be a molecular mechanism operating that differ from host to host or the secondary structure of the 3′ NCR is crucial for its proper activity. The entire genomic sequence of SNV (the Four Corners disease) has been determined by using RNA extracted from autopsy material as well as RNA extracted from cell culture-adapted virus. The L RNA is 6562 nucleotides in length; the M RNA is 3696 nucleotides, and the S RNA is 2059 nucleotides in length. Replication of the hantavirus occurs in the host cell cytoplasm.

Attachment is mediated by an interaction of either G1 or G2 or both integral viral envelopes. In the entry and coating phase, there is endocytosis of virions and a pH-dependent (acidic) fusion of viral membranes, release of three (S, M, and L) RNA segments and proteins in the cell cytoplasm (Bhide 4). Primary transcription occurs with the negative sense vRNA to virus-complement mRNA from the genome templates using host cell derived capped primers and viron-associated polymerase. The association of the L protein with the three nucleocapsid species initiates transcription of viral genes.

A Negative-sense genome serves as the template for the L protein to produce positive-strand genome and mRNA. The viral L protein is also thought to have an endonuclease activity that cleaves cellular messenger RNAs for the production of capped primers used to initiate transcription of viral mRNAs. As a result of this “cap snatching,” the mRNAs of hantaviruses are believed to be capped and contain non-templated 5″ terminal extensions. Translation follows where it is thought that the viral L and S segments are translated at free ribosomes while the M mRNA is translated in the endoplasmic reticulum.

Synthesis of cDNA must take place in order to serve as the template for genomic RNA. Switching between transcription and replication may depend on the presence of newly synthesized nucleocapsid protein. The secondary transcription amplifies the synthesis of mRNA species. There is continual translation and replication taking place. In the appendix is a diagram of the coding strategies of the RNA segments. At the morphogenesis stage, an accumulation of G1 and G2 form heterodimers and are transmitted from the endoplasmic reticulum to the golgi complex, where glycosylation is completed.

Hantavirions are believed to form by association of nucleocapsids embedded in the membranes of the Golgi,and generally budding goes into the golgi cisternae. Lastly, nascent virions are then transported in secretory vesicles to the plasma membrane and released by exocytosis. There has been much new research involving hantaviruses. Although there are approximately 30 different sero/genotypes known, only four have been completely sequenced: Hantaan, Puulama, Pirparinen, and Sin Nombre.

One article dealt with the mechanisms of completing a gene sequence and how closely related the strains are to each other. The L protein is the longest and is therefore the most difficult to sequence. However, the sequences of the L and termini are essential for establishing a reverse-genetic system. Previously the S and M were sequenced apart from the 5′ and 3′ termini. The L protein of the strain TUL is the most closely related with the L proteins of two strains of Puulama virus, followed by the L proteins of the Sin Nombre, Hantaan, and Seoul viruses.

Close to the carboxyl terminus of the L protein, there is an acidic region of 38 amino acids which have been also described for the L proteins of Puulama virus and Sin Nombre virus. Completion of the TUL L sequence allowed comparison of the genome segments and proteins of 6 completely sequenced hantaviruses. All the sizes were similar with the exception of the S segment in which the size of the 3′ noncoding varies. This conforms with the established view that hantaviruses have been co-evolving with their natural hosts. The Tula hantavirus was the first hantavirus to be sequenced that is not linked to any human disease.

Hantaviruses are viruses that are able to diverge from their normal sequence. When the outbreak of 1993 occurred in Southwestern United States, no one had a clue about what was causing the death of these people. When hantavirus was found to be the cause of the illnesses, it was hard to believe. But it was true. A mutation had occurred that had caused the hantavirus to change its entire mechanism of infection. From the research of the article above, it becomes apparent that hantaviruses are constantly evolving from each other.

Schizophrenia a mental disorder

When I lived in Germany, I had a friend who played on my High School tennis team. On a sunny afternoon after our tennis lessons we decided to drink an ice tea and have a little snack at the tennis snack bar. We started talking about tennis strategies, but my friend, Thomas, was kind of depressed and sad. When I asked him what was really bothering him, he started tell me about his sick mother. He tried to explain her disease to me, but I could not understand it. He said, my mother is suffering from persecution mania and in addition, she sometimes talks about things that make no sense.

Nevertheless, I saw Thomas again after the summer holidays and I asked him how his mother was doing now. He responded with a very sad voice and also had tears in his eyes because his mother committed suicide and the doctors told him that she had schizophrenia.  Schizophrenia is a mental disorder marked by the loss of contact with reality. When a person’s thinking, feeling, and behavior is abnormal, it interferes with his or her ability to function in everyday life. Delusions, hallucinations, and irregular thinking and emotions are produced. If these signs are present, he or she may have the mental illness called schizophrenia.

About one hundred years ago, schizophrenia was first recognized as a mental disorder and researchers have been searching for a cure ever since. The cause of schizophrenia is still unknown today and scientists have concluded that schizophrenia has more than one cause. Scientists have developed dozens of theories to explain what causes this disease, but researchers are focusing on four leading theories: the Genetic Theory, the Environmental Theory, the Biochemical Theory, and the Bio-Psycho-Social Theory. The Genetic Theory argues that schizophrenia is caused by traits in a person’s genetic makeup.

A normal person has twenty-three pairs of chromosomes. Each pair contains one chromosome from each parent. In corresponding locations called loci of each chromosome, the genes for specific traits are located. Some researchers believe that mutations with these genes can cause schizophrenia. We inherit our genes from our parents, but this does not mean that the parents of a schizophrenic are mentally ill. Problems in a persons genetic make up could come from mutated chromosomes or recessive genes. In an attempt to prove this theory, scientists study identical twins.

Due to the fact that identical twins have identical genetic make up, researchers are able to determine if heredity is the main cause of schizophrenia. However, evidence seems to disprove this theory. In some instances, both identical twins are schizophrenics and other times only one is affected. To defend this theory, it should be noted that this research is complicated. Identical twins are relatively rare, especially twins who are both diagnosed with schizophrenia. Studies have also shown that children with one parent diagnosed with schizophrenia have a ten percent chance of suffering from schizophrenia.

When both parents are schizophrenic, their risk raises to approximately forty percent. Little is known about the Environmental Theory. The theory is built mainly on the effects of stress on human behavior. Most researchers agree that stress alone cannot be the main cause of schizophrenia. Most researchers agree that stress could possibly trigger or worsen the symptoms when the illness is already present. Other researchers focus on drug abuse. Like stress, certain drugs such as amphetamines can make psychotic symptoms worse if a person already has schizophrenia. Furthermore, these drugs can, in a sense, create schizophrenia.

Other researchers that support the Environmental Theory believe that “slow viruses” may be to blame. Slow viruses are viral infections that go undetected for long periods of time. Signs and symptoms are delayed and may occur many years after the first infection. The Bio-Chemical Theory suggests that schizophrenia is caused by mixed up signals to the brain. When something acts upon one of our senses, electrical impulses are sent to the brain. These impulses allow us to feel, smell, taste, hear, see, and they also manage our thought processes. In our body we have a complex nervous system.

For example, there is not simply a single nerve that travels from our feet to our brain. In order for information to be sent to the brain, the nerves must interact with each other, translating the messages from one nerve to the next. Because the system is so complex, it is possible for the signal to get mixed up. When this happens, our brain may misinterpret the signal or may not receive it at all. If the signal does get mixed up on the way to the brain, the make up of the impulse can undergo a chemical change, resulting in irregular thought processes and abnormal behavior.

Scientists have undergone in-depth studies on a chemical in the brain called dopamine. They believe that schizophrenics have higher levels of this chemical than a mentally sound person does. To experiment this theory, researchers have injected animals and humans with amphetamines increasing the amount of dopamine reaching the brain. Following the injection, the animals exhibit the same type of behavior as humans who have been diagnosed with schizophrenia, such as standing still for long periods of time or continuously pacing.

In humans, research has shown that when given small doses of amphetamines the amount of dopamine in the brain slightly increases. Although the increase is small it still causes delusions and hallucinations. In conclusion, researchers believe that an increased amount of dopamine to the brain causes abnormal behavior, however, they cannot safely say that this is the sole cause of schizophrenia. The Bio-Psycho-Social Theory combines all of the previous theories. Some researchers believe that bio-chemical abnormalities are a contributing factor but that other events must also occur.

They suggest that environmental and social problems have to be considered along with biological problems. Social scientists believe that no chemical factors are involved, instead they believe “mental disorders are described as a consequence of human motivations, drives, and unconscious forces. ” (Schizophrenia, Douglas W. Smith). These scientists suggest that people become overloaded with stress, information, and stimulation. When this happens they lose their ability to cope with the anxiety which accompanies these stressors. Instead of dealing with their problems they seek peace in their own world.

For example, it is common for individuals to return to “happy times” in their life such as infancy and they begin to act like a child. Scientists have asked if there is a particular nationality that suffers more than any other. Studies have been done in Ireland and it appears that one in every twenty-five people show signs of schizophrenia, opposed to one in every hundred in the United States. E. Fuller Torrey has spent a great deal of time researching a number of schizophrenics in Ireland. Torrey has discovered that the population of schizophrenics has been rising since the 18th Century.

After he made his findings public other scientists began asking questions as to why the Irish are suffering so badly. The basis of their research has focused around their diet, mainly potatoes. If potatoes are exposed to too much sunlight they produce an alkaloid called solanine. Solanine has the ability to induce gastro-intestinal problems and psychotic symptoms such as hallucinations. The idea that schizophrenia in Ireland is caused by the potato is not as far fetched as people might believe. Closer to home, a mental disease that afflicted southerners, pellagra, was caused solely from the lack of the vitamin niacin.

This may lead us to believe that a mental disorder can be caused by too much exposure or lack of a certain type of food. Another possibility, is the amount of insecticides the Irish consume from the potato. At planting time farmers use high amounts of chemicals on their potatoes to protect them from insects. When an insect ingests the chemicals they are easily killed because the chemicals interfere with the normal functioning of the nervous system by disrupting the transmission of nerve impulses. If large doses of these chemicals have the same affect on humans as they do on insects this could answer the Irish dilemma.

These toxins could be especially dangerous to women who are pregnant by damaging the fetal nerve tissue. Despite all these theories, it is quite evident that the cause of schizophrenia is still a mystery. It also seems clear that this disease is not caused by any one factor. As of now, researchers are leaning toward the Bio-Chemical theory. The brain is the most complex organ in the human body and an imbalance of the brain’s chemical system has been suspected as the main cause of schizophrenia for a long time. As previously mentioned, some researchers point to an excess of or lack of dopamine a chemical substance in the brain.

Others suspect different neurotransmitters which are substances that allow communication between nerve cells. The area of the brain thought to be affected in most cases of schizophrenia is the limbic system. This is the area of the brain that acts like a gate for incoming stimuli or messages. In any case, it appears that all schizophrenics have some sort of abnormal chemicals that are not found in healthy people. Schizophrenia is a complicated and difficult disease. It is hard to diagnose mental disorders because there are no physical indications. In the case of schizophrenia, a person can be mistaken for a shy child or person.

They are not in touch with their surroundings. Besides recognizing these symptoms, other methods of diagnosing schizophrenia is with the use of pictures and drawings. The doctor will listen to what the patient “sees” and analyze it. In doing this it is possible to determine their state of mind. Another process used in the diagnosis is Rorschach, better known as inkblots. These inkblots are used worldwide and Doctors have analyzed normal and abnormal answers. By listening to answers a doctor can determine what a common answer from a schizophrenic is. A normal persons answer would be something ordinary like a person or a mountain.

A person suffering from schizophrenia would see something weird like a beast or some conflict. In the past individuals have schizophrenia were labeled as crazy and families were embarrassed to have a mentally ill person in their family. These people would be isolated in a mental institution with bars on the windows, the building being dark and desolate. Also a common treatment for schizophrenia was insulin shock treatment. A patient would receive enough insulin to induce a seizure. This treatment worked for very few patients. The environment that these patients lived in was more damaging to them than helpful.

Mental illness was not accepted or thought of as a disease. When patients were taken to the hospitals it was common for them to be left there. Family would generally desert them because the environment was terrible, family and friends dreaded visiting. The modern day treatment for schizophrenia has many aspects. It involves medicine, counseling, electro-convulsive therapy and hospitalization. The medications most commonly used are; anti-psychotics which are used to help calm agitation, diminish destructive behavior and hallucinations and may help correct disturbed thought processes.

Secondly are anti-depressants, normally slow acting drugs but if no improvement occurs within three weeks, they may not be effective at all. Thirdly, are mood normalizers such as lithium carbonate used in manic depressive states to help stabilize mood swings which are part of the condition. Lastly, tranquilizers are used for calming agitation and anxiety. Unfortunately, along with these medications come some side effects such as inability to concentrate, and tiredness. However, there are side effect controls available. Electro-convulsive therapy is the application of electrical currents to the brain.

It is mainly used for patients suffering from extreme depressions who are suicidal and who seem unable to shake the depression under any circumstances. Unlike in the past, hospitals now have a happy environment. The family is involved with the treatment of the patient. The family themselves try to cope. They learn how things can change when the patient returns home. After the patient is released it is possible for them to go on living a normal life. A schizophrenic will most likely have to take doses of medication for the rest of their life.

Side effects will be felt and unreasonable fears may still be evident but their life will be basically normal. Researchers anticipate massive progress on the treatment for schizophrenia in the future. They believe hospitalization will be a thing of the past. Patients will be injected with medications monthly and attend group therapy with their family. The disease is detected early because of education and research. The drugs used for treatment have few side effects. Scientists hope that in the years to come treatment for schizophrenia will be non-existent. Researchers hope to pinpoint the cause and eliminate it at birth through screening.

With this treatment schizophrenia could be wiped out. Although it may surprise some people, schizophrenia is a common disorder, striking one person in every hundred. For most people, young adulthood means leaving home, starting a job and starting a family. For most schizophrenics, young adulthood means first admission to a psychiatric hospital. An unfortunate reality for young schizophrenics is the need for hospitalization during their most vibrant and productive time. The age of the first admission is younger for men than women, early twenties for males and mid-twenties for women.

The reasoning behind this variation is not exactly known but there is speculation. One biological theory that exists is the help of the female sex hormones. Scientists speculate that these hormones may help delay the horrifying symptoms that afflict schizophrenics. Another question raised is who gets schizophrenia more commonly, men or women? Studies have shown there is no great variation in the numbers but in the severity of the symptoms. Men seem to suffer more severely. Scientists have attempted to explain this through differences in the brain. Research has shown schizophrenia tends to affect the left side of the brain.

Males are generally “left- brained” or “right-brained” while females have less specialization on either side of the brain. Yet another startling fact about schizophrenia is the amount of schizophrenics who are winter born. A scientific explanation for this is seasonal viruses, which may have infected the fetus but remain dormant or not as active until many years later. This fact was discovered as early as 1929 but was ignored for about forty years. By the late 1960’s studies were being done in six countries using over 125,000 people in their research.

Another theory is the lack of nutrition, babies developing during the summer months do not seem to receive as much protein, thus causing abnormalities in the child. Although schizophrenia is a serious and devastating disease the outcome is not always bad. At least 25% of the treated schizophrenics recover fully to live a normal life in every aspect. Another group are not so well off and remain severely psychotic, this occurs in about 10% of the treated schizophrenics. The other 65% go through periods of psychosis and phases of recovery. An optimistic fact about the disease is people tend to “grow out of it” in their mid-life.

Prenatal Screening Essay

Screening for Down syndrome is available to about 53. 5% of mothers on a maternal age basis, and the remaining 46. 5% of health boards provide serum screening for all ages. There are several methods used in prenatal screening, these are usually used separately, and a number of factors are taken into account to determine which method should be used. Amniocentesis has been around for 20 years and is probably the most well known screening method. It involves testing a sample of the amniotic fluid surrounding the foetus, ultrasound is used to guide a needle through the abdomen, into the womb and a small amount of amniotic fluid (20ml) is removed.

The procedure is usually carried out at 14-16 weeks. Amniocentesis tests for chromosome disorders, and is 99. 8% reliable for chromosome number, there is however a risk of miscarriage (usually 1/250 or less) after the procedure. This is one of the reasons why amniocentesis has only been offered to over 35’s (since they have a much higher risk of having a Down syndrome child)(Webb 1990). Previous studies on amniocentesis concentrated on problems that might arise during pregnancy or immediately after, these studies found that children whose mothers had amniocentesis are more likely to have breathing problems in the first few days after birth.

A study performed by Jo-Anne Finegan in Toronto followed 88 women who had, had amniocentesis, there was an increased incidence of ear infection in this group. Finegan tested the stiffness of the eardrum and found children in the amniocentesis group were more than three times as likely to have abnormal readings. It is thought that there is a disruption of the delicate balance of pressure across the eardrum when the amniotic fluid is removed, which could cause the problems(Webb 1990).

Chorionic villus sampling is another form of sampling, it involves taking a small piece of placenta and genetic testing is carried out on it, there is a slightly higher chance of foetal loss with this procedure (Dick 1996). A more recent form of prenatal testing involves serum markers. Blood is taken from the pregnant women and the maternal blood is tested for three hormones, this test is called the ‘triple screen’ test. The three hormones tested are alpha foeto-protein (AFP), human chorionic gonadotrophin (HCG) and oestradiol (E3).

AFP is based on the fact that Down syndrome foetuses tend to be smaller on average, have smaller placentas and thus secrete less AFP. All three hormones can be tested individually, but are not so reliable this way. AFP results detect 20%-25% if carried out alone (Cuckle 1984), tests combining more than one measure detected 48%-91%. A study using AFP and HCG detected 90% of cases in women over 35 and 43% in women under 30, it also found that detection rates were better when the test was performed before week 17 (Gouldie et al 1995).

Prenatal sonography looks at the foetus using ultrasound, by measuring the iliac angle in the pelvis the risk of Down syndrome can be measured. A study performed shows that the mean iliac angle is 60o for normal foetuses and 75o in foetuses with Down syndrome, by measuring the iliac angle in foetuses the liklihood of Down syndrome can be worked out, for example if the iliac angle is 50o the liklihood is 1/588 of the foetus having trisomy 21, if however the angle is 80o then the chance is 1/50. This type of prenatal testing although not as reliable as amniocentesis is much safer.

Saridogan et al 1996 pointed out a number of reasons why Down syndrome may not be detected, first of all women may decline the test, this may be due to ignorance of the test or to cultural/religous reasons. Another reason may be due to the late presentation of the woman, as stated above testing before week 17 gives the best results. The triple test is not 100% reliable, there are incidences when there is a negative test, and the child is born with Down syndrome the reason for this is not always known. Prenatal Screening Procedures In an uncomplicated pregnancy, expect about a dozen doctor visits

First VisitBlood tests: To check the woman’s blood group and sometimes, to check for presence of hepatitis B virus, which might be transmitted to the baby. Cervical smear test: To test for an early cancer of the cervix (if a test has not been performed recently). Also called a Pap smear. First Visit and Throughout the PregnancyBlood tests: To check for anemia in the woman, and in women with Rh-negative blood groups, to look for the presence of Rhesus antibodies. Urine test: To check for proteinuria, which could indicate a urinary tract infection or preeclampsia. Blood and urine test: To check for diabetes mellitus.

Blood pressure check: To screen for hypertension, which interferes with blood supply to the placenta and is a sign of preeclampsia. First Visit and After ANY InfectionBlood tests: To screen for rubella, which can cause defects in the baby, and for syphilis and HIV (the AIDS virus) which can also be passed on. First 12 WeeksChorionic villus sampling: May be performed if there is a risk of certain genetic (inherited) disorders being passed on. 16 to 18 WeeksUltrasound scanning: Is carried out to date the pregnancy accurately and to detect any abnormalities present in the fetus.

Amniocentesis: Carried out on older women and those with spina bifida or Down’s syndrome to detect possible abnormalities in the fetus. Blood test: In some cases, the amount of alpha-fetoprotein in the blood is tested to determine whether the baby has spina bifida. Fetoscopy and fetal blood sampling: In some cases, these are carried out if there is doubt about the normality of the baby. High-risk or overdue pregnancies Blood and urine tests: To assess placental function and fetus health. Electronic fetal monitoring: To check on the fetal heart beat.

Acquired Immune Deficiency Syndrome(AIDS)

In 1918 the United States experienced one of the worst epidemics in its history. With 500,000 dead in a matter of 6 months, the Spanish influenza left its mark. With approximately 11. 7 million dead worldwide, Acquired Immune Deficiency Syndrome(AIDS) is still leaving its mark. It is a pandemic the likes of which the world has always feared to see. The HIV virus comes in several varieties, yet they kill basically the same. Our understanding of this virus and how it works is essential to finding its cure, and to preventing its spread. Who it affects and the reasons for its spreading are also important to fight against it.

And finally, what can be done to treat and prevent it is essential. According to the World Health Organization we began to see what AIDS truly was in the late 1970s to early 80s, mostly in men and women with multiple sex partners located in East and Central Africa, but also in bisexuals and homosexuals in specific urban areas of the Americas, Ausrtalasia and Western Europe. Aids was and is spread still through infected hypodermic needles which drug abusers are affected by, but also through transfusion of the blood and its components.

And sadly, whenever a mother is infected, the unborn child will almost positively receive the virus before, during, or after the pregnancy. The viruses which cause AIDS, otherwise known as Human Immunodeficiecy Viruses(HIV) were first discovered in 1983 cooperatively by Dr. Robert Gallo of the National Cancer Institute and Dr. Luc Montagnier of the Pasteur Institute in France. Aids is caused mainly by the HIV-1 virus, while the HIV-2 virus is less pronounced among those infected.

Scientists are puzzled as to why this dominant HIV-1 virus has 10 different genetic subtypes, some think that it is so the virus will survive no matter what. HIV is part of a group of viruses called retroviruses. This category basically describes how the virus transmits and reproduces itself. Which is to say that upon entering the body the virus attaches itself to a T-4 cell(T-Helper cell), which is the type of cell that marks the bad things in our body so that another cell, the B-lymphocyte, can activate the production of antibodies, which are what would normally kill the virus.

So, after attaching itself to this cell it then injects its viral replicating DNA in, which then copies itself on to the cells DNA, thus changing the whole function of the cell from killing the foreign agents which enter our body, to producing more of the virus that will eventually lead to the death of our body, because the cell is then used as a manufacturing plant for the virus. The one cell that entered your body is thus turned into 500, which then turns into 25,000, then 12,500,000.

The virus is not strong merely because it replicates, however, it is strong because of what it replicates on, which is the helping cell of your immune system. But the most bizarre thing of the whole virus is that it doesnt kill you. It only weakens your immune system so other viruses and even bacteria can finish the job. The first set of symptoms are called AIDS-related complex(ARC). These symptoms include fever, diarrhea, weight loss, and fatigue. These are only signs that you might have the virus HIV, and are not the full-fledged symptoms of AIDS.

The two most common infections seen in AIDS patients are Pneumocystiscarinii Pneumonia(PCP), which is a parasitic infection of the lungs, and Karposis Sarcoma(KS), which is a type of cancer. The purplish dots on the skin that are usually associated with AIDS are from KS. Other common infections are non-Hodgekins lymphoma, primary lymphoma of the brain, severe infections with yeast, zytomegalovirus, herpes, and parasites such as taxoplasma or cryptosporidia. Some neurological disorders are: chronic aseptic meningitis,focal deficits, hallucinations, and progressive dementia.

So as one can see any way it can open you up to an infection, is a bad way. The full-blown AIDS patient is usually very fragile and weak, having to be placed in hospital care because they find it hard to breathe. The slightest breeze, sometimes sets their whole body into a shiver that might not go away for a minute or a day. They usually have a constant fever, and an even more persistent wheeze of a cough, wheeze, because they dont have enough strength in their body to actually cough right. It is estimated that one-quarter to one-half of all those infected will develop AIDS within 4-10 years.

This estimate, is said to be very shaky, because scientists are saying the percentage will be higher. People with the virus, however, can exhibit no symptoms, or mild symptoms for sometimes up to 20 years. It was once thought that homosexuals and bisexuals were the only ones infected and getting infected by HIV, but now it is known that it can be transmitted by any sex preference, gender, race, and nationality. The main HIV viruses are only transmittable through the direct exchange of bodily fluids like semen, vaginal excretions, and blood.

But there is a virus, though only reported a few times, that is transmitted through the saliva in our mouths. Could it be that AIDS is the ultimate punishment for promiscuity? Could this be Gods way of saying, stop messing around down there? By the end of 1997 11. 7 million were dead because of it, and 2. 7 of those million were under the age of 15. More recently a report from the United Nations Program on HIV/AIDS(UNAIDS) and the World Health Organization(WHO) stated that 50% of the 5. 8 million newly infected people in 1998 were in the age group of 15-24.

These are frightening statistics, because now HIV has become the plague of the younger generation, which means that it will spread undoubtedly. The treatment for AIDS has progressed immensely in the past few years alone. Getting told that you are HIV positive no longer means that you were just given a death sentence. Conventionally, the normal AIDS patient would have to require retroviral intervention in addition to lymphoma, or whatever else they might have, treatment, which would usually be chemotherapy and AZT or inosine pronobax which normally extends the ARC period of the patients life.

This treatment would probably still be in effect, if it werent for the increased pressure put on by the AIDS activists, polititans, and people. Now however, drug cocktails are the most effective. In June of 1997, a federal task force released new guidelines, calling for early treatment with the use of 2 nucleosid analogues(category to which AZT belongs) and 1 pro tease inhibitor. So if the government says its ok then it must be. This combining of different drugs is not a cure in the least, even though one doctor stated that with his patients all traces had been eliminated from the bloodstream!

Dont get to excited though, because he forgot to mention that there were traces still found in the lymph nodes! So the drugs are really only used to manage the life one would live if infected. The President made a statement challenging the scientists of the United States to find a cure by 2007. The scientific community was displeased with his comment, because he has yet to mandate the appropriate funds for this challenge. The reason AIDS is a pandemic and not an epidemic, is because it is prevalent throughout a whole country,continent and world. I think that a solution to this societal problem is quite a monumental task.

It would require at least half the worlds cooperation. But before any of the healing can start, the world as a whole must come to the decision that AIDS needs to be stopped, killed, annihilated, whatever, youd like to call it. And when I say the world, I dont mean its leaders, I mean the people, the masses. The societal opinion and feeling about AIDS needs to change. We need to address why it is spreading still, even though almost every person on Earth knows what it is. We need to bring out in the open, as Swift did in Gullivers Travels, the problems of our society.

More specifically, we need to talk with our youth and try to stop promiscuity before it happens. We need to make sure that our children know how to use protection, when they do have sex, even it makes us feel awkward, or like were showing them too early. The question becomes would we rather our children learn from people you dont even know, or would we rather teach them ourselves? The fate of many will depend less on science than on the ability of large numbers of human beings to change their behavior in the face of growing danger.

Addison’s disease Essay

Addisons disease is a disorder of the endocrine system. It is a hormonal disorder that can strike anyone, any gender at any age. Addisons disease has also been called Adrenal Insufficiency (hypocortisolism) because the root of the disease is in the adrenal gland not producing enough of the hormone cortisol, or sometimes not enough of the hormone aldosterone to satisfy the bodys needs. Cortisol is in the class of hormones called glucocorticoids and affects almost every organ in the body.

One of the most important functions of cortisol is to help regulate the bodys response to stress. Cortisol is also responsible for other necessary functions including: helping to maintain blood pressure and cardiovascular functions, helping to slow the immune systems inflammatory response, helping to balance the effects of insulin in breaking down sugars for energy, helping to regulate the metabolism of proteins, carbohydrates, and fats, and helping to maintain proper arousal of sense of well being.

The amount of cortisol is precisely balanced and regulated by the brains hypothalamus. Aldosterone is in a class of hormones called mineralocorticoids which is also produced by the adrenal glands. The main functions of aldosterone are to help to maintain blood pressure and helping the kidneys retain needed sodium and excrete unwanted potassium to maintain the balance of water and salt in the body. When adrenal insufficiency occurs, there are many symptoms that begin gradually and therefore the disease can go undiagnosed for years.

Some of the most common symptoms are chronic fatigue, muscle weakness, loss of appetite, and weight loss. Some symptoms that can also occur in some patients are nausea, vomiting, and diarrhea. The previously mentioned symptoms are fairly common with many different disorders however some of the most defining symptoms of Addisons disease are low blood pressure that drops when standing, and skin changes or hyperpigmentation that is most visible on areas of the body such as scars, knees, elbows, knuckles, lips, and skin folds.

Patients can also suffer from depression, irritability, and a craving for salt, and amenorrhea in female patients. Diagnosing Addisons disease is most accurately done with biochemical laboratory tests which consist of an injection of ACTH then monitoring the ACTH output in a patients urine and/or the levels of ACTH in the patients blood to see how the persons body reacts to the injection. Physicians can also detect Addisons disease by an insulin-induced hypoglycemia test, which monitors how the adrenal glands, the pituitary glands, and the hypothalamus respond to stress.

In this test the patients levels of blood glucose and cortisol are measured over an hour and a half following an injection of fast acting insulin. Physicians may also use test such as x-rays of the adrenal glands to check for calcium deposits that may indicate TB. Physicians my also use different imaging tools such as a CT scan to compare the size and shape of the patients pituitary gland. The pituitary glands of persons suffering from Addisons disease tend to be smaller in size and misshapen than those persons who do not have Addisons disease.

The most common treatment for Addisons disease is hormone replacement therapy. During this treatment, patients are given cortisol and/or aldosterone hormones with similar steroids in order to make up for the hormones that the body is failing to produce on its own. Due to the fact that there is no permanent cure for Addisons disease, once the patients are started on the therapy regimen of replacement hormones, they will more than likely stay on them for the duration of their lives.

If a patient should happen to fall into an addisonian crisis they are instructed to administer an injection of hydrocortisone, saline, and dextrose to bring them out of the crisis. The injection works to replace the cortisol, raise the blood pressure and also raise the blood sugar levels of the patient. Although Addisons disease can be life threatening, it is possible to live a fairly normal life with the proper treatment. President John F. Kennedy was diagnosed with Addisons disease and, with the proper treatment, was one of our countries greatest leaders.

Schizophrenia – serious, chronic mental disorder

Schizophrenia is a serious, chronic mental disorder characterized by loss of contact with reality and disturbances of thought, mood, and perception. Schizophrenia is the most common and the most potentially sever and disabling of the psychosis, a term encompassing several severe mental disorders that result in the loss of contact with reality along with major personality derangements. Schizophrenia patients experience delusions, hallucinations and often lose thought process. Schizophrenia affects an estimated one percent of the population in every country of the world.

Victims share a range of symptoms that can be devastating to themselves as well as to families and friends. They may have trouble dealing with the most minor everyday stresses and insignificant changes in their surroundings. They may avoid social contact, ignore personal hygiene and behave oddly (Kass, 194). Many people outside the mental health profession believe that schizophrenia refers to a split personality. The word schizophrenia comes from the Greek schizo, meaning split and phrenia refers to the diaphragm once thought to be the location of a persons mind and soul.

When the word schizophrenia was established by European psychiatrists, they meant to describe a shattering, or breakdown, of basic psychological functions. Eugene Bleuler is one of the most influential psychiatrists of his time. He is best known today for his introduction of the term schizophrenia to describe the disorder previously known as dementia praecox and for his studies of schizophrenics. The illness can best be described as a collection of particular symptoms that usually fall into four basic categories: formal thought disorder, perception disorder, feeling/emotional disturbance, and behavior disorders (Young, 23).

People with schizophrenia describe strange of unrealistic thoughts. Their speech is sometimes hard to follow because of disordered thinking. Phrases seem disconnected, and ideas move from topic to topic with no logical pattern in what is being said. In some cases, individuals with schizophrenia say that they have no idea at all or that their heads seem empty. Many schizophrenic patients think they possess extraordinary powers such as x-ray vision or super strength. They may believe that their thoughts are being controlled by others or that everyone knows what they are thinking.

These beliefs are caused by delusions. Most specialists agree that symptoms are provoked by chemical disturbances of the brain, but no exact mechanism is known (Mueser, 102). Those with schizophrenia regularly report unusual sensory experiences, especially when the illness is in an acute stage. Often these experiences are in the form of hearing voices. Persons may hear one or two voices making comments on their behavior. They may not know the voice, or they may believe it is the voice of God, the Devil, or a friend.

When the voice issues orders to behave in a particular way, the experience is known as a command hallucination. These hallucinations can be very dangerous to the sufferer and others. When the voice commands the person to do something, the schizophrenic person will perform that task as instructed (Kass, 188). Particular, repetitive movements sometimes are seen in schizophrenics. Victims might swing one leg back and forth all day, or constantly shake their heads. Catatonic behavior is another symptom; a victim might keep the same position for hours, unable to talk or eat.

Catatonic schizophrenia is marked by striking motor behavior. Some victims may be overly intrusive, constantly prying into the affairs of those around them (Gingerich, 64). When compared to other people in general, those with schizophrenia are less likely to marry or remain married; more likely to have school problems; often unable to keep their jobs; more prone to suicide attempts. People with schizophrenia also tend to fall into other groupings that can help in diagnosis. The majority range in age from adolescence to the mid twenties at the time the psychosis begins.

No single patient is likely to show all the symptoms associated with the illness or fall into all of the categories listed. One person may experience only auditory hallucinations and exhibit only inappropriate emotions. Another might become reclusive and suffer from delusions (Arasse, 210). The modern era of medical treatment for schizophrenia began in 1952 with the use of the tranquilizer chlorapromazine. This drug, for the first time, controlled acute systems, reduced hospitalization from years to days, and lowered the rate of relapse by more than fifty percent.

Not everyone responds to these drugs. Long term control is less successful than short term alleviation. Prolonged medication may bring harmful side effects, especially the neurological muscle disorder known as tardive dyskinesia (TD), which causes involuntary facial movements. Dopamine is the primary neurotransmitter that appears to be involved in this disorder, and most medications used to treat schizophrenia target this neurotransmitter and its receptors in the brain. Schizophrenia seems to be a syndrome of multiple causes and types.

Genetics seem to play a role, but there is no single schizophrenia gene. While it is clear that a supportive family can be helpful in preventing relapse, it is also agreed that family strife does not cause schizophrenia (Young, 35). One of the most recent advances in treating schizophrenia is the drug clozapine. This drug has been used in Europe and China for a number of years and now has been approved by the Food and Drug Administration in 1990 for use in the United States. Clozapine is sometimes effective in cases where other drugs have failed to blunt systems.

This drug appears to have fewer side effects than some of the anti-psychotic drugs. A major drawback to its use is that it can dangerously lower the count of white blood cells. Other new medications that have beneficial effect similar to clozapine but that appear to be safer are now undergoing testing and may be available in the near future. Various medications are handled by the body in different ways, so one drug may be selected over another because it has less chance of damaging a diseased liver, worsening a heart condition, or affecting a patients high blood pressure.

For all the benefits that anti-psychotic drugs provide, clearly they are far from ideal. Some patients will show marked improvement with drugs, while others might be helped only a little, if at all. Ideally, drugs soon will be developed to treat successfully the whole range os schizophrenia symptoms. Roughly one third of schizophrenic patients make a complete recovery and have no further recurrence, one third have recurrent episodes of the illness, and one third deteriorate into chronic schizophrenia with severe disability (Kass, 206).

What happens when two people fall in love

We may think of love as a sweet heart throbbing fairy tail situation, but in reality, unexpected dreadful circumstances often occur. As a couple falls helplessly in love, they become sexually active. Because of this intimate, uncontrollable love, a couple, with extremely high endodorphine levels may make a poor choice about contraceptives. This poor choice may result in a STD or even the life-concluding virus, HIV/AIDS. In this situation the couple develops mixed emotions which may cause a painful breakup leading to depression, which is the number one cause of suicide.

Being in love is a sense of excitement, of heightened emotion, heightened senses, of being in the unknown, of abduction, of not being in control of yourselfits like an excuse, ‘I don’t now what I’m doing. I’m in love'”(Gochros and Ricketts 27). Every day, people all over the world experience this intense description of love. Dr. JM Morris explains this in profound detail. “The first step to falling in love is imprinting. Imprinting is finding a specific physical trait that attracts you to a certain person. Then there is a subliminal attraction, which is a personal quality, such as a person’s laugh.

Next is the hypotaemic stage. When experiencing this stage, a person becomes nervous and develops sweaty palms when their object of affection is close to them. Then chemical anvetamines in the brain such as dopamine, norepine, and phenye ethyeamine react, causing a natural drug rush. ” Now that the couple has fallen in love, certain addictions and attachments occur. Dr. Morris continues, “The brain chemical, oxytocin, otherwise known as the ‘cuddle chemical’ promotes a realxed satisfying attraction and strong bonds due to endodorphine levels urging the couple to make love.

Through this addiction, the couples brains actually begin to grow together. ” So now the endodrophine level is at its peak and it is the perfect time and place for the couple to have sex, but there is only one problem, they have no form of contraceptives. The couple, so in love and naturally drugged on endodorphine, cannot resist their feelings and proceed by engaging in unprotected sex. The use of contraceptives have become vital when considering that unprotected intercourse is likely to result in pregnancy and more importantly, it carries a high risk of acquiring a sexually transmitted disease (Contraception: choosing).

There are presently many forms of contraceptives available to fit persons cost, comfort and preference. When making this crucial choice, it is important to consider all your options. There are types of contraceptives, which are excellent for preventing pregnancy, but have absolutely no effectiveness against STD’s. The Combined pill, mini-pill, Depo-Provera, Norplant, IUD, and morning after pill are all in this category (Roland 6). Contraceptives, which prevent pregnancy and STD’s, include the male and female condom, spermicides and diaphragms. The male condom is the most common use of contraception for males.

It is a protective covering made of latex and polyurethane that fits over the penis. The condom keeps the semen from entering to vagina (Kronenfeld, Whicker 43). The female condom which is not commonly used, not only has a high cost, but is bulky and difficult for the female to insert. It is a polyurethane sheath that lines the entire vagina and partially covers the external genitals (Birth Control 2). Spermicides are another over the counter contraceptive. These products are a type of spermicidle jelly or foam in the form of a capsule, which are inserted into the vagina before intercourse.

There are no serious side effects but it may be messy. The woman can also use a diaphragm or cervical cap, which is a flexible rubber barrier used with spermicidal cream or jelly. It is inserted before intercourse to block and kill sperm moving toward the uterus (Emergency Contraceptives 2). All of these contraceptives are effective in stopping pregnancy and STD’s but the only thing that can completely prevent sexual mistakes is abstinence. If a couple decides not to use any of these methods of contraception they are at a high risk for sexually transmitted diseases and even HIV/AIDS.

Present day, more than fifty organisms and syndromes are now recognized as sexually transmitted. These diseases can lead to serious health problems, and when untreated, can lead to major consequences (Anderson and Smith 22). Sexually transmitted diseases can cause pelvic inflamation, a woman who develops a serious case of this may die. But an even more serious STD that causes death is HIV/AIDS (Clinic). The two most common STD’s are Chlamydia and Syphilis. Although Chlamydia can be extremely painful for females in the lower abdomen, 80% of the infected have no symptoms at all. Chlamydia is curable with certain antibiotics.

Syphilis, although curable as well, can cause sever damage to the nervous system and other body organs, resulting in long term damage. Other STD’s cause painful blisters and warts to develop on the mouth and genitals and anus. Genital herpes, genital warts, and scabies are all included in this category. These sores are extremely painful and sometimes are incurable (Holmes and Mardh and Sparling and Wiesner). Other popular STD’s include Garderella Vaginits, Hepatitis A, B, C and D, and Gonorrhea, they all have symptoms including, vaginal discharge, pain while urinating, possible bleeding, ect.

Some people have no symptoms at all and most of these STD’s can be cured by antibiotics (Clinic). But one STD that cannot be cured by antibiotic or any other way is the life concluding disease, HIV/AIDS. HIV is the virus that causes AIDS, this infection damages the body’s immune system that protects the body from disease. As HIV forms to AIDS the immune system is extremely weak, when this happens, other diseases and infections enter the body, eventually causing death (Schettler 1-2).

The only guarantee to keep from getting a STD is to practice sexual abstinence, but on a more realistic note, it is extremely important to use contraceptives during sexual intercourse to lessen the chances of infection. Being infected with and STD is a very difficult situation. It causes hardship between the sexually active couple, it effects the victim’s family and friends who care about them, and if the victim is bearing a child at the time, it ould effect the baby’s health as well.

The STD might cause a difficult breakup between the two partners, or for teenagers, it creates a conflict between them and their parents. A person may be deeply bothered by long term scars that can effect their future, like women becoming unable to bear children because or the damage done, or even the embarrassment it causes. In many cases the victim falls in a stage of depression. Depression, effecting over one in five Americans in their lifetimes is the number one cause of suicide (Campbell51). People who have AIDS are at an extremely high risk of taking their own lives (Pahl 3).

They don’t want to go through the pain of a slow death or wish to face the humility. An infected person may feel dirty and unwanted; this type of depression often leads to suicide (Fagan 8). So now when we think of love, we may see it a little differently after being educated. We can see how love and death can tie together; love leads to sex, allowing high endodrophine levels to make a poor choice of contraceptives, which, in turn, leads to STD’s, HIV/AIDS, which causes depression, resulting in suicide.

Alzheimer’s Disease – progressive and irreversible brain disease

Alzheimer’s Disease is a progressive and irreversible brain disease that destroys mental and physical functioning in human beings, and invariably leads to death. It is the fourth leading cause of adult death in the United States. Alzheimer’s creates emotional and financial catastrophe for many American families every year. Fortunately, a large amount of progress is being made to combat Alzheimer’s disease every year. To fully be able to comprehend and combat Alzheimer’s disease, one must know what it does to the brain, the part of the human body it most greatly affects.

Many Alzheimer’s disease sufferers had their brains examined. A large number of differences were present when comparing the normal brain to the Alzheimer’s brain. There was a loss of nerve cells from the Cerebral Cortex in the Alzheimer’s victim. Approximately ten percent of the neurons in this region were lost. But a ten percent loss is relatively minor, and cannot account for the severe impairment suffered by Alzheimer’s victims. Neurofibrillary Tangles are also found in the brains of Alzheimer’s victims.

They are found within the cell bodies of nerve cells in the cerebral cortex, and ake on the structure of a paired helix. Other diseases that have “paired helixes” include Parkinson’s disease, Down’s Syndrome, and Dementia Pugilistica. Scientists are not sure how the paired helixes are related in these very different diseases. Neuritic Plaques are patches of clumped material lying outside the bodies of nerve cells in the brain. They are mainly found in the cerebral cortex, but have also been seen in other areas of the brain.

At the core of each of these plaques is a substance called amyloid, an abnormal protein not usually found in the brain. This amyloid core is surrounded by cast off fragments of dead or dying nerve cells. The cell fragments include dying mitochondria, presynaptic terminals, and paired helical filaments identical to those that are neurofibrillary tangles. Many neuropathologists think that these plaques are basically clusters of degenerating nerve cells. But they are still not sure of how and why these fragments clustered together.

Congophilic Angiopathy is the technical name that neuropathologists have given to an abnormality found in the walls of blood vessels in the brains of victims f Alzheimer’s disease. These abnormal patches are similar to the neuritic plaques that develop in Alzheimer’s disease, in that amyloid has been found within the blood-vessel walls wherever the patches occur. Another name for these patches is cerebrovascular amyloid, meaning amyloid found in the blood vessels of the brains.

Acetylcholine is a substance that carries signals from one nerve cell to another. It is known to be important to learning and memory. In the mid 1970s, scientists found that the brains of those afflicted with Alzheimer’s disease contained ixty to ninety percent less of the enzyme choline acetyltransferase(CAT), which is responsible for producing acetylcholine, than did the brains of healthy persons. This was a great milestone, as it was the first functional change related to learning and memory, and not to different structures.

Somatostatin is another means by which cells in the brain communicate with each other. The quantities of this chemical messenger, like those of CAT, are also greatly decreased in the cerebral cortex and the hippocampus of persons with Alzheimer’s disease, almost to the same degree as CAT is lost. Although scientists have been able to identify many of these, and other changes, they are not yet sure as to how, or why they take place in Alzheimer’s disease.

One could say, that they have most of the pieces of the puzzle; all that is left to do is find the missing piece and decipher the meaning. If treatment is required for someone with Alzheimer’s disease, then the Alzheimer’s Disease and Related Disorders Association(ADRDA), a privately funded, ational, non- profit organization dedicated to easing the burden of Alzheimer victims and their families and finding a cure can be contacted.

There are more than one hundred and sixty chapters throughout the country, and over one thousand support groups that can be contacted for help. ADRDA fights Alzheimer’s on five fronts 1- funding research 2- educating and thus increase public awareness 3- establishing chapters with support groups 4- encouraging federal and local legislation to help victims and their families 5- providing a service o help victims and their families find the proper care they need.

Of all the scientists to emerge from the nineteenth and twentieth centuries there is one whose name is known by almost all living people. While most of these do not understand this man’s work, everyone knows that its impact on the world of science is astonishing. Yes, many have heard of Albert Einstein’s General Theory of relativity, but few know about the intriguing life that led this scientist to discover what some have called, “The greatest single achievement of human thought. “

A Look At Anemia Related To Nutritional Issues

“Anemia can be defined as a decrease in the oxygen-carrying capacity of the blood caused by low hemoglobin concentration” (“A Practical Guide”, 1). “Cells in the body require oxygen to fully utilize fuels. The oxygen is transported from the lungs to tissues throughout the body via red blood cells. Oxygen binds to hemoglobin, a specific molecule within each red blood cell. This molecule consists of heme, which is a red pigment, and globin, which is a protein.

If the amount of functioning hemoglobin is reduced, a condition known as anemia arises” (“Anemia”, 1). “The anemia that may result can take many forms, including that caused by a low iron level (iron deficiency anemia), a vitamin deficiency (megaloblastic anemia), a thyroid deficiency, the premature destruction of red blood cells (hemolytic anemia), replacement of normal bone marrow cells by cancer cells or leukemia (myelophthisic anemia), injury to bone marrow (aplastic anemia), and inborn structural defect in red blood cells (e. g. ckle-cell anemia), inhibition of erythropoietin production by the immune system (anemia of chronic disease), and a normal or high iron level but an inability to manufacture hemoglobin or make use of the iron (sideroblastic anemia)” (“Anemia”, 2).

There are also several other less common types of anemia including: aplastic anemia, Thalassemia, acquired hemolytic anemia, inherited hemolytic anemia, sickle cell anemia, and anemia caused by miscellaneous factors (“Anemia”, 3-4). All of these different types of anemia can be grouped into categories according to their causes and treatments.

In all, more than 400 different forms of anemia have been identified, many of them rare. An anemic person often appears pale and weak and may feel breathless, faint or unusually aware of a pounding heart. The disorder may arise from a number of underlying conditions, some of which may be hereditary, but in many cases poor diet is to blame. Although some forms of anemia require supervised medical care, those stemming from improper nutrition can typically be treated at home once a physician has determined the cause”(“Anemia”, 1-2).

Anemia induced by poor nutrition encompasses a large part of the disease. It is important to investigate anemia related to nutrition, because it is a problem that is present in our lives and there is a lot of action we can take to prevent and treat this disease. The most common forms of nutritional anemia are iron-deficiency anemia, folic-acid deficiency anemia, and Pernicious anemia, which is commonly known as anemia caused by a vitamin B12 deficiency. There is an abundant amount of information available on the various types of nutritional anemia and treatments for those diseases.

International Nutritional Anemia Consultative Group was established in 1977 in response to the need for developing a worldwide awareness of the problem of nutritional anemia and the need for an infrastructure that could assist in dealing with this problem”(ilsi. org, 1). “The International Nutritional Anemia Consultative Group network provides consultative services and advice to operating and donor agencies seeking to reduce nutritional anemia and its accompanying adverse physiological consequences” (ilsi. org, 1).

Anemia is not itself a disease, rather it is a set of signs and symptoms which represent some other pathology. Because anemia affects oxygen transport, fuel utilization is affected. Thus a common symptom in mild anemia is fatigue. Other symptoms may include: shortness of breath pale skin, heart palpitations, noises in the ear, excessive thirst, weight loss, memory problems, or even jaundice, which is characterized by yellowish skin due to liver enzyme problems” (“Anemia”, 1)wellweb. “Because anemia is a hematologic (involving the blood) problem, the most basic testing involves a Complete Blood Count (CBC).

This can provide much of the needed information, including: a white blood cell count (cells important to fighting infection), and the hematocrit, which is the ratio of volume of the red blood cells (erythrocytes) divided by the complete blood volume. In addition, a blood smear is an important diagnostic test. As the name implies, this involves inspection of a sample of blood under the microscope to locate abnormalities within the structure of the cells. To be labeled anemia, the red blood cell count must be less than 4. 5 million/microliter for men, or less than 4 million/microliter for women. Normal levels are approximately 5. illion/microliter for men and 4. 8 million/microliter for women” (“Anemia, 1)wellweb.

“It’s fairly easy to recognize when a patient is anemic. Generally far more complex and costly-though it doesn’t have to be-is the task of defining precisely why the disorder exists. Yet an accurate diagnosis is essential for specific treatment to be started promptly” (Burns, 10). “Recent advances in blood-count automation, however, now enable the primary care practitioner to analyze the results of a complete blood count (CBC) and formulate a logical plan for diagnosing the cause of anemia with only a small number of inexpensive tests” (Burns, 10).

The condition of anemia can exist in three different ways including: decreased red-cell production, increased red-cell destruction, or loss of blood through hemorrhage. The three forms of nutritional anemia in this study are all a product of decreased red-cell production (Burns, 10-12). “The most common type of anemia is iron-deficiency anemia” (“Anemia”, 1). “Iron-deficiency is defined as anemia with biochemical evidence of iron deficiency” (Dreyfuss, background). “Iron deficiency anemia is the most common micro nutrient deficiency in the world today.

It impacts the lives of millions of woman and children contributing to poor cognitive development, increased maternal mortality and decreased work capacity. Yet with appropriate public health action, this form of micro nutrient malnutrition can be brought under control” (Dreyfuss, preface). “Iron deficiency anemia significantly impairs mental and psychomotor development in infants and children. Although iron deficiency can be reversed with treatment, the reversibility of the mental and psychomotor impairment is not yet clearly understood” (“Anemia and Iron status”, 1).

Although nutritional iron-deficiency has declined in industrialized nations, 500 to 600 million people (one-sixth of the world’s population) are still affected by this problem worldwide. Even in the U. S. , iron deficiency is the most prevalent nutritional deficiency” (“Anemia, 7) webmd. Iron deficiency anemia is characterized by an inadequate amount of red blood cells caused by a lack of iron. It’s very prevalent in less-developed countries, but is still considered to be a problem in developed countries (Dreyfuss, background).

This type of anemia is most prevalent in young children, ages 6-24 months, and in women of reproductive age. Older children, adolescents, adult men, and the elderly have also been found to have iron deficiency anemia (Dreyfuss, background). “Iron deficiency generally develops slowly and is not clinically apparent until anemia is severe even though functional consequences already exist” (Dreyfuss, background). “There are several main causes of the deficiency, including insufficient consumption of iron-containing foods, poor absorption of iron by the body, and loss of blood” (Mayo, 957).

Poverty, abuse, and living in a home with poor household conditions also place children at risk for iron deficiency anemia” (“Anemia and iron status”, 1). Iron-deficiency anemia is suspected to exist when blood smears show pale-colored and extremely small cells that are uneven in shape. After a blood smear yields these results, iron levels are checked. If they are low, physicians measure ferritin, which is a protein that binds iron. If ferritin levels are low, the diagnosis of iron-deficiency anemia is confirmed (“Anemia, 11)webmd.

A varied array of interventions exist that are designed to prevent and correct iron deficiency anemia. These include dietary improvement, fortification of foods with iron, iron supplementation, and other public health measures, such as helminth control” (Dreyfuss, 4). Supplementation of iron is one approach to treating this disease. “In many populations, the amount of iron absorbed from the diet is not sufficient to meet many individuals’ requirements. This is especially likely to be true during infancy and pregnancy, when physiological iron requirements are the highest.

If the amount of absorbable iron in the diet cannot be immediately improved, iron supplementation will be a necessary component of programs to control iron deficiency anemia” (Dreyfuss, 4). “Iron supplements are essential for the rapid treatment of severe iron deficiency anemia in all sex and age groups” (Dreyfuss, 4). “A daily protocol of iron supplementation is recommended for treatment and prevention in the priority target groups. Numerous studies have evaluated whether the frequency of iron supplementation can be reduced from daily to twice or once per week without compromising the efficacy of supplementation.

The efficacy of once-or twice-weekly supplementation in school-age children, adolescents, and nonpregnant women is promising, and the operational efficiency of intermittent dosing regimens if being evaluated. While research is ongoing to evaluate these regimens in different population groups, the current recommendation remains daily supplementation for young children and pregnant women” (Dreyfuss, 5). “In industrialized countries nutritional anemias have been reduced dramatically. Food fortification is the most beneficial preferred way of preventing nutritional anemia.

In developing countries food fortification programs have been demonstrated to be efficient, yet the incidence of nutritional anemia is high. Inadequate and poor quality of the diet, in conjunction with the high incidence of infection, are the most common immediate causes of nutritional anemias. These factors are linked to socioeconomic development. Long term reduction in the prevalence of nutritional anemias will not occur unless direct methods of control are complemented by improvements in socioeconomic conditions” (Haschke, 18-20).

Fortification of suitable food vehicles with absorbable forms of iron is a highly desirable approach to controlling iron deficiency. If a fortifiable food exists that is consumed by many people at risk of iron deficiency, fortification is likely to be the most cost-effective component of its control” (Dreyfuss, 5). “There are many possible strategies for iron fortification. One approach is to fortify a staple food that is consumed in significant quantities by most of the population” (Dreyfuss, 5).

In the Caribbean, South America, North America, and Great Britain this approach has been a success using wheat flour (Dreyfuss, 5-6). A second approach that has been a success, using fish sauce, curry powder, salt, and sugar, is the fortification of condiments that are frequently used (Dreyfuss, 6). Another method used to combat this type of anemia is diet improvement. “The amount of iron absorbed from the diet is highly dependent on the composition of the diet, namely, the quantities of substances that enhance or inhibit dietary iron absorption” (Dreyfuss, 6).

Foods rich in iron that your body can readily absorb include meats (especially liver), fish, poultry, eggs, legumes (peas and beans), potatoes, and rice” (Mayo, 957). “The highest sources of iron are in red meats, but also in chicken, seafood (notably cooked clams), dried peas and beans, dried fruits, dark leafy vegetables, molasses, wheat bran and wheat germ, oatmeal and soybean flour” (Blood disorders, 1). These food sources, along with Vitamin C-rich foods promote the absorption of iron (Dreyfuss, 6).

There are also foods that reduce your body’s ability to absorb iron: large quantities in the diet of bran, calcium, tea, excessive zinc and a compound called phytate (found in unleavened bread, unrefined cereals and soybeans) block the entry of iron into your digestive system. Spinach and lentils contain iron, but very little of it gets absorbed because these vegetables also contain phytate” (intelihealth, 2). Males require approximately one gram of iron each day. Pregnant, lactating, or menstruating women and growing children require approximately 1. 5 to 2 grams each day (Blood disorders, 1).

However, only about 10 percent of the iron you eat is actually absorbed by your body, so the average man would need to eat about 10 grams of iron per day. Your body absorbs iron in different quantities from different foods” (“Blood Disorders”, 1). “Eating plenty of iron-containing foods is particularly important for people who have high iron requirements, such as children and pregnant or menstruating women. It is also crucial for those whose diets are low in iron, including strict vegetarians, people on weight-reduction diets, and infants” (Mayo, 957).

The Differences and Similarities of Pneumonia and Tuberculosis

Pneumonia and tuberculosis have been plaguing the citizens of the world for centuries causing millions of deaths. This occurred until the creation and use of antibiotics become more widely available. These two respiratory infections have many differences, which include their etiology, incidence and prevalence, and many similarities in their objective and subject indicators, medical interventions, course, rehabilitation and effects. To explore the relationship between pneumonia and tuberculosis we will examine a case study.

Joan is a 35 year old women who was feeling fine up till few weeks ago when she develop a sore throat. Since her sore throat she had been experiencing chest pain, a loss of appetite, coughing and a low fever so she went to visit her doctor. Her doctor admitted her to the hospital with bacterial pneumonia and after three days of unsuccessful treatment it was discovered that she actually had active tuberculosis. This misdiagnosis shows the similarities between the two diseases and how easily they can be confused.

Pneumonia Pneumonia is a serious infection or inflammation of the lungs with exudation and consolidation. Pneumonia can be one of two types: lobar pneumonia r bronchial pneumonia. Lobar pneumonia affects one lobe of a lung while bronchial pneumonia affects the areas closest to the bronchi (O’Toole, 1992). In the United States over three million people are infected with pneumonia each year; five percent of which die. Etiology There are over 30 causes for pneumonia however there are 4 main causes which are bacterial, viral, mycoplasma and fungal (American Lung Association, 1996).

Bacterial pneumonia attacks everyone from young to old, however “alcoholics, the debilitated, post-operative patients, people with respiratory isease or viral infections and people who have weakened immune systems are at greater risk” (American Lung Association, 1996). The Pneumococcusis bacteria, which is classified as Streptococcus pneumoniae, causes bacterial pneumonia and can be prevented by a vaccine. In 20 – 30% of the cases the infection spreads to the blood stream (MedicineNet, 1997) which can lead to secondary infections.

Viral pneumonia accounts for half of all pneumonia cases (American Lung Association, 1996) unfortunately there is no effective treatment because antibiotics do not affect viruses. Many viral pneumonia cases are a result of n influenza infection and commonly affect children, however they are not usually serious and last only a short time (American Lung Association, 1996). The “virus invades the lungs and multiplies, but there are almost no physical signs of lung tissue becoming filled with fluid. It finds many of its victims among those who have pre-existing heart or lung disease or are pregnant” (American Lung Association, 1996).

In the more severe cases it can be complicated with the invasion of bacteria that may result in symptoms of bacterial pneumonia (American Lung Association, 1996). During World War II mycoplasma were identified as the “smallest free- living agents of disease in humankind, unclassified as to whether bacteria or viruses, but having characteristics of both” (American Lung Association, 1996). Mycoplasma pneumonia is “often a slowly developing infection” (MedicineNet, 1997) that often affects older children and young adults (American Lung Association, 1996).

The other main cause of pneumonia is fungal pneumonia. This is caused by a fungus that causes pneumocystic carinii pneumonia (PCP) and is often “the first sign of illness in many persons with AIDS and can be successfully reated in many cases” (American Lung Association, 1996). In Joan’s case bacterial pneumonia was suspected because her immune system was weakened by her sore throat and her signs and symptoms correlated with pneumonia. Tuberculosis (TB) Tuberculosis was discovered 100 years ago but still kills three million people annually (Schlossberg, 1994, p. ).

Cases range from race and ethnicity. In 1990 the non-Hispanic Blacks had 9, 634 cases while the American Indians and Alaskan Natives had 371 cases (Galantino and Bishop, 1994). It is caused by bacteria called either Mycobacterium tuberculosis or Tubercle bacillus. Tuberculosis can infect any part of the body but is most often found in the lungs where it causes a lung infection or pneumonia.

Etiology There has been a resurgence of TB due to a number of factors that include: 1. the HIV / AIDS epidemic, 2. the increased number of immigrants, 3. he increase in poverty, injection drug use and homelessness, 4. poor compliance with treatment regiments and; 5. the increased number of residents in long term facilities (Cook & Dresser, 1995). The tuberculosis bacteria is spread through the air however transmission will only occur after prolonged exposure. For example you only have a 50% chance to become infected if you spend eight hours a day for six months with someone who has active TB (Cook & Dresser, 1995). The tuberculosis bacteria enters the air when a TB patient coughs, sneezes or talks and is then inhaled.

The infection can lie dormant in a person’s system for years causing them no problems however when their immune system is weakened it gives the infection a chance to break free. Types of TB Treatments Types of treatment will depend on whether the patient has inactive or active tuberculosis. To diagnose active TB the doctor will look at the patients’ ymptoms, and outcomes of the skin test, sputum tests, and chest x-rays. A person has active tuberculosis when their immune system is weakened and they start to exhibit the signs and symptoms of the disease.

They also have positive skin tests, sputum tests and chest x-rays. When this occurs the treatment is more intense. The disease is treated with at least two different types of antibiotics in order to cure the infection. Within a few weeks the antibiotics will build the body’s resistance and slow the poisons of the TB germ to prevent the patient from being contagious. An example of treatment would be short- course chemotherapy, which is the use of isoniazid (INH), rifampin, and pyrazinamide in combination for at least six months (Cook & Dresser, 1995).

The drugs need to be taken for six to twelve months or there may be a reoccurrence. Failure to take the antibiotics consistently will result in a multi-drug resistant TB (MDR TB) which “is much harder to treat because the drugs do not kill the germs. MDR TB can be spread to others, just like regular TB” (American Lung Association, 1996). Inactive tuberculosis is when a person is infected with the tuberculosis acteria, but their immune system is able to fight the infection, therefore only showing a positive skin test and a negative x-ray and sputum test.

The patient may be infected but they are not contagious which means the doctor will start a preventative treatment program. This program includes the use of the drug isoniazid for six to twelve months to prevent the TB from becoming active in the future. Once the treatment for Joan’s pneumonia was unsuccessful it was rediagnosed because she remembered her exposure to TB when her grandfather contracted it when she was seven years old. She has been unaware that she has een caring the infection in a dormant state for 28 years.

Due to her sore throat, which weakened her immune system, her TB became active therefore she was given a new treatment plan. This plan included the use of isoniazid, rifampin, and pyrazinamide. Objective and Subjective Indicators Tuberculosis and pneumonia have similar objective and subjective indicators because they both cause infection of the lungs. Because of theses similarities in the indicators Joan’s case was easily misdiagnosed without the information of the TB exposure. The subjective indicators are chest pain, headaches, loss of appetite, ausea, stiffness of joints or muscles, shortness of breath, tiredness and weakness.

The patient has to be able to tell the doctor these symptoms in order for the correct diagnosis to be made because of the overlap between the two diseases. The objective indicators include coughing, chills, fever, night sweats and blood-streaked or brownish sputum. These signs will be observable by the doctor. Medical Interventions The diagnostic procedures for pneumonia and tuberculosis is also similar. The usual procedure is for the doctor to get a previous medical history along with a history of possible exposure and onset of symptoms. From there a physical examination will occur.

The doctor will listen to the patients chest for crackles. After that, tests such as the CBC blood test, x-rays, blood and sputum test, biopsy or a bronchoscopy can confirm an infection of the lungs. A tuberculosis specific test is the Mantoux test which is a skin test that confirms the presence of the TB bacteria in the patients system. A conservative treatment would include antibiotics such as penicillin and isoniazid (INH) that would treat the infection in the lungs. Or bronchodilators may be used to help keep the airways open. Other treatments may include a proper diet or bed rest.

There are not many choices when it come to surgical management for pneumonia or tuberculosis. In fact there is usually only one that is often used. That surgery is thoracentesis and it is used to remove the pleural effusion from the lungs. The Course The course of pneumonia and tuberculosis can vary from person to person. In general the course begins with the development of symptoms and the visit to the doctor. After the visit to the doctor tests and examinations will occur to confirm the presence of pneumonia or tuberculosis. Once the infection has been confirmed medication may be prescribed along with possible bed rest.

A prompt recovery can occur if: 1. they are young, 2. their immune system is working well, 3. the disease is caught early and; 4. they are not suffering from other illnesses. Most patients will be able to respond to the treatments and begin to improve within a couple of weeks. Throughout the treatment medical evaluation, drug monitoring and bacteriology is completed. They will check the sputum twice monthly for TB until the smear is negative and the patient is asymptomatic which usually occurs ithin the first three months (Galantino and Bishop, 1994).

For both diseases they will also watch the patient for drug side effects, resistance and compliance. In Joan’s case the TB infection was caught too late to use preventive treatments but once it turned active it was discovered after two weeks. Bio-Psycho-Social Effects There are many secondary biological effects from pneumonia and tuberculosis. Tuberculosis and Bacterial Pneumonia can enter the body’s blood steam and cause damage or further infection to any part of the body, which includes the kidney, joints, bones, liver, brain, reproductive organs or urinary ract.

Other secondary problems that may arise from either disease include anemia, pleurisy, lung abscess, pulmonary edema, chronic interstitial pneumonia, acute respiratory failure, empyema, slowing of the intestines or hyponatremia which is low blood sodium (National Jewish Center for Immunology and Respiratory Medicine, 1989). The patient may also suffer from psychological and social problems throughout the course of the disease. In extreme cases patients may be unable to participate in physical, recreational, or normal day activities which may cause social deprivation or depression.

However most patients can expect to keep their jobs, stay with their families throughout the treatment and lead normal lives. In Joan’s case she was hospitalized so had become socially deprived and was becoming very depressed. This is in part due to the fact the her treatment was ineffective for the first three days from the misdiagnoses. Goals and Interventions for the Pneumonia or Tuberculosis Patient To facilitate the recovery of patients who have pneumonia or TB there will be interventions from the Physical Therapist, Respiratory Therapist and Social Worker.

Each profession will have roles in motivating , supporting and increasing the functional capability of the patient. The most common objectives of treatment include: 1. to decrease discomfort, 2. to facilitate the exchange of oxygen and carbon dioxide in the lungs, 3. to prevent atrophy from the increased bed rest, and 4. to prevent social withdrawal.

Rehabilitation Goals and Interventions 1. Maintain or increase muscle strength during decreased activity -provide a progressive resistive exercise program -promote weight bearing activities, engage in recreational activities and self care activities

2. Maintain or increase mobility of soft tissue and joints during bed rest and decreased level of activity – provide passive and active range of motion -recreational activities combining aerobic, stretching, and strengthening

3. Develop, improve, restore or maintain coordination – practice skills with walking, dressing, hygiene and standing

4. Promote psych-social adaptation to disability and prevent social withdrawal – educate to adapt lifestyle – get involved in support groups and social interactions – body positions that decrease discomfort – Social Worker may help here

5. Alleviation of chest pain and aid in respiration – use chest physio, oxygen treatments and respiratoy therapy – teach effective breathing techniques and postural drainage to keep airways open

6. Prevention of reoccurrence – preventive therapy that includes education on proper diet Joan was referred to see a Physical Therapist, Respiratory Therapist and Social Worker. Her goals where to decrease her discomfort, education to adapt her lifestyle and in different body positions that will promote easier breathing. The Social Worker was also there to encourage her to join a support group to elp her cope with the restraints from her disease.

Every year millions of people throughout the world are affected by the pneumonia and tuberculosis disease. These two respiratory infections have similarities and differences. These similarities stem from the fact that both diseases attack a persons lungs causing inflammation and consolidation. In fact tuberculosis is a chronic infection that can affect the lungs and cause pneumonia. Since both infections cause consolidation indicators like coughing, chest pain and shortness of breath are found in pneumonia and tuberculosis.

The roblem with these similarities, as was seen in Joan’s case, is that it can be easily misdiagnosed when the proper tests are not used. The differences in the two infections are mainly just in their etiologies. For pneumonia there are over 30 different causes but the four main categories are bacterial, viral, mycoplasma and fungal while tuberculosis is only caused by a bacteria called Tubercle bacillus. Fortunately pneumonia and tuberculosis can be kept under control with the use of antibiotics and the earlier that the infection is caught the better chance of a prompt recovery.

Leukemia, a group of blood cancers

Leukemia strikes all ages and both sexes. In 1995 approximately 20,400 people died from Leukemia. The all time five year survival rate is 38%. This rate has gone to 52% in the mid 1980’s. Approximately 25,700 cases were reported in 1995 alone(American Cancer Society-leukemia, 1995). Leukemia is a form of cancer in the blood cells. Most forms of Leukemia occur in the white blood cells. These abnormal cells reproduce in large quantities and look and perform differently than normal cells(MedicineNet- leukemia, 1997).

Right now the causes of Leukemia are unknown. Some studies have shown that xposure to high-energy radiation increases chances of contracting leukemia. Such radiation was produced in the atomic bombing of Japan during World War II. There is also enough energy in nuclear plants so strict safety precautions are taken. Some research shows that exposure to electric magnetic fields, such as power lines and electric appliances, is a possible risk factor. More studies are needed to prove this link.

Some genetic conditions, such as Down’s syndrome, are also believed to increase the risk factor. Exposure to some chemicals is also suspected to be a risk factor. By learning the causes of leukemia reatment options will become available(MedicineNet-leukemia, 1997). There are many symptoms of leukemia. The symptoms of leukemia are the same for all the different types of leukemia. The acute types of leukemia, ALL and AML, symptoms are seen more quickly than in the chronic types of leukemia, CLL and CML, where symptoms do not necessarily appear right away.

The symptoms are flu symptom, weakness, fatigue, constant infections, easily bleed and bruise, loss of weight and appetite, swollen lymph nodes, liver or spleen, paleness, bone or joint pain, excess sweating, swollen or bleeding gums, nosebleeds and ther hemorrhages, and red spots called petechiae located underneath the skin. In acute Leukemia the cancerous cells may collect around the central nervous system. The results can include headaches, vomiting, confusion, loss of muscle control, or seizures.

These clumps of cancer cells can collect in other various parts of the body(MedicineNet-leukemia, 1997 and American Cancer Society- leukemia, 1995). Leukemia can be diagnosed in a number of ways. Blood work is commonly done in the laboratory. Different forms of blood work include checking the hemoglobin count, platelet count, or white blood cell count. X-rays are outinely done for treatment follow-up. Ultrasound is also used as a treatment follow-up. CT Scan is a special type of x-ray used as a detailed cross section of a specific area of the body.

Bone marrow is routinely tested to examine progress of the disease. Spinal taps are also used in certain types of cancers. The spinal fluid is checked to see if cancer cells are present(Parent and Patient handbook-hematology/oncology clinic, Children’s Hospital of Michigan, 19?? ) Treatment of Leukemia is very complex. Treatments are tailored to fit each patient’s needs. The treatment depends on the type of the cancer and eatures of the cells. It also depends on the patient’s age, symptoms, and general health. Acute Leukemia must be treated immediately. The goal of treatment is to get the cancer into remission.

Many people with Leukemia may be cured. To be considered cured, you must be cancer free for at least five years. This time also varies depending on the type of cancer. The most common treatment of Leukemia is chemotherapy. Bone marrow transplants, Radiation, or biological therapy are also available options. Surgery is also occasionally used. Chemotherapy is a treatment method in which drugs are given to kill off the cancerous cells. One or more drugs may be used depending on the type of Leukemia. Anticancer drugs are usually given by IV injection. Occasionally they are given orally.

Chemotherapy is given in cycles: a treatment period followed by a recovery period followed by another treatment period and this process continues for a certain amount of time. Radiation therapy is used along with chemotherapy in some occasions. Radiation uses high energy beams to kill the cancerous cells. Radiation can be applied to either one area or to the whole body. It is applied to the whole body before bone marrow transplants. Bone marrow transplants are used in certain patients. The patients bone marrow is killed by high doses of drugs and radiation.

The bone marrow is then replaced by a donor’s marrow or the patient’s marrow that was remove before the high amounts of drugs and radiation. Biological therapy involves substances that affect the immune system’s response to the cancer(MedicineNet-leukemia, 1997). In conclusion, Leukemia can be fatal, but with early diagnosis, proper treatments, and a lot of luck, it can be put into remission. With treatment options improving constantly, there may one day be a sure cure. Leukemia is a very dominant disease and very hard to treat. The key may be in the causes.

Use of Do Not Resuscitate

Many influences such as cultural background, values, morals, and beliefs bring great force to bear upon almost every decision a person must make throughout an average day whether it be a choice, idea , or action. These influences are used in the formation of attitudes about ones self in general, and about right or wrong. All people have these childhood influences to credit for our attitudes, choices, ideas, and even beliefs that are held dear. Attitudes developed during childhood and throughout life play a key role in the way people interact with one another, handle crises, or even deal with day-to-day problems that occur in their lives.

These beliefs are central to every human whether they be carpenter, politician, or registered nurse. So enmeshed in our daily lives are these values, that very often their role in the decision process goes unnoticed. In fact, one can live their entire life and never have awareness as to what triggers certain emotions, feelings toward the other sex, or even what drives the direction of thought. Yet, they are passed on to every generation often blindly, with every gesture, every arched eyebrow, and every fairy tale. The awareness of their presence is secondary to the need to have them.

They are the thread that stitches communities together, brings people to a common ground, and gives many a purpose for living. Attitudes about death and dying are derived from a lifelong process of experiencing life and the beliefs about death that one accepts as their own. In many cultures beliefs and issues surrounding death are the ones held dearest and closest to oneself. Many, if not all, cultures accept that death is but another step in the process of life. However, differences in how one may choose to welcome or elude death are varied and many.

How one chooses to face death, what instrumentation, and even where to die (when one has the choice) are all matters of personal preference. Use of Do Not Resuscitate (DNR) orders or exhaustive measures are also matters of preference ( when there is a living will and these decisions are made ahead of time), and these preferences affect many lives ranging from friend to caregiver. As a caregiver, the nurse must deal with death and those that are dying on an almost daily basis. As a nurse, one must be aware of his or her own personal feelings and beliefs regarding death and be prepared to respect the wishes of the patient regarding this issue.

More often, the nurse will be the very person to carry out a DNR order. This means that the nurse may have to stand and watch or take the hand of a patient while he or she dies. The decision that a nurse will make will be based on attitudes toward death and dying, as well as the very notion of the DNR order. Some nurses may perceive a DNR order as an easy way out of expensive medical bills and a direct hand in the death of the patient, while others may see it as a merciful end to a painful and tormented existence.

When confronted with the legality of DNR orders and the humanity of caring and wanting to preserve life, the nurse is often confronted with a dilemma. The nurses decision can be one that can affect her career as well as the wishes of the patient. Whatever the nurses feelings are, they must be addressed in order to better serve the patient and to ensure that the patients rights and best interests are at the center of the concern. By addressing the nurses issues with DNR orders or just death itself, the patient benefits from the knowledge that the nurse has an understanding of why he or she may feel a certain way about a particular topic.

Understanding of where our values, beliefs, and perception originate can only serve to, help us become stronger, more compassionate, and wiser. Researchers of this study believe that results will contribute to the already vast body of nursing knowledge by delivering an article that when read, may aid the readers to look within oneself and determine what beliefs, or lack of, are governing their actions. In addressing this issue, the researchers feel that a nurse will gain valuable insight which may help him or her to better cope with the issues surrounding a patient that is near death and has a DNR order attached to his or her chart.

The researchers will also present information on the process whereby formation of these attitudes or beliefs occurs and in doing so will provide source from whence changes and or understanding of what we believe can be achieved. Furthermore, the researchers believe that the extent to which these findings can be generalized are not just limited only to certain floors or departments within a hospital setting but, are available to everyone with the desire to understand what makes them care about certain issues. Still, these findings can be useful in areas of oncology, pediatrics, geriatrics, and or any area where DNR orders are in place.

Also, these findings can be useful in palliative, as well as curative settings, within the home health community, and the retirement community. In general, the researchers hope that this information which may aid anyone in their search for understanding of who and what they are, will also serve as a tool to affect a change in how those that read this study treat one another as well as what one says and does. Theoretical Framework Kohlbergs Theory of Moral Development will be used as a conceptual framework for this study (Wong, 1995).

Kohlbergs theory consist of three levels. Within each level are two distinct stages of moral development. Within level one, the Pre-moral level, are the stages one and two which state that a person obeys rules to prevent punishment or to bring about reward respectively. Within Kohlbergs level one is Piagets stage one of moral reasoning called Moral Realism from which attitude formation, and attitudes about death and dying are formulated ( Coffey & March, 1983). The second Kohlberg level is known as the Pre-Conventional level. Within this level are stages three and four .

Stage three addresses the method whereby individuals pursue the approval of others by portraying themselves as good. Stage four states that people have respect for authority and social order and that people are oriented toward duty and respect for authority. Also within this level is Piagets second stage of moral reasoning called Morality of Cooperation which deals with the way cooperation is achieved in moral development and its implications on developing morals and attitudes. The last level of Kohlbergs model is the Post-Conventional level. Within this level are the fifth and sixth stages.

Stage five addresses that people are receptive to obeying democratically accepted laws and rules of behavior, while stage six implies that morality is individual conscience. Within this section studies will be presented that state that nurses function at this level of Kohlbergs Theory of Moral Development. It is because of this level that one can be in touch with the emotions and attitudes that are responsible for how people feel and act regarding a specific subject. These actions and the attitudes behind them are the foundations for what makes something right or wrong (at least in the mind of the person or persons involved).

Kohlbergs model will be used to explain the actions of individuals based on the level of development previously stated by the many levels of Kohlbergs model. It has been stated that nurses function at the stage 6 level that states morality is individual conscience. With all the stages having been laid out quite specifically, a researcher should be very capable of assigning a specific subject to a specific stage of development and also be able to determine with some degree of accuracy the attitudes held by that person by the way a set of questions are answered (Kohlberg, 1969).

Problem Statement What factors, moral and ethical, influence nurses attitudes and decisions regarding patient care of a client with DNR orders? Statement of Purpose The researchers believe that independent variables such as patient demographics, as well as physiological aspects ranging from age and sex to acuity and nature of disease will have an affect on the dependent variable, the nurses attitude on death and dying.

This study will explore the nurses attitudes about death and dying as well as specific issues about DNR orders which may have deep rooted origins and may be affected by various factors such as familial wishes and cultural issues that are out of the control of the nurse. In this descriptive study, the researchers will attempt to add to the vast body of nursing knowledge by exploring the attitudes that nurses have toward death and dying as well as their attitude toward the DNR order itself.

The researchers believe that by investigating the origins of ones values and beliefs the nurse will become a better nurse and a better person . This insight into oneself will allow the nurse to deliver better patient care and develop a sense of who they are and where they come from. Research Question What factors that affect nurses attitudes toward death, the dying, and the DNR order can be discovered and identified in a descriptive study by the use of a subject specific questionnaire such as a DNR questionnaire? Definition of Terms Theoretical Definitions

DNR Order: “A note written in the patient record and signed by a qualified, usually senior or attending physician, instructing the staff of the institution not to attempt to resuscitate a particular patient in the event of cardiac or respiratory failure. This instruction is usually only given when a person is so gravely ill that death is imminent and inevitable” (Mosbys Medical & Nursing Dictionary, 1996). Attitude: “State of mind, behavior, or conduct regarding some matter, as indicating opinion or purpose” (Britannica World Language Dictionary, 1995).

Nurse: “A person educated and licensed in the practice of nursing; one who is concerned with “the diagnosis and treatment of human responses to actual or potential health problems” (American Nurses Association). The practice of the nurse includes data collection, diagnosis, planning, treatment, and evaluation with men in framework of the nurses singular concern with the persons response to the problem rather than to the problem itself. The concerns of the nurse or thus broader and less discrete and circumscribed than the traditional concerns of medicine.

In a cooperative participatory relationship with the client or patient, the nurse acts to promote, maintain, or restore the health of the person; wellness is the goal. A collegial collaborative of relationship with other health professionals who share a mission and a common data base furthers the practice of nursing. Guided by a humanitarian, ethical principles, the nurse practices in a personal, nurturing, and protective manner that promotes health in all ways.

The nurse may be a generalist or a specialist and, as a professional, is ethnically and legally accountable for the nursing activities performed and for the actions of others to whom the nurse has delegated responsibility” (Mosbys Medical & Nursing Dictionary, 1996). Questionnaire: A written or printed form comprising a series of questions submitted to a number of persons in order to obtain data for a survey or report ” (Britannica World Language Dictionary, 1995).

Operational Definitions DNR order: An order made by a physician (of one of the three hospitals involved in the UCO DNR study) after consultation with family members which entails the lack of effort to revive a patient that has naturally ceased to breath or has experienced cardiopulmonary arrest. Attitude: An inner personal feeling toward a certain subject, person, or philosophy that could be positive or negative held by one or more nurses involved in the UCO descriptive DNR study.

Nurse: A graduate of a one (Licensed Practical Nurse), two, or a four year, accredited nursing program, or a graduate of a certificate program and licensed by any state to practice as a nurse and currently employed at any one of three metropolitan hospitals in the Southwestern United States which are currently assisting with the UCO DNR research project. Questionnaire: The tool used to ascertain attitudes and acquire information about DNR orders from participating nurses employed at one of the three Southwestern United States Hospitals involved in the UCO DNR study.

Culture & Democracy

America has a highly developed health care system, which is available to all people. Although it can be very complex and frustrating at times it has come a long way from the health care organizations of yesterday. Previously most health care facilities were a place where the sick were housed and cared for until death. Physicians rarely practiced in hospitals and only those who were fortunate could afford proper care at home or in private clinics. Today the level of health care has excelled tremendously. Presently the goal of our health care is to have a continuum of care for the patient, one which is ntegrated on all levels.

Many hospitals offer a referral service or discharge plan to patients who are being discharged. Plans for the patient are discussed with a discharge planner. The discharge planner is a person who is trained in assessing what the patient’s requirements for health care will be after discharge from the hospital. This enables the patient to continue ! their care at a level which is most appropriate for them. Items reviewed for discharge planning include but are not limited to therapies, medication needs, living arrangements and identification of specific goals.

A few of the options that are available for persons being discharged from an acute care hospital can include home health care, assisted living facilities, long term care or hospice Home Health Care According to Growing Old in America (1996), “Home health care is one of the fastest growing segments of the health care industry” (p. 114). Alternatives for home care can meet both the medical and non-medical needs of a patient. These services are provided to patients and their families in their home or place of residence. Home care is a method of delivering nursing care and other therapies as required by the patient’s eeds.

Numerous alternatives are available for persons seeking health care at home. With transportable technologies such as durable medical equipment, oxygen supply and intravenous fluids there are countless possibilities for treatment within the home setting. As stated in The Continuum of Long Term Care “Home health programs range from formal organizations providing skilled nursing care to relatively informal networks that arrange housekeeping for friends” (p. 185). This has allowed for home care to quickly become an essential component of the health c! are delivery system in the United States.

In a ome health care situation the primary care giver is usually not the physician. The physician is communicated with by phone and with documentation from the caregivers. The primary caregivers are usually the nurses and other team members who are involved directly with the patient’s care. Although, the original order to begin home care must be initiated by the physician if skilled care is to be obtained. According to the 1995 Guide to Health Insurance for People with Medicare “Medicare pays the full cost of medically necessary home health visits by a Medicare-approved home health agency”.

This overage must meet specific criteria, but it can be a relief to family members to know that their loved ones can be taken care of at home without worrying about the expenses. Unfortunately, if the care to be given within the home is termed “not medically necessary” the expense is not covered. This can include items such as meal and medication delivery, a percentage of necessary durable medical equipment, personal care and homemaker services. My employment within a home health care agency has allowed for review of services that are not covered by Medicare and/or private insurance.

Health care services hat are not included can become quite numerous. It is often difficult for family members to understand why specific services are not covered especially when they appear to be necessary for the care of the patient. These costs can add up quite quickly and the impact of the cost can become quite distressing for family members and patients on a limited budget. In these cases a Social Worker is usually provided to help the patient and family explore other avenues which may enable them to cover their health care costs.

Assisted Living Assisted living is an arrangement to residents of a facility that enables them to omplete certain daily activities while remaining independent. The services provided enable the resident to achieve maximum function of their activities of daily living. The services are unskilled and non-specialized personnel provide the activities essential to the care of the resident. These services help assist the aged, blind, disabled, and other functionally limited individuals with necessary daily activities which they require help with or are unable to perform on their own.

An example of some of the services which may be available are light housekeeping, meal preparation, medication reminders and personal care. The personal care does not include specific health oriented services which would require the services of a certified or licensed professional. It is stated well in Aging “Although the level of services provided may vary, assisted living communities all share a common goal: e! nabling people to live as active and independent a life as possible” (p. 212). The goal of an assisted living facility is to have the residents feel independent within their own home.

According to the article Assisted Living’s Future In Michigan Debated “Assisted living facilities can offer consumers a great pportunity to get personalized care in a comfortable setting” (p. 2). Currently there is some controversy surrounding the different types of assisted living facilities. In Michigan facilities termed assisted living have no real legal meaning and are not required to be licensed under this name. According to the article Assisted Living’s Future In Michigan Debated “Unlicensed facilities, unsubsidized care, untrained staff, and unmet promises make some places seem more like un-assisted living”.

Unfortunately many facilities are misleading as to what level of care they are providing. Both the government and national organizations are currently addressing this issue. My own experience with an assisted living facility has been quite good. Formerly my grandmother was a resident of an assisted living facility. The facility was specifically built for seniors and was that of an apartment like structure. The facility provided social and recreational activities on a continual basis. There was also transportation service available for residents who wished to use it.

My grandmother thoroughly enjoyed living in an assisted living facility where she had the opportunity to make numerous riends, participate in activities and remain independent. Long Term Care Long-term care patients are categorized by having a chronic condition and/or disease. The long-term care facility can be either hospital-based or freestanding. It consists of an organized medical staff, which provides continuous nursing services under professional nurse direction. The patient’s status is reviewed on a regular basis to determine if they meet criteria to remain at the facility.

The long-term care facility is regulated by state licensure regulations, federal regulations and Joint Commission on Accreditation of Health Care Organizations (JCAHO). State licensure is mandatory, Federal regulation is only necessary if the facility participates with Medicare and Medicaid, and JCAHO standards are voluntary. Long term-care is very expensive and it often becomes a financial catastrophe for the elderly person and their family. Private insurance is unlikely to cover the full cost of care and Medicare only pays for a limited amount.

The person usually must eliminate a substantial amount of their assets to become eligible for Medicaid which covers long term care. According to Growing Old In America “In order for elderly ersons to qualify for nursing home care under Medicaid, they usually must reduce their personal financial status to the poverty level (p. 119-120). Regretfully, the cost is not the only disturbing factor of a long-term care facility. A family decision to place my grandfather who was suffering from Alzheimer’s disease into a nursing home was a very difficult and emotional experience for everyone involved.

Regular visits by all family members continually raised concerns about the quality of care that he was receiving. Staffing was also a concern for our family. It seemed there as not enough staff to meet the needs of the patients within the facility. Although licensing agencies regulated these aspects, this was not comforting to our concerns. Fortunately, we were able to move my grandfather to a different facility. The nursing home was newer and better staffed and all family members felt more comfortable about the care he was receiving.

The experience of placing a loved one into a long term care facility is one I would prefer to not experience again. It is comforting to know that there are good facilities availab! le and caregivers that really care about the patient’s needs. These aspects are very important for families to understand before making a final decision when they must place a loved one into a facility. Hospice Unfortunately the last resort for some patients may be hospice care. Hospice is an organized program that offers dying persons and their families an alternative to traditional care for terminal illness.

As stated in Aging “Hospice care is exclusively for dying people. It therefore brings expertise to helping patients and their families face issues specific to death and dying” (p. 180). Hospice enables the patient to receive palliative medical care, while meeting the sychosocial and spiritual needs of the patient, their family and friends. Hospice programs also offer bereavement services for 13 months (or beyond if required) following the patient’s death for any family members or friends who wish to receive the service.

The article The Continuum of Long term Care emphasizes “The philosophy of hospice is that terminally ill individuals should be allowed to maintain life during their final days in as natural and comfortable a setting as possible” (p. 198). The quality of life of the terminally ill patients relies heavily on the psychosocial skills of their health care team. The health care team consists of a physician, nurse, social worker, chaplain, home health aide and volunteers.

The team develops an individual care plan which will provide an appropriate support system for the patient and their family up to and beyond the patient’s death. Weekly meetings allow the team to focus on the changing needs of the patient and make adjustments to their plan. Hospice care can be received in a variety of organizational settings. The most preferred setting is of course within the patient’s own home, but nursing homes, hospitals and long term care facilities are a few who can also provide hospice care. Hospice care is a covered benefit under Medicare and most private insurance companies.

The regulating agencies that set the standards for hospices are Medicare, the National Hospice Organization, Joint Commission on Accreditation of Health Care Organizations (JCAHO) and state hospice agencies. I have found that the medical record content in a hospice program contains an extensive amount of identifying information in regards to the patient and their primary caregiver(s). All aspects of patient care are well documented and assure well-coordinated, continuous care. The medical record acts as a communication tool between he different team members and is used on a continuous basis throughout the patient’s care.

Conclusion Although there are many options other than those listed for health care after discharge from a hospital, The most important aspect for a person is to be well informed and knowledgeable about the variety of options available. It can be very confusing, especially to an elderly person when talk of finances, regulations and covered and non-covered items are discussed. It is our responsibility as future health care administrators to provide adequate information to the person who is opting for alternatives to health care.

The Health Care System

America has a highly developed health care system, which is available to all people. Although it can be very complex and frustrating at times it has come a long way from the health care organizations of yesterday. Previously most health care facilities were a place where the sick were housed and cared for until death. Physicians rarely practiced in hospitals and only those who were fortunate could afford proper care at home or in private clinics. Today the level of health care has excelled tremendously. Presently the goal of our health care is to have a continuum of care for the patient, one which is ntegrated on all levels.

Many hospitals offer a referral service or discharge plan to patients who are being discharged. Plans for the patient are discussed with a discharge planner. The discharge planner is a person who is trained in assessing what the patient’s requirements for health care will be after discharge from the hospital. This enables the patient to continue ! their care at a level which is most appropriate for them. Items reviewed for discharge planning include but are not limited to therapies, medication needs, living arrangements and identification of specific goals.

A few of the options that are available for persons being discharged from an acute care hospital can include home health care, assisted living facilities, long term care or hospice Home Health Care According to Growing Old in America (1996), “Home health care is one of the fastest growing segments of the health care industry” (p. 114). Alternatives for home care can meet both the medical and non-medical needs of a patient. These services are provided to patients and their families in their home or place of residence. Home care is a method of delivering nursing care and other therapies as required by the patient’s eeds.

Numerous alternatives are available for persons seeking health care at home. With transportable technologies such as durable medical equipment, oxygen supply and intravenous fluids there are countless possibilities for treatment within the home setting. As stated in The Continuum of Long Term Care “Home health programs range from formal organizations providing skilled nursing care to relatively informal networks that arrange housekeeping for friends” (p. 185). This has allowed for home care to quickly become an essential component of the health c! are delivery system in the United States.

In a ome health care situation the primary care giver is usually not the physician. The physician is communicated with by phone and with documentation from the caregivers. The primary caregivers are usually the nurses and other team members who are involved directly with the patient’s care. Although, the original order to begin home care must be initiated by the physician if skilled care is to be obtained. According to the 1995 Guide to Health Insurance for People with Medicare “Medicare pays the full cost of medically necessary home health visits by a Medicare-approved home health agency” (p. ).

This overage must meet specific criteria, but it can be a relief to family members to know that their loved ones can be taken care of at home without worrying about the expenses. Unfortunately, if the care to be given within the home is termed “not medically necessary” the expense is not covered. This can include items such as meal and medication delivery, a percentage of necessary durable medical equipment, personal care and homemaker services. My employment within a home health care agency has allowed for review of services that are not covered by Medicare and/or private insurance.

Health care services hat are not included can become quite numerous. It is often difficult for family members to understand why specific services are not covered especially when they appear to be necessary for the care of the patient. These costs can add up quite quickly and the impact of the cost can become quite distressing for family members and patients on a limited budget. In these cases a Social Worker is usually provided to help the patient and family explore other avenues which may enable them to cover their health care costs.

Assisted Living Assisted living is an arrangement to residents of a facility that enables them to omplete certain daily activities while remaining independent. The services provided enable the resident to achieve maximum function of their activities of daily living. The services are unskilled and non-specialized personnel provide the activities essential to the care of the resident. These services help assist the aged, blind, disabled, and other functionally limited individuals with necessary daily activities which they require help with or are unable to perform on their own.

An example of some of the services which may be available are light housekeeping, meal preparation, medication reminders and personal care. The personal care does not include specific health oriented services which would require the services of a certified or licensed professional. It is stated well in Aging “Although the level of services provided may vary, assisted living communities all share a common goal: e! nabling people to live as active and independent a life as possible” (p. 212). The goal of an assisted living facility is to have the residents feel independent within their own home.

According to the article Assisted Living’s Future In Michigan Debated “Assisted living facilities can offer consumers a great pportunity to get personalized care in a comfortable setting” (p. 2). Currently there is some controversy surrounding the different types of assisted living facilities. In Michigan facilities termed assisted living have no real legal meaning and are not required to be licensed under this name. According to the article Assisted Living’s Future In Michigan Debated “Unlicensed facilities, unsubsidized care, untrained staff, and unmet promises make some places seem more like un-assisted living” (p. ).

Unfortunately many facilities are misleading as to what level of care they are providing. Both the government and national organizations are currently addressing this issue. My own experience with an assisted living facility has been quite good. Formerly my grandmother was a resident of an assisted living facility. The facility was specifically built for seniors and was that of an apartment like structure. The facility provided social and recreational activities on a continual basis. There was also transportation service available for residents who wished to use it.

My grandmother thoroughly enjoyed living in an assisted living facility where she had the opportunity to make numerous riends, participate in activities and remain independent. Long Term Care Long-term care patients are categorized by having a chronic condition and/or disease. The long-term care facility can be either hospital-based or freestanding. It consists of an organized medical staff, which provides continuous nursing services under professional nurse direction. The patient’s status is reviewed on a regular basis to determine if they meet criteria to remain at the facility.

The long-term care facility is regulated by state licensure regulations, federal regulations and Joint Commission on Accreditation of Health Care Organizations (JCAHO). State licensure is mandatory, Federal regulation is only necessary if the facility participates with Medicare and Medicaid, and JCAHO standards are voluntary. Long term-care is very expensive and it often becomes a financial catastrophe for the elderly person and their family. Private insurance is unlikely to cover the full cost of care and Medicare only pays for a limited amount.

The person usually must eliminate a substantial amount of their assets to become eligible for Medicaid which covers long term care. According to Growing Old In America “In order for elderly ersons to qualify for nursing home care under Medicaid, they usually must reduce their personal financial status to the poverty level (p. 119-120). Regretfully, the cost is not the only disturbing factor of a long-term care facility. A family decision to place my grandfather who was suffering from Alzheimer’s disease into a nursing home was a very difficult and emotional experience for everyone involved.

Regular visits by all family members continually raised concerns about the quality of care that he was receiving. Staffing was also a concern for our family. It seemed there as not enough staff to meet the needs of the patients within the facility. Although licensing agencies regulated these aspects, this was not comforting to our concerns. Fortunately, we were able to move my grandfather to a different facility. The nursing home was newer and better staffed and all family members felt more comfortable about the care he was receiving.

The experience of placing a loved one into a long term care facility is one I would prefer to not experience again. It is comforting to know that there are good facilities availab! le and caregivers that really care about the patient’s needs. These aspects are very important for families to understand before making a final decision when they must place a loved one into a facility. Hospice Unfortunately the last resort for some patients may be hospice care. Hospice is an organized program that offers dying persons and their families an alternative to traditional care for terminal illness.

As stated in Aging “Hospice care is exclusively for dying people. It therefore brings expertise to helping patients and their families face issues specific to death and dying” (p. 180). Hospice enables the patient to receive palliative medical care, while meeting the sychosocial and spiritual needs of the patient, their family and friends. Hospice programs also offer bereavement services for 13 months (or beyond if required) following the patient’s death for any family members or friends who wish to receive the service.

The article The Continuum of Long term Care emphasizes “The philosophy of hospice is that terminally ill individuals should be allowed to maintain life during their final days in as natural and comfortable a setting as possible” (p. 198). The quality of life of the terminally ill patients relies heavily on the psychosocial skills of their health care team. The health care team consists of a physician, nurse, social worker, chaplain, home health aide and volunteers.

The team develops an individual care plan which will provide an appropriate support system for the patient and their family up to and beyond the patient’s death. Weekly meetings allow the team to focus on the changing needs of the patient and make adjustments to their plan. Hospice care can be received in a variety of organizational settings. The most preferred setting is of course within the patient’s own home, but nursing homes, hospitals and long term care facilities are a few who can also provide hospice care. Hospice care is a covered benefit under Medicare and most private insurance companies.

The regulating agencies that set the standards for hospices are Medicare, the National Hospice Organization, Joint Commission on Accreditation of Health Care Organizations (JCAHO) and state hospice agencies. I have found that the medical record content in a hospice program contains an extensive amount of identifying information in regards to the patient and their primary caregiver(s). All aspects of patient care are well documented and assure well-coordinated, continuous care. The medical record acts as a communication tool between he different team members and is used on a continuous basis throughout the patient’s care.

Conclusion Although there are many options other than those listed for health care after discharge from a hospital, The most important aspect for a person is to be well informed and knowledgeable about the variety of options available. It can be very confusing, especially to an elderly person when talk of finances, regulations and covered and non-covered items are discussed. It is our responsibility as future health care administrators to provide adequate information to the person who is opting for alternatives to health care.

Medicine and Health in Elizabethan Times

The Elizabethan era was not only a period of rations medical science, but also a time of great superstition. Medicine remained attached to astrology and other beliefs such as the supernatural. (Davis) Elizabethan times was the era in which Queen Elizabeth I and Shakespeare lived. However the times were very unsanitary. People threw their trash out the window and if their dog or cat died, they would throw that out the window also. When it rained, cats and dogs would flow down the street. This is where the quote “Raining cats and dogs” derived.

Because of all of these things, health was a major concern in Elizabethan England. Poor sanitation and a rapidly growing population contributed to the spread of disease. (Andrews) Medicine and health in the sixteenth century was very different from that of today, however their medical problems were very different from the medical challenges we face presently. Deadly diseases were the main cause of poor health and fear of dying in Elizabethan times. They (the diseases) were believed to be caused by devils, spirits and demons, and were to be challenged by white magic and prayers.

The most famous and dreaded disease in Elizabethan Times was the plague. This disease spread rapidly, had no cure and caused numerous fatalities. “An outbreak in 1593 is reported to have killed 15, 000 people in the London area alone,” (Andrews). “Even worse than the plague, but fortunately less common, was the so called “sweating sickness. Someone with this would suffer a high fever that usually proved fatal within 24 hours,” (Andrews). Other major diseases included malaria, spread by mosquitoes; syphilis, which was sexually transmitted; and scurvy, caused by poor diet and particular common among sailors.

Epidemic diseases became common during the sixteenth century. Among them were typhus, smallpox, diphtheria, and measles. In children there were epidemics of plague, measles, smallpox, scarlet fever, chicken pox and diphtheria. Many children were abandoned, especially the ones with syphilis (it was feared they would pass it on ). Smallpox probably caused the most deaths in villages. Most people had no understanding of the disease and those who survived it were often scarred for life. (Chamberlin) Medicine was not very scientific at this time and often beliefs were relied upon to determine a treatment of disease.

The biggest belief was that health revolved around the four fluids, or humours; blood, phlegm, yellow bile and black bile. The amounts of these humours determined a person’s physical or mental health. A person with a dominant presence of blood was supposedly happy and generous. A dominance of yellow bile meant that the person was violent and vengeful. An excess of phlegm resulted in a person being dull, pale and cowardly. Black bile justified someone’s laziness. The three main organs in the body according to the Elizabethans were the heart, liver, and the brain.

The liver was considered the great blood forming, nutritiongiving organ from which the four humours arose,” (Davis). It was also considered the origin of the veins which spread throughout the body. Elizabethans believed the heart to be the center of life. The heart was the place of affections and emotions-joy, anger, hope, fear, etc. , and the source of the soul. The brain was the place of reason, memory, and imagination. (Davis) “Many physicians in Elizabethan England held medical degrees from Oxford or Cambridge University. They studied the works of ancient Greek physicians Hippocrates and Galen.

Ancient medical knowledge was high respected, and doctors were warned against excessive experimentation. After completing their studies, every new doctor was examined by the Royal College of Physicians before receiving a license to practice medicine,” (Andrews). Back then, physicians were associated with the Catholic Church and they had been forbidden to shed blood. Therefore, practices involving bloodshed, such as surgery, was the responsibility of surgeons. Surgeons would bandage wounds, remove bullets and arrowheads, set broken bones, and pull teeth.

They rarely performed surgery in which the body was opened. There was no anesthetic and the patients were fully awake. Many died soon afterward due to infection or from shock to their systems. Elizabethan apothecaries, or pharmacists, had no formal medical training, like surgeons. “They learned their skills through apprenticeship. Apothecaries dealt mostly in herbs and tonics, but they could make a good living by selling tobacco on the side. In small villages medical issues were often handled by “wise women”, old women who knew and practiced folk cures.

Much of this involved the use of herbs and other plants. A few of these “wise women” also could set broken bones. They are frequently referred to as beldames in Shakespeare’s plays,” (Andrews). The practices of the sixteenth century were very different from those of today. Most Elizabethans believed that health was governed by four basic fluids, or humours; blood, phlegm, yellow bile and black bile. “The people believed that the four humours had to be in balance to maintain health,” (Andrews). Because of this a popular cure was blood letting, or removing “excess” blood from the patients veins.

Many doctors also recommended that healthy people be bled on a regular basis to keep the fluids properly balanced. Doctors often considered a patient’s horoscope when planning a treatment. Other remedies included drugs made from herbs, minerals, and animal parts. The first effective remedy for malaria was a plant from Peru named Cinchona. It cured quickly and acted specifically on only a certain kind of fever. (Chamberlin) The physicians of the Elizabethan period were men of good education. They contributed greatly to the medical advancements of this era.

For mental illness, Jean-Baptiste Denis extended the new technique of transfusing blood to the treatments of mental patients. However, this ended when a patient died. Ambroise Pare discovered the effectiveness of hygiene on wound healing. “One night after treating many gunshot wounds with boiling oil, he ran out of oil. So for many of the soldiers Pare simply cleaned and dressed their wounds and went to bed. The next day he awoke to see that the wounded treated with oil were feverish and in pain, while the ones cleaned and dressed were sleeping and doing well,” (Lyons and Pertrucelli).

Boiling oil was no longer used and he also later influenced many physicians to stop using cauterizing irons. Physician William Harvey studied the circulation of blood in 1616 and for the first time he demonstrated the real action of the heart and the course that the blood took through the arteries. Jan Baptista van Helmont believed that fever was not due to unbalanced humours, but discovered that it was a reaction to an invading irritating agent. He didn’t use bloodletting and purging but used chemical medicines and improved the sued of mercury. (Lyons and Pertrucelli)

William Shakespeare has been credited as being ahead of his time with regard to his understanding of the medical field. Proof of his excellence lies within his dramas. “Doctors are featured in Shakespeare’s plays more often than any other professionals,” (Andrews). In conclusion, Elizabethan medicine was very different from our present day practices and beliefs. Furthermore, the medical problems of the sixteenth century were very different from those of today. Medicine and health in the Elizabethan times was not the best, but it helped to achieve to greatness in the medical field we have today to say the least.

Skin Cancer Essay

Gone are the days when people sent children outside to play to get a little color in their cheeks. They know too much about the dangers of unprotected sun exposure and the threat of skin cancer. Or do they? Despite the fact that 58% of parents remembered hearing about the importance of protecting their children from the sun, children are still playing in the sun without sunscreen or protective clothing (3. , p 1). Sunburn is the most preventable risk factor of skin cancer. Skin type and family history cannot be changed. Protection from the sun and education of the potential hazards of the sun eed serious attention.

The American Cancer Society estimates that over 850,000 cases of skin cancer will occur in the United States during 1996. Of those cases, they predict that 9,430 will end in death (4. , p 1). Apparently, Americans still do not have an adequate amount of prevention information to help reduce the disfigurement and mortality from this cancer. Exposure to the ultraviolet radiation from the sun is the most frequently blamed source of skin cancer. Due to the reduction of ozone in the earth’s atmosphere, UV radiation is higher today than it was several years go.

Ozone serves as a filter to screen out and reduce the UV light that reaches the earth’s surface and its people. Very simply, sunburn and UV light can damage the skin and lead to skin cancer (1. , p 1). The American Cancer Society also faulted repeated exposure to x-rays, artificial forms of UV radiation like tanning beds, and contact with chemicals like coal tar and arsenic as other causes of skin cancer (4. , p 1). Additionally, if there is a history of skin cancer in the family, an individual may be at a higher risk (1. , p 1).

Individuals who have experienced only one serious sunburn have increased their risk of skin cancer by as much as 50% (1. , p 4). There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. Basal cell carcinoma usually imposes itself on areas of the skin that have been exposed to the sun. It usually appears as a small raised bump with a smooth shiny surface. Another type resembles a scar that is firm to the touch.

Although this specific type of skin cancer may spread to tissue directly surrounding the cancer area, it usually does not spread to other areas of the body (9. p 2-3). Squamous cell carcinoma growths also appear most frequently on areas of the body that have been exposed to the sun. These areas can include the hands, lower lip, forehead, and the top of the nose. Additionally, skin that has been exposed to x-rays, chemicals, or has been sunburned can host these tumors. The squamous tumors may feel scaly or develop a crusty appearance. Some growths may bleed. These particular tumors may spread to lymph nodes in the surrounding area (9. , pp 2 -3). Malignant melanoma is a far more serious type of skin cancer.

It can spread quickly to other parts of the body through the lymph system or blood. This type of skin cancer is more common among adults. Findings have indicated that men most often develop melanoma on the trunk of the body. Whereas, women most often develop it on the arms and legs (6. , pp 2-3). The warning signs of melanoma are: changes in the color, size, or shape of a mole, bleeding or oozing from a mole, or a mole that is hard, lumpy, swollen, and is tender to the touch, or feels itchy. A new mole can also be an indicator of melanoma. A simple “ABCD” rule outlines the warning signs of melanoma.

A” is for asymmetry. One half of the mole does not match the other. “B” is for border irregularity. The edges are ragged, notched, or blurred. “C” is for color. The pigmentation is not uniform. “D” is for a diameter of greater than 6mm. Any progressive increase in size should be of particular concern (8. , p 1). For both basal and squamous cell carcinomas, surgery is the most common treatment. Electrosurgery is the process in which the cancer is scooped out with a sharp instrument and then an electric current is used to burn the edges around the site to kill any remaining cancer cells.

Cryosurgery freezes the tumor to kill the diseased tissue with liquid nitrogen. Simple excision cuts the cancer from the skin along with some of the healthy tissue around it. Micrographic surgery removes the cancer and as little normal tissue as possible. During this surgery, the doctor removes the cancer and then uses a microscope to look at the cancerous area to make sure no cancer cells remain. This particular treatment has the highest 5-year cure rate. Laser therapy uses a narrow beam of light to remove the cancer cells. Surgery may leave a permanent scar on the skin.

Depending on the size of the cancer removed during surgery, skin grafting may be necessary. Radiation therapy uses x-rays to kill cancer cells and shrink tumors. Chemotherapy uses drugs to kill the cancer cells. Topical chemotherapy is often administered as a cream or lotion placed on the affected skin to kill the cancer cells. Systematic chemotherapy is a treatment administered in the form of a pill or injection. This allows the drug to enter the bloodstream, travel through the body and kill cancer cells. Systematic chemotherapy is in the process of being tested in clinical trials.

Biological therapy, or immunotherapy tries to get the person’s own body to fight the cancer. It uses materials made from the infected person’s body to boost, direct, or restore the body’s own natural defenses against the cancer. Photodynamic therapy uses a certain type of light and a special photosensitive chemical to kill cancer cells (9. , pp 2-5). Malignant melanoma is classified by stages. In Stage 0 melanoma, abnormal cells are localized to the outer layer of the skin cells and do not invade deeper tissues. At stage I, cancer is found in the epidermis and/or the dermis, but it has not yet spread to nearby lymph nodes.

The tumor measures less than 1. 5 millimeters thick. At stage II, the tumor measures 1. 5 millimeters to 4 millimeter thick. The cancer has spread to the lower part of the dermis, but not into the tissue below the skin or into the nearby lymph nodes. At stage III, indications are that the tumor has spread to nearby lymph nodes or there are additional growths between the original tumor and the lymph nodes in the area. At stage IV, the tumor has spread to other organs or to lymph nodes far away from the original tumor. The type of treatment is based on the stage of the cancer.

Four of the most common kinds of treatments are: surgery, chemotherapy, radiation therapy, and biological therapy. Surgery is the primary treatment for all stages of melanoma. After surgery, chemotherapy is normally used to kill any cancer cells that may remain (6. , pp 2-5). Individuals that have treatment for basal cell carcinoma should be clinically examined every 6 months for at least 5 years. Thereafter, an examination for recurrent growths or new tumors should be done on an annual basis. It has been found that 36% of individuals who develop a basal cell carcinoma will develop a second primary basal cell carcinoma within 5 years.

Since squamous cell carcinomas have definite metastatic potential, these patients should follow a 3 month re-examination schedule for the first several years, and then follow a 6 month schedule of examinations for an indefinite period of time (10. , pp 4-6). Overall, there is an increased incidence of second primary melanomas in affected individuals. A minimum of 3 percent will develop second melanomas within 3 years. Thus, patients need close follow up for the development of subsequent primary melanomas. An appropriate interval of re-examination may be 6 months for patients with atypical moles and without a family history of melanoma.

If patients have not shown evidence of recurrence or a second primary melanoma by the second anniversary of diagnosis, the interval between examinations can be extended to 1 year. For patients with atypical moles, or a positive family history of melanomas, examinations should be considered every 3 to 6 months (11). The American Cancer Society reports that basal cell carcinoma, the most prevalent skin cancer, and squamous cell carcinoma have a notable prognosis if detected and treated early. Although, individuals with non-melanoma skin cancers are at a high risk for developing future skin cancers.

While melanoma is the rarest of the skin cancers, it is the most deadly (7. , pg. 1). The American Cancer Society also states, “Malignant melanoma can spread to other parts of the body quickly; however, when detected in its earliest stages, and with proper treatment, it is highly curable. The 5-year relative survival rate for patients with malignant melanoma is 87%. For localized malignant melanoma, the 5-year relative survival rate is 94%; and rates for regional and distant disease are 60% and 16%, respectively. About 82% of melanomas are diagnosed at a local stage” (8. , p 2).

When the statistics show that over one million new cases of skin cancer will be diagnosed in the United States this year, Americans have their work cut out for them. By the year 2000, Americans will have a 1 in 75 lifetime risk of developing melanoma or other skin cancers (5. , p 1). Early detection is by far the most crucial element of surviving this terrible disease. Changing society’s belief that being tanned connotes health and beauty continues to be a challenge. The notion has to be replaced with the belief that staying out of the sun, or taking extreme precautions while in the sun is smarter.

Anthrax Vaccination Essay

The anthrax vaccination is the only known defense available for United States Troops against the deadly anthrax virus. Many experts have said it is not effective against inhalation anthrax. Studies have not been conclusive in their findings. The chance of living if you have received the anthrax vaccination seems better. More studies should be conducted outside the Department of Defense, with their cooperation, before the process to vaccinate troops continues. Anthrax is a disease normally associated with plant eating animals (sheep, goats, and cattle) caused by the bacterium Bacillius anthracis.

It is now controlled through vaccination programs throughout the world including the United States. Human infection with anthrax usually results from contact with infected animals or products. Anthrax was discovered by Robert Koch in 1876. An effective vaccine for animals was developed in 1881 by Louis Pasteur. In humans, the disease appears in both external and internal forms. The external form is contracted through cuts and breaks in the skin. The internal form is caught by inhaling anthrax spores, which invade the lungs and intestinal tract (Funk and Wagnalls New Encyclopedia, 1996).

Russian scientists have created a new form of the anthrax virus by genetic engineering. Col. Arthur Friedlander , chief of the bacteriology division at the U. S. Army Medical Research Institute states, The evidence that they presented suggested that it could be resistant to our vaccine (Riechman, Army Times 03-09-98). When anthrax is used as a biological weapon, people become infected by breathing the spores released in the air. Anthrax is 100,000 times deadlier than the deadliest chemical warfare agent. It is the preferred biological agent because it is easy to produce in bulk and the materials are low in cost.

Dr. Jose Ramero Cruz, of the World Health Organization states,Because anthrax spores are resistant to dryness and heat, they are relatively easy to grind and store. U. S. officials say that as many as 12 countries including Russia, Iraq, and North Korea, have established capabilities to produce and load deadly anthrax spores into weapons (D. Funk, Army Times, 3-19-98). An anthrax loaded scud missile could kill 100,000 people in an urban area according to a 1993 study, Proliferation of Weapons of Mass Destruction: Assessing the Risks, (J. Erlich, Army Times, 9-8-97).

No country is known to have released the biological agent during wartime. Anthrax has the potential to cover large areas of the battlefield. It is not known what branch of service, front line, or rear area troops would be at greater risks. Defense Secretary William Cohen stated, Anthrax is the poor mans atomic bomb (D. Funk, Army Times,1-12-98). The anthrax vaccine is used to protect against anthrax. It contains only dead organisms. Human vaccination was developed in England and the United States in the 1950s and early 1960s.

The vaccination was licensed and approved by the United States Food and Drug Administration in 1970. The vaccination is produced by Michigan Biologic Products Institute located in Lansing, Michigan. It has been administered to veterinarians, laboratory workers, and livestock handlers safely for over twenty five years (D. Funk, Army Times, 8-31-98). The anthrax vaccination prevents illness by stimulating the bodys natural disease fighting abilities. It has not been proven whether the vaccination will work against inhaled anthrax. The informational insert that usually comes with the vaccine could not be obtained.

I did find that according to the Michigan Department of Public Health in Lansing, Michigan there are no references for using the vaccine for inhaled anthrax (Joyce, AGWVA). Chairman of the Joint Chiefs of Staff, General Henry H. Shelton says we have stockpiled a safe and effective vaccine to protect our forces against anthrax (DefenseLINK a. , 18June98). There are many views and arguments to this statement. One that may not be resolved until further research can be done or anthrax is used against roops who have received the vaccination.

Almost all cases of inhalation anthrax in which treatment was started after symptoms began, have resulted in death, regardless of treatment afterwards. Being vaccinated greatly increases your chances of surviving an exposure to anthrax. Without the vaccination or protection (MOPP gear) it has a ninety-nine percent death rate to unprotected persons (PROMED (03) PRO/AH). From this point of view, it would beneficial to receive the vaccination. Since 1970, there have been no known long term side effects associated with the anthrax vaccination.

Reported side effects to the vaccine are mostly limited to local reactions. They include, sore arm, redness, and slight swelling at the injection site in 30 percent of recipients. Severe local reactions such as swelling that may extend from the elbow to the forearm are rare (Arnot Ogden Medical Center, 1998). Minor adverse reactions can include, but are not limited to flu like symptoms. Out of 133,870 immunizations, only seven (. 005 percent) severe reaction cases have been reported. Six were found to be minor effects and all service members were returned to duty.

Only one service member had a more severe illness (Guillain-Barre Syndrome) that occurred after receiving his third dose of anthrax vaccination. He began recovery one month after onset of the illness (D. Funk, Army Times, 8-31-98). No studies have been conducted to determine if the anthrax vaccination causes cancer, induces genetic mutation, impairs fertility, or causes fetal harm ( Joyce, AGWVA). Service members have already begun the immunization process against anthrax. Phase I of the immunization process began with all service members expected to be going to a high threat area on

August 16, 1998. Those already in Korea will begin September 9,1998. Service members serving in the Persian Gulf began in early March of 1998. About 48,000 have begun the series. Phase II will be for units first to deploy (XVIII Airborne Corps and subordinate units) in the event of a military incident. It is scheduled to begin in fiscal year 2000. Phase III will include the remaining forces and new recruits by fiscal year 2003. All 2,400,000 active duty, reserve, and national guard members will be vaccinated (D. Funk, Army Times,8-31-98).

All service members will be required to take the vaccination as stated in Department of Defense Directive 6205. 3 unless medically deferred. Some examples of soldiers who will be deferred are pregnant soldiers, and soldiers who are HIV positive. Family members will not be required to receive the vaccination and there is no plan to vaccinate them at this time. Withdrawing them from the region will be the first resort ( DefenseLINK a. 18JUN98). The majority of service members that have been required to receive the vaccination have done it.

Sixteen service members, 14 Navy, and 2 Air Force have refused to ake the vaccination. Two sailors have been discharged and the rest have received disciplinary action. A Fort Stewart, Georgia soldier is facing a probable discharge after choosing to go AWOL rather than take the required series of shots. It is conceivable that the number of refusals could rise when the program spreads to troops who dont feel an immediate threat said Secretary of Defense William H. Cowan (D. Funk, Army Times, 8-31-98). A total of six vaccinations will be administered in order for the series to be complete.

Three vaccinations will be given 2 weeks apart from each other initially. It will be followed by 3 additional vaccinations given at 6, 12, and 18 months. A booster shot annually will be given afterwards (ProMED(03), PRO/AH). While the entire vaccination series is 6 shots, military officials think it is possible service members dont need that many shots. Research to determine that is continuing, said Rear Admiral Michael Cowan, deputy director of medical readiness for the Joint Staff. Until we know for certain that it is safer to give fewer shots, well go with standardization, approved series,he said (D. Funk, Army Times, 8-31-98). The cost to immunize an estimated 2,400,000 military personnel will be approximately 130,000,000 million dollars(DefenseLINK News 8-14-98).

The estimated 130,000,000 dollars needed to vaccinate all active duty, reserve, and national guard forces against anthrax is wasted money, said Victor Sidel, a physician at the Albert Einstein College of Medicine in New York and co-president of International Physicians for the Prevention of Nuclear War, which won the Noble Peace Prize. It is a snare and delusion, said Sidel of troops taking the vaccination.

Theres very kind of evidence that this material is ineffective against the strains that are likely to be used. And there is evidence that the material causes adverse reactions (D. Reichman, Army Times, 3-9-98). In conclusion, the best believed defense available to the United States military is the anthrax vaccination. Studies against the vaccination have not been conclusive enough to persuade me to trust this vaccination 100 percent. It should be handed down to an independent research team outside the Department of Defense for further study. If the choice was mine to make today, I would not take the vaccination.

Cystic Fibrosis – Genetic Disease

Cystic fibrosis is the most common autosomal recessive genetic disease of white Indo-Europeans (Caucasians). Three main systems are usually affected by cystic fibrosis. These include the lungs and respiratory tract, the digestive tract (especially the pancreas and intestines) and the sweat glands. The lungs will normally have a thick mucus line them in cases of cystic fibrosis which requires physiotherapy to dislodge the mucus and create sputum. The digestive enzymes that would come from the pancreas are blocked by the thick mucus; thus the person afflicted with the disease has trouble digesting foods that are high in fat and protein.

In cases that involve cystic fibrosis the salt that is lost during perspiration is much more than in “normal” situations. The upper respiratory tract is normally lined with a little bit of mucus that is sent out of the lung by the constant movement of the cilia that line the respiratory tree. “It is clear from detailed research that poor mucus clearance is not due to uneven ciliary beating. However, there is no doubt that mucus is poorly cleared against gravity in the presence of bacterial infection” (Harris 13-14). The pancreas itself secretes fluids that aid in the digestion and absorption of food in all of us.

When cystic fibrosis is present these enzymes are not going where they are needed. Most of the time there is need for supplemental nutrients, supplemental minerals, and/or dietary management. In the case of dietary management there is a plan for seven to eight small meals throughout the day. “This meal pattern enables the patient to consume more food without feeling too full and enhances the utilization of nutrients” (Ekvall 391). The sweat gland of a cystic fibrosis patient, when viewed under the microscope appears normal.

The secretions that the gland gives off are where the abnormality occurs. “It is known that the basic defect in cystic fibrosis is expressed as an abnormal regulation of the movements of salt across the layer of cells that line certain specialized ducts such as the sweat gland duct” (Harris 26). This causes a great deal of salt loss and therefore requires most cystic fibrosis patients to ingest salt pills to compensate for the loss. When all of the treatments are used together most patients of this fateful disease live long happy lives.

The physiotherapy that they must endure is the most grueling for most of the patients. This involves coughing up as much of the sputum as possible while inhaling a moisturizing mist and getting pounded on the back to loosen the mucus deep within their lungs. This activity is especially frustrating in the adolescent years when resistance comes into play. Parents find that the teenage years are the most grueling because there is a rebellious stage that most teenagers go through anyway. Having this disease on top of that is almost asking for further trouble.

The well siblings of those who are afflicted with this disease do not see it as a problem. Early on in life they are observant of their parents’ frustrations, but later learn that this is just another facet of life that is dealt to certain individuals. They see that their parents do not treat them any differently than their sibling who has the disease. ” ‘We both have to do chores,’ ‘She does the same amount,’ ‘We get treated the same’ are not uncommon among those families with sick and well children” (Bluebond-Langner 201).

The life of the child with this debilitating disease is not always as easy as some of these previous books have lead one to believe. This disease affects the person who has it, the siblings in the household, anyone who comes into contact with the sick person, and especially the parents of the sick individual. Yes, the afflicted is the most directly influenced by cystic fibrosis, but it is the parents who must provide most of the care to the person afflicted. This is a disease that is primarily identified early in a child’s life and treated from that day forward.

As stated before special diets or extra vitamins can be required to help children digest their food properly, and antibiotics are given to fight lung infections. In addition to all of this is the rigorous task of physiotherapy. This must be done two or three times daily so that the mucus does not have a chance to build up and cut off the supply of life giving air. “All this treatment is normally given in the child’s own home and has to be provided by the parents.

Obviously such an extensive program challenges even the most able” (Burton 8). Emergency hospitalization to combat lung infections and bowel obstructions are other factors that the parents of a cystic fibrosis patient must endure. The child who grows up with cystic fibrosis becomes increasingly aware of his/her differences as he/she gets older. These differences can either inhibit or benefit the child in his/her relationship with others. The friends that he/she makes can help with the daily procedures.

This may be hard for them to cope with at first, but in the end will benefit all parties involved. The friends will better understand what their buddy has to go through with this disease. It will become more acceptable, and fewer people will consider it an inhibition. Rather, it can be viewed as a learning experience for everybody who may come into contact with the child who endures the pain of cystic fibrosis. There are some cases that are not as severe as others are, but there are those that cannot be turned around quite as easily.

Whether it is because the treatment did not get started early enough, or the disease is out of control death is a factor that must be considered in most cases involving cystic fibrosis. Death will come to all of one day, but it may come earlier to some. The problems that some families may have with their communication can cause great pain and suffering when it comes time to dealing with the death of a loved one. “The long standing problems of communication that exist in many family groups may be accentuated when the prospect of death shows itself” (Bowers 58).

Cystic fibrosis is a disease that can take the life of some one who is very close to our hearts. Education of the treatments, side effects, and problems involving this disease is key to winning the battle against it. The more people can know about different situations that better. If there is some one in a school that has this disease try to educate the entire school about this person’s situation so that the entire student body can help in the fight. If educators and students all join in the fight, this disease can be kept down and help those afflicted lead as “normal” a life as possible.

Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID)

Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) was first recognized in the 1700’s but was not understood so therefore it was forgotten. Many cases show up in medical records through the years, but in 1905, Dr. Morton Prince wrote a book about MPD that is a foundation for the disorder. A few years after it was published Sigmund Freud dismissed the disorder and this dropped it from being discussed at any credible mental health meetings. Since then the disorder has been overlooked and misdiagnosed as either schizophrenia or psychosis.

Many in the medical profession did not believe that a person could unknowingly have more than one personality or person inside one body, even after in the 1950’s Three Faces of Eve was published by two psychiatrists. In 1993, records showed that three to five thousand patients were being treated for MPD compared to the hundred cases reported ten years earlier. There is still as increase in the number of cases being reported as the scientific community learns more and more about the disease and the public is becoming more and more aware of this mental disorder.

There are still many questions left unanswered about the disease, like “Is it genetic? ” or “Is a certain type of personality more vulnerable to the disorder? ” but many aspects of how people come by the disorder are already answered (Clark, 1993, p. 17-19). MPD is commonly found in adults who were recurrently abused mentally, physically, emotionally, and/or sexually as young children, between birth to 8 years of age. The child uses a process called dissociation to remove him/herself from the abusive situation.

Dissociation is when a child makes up an imaginary personality to take control of the mind and body while the child is being abused. The child can imagine many personalities but usually there is a personality for every feeling and or emotion that was involved during the abuse (BoyyM, 1998, p. 1). As an adult, the abused child finds it hard to keep track of time and may have episodes of amnesia. Other symptoms that will appear in adults with MPD are depression, auditory and visual hallucinations (hearing voices) and suicidal thoughts.

Another major symptom is when the adult has no recollection of their childhood. The adult with MPD has no idea they were abused as children and also unaware of the other personalities living inside of their head (Multiple Personality Disorder-fact sheet, 1996-99, p. 1). Multiple Personality Disorder is when there is “the presence of two or more distinct identities or personalities, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self”(BoyyM, 1998, p. 1). There can be anywhere from two to over a hundred different personalities.

Usually each personality will fall into one of the following categories: core, host, protectors, internal self-helper, fragments, child members, preteen, teenager, adults, artistic/music, cross-gender, cross-colored, animal members, inanimate members (BoyyM, 1998, p. 2-3). The host personality is the person who is the multiple, this is the original personality, or the one that created the other personalities, but is unaware of them. The most common apparent identities are the child, persecutor, rescuer, and helper. The child is the identity that is under the age of twelve.

They behave as children often sucking thumbs, twisting hair, like to eat cookies, throw tantrums, and use child-like vocabulary. The Persecutor identity is the self-destructive identity that is violent and angry. Persecutor identities usually have a drug/alcohol problem and generally put the host at risk. The rescuer personality is usually devoid of emotion but logical, able, proficient, and responsible. The helper personality knows the most about the history of the multiple; they generally want to help everyone for the general good.

The helper personality is the personality that is most helpful in therapy because they usually know about all the other identities (Clark, 1993, p. 80-83). Sub-personalities are not only part of a person with MPD but they are also evident in emotionally normal persons as well. Although, in a normal person, he/she remembers when their sub-personality takes over, but in a MPD patient, the personality disconnects from the host that the host can not remember what happens. When a traumatic experience happens, whether positive or negative, a sub-personality will develop.

In a normal person, the splitting is broken into an “ok self” and a “not ok self”. In a multiple, the personalities are more defined; they are broken into smaller fragments that disassociate from the human host (Rowan, 1990, p. 7, 20). In the book by Terri A. Clark, M. D. , it shows the distinct the personalities are in several cases. It also displays how each identity can be different from the other identities and the host. In one of Clark’s cases, Veronica, one of the personalities of her patient Regina, showed up for the weekly appointment instead of Regina (note that it really was Regina, but she was a different identity).

Clark noticed a change in the appearance of Regina on her arrival and noted the difference in her voice. Veronica (Regina) continued to speak to Clark as if it was the first time they had met. Although, Veronica knew about Clark, Regina’s personal life, and therapy, this was the first time Clark had met this personality. Clark discovered while talking to Veronica that she had a separate business which she ran on the weekends, and when Veronica was in control of the body. Regina had no idea about the business; Veronica used the fake name and an Art Gallery’s telephone number in which to run her business.

Veronica even had a different handwriting than Regina. According to Clark, each personality has its own distinct features, such as handwriting, fashion taste, hobbies, and culinary taste. In most cases, there will always be personality that writes with their left hand, while the host and other identities write with their right. In Regina’s case, Veronica wore different clothes than Regina and she had an interest in fine art. Each personality of a host, when asked, will tell you they have a certain type of hair color and cut, height, weight, and even gender (Clark, 1993, p. -78).

The problem with having all these personalities is that they do not mesh well. Consequences can arise from having so many different traits inside one body like eating and sleep disorders, depression, anxiety, and substance abuse (Smith, 1993, p. 1). Each alter personality also has their own name, these names can come from anything but there are three common factors that influence the alters name. Some alters are just born with the name, this is when the alter is modeled after a real or fictional character.

Some alters are named after emotional responses, such as Sad One or Angry Janie. Many alters are named for the specific job they are supposed to do, like Director, Helper or Avenger. The names chosen have been created by a child so they are most likely modeled after a fictional or real character. Although the host will have no idea of the other personalities and will not respond to the names at first, the alters respond to the birth personalities name (Clark, 1993, 90-91). The circumstances that the identities get the host into can also become a problem.

The different alters while in possession of the body can go somewhere where the host does not know and then leave and the host is left with no idea how he/she got there and how to get back. In Sybil, one of the first times she realized she had a problem was when she had to leave her Columbia University Chemistry Lab when something broke. The last thing she remembered was standing at the elevator but when she regained consciousness she was in the warehouse district of Philadelphia. Miles from where she had been before in New York and it was five days later (Schreiber, 1973, p. 23-36).

The persecutor identity has a tendency to leave the host in dangerous situations. Carla, one of Clark’s patients, had a persecutor alter named Godiva. Godiva was always putting Carla in sticky situations like Godiva would pick up men at bars and bring them home or go home with them. Carla would come to consciousness with an unknown man in her bed and she would pass out, another alter would have to come out and rescue Carla. CJ (Carla’s big burly male alter) would come out punch the guy and leave. Christine (Carla’s logical alter) would come out and handle the situation using her negotiation skills.

At other times Timmy (the young boy who was an escape artist) would come out talk his way out of the situation, leaving the man so bewildered because he was with a woman who thought she was a young boy. When this occurred it would leave the other alters upset at Godiva (Clark, 1993, p. 99). There are three different types of relationships that alters can have between each other. The first one is, “one-way amnesia”, this is when alter number one knows about alter number two but alter number two does not know about number one.

The second relationship is “‘two-way amnesia’ exist when neither alter know about each other”(Clark, 1993, p. 87). Cognizance, the third relationship, is when all the alters know about each other but the host personality knows about none of them. The host will hear conversations in his/her head, these conversations are between the alters. This is when the alters know the host personality but is unable to affect it as long as the host is in control (Clark, 1993, p. 87-88). The cause of MPD is severe trauma, most of the trauma happens at a young age and the violator is usually someone who the child knows.

In satanic cults, children mistreated and abused, to intentionally cause MPD, do not know everyone who is involved in the abuse. Examples given by Clark are children put in a coffin with rats, snakes, and bugs then buried alive. Later the satanic cult leader or priest will rescue the child therefore making the child feel obligated to that person. In satanic cults, children are also raped. During the rape, men and women would violate the child they would also violate the child with objects such as a knife, an upside down crucifix, and other objects (Clark, 1993, 181-198).

The child gets to the point where they think they are going to die, and they disassociate themselves from the situation, this is when the personalities are born. Other types of abuse are emotional and psychological abuse by a parent. One of Clark’s patients remembered under hypnosis a time when she was two. Her mother took her outside put her in a tree and told her to jump, the child after a slight hesitation did so, and the mother stepped back, watched the child fall to the ground, and laughed.

These traumatic events and others are the cause of MPD (Clark, 1993, 105-106). No matter how bad the abuse was and how many different personalities are present; a MPD patient can be cured. The process to recovery for a MPD patient is long and hard. The personalities are not being made to disappear but to become one. There has to be a fusion of all the alters into the host, the host has to learn to express all the emotions, that for so long, another alter would take care of for them. Although some MPD patients are harder than others to fuse, but all patients can be cured.

Patients that were subject to Satanic Ritual Abuse are more difficult to fuse due to the threats that the cult made or are making on their lives. A patient that was in a cult must have lost all contact with the cult before successful fusion can take place. When fusion is successfully accomplished, the host person can handle their emotions as where before fusion they were unaware of many common emotions (Clark, 1993, 208-213). Research is continuing to be done on this disorder. Many people still doubt the realism of the disorder, especially as more people fake the disorder to get out of judicial problems.

About 1% of America’s population has MPD, but many are scared to see Psychiatrist, and many fake the disorder (Smith, 1993, p. 1). As awareness for the disease is becoming more prevalent, more patients are discovering after years of misdiagnosis, they finally can start the right kind of therapy. Multiple Personality Disorder is not a disease or mental illness, it is a disorder caused by traumatic events in early childhood. MPD is treatable and a MPD patient can hope to one day live a normal life with every part of his/her personality fused into one.

A MPD patient is not something to be afraid of as where they usually just inflict pain upon themselves and not on others. MPD patients can be your next door neighbor, parent, and even spouse. They do not seem that different from normal people, and many do not even know they have the disorder. Awareness is the key, not only awareness of MPD but of child abuse, if child abuse is stopped MPD will not be a problem. Many Christians believe that Multiple Personality Disorder is demon possession, but MPD and demon possessions differentiate in many ways.

MPD although it can be caused by satanic ritual abuse is not evil, it is a process of the mind. Possession on the other hand, is when a body is taken over by an evil spirit. It is the physical body that the demon has control over not the mind. In MPD the only part affected is the mind, the body is not changed and does not convulse as it does in possession. In Ephesians 6:12(NIV) it is written, “For our struggle is not against flesh and blood, but against rulers, against authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.

Demon possession is the fight against the flesh MPD is the fight against the mind. In Matthew 8:28-31 we see demon possession, “When he arrived at the other side in the region of the Gadarenes, two demon-possessed men coming from the tombs met him. They were so violent that no one could pass that way. “What do you want with us, Son of God? ” they shouted. “Have you come here to torture us before the appointed time? ” Some distance from them a large herd of pigs was feeding. The demons begged Jesus, “If you drive us out, send us into the herd of pigs.

He said to them, “Go! ” So they came out and went into the pigs, and the whole herd rushed down the steep bank into the lake and died in the water. ” This shows that demons are first only in possession of body and second afraid of Jesus Christ. If a Bible is brought into a room with one that is possessed they will immediately ask for the person to leave. I do not believe that MPD is demon possession, I do believe that they are more susceptible to it if they have been involved in a satanic cult.

MPD patients are gifted, smart individuals who suffered greatly as children and they used their only defense their imaginations to alleviate the pain. In Mark 10:13-16 says, “People were bringing little children to Jesus to have him touch them, but the disciples rebuked them. When Jesus saw this, he was indignant. He said to them, ‘Let the little children come to me, and do not hinder them, for the kingdom of God belongs to such as these. I tell you the truth, anyone who will not receive the kingdom of God like a little child will never enter it. ‘ He took the children in his arms, put his hands on them and blessed them. “

Different Illnesses Essay

Illnesses caused by microorganisms and transmitted from an infected person or animal to another person or animal. Some diseases are passed on by direct or indirect contact with infected persons or with their excretions. Most diseases are spread through contact or close proximity because the causative bacteria or viruses are airborne; i. e. , they can be expelled from the nose and mouth of the infected person and inhaled by anyone in the vicinity.

Such diseases include diphtheria, scarlet fever, measles, mumps, whooping cough, influenza, and smallpox. Some infectious diseases can be spread only indirectly, usually through contaminated food or water, e. g. , typhoid, cholera, dysentery. Still other infections are introduced into the body by animal or insect carriers, e. g. , rabies, malaria, encephalitis, Rocky Mountain spotted fever. The human disease carriers, i. e. , the healthy persons who may be immune to the organisms they harbor, are also a source of transmission.

Some infective organisms require specific circumstances for their transmission, e. g. , sexual contact in syphilis and gonorrhea, injury in the presence of infected soil or dirt in tetanus, infected tranfusion blood or medical instruments in serum hepatitis and sometimes in malaria. In the case of AIDS, while a number of different circumstances will transmit the disease, each requires the introduction of a contaminant into the bloodstream.

A disease such as tuberculosis may be transmitted in several waysby contact (human or animal), through food or eating utensils, and by the air. Control of communicable disease depends upon recognition of the many ways transmission takes place. It must include isolation or even quarantine of persons with certain diseases. Proper antisepsis (see antiseptic ) should be observed in illness and in health. Immunologic measures (see immunity ) should be utilized fully. Some sexually transmitted infections are associated with cancer (cervical or penile).

Education of the population in rules of public health is of great importance both in the matter of personal responsibility (disposal of secretions, preventing contact with the blood of others, proper handling and preparation of food, personal hygiene) and community responsibility (safe water and food supply, sterile blood supply, garbage and waste disposal). Animal and insect carriers must be controlled, and the activities of human carriers must be limited. Non-communicable diseases are also called chronic Chronic diseasessuch as heart disease, cancer, and diabetesare the leading causes of death and disability in the United States.

These diseases account for 7 of every 10 deaths and affect the quality of life of 90 million Americans. Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. Adopting healthy behaviors such as eating nutritious foods, being physically active, and avoiding tobacco use can prevent or control the devastating effects of these diseases. CDCs National Center for Chronic Disease Prevention and Health Promotion is at the forefront of the nation’s efforts to prevent and control chronic diseases.

The center conducts studies to better understand the causes of these diseases, supports programs to promote healthy behaviors, and monitors the health of the nation through surveys. Critical to the success of these efforts are partnerships with state health and education agencies, voluntary associations, private organizations, and other federal agencies. Together, the center and its partners are working to create a healthier nation. SARS stands for Severe Acute Respiratory Syndrome. It’s a new disease that began in south China. Symptoms include a fever of over 100 degrees and a cough.

Scientists think SARS may be caused by a new virus, and they’re working hard to stop it. Most people who get SARS have been in very close contact with someone else who has the disease. Doctors treating SARS and family members of SARS patients are at risk, but the disease doesn’t seem to be spread by casual contact. So there’s no reason to panic, but if you’re worried about SARS, talk to your parents and your doctor. SARS Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV).

SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained. This fact sheet gives basic information about the illness and what CDC has done to control SARS in the United States. To find out more about SARS, go to CDC’s SARS website and WHO’s SARS website. The SARS outbreak of 2003 According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak.

Of these, 774 died. In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world with SARS. SARS did not spread more widely in the community in the United States. For an update on SARS cases in the United States and worldwide as of December 2003, see Revised U. S. Surveillance Case Definition for Severe Acute Respiratory Syndrome (SARS) and Update on SARS Cases — United States and Worldwide, December 2003. Symptoms of SARS In general, SARS begins with a high fever (temperature greater than 100.

F [>38. 0C]). Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After 2 to 7 days, SARS patients may develop a dry cough. Most patients develop pneumonia. How SARS spreads The main way that SARS seems to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes.

Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS), is a common disorder of the intestines that affects nearly one out of five people in the United States. According to the book, Irritable Bowel Syndrome & the Mind-Body-Brain-Gut Connection by William B. Salt II, IBS is the most common functional gastrointestinal disorder. The symptoms include constipation, diarrhea or alternating bouts of both, bloating, abdominal pain and many other problems. Symptoms of irritable bowel syndrome usually begin during adolescence or early adulthood. Altered bowel movements occur over periods of days to weeks.

Occasionally, symptoms may be continuous. In a given individual, both constipation and diarrhea can occur, or either can be the recurring symptom. The course of the disease varies from patient to patient, but individually, it can follow a consistent pattern. The diarrhea of irritable bowel syndrome is usually of small volume, but frequent. Episodes commonly occur during periods of stress. The initial morning movement may be normal, but followed by successively loose bowel movements throughout the rest of the day. Bowel movements may be associated with extreme urgency.

The diarrhea rarely awakens patients from sleep and there is usually no associated fever or rectal bleeding. The abdominal pain of irritable bowel syndrome can vary in severity from mild to severe. It is usually felt in the lower abdomen, especially on the left side. The pain may be dull, sharp, crampy or continuous. It is commonly relieved by the passage of gas or by defecation *1*. Each year, 2. 6 million people seek treatment for symptoms related to functional gastrointestinal disorders, and visits to physicians total 3. illion (Salt xiv).

The average age of onset of IBS is between 20 and 29 years of age, and IBS is prevalent throughout the world including China, the United Kingdom, Australia, New Zealand and Scandinavia (Salt xiv, xv). The public is made aware of cases of HIV, heart disease, various forms of cancer, etc. , on a daily basis, yet IBS is relatively unheard of. Because of this, millions of people who suffer from IBS feel there is a stigma attached to their disease and they must suffer in silence. IBS is not a rare disease.

In fact, it is the second leading cause of absenteeism in the workplace, coming in behind the common cold *2*. Unlike the common cold, however, there is no over-the-counter drug that can be picked up at the local drug store at the first sign of symptoms. Furthermore, there are few prescription drugs that have been used to treat IBS with positive results. The first prescription drug specifically developed for diarrhea-predominant IBS, Lotronex, was released to the market in March of 2000. Glaxo Wellcome, maker of Lotronex, says the precise mechanism of action of the drug is not fully understood.

However, the working hypothesis is that the experimental drug blocks the action of the neurotransmitter serotonin and 5-HT3 receptor sites in the gastrointestinal track. The thinking is that serotonin and 5-HT3 receptors play a role in increasing the sensations of pain and affecting bowel function in IBS patients. In addition, nerves that control the muscles in the gut may overreact to stimuli such as gas and the passage of food after a meal. This may cause painful spasms and contractions and speed up or slow the passage of stool through the colon, resulting in diarrhea or constipation *3*.

Lotronex has only been shown to work in women, and there is presently no medication available for men suffering from Irritable Bowel Syndrome. Lotronex works by blocking the level of serotonin in the intestinal system in order to reduce the cramping abdominal pain and discomfort, urgency and diarrhea. The first step in determining if the bowel problems in question are caused by IBS is to visit a physician for a check up. Chances are, he will refer the patient to a gastrointerologist, who will then order outpatient testing to be done at a hospital.

This battery of tests can include an upper and lower GI, a barium enema/X-ray, an EGDwhich consists of sticking a scope down the throat to look into the stomach, an ultrasound, and any other deemed necessary by the specialist. IBS will be diagnosed after it is determined that the patients organs are functioning properly and their insides are healthy, leaving no obvious cause for their symptoms. After the initial diagnosis, the doctor will share a variety of treatment options and suggestions with the patient.

At this point, its important to deal with a physician that is understanding and willing to work with the patient to manage the symptoms. Since there is no one specific cure, the patient is about to begin a long journey to try to find the right balance of medication, therapy, stress relief, relaxation techniques and eating habits. Many top physicians agree that Irritable Bowel Syndrome is not a diagnosis, is a vague term, and carries little significance. A more correct name for the various GI problems that doctors associate with it should be “unknown” bowel disorder.

IBS is a term that physicians will give to a patient if they have no idea what their problem is from. Its purpose is to give the patient a name for their problem so the doctor can avoid using those words you’ll never hear him or her say, “I don’t know. ” Physicians have a reputation for being more concerned with treating symptoms than finding or treating the cause, bringing suffering patients back into their office again and again *4*. Because of the common occurrence of Irritable Bowel Syndrome, and the inability of the medical profession to find a cause or cure for the disease, there is a pressing need to support more research.

Unfortunately, research remains severely underfunded for functional gastrointestinal disorders. Less than 1% of digestive research funding, through the National Institutes of Health (NIH), is allocated for functional disorders *5*. The worst part for most IBS patients is not knowing why theyre suffering from this syndrome. There are many support groups on the Internet, including www. ibsgroup. org *6* and www. allhealth. com *7*. In addition, there are various organizations such as the International Foundation for Bowel Dysfunction, which is a nonprofit and informational research program.

According to an article in Johns Hopkins Magazines April 1997 issue, there are four major procedures to follow to control IBS: eat more fiber, avoid culprit foods, medication, and reduce stress. First of all, increasing the daily dietary intake of fiber can dramatically improve bowel function. Fiber therapy is effective for both diarrhea and constipation predominant IBS sufferers because it stretches the bowel wall, actually decreasing tension in the bowel. Patients are advised to increase fiber gradually so as not to cause gas or bloating.

Doctors further recommend getting enough sleep and physical exercise in order to keep the bowel regular. Secondly, avoiding culprit foods can minimize symptoms. Fatty, fried or spicy foods are typical culprits for aggravating IBS. Some patients and physicians suggest avoiding traditionally gassy foods such as cabbage, beans, fructose, bran cereals and anything high in gluten. Milk can trigger symptoms in lactose intolerant IBS patients. The only way to pinpoint foods is to keep a daily diary of everything eaten in a two-week time period.

If a certain food seems to elicit a negative reaction in the digestive system, simply eliminate that food from the diet. Third, medication commonly prescribed for patients with IBS includes antispasmodic or anticholinergic medications. These are used to temporarily alleviate abdominal cramps. Over-the-counter antidiarrheal drugs or laxatives should be used as infrequently as possible and in small doses. Some physicians prescribe antidepressants to relieve pain and improve motility of the digestive system. The final recommendation of this article was to reduce stress.

Doctors used to view IBS as a disease that was all in the head of patients. Although many physicians realize the legitimacy of the syndrome, it has been proven that stress can aggravate symptoms by causing an anticipatory response. Many patients complain of anxiety and feeling a lack of control in certain situations, which increases the probability of experiencing problems with IBS symptoms on that particular occasion *8*. Because of the lack of response from medical doctors and failure to be taken seriously, many IBS sufferers have chosen to take a different route to healingalternative therapy.

Various forms of this type of therapy include the use of herbs, vitamins and minerals, yoga, aromatherapy, meditation, massage and acupuncture. According to the April 2000 issue of GreatLife magazine, Australian researchers treated 116 IBS patients three times a day with the following herbs: Dang Shen, Huo Xiang and Fang Feng. Improvement in these patients was confirmed by gastroenterologists (18). Further herbs used in the management of IBS symptoms include milk thistle, licorice, burdock root, red clover, alfalfa, aloe vera, skullcap, peppermint, valerian root, balm, chamomile, ginger and pau darco.

Vitamins and minerals can be used to supplement the body to help heal the intestines and lower the stress level in IBS patients. It is important to have extra B vitamins in the body for proper muscle tone in the gastrointestinal tract, proper absorption of foods, protein synthesis, and metabolism of carbohydrates and fats. Acidophilus is a necessary nutrient to replenish the friendly bacteria and to aid in digestion and the manufacture of B vitamins. Garlic is also used as a digestive aid and destroys toxins in the colon.

A major metabolic fuel for the intestinal cells, L-Glutamine maintains the absorption surfaces of the gut. Calcium and magnesium supplements are also needed to help the nervous stomach and the central nervous system. Other than taking nutritional supplements, the use of relaxation techniques such as breathing exercises, yoga, aromatherapy, meditation, massage and acupuncture can be beneficial to the IBS patient. Because the digestive tract is highly sensitive to emotional stress, anxiety about having an attack can aggravate your symptoms.

Stress management can help to alleviate and improve daily anxiety and pressures. Relaxation, 101 Essential Tips details the importance of practicing relaxation techniques. Any physical exercise is helpfula daily 20-minute walk helps to control stress levels, calms the digestive tract and keeps the IBS from flaring up. Yoga is highly recommended because it not only conditions muscles and connective tissue, but is also thought to improve the functioning of internal organs, including those in the digestive tract.

Stretching and yoga are holistic therapies benefiting both the body and mind (20). Aromatherapy is becoming increasingly popular as a healing art and can be used in an oil form in conjunction with massage. Aromatic essential oils are extracted from flowers, herbs and resins (31). They are commonly found in perfumes, body lotions and candles. Deep, slow, steady breathing relaxes and calms your mind and body. Toxic wastes are expelled and emotional balance is restored (24). Meditation goes hand in hand with breathing exercises.

It enhances the clarity of consciousness by stilling the mind (25). Some people choose to repeat a specific word or phrase as they meditate, for example, inner as they inhale and peace as they exhale. Massage is one of the most beneficial therapies for relaxation because it eases the pain and tension, bringing vitality to a sluggish system and soothing and calming the overactive nervous system (28). Acupuncture is an ancient technique in which a skilled practitioner inserts hair- thin needles into specific points on the body to prevent or treat illness.

Practiced for over 2,500 years in China, where it originated, acupuncture is part of the holistic system of raditional Chinese medicine (TCM), which views health as a constantly changing flow of energy, or qi (pronounced “chee”). Acupuncture helps regulate imbalances in this natural flow of energy, which result in disease *9*. Anxiety plays a major role in Irritable Bowel Syndrome by exaggerating the symptoms and, in some cases, actually causing the individual to trigger a reaction simply by anticipating it. Lucinda Bassett, former IBS sufferer, wrote a book called From Panic to Power and details the role anxiety played in her life.

I began avoiding situations where I couldnt come and go as I pleased, situations where I couldnt be in control . . . it was difficult for me to sit in class. I felt anxious, panicky, and trapped. I made all kinds of excuses for my lack of social activity and my inability to travel with friends . . . my world became smaller and smaller (Bassett xv). She also states that IBS is an anxiety-related problem common to many people with anxiety disorder and that by age fourteen, everything in her life revolved around her fear of diarrhea.

She was constantly in a state of worry and felt uncomfortable in any situation where she couldnt run if need be (Bassett 5). A recent guest of the Montel Williams show, Bassett is now cured of both her anxiety disorder and her Irritable Bowel Syndrome. Her public appearance was one of the few times the subject of IBS has been aired on national television. However, the month of April was designated in the year 2000 as the first National IBS Awareness Month *8*. A celebrity IBS sufferer, Camille Grammerwife of Frasier star, Kelsey Grammercame forth recently to speak about the disease on NBCs Today Show.

According to Kelsey Grammer, You dont hear much about IBS because some of the symptoms involved relate to subjects traditionally considered taboo by the public and the press . . . The Grammers are working with the International Foundation for Functional Gastrointestinal Disorders (IFFGD) to raise awareness and educate the public about this condition and its effects. Camille Grammer found out she has IBS nearly four years ago, but says, As long as I can remember, Ive always had stomach and bowel problems and have never really known what to do about it.

I have been amazed to learn how so many women have been suffering in the same way. I hope that my efforts to speak openly about my condition will encourage others to do the same and get the help that they need. The Grammers have been working with IFFGD to create and broadcast television and radio public service announcements to educate the public through the media. Nancy J. Norton, President and Founder of IFFGD, hopes this will inspire a national openness about IBS to make it easier for patients to discuss the issue *10*.

Its time for people with IBS to realize that theres light at the end of the tunnel. Theyre not crazy. The symptoms arent all in their head. There may not medically be a cause or a cure, but now there can be an understanding. Why some people feel the burden of stress in their gutand not, for instance, in their heartcan also be explained by the close communication between the brain and the gut. When the big brain consciously perceives a stressful situation, it calls on its fraternal twin through specialized mast cells, embedded in the gut’s lining.

These mast cells secrete a chemical called histamine, which activates the nerves controlling the gut, telling the muscles to contract. Hence, the cramps and bathroom trips so often associated with bouts of stress *11*. Now that theres an understanding, hopefully physicians will open their eyes to potential triggers and/or causes of Irritable Bowel Syndrome, such as gluten or wheat irritability, lactose intolerance, candida albicans and intestinal fungus. Wheat or gluten allergies are inherited from previous generations. These products can cause serious gastrointestinal upset in a wheat or gluten sensitive individual *12*.

When the person eats milk products, symptoms such as gas, bloating and abdominal pain may occur *13*. Candida albicans can cause a variety of complications including digestive problems *14*. These items are just a few examples of possible causes of Irritable Bowel Syndrome and should researched in depth in order to be ruled out. In conclusion, IBS is a legitimate and serious condition that deserves a lot more attention than it has gotten in the past. Advances are being made in the pharmaceutical area and patients are opening their eyes to the idea of alternative medicine.

Many IBS sufferers are choosing to take control of their health and learn as much as possible about the disease. Where the medical profession lacks knowledge, perhaps the patient can provide the breakthrough information needed to find a cause, and ultimately a cure, for this debilitating disease. Most of all, having a celebrity spokesperson such as Camille Grammer, will hopefully do for Irritable Bowel Syndrome what Montel Williams has done for Multiple Sclerosis and Michael J. Fox has done for Parkinsons Diseaseawareness is the key to overcoming this major medical obstacle.

Rheumatoid Arthritis Essay

Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0. 3% to 1. 5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness.

RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small hand joints. RA is usually characterized by the inflammation of the synovium, which lines the joints and tendon sheaths of the body. The etiology of this disease is unknown. There are multiple factors involved in this disease, including autoimmune reactions and environmental factors. There is also a genetic predisposition that has been identified that can be related to the cause of RA. Rheumatoid arthritis develops as a result of an interaction of many factors.

Much research is going on now to understand these factors and how they work together. Rheumatoid arthritis is one of several “autoimmune” diseases because a person’s immune system attacks his or her own body tissues (Gordon, pp 16). A feature of rheumatoid arthritis is that it varies a lot from person to person. For some people, it lasts only a few months or a year or two and goes away without causing any noticeable damage. Other people have mild or moderate disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions.

Still others have severe disease that is active most of the time, lasts for many years, and leads to serious joint damage and disability. Rheumatoid arthritis occurs in all races and ethnic groups. Although the disease often begins in middle age and occurs with increased frequency in older people, children and young adults also develop it. In 1987, the American Rheumatism Association developed seven criteria to define RA. First, morning stiffness in and around joints lasting at least one hour before improvement.

Second, there is arthritis of three or more joint areas. Third, there is swelling of at least one wrist, MCP, or PIP joint. Fourth, there is simultaneous symmetrical swelling in joints. Fifth and sixth, there are subcutaneous rheumatoid nodules and presence of rheumatoid factor. Lastly, there are radiographic erosions and/or Perarticular osteopenia in hand and/or wrist joints (Ryan, pp 57). Diagnosing and treating rheumatoid arthritis is a team effort between the patient and several types of health care professionals.

When assessing a patient with RA, the professional should be looking at their activities of daily living, productivity skills and interests, leisure skills and interests, active and passive range of motion, muscle strength, hand functions, endurance, and cognitive features. Some psychosocial areas to be aware of are self-concept, coping skills, interpersonal and social skills, communication skills, and support systems. Occupational therapy for an individual with RA will help the patient understand his or her disease and its effects on his or her life.

The Occupational therapist will help the patient to improve his or her ability to perform daily activities, prevent loss of function, and direct successful adaptation with the disease. The Occupational therapist will also help the patient to develop problem-solving skills needed to make adaptations throughout one’s life. The Occupational therapist will also treat the physical and psychosocial difficulties that may limit the patient’s occupational performance (Fienberg, pp 816).

The Occupational Therapist will review, observe and interview the patient, as well as administrating screening tests, to determine the capabilities and limitations of the patient’s occupational performance. Some assessment tests that can be done to determine areas of occupational dysfunction important to the person are the Canadian Occupational Performance (COPM) interview, the Robinson Bashall Functional Assessment, the Stanford Health Assessment Questionnaire, the Assessment of Motor and Process Skills (AMPS), manual muscle tests, the goniometer, and the dynamometer and pinch meter (Hammond, pp 257).

The Robinson Bashall Functional Assessment, as well as the Stanford Health Assessment Questionnaire, is a functional assessment that allows the therapist to get a better understanding of the practical capabilities of patients that are suffering from RA. The Assessment of Motor and Process Skills allows an accurate estimate of ability to do IADLs based on performance of three tasks. Treatment addresses the problems identified by evaluation of the patient, and often are guided by the progression of the disease.

Some specific goals to work on with an individual with RA may be to maintain joint mobility, prevent joint deformity, maintain or increase strength and functional ability, balancing activity with rest, develop problem-solving skills to modify daily activities at home and at work to protect joints and preserve energy, and especially promote psychosocial adaptations to deal with their chronic disability. (Pisetsky, 2789). There are various drugs to treat RA and can be divided into four different classes.

These classes are nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and analgesics. The drugs from the first three classes can reduce the number of painful and tender joints, duration of morning stiffness, and indicators of inflammation. NSAIDs are useful for their treatment of RA due to their anti-inflammatory and analgesic actions. These medications will improve mobility and strength, but they will not stop disease progression.

DMARDs alter the course of RA, although they do not prevent bone erosion. Methotrexate (Rheumatrex) is the most frequently prescribed drug for the initial treatment of moderate to severe RA. Some other DMARD drugs that are used are Sulfasalazine (Azulfidine), Hydroxychloroquine (Plaquenil), Cyclosporine (Neoral), Azathioprine (Imuran) (Pisetsky, 2792). Among the newest therapies that are being used to treat RA, ‘biologics’ act on altering the normal immune response by blocking the inflammatory process.

These drugs, Etanercept (Enbrel) and Infliximab (Remicade), are administered intravenously and subcutaneously, so that it binds to tumor necrosis factor (TNF), blocking its interaction with cell surface receptors (TNFR). These drugs reduce the signs and symptoms of moderately to severely active RA (Pisetsky, pp 2793). A person with arthritis may state independence in a given activity but it may be difficult or painful to complete. An individual with RA may experience problems in various areas of living.

Self-care is one area in that the patient may be experiencing difficulty, such that the person may be unable to perform ADLs because of motor limitations. These limitations may be related to those of bending, reaching, lifting, and carrying. The Occupational therapist may provide the patient with self-help devices, if needed, and instructions on how to use them. This may allow the individual to perform his or her ADLs so that he or she is able to keep his or her body clean and managed.

Another area that the RA patient may have difficulty is in productivity. The person may be unable to perform some job tasks when pain and swelling intensify. These job tasks may involve bending, reaching, lifting, or carrying. With such demands, his or her productivity skills may be impaired and need to be adapted to fit his or her needs. An Occupational therapist may suggest modifications or adaptations in the workplace that will help the person to perform his or her job tasks.

The OT may also suggest modifications or adaptations in the home that will improve safety and help the person to perform household tasks. The person may also be limited to the leisure activities that he or she can participate in due to their physical limitations, so the OT may explore interests and develop leisure activities that are based on the patient’s interests and physical abilities. An Occupational therapist may also help the patient to deal with sensorimotor issues that the RA patient deals with.

The person may have limited ROM of the major joints, muscle weakness in the large muscle groups, swelling in the major joints, and joint deformities, especially in the hand and wrist. The person may also experience stiffness in the morning, feelings of constant fatigue, and also may experience pain and tenderness in the joints. The Occupational therapist must work on all these areas to improve and increase mobility in the joints. The OT may consider splints to maintain wrist extension of the hand or even knee splints to maintain knee extension.

The OT would work on increasing or maintaining muscle strength, positioning, and even improving functional ability and endurance. All these interventions would help the person to maintain or increase their function in their joints, so that he or she can be more productive in his or her meaningful daily activities. The person may also experience some psychosocial areas of difficulty that may need to be addressed to the Occupational therapist.

The person suffering from RA may experience feelings of hopelessness and helplessness and may have a poor self-concept. He or she may have anxiety or become depressed. Lastly, the person may exhibit manipulative behavior. The OT may address these problems by promoting acceptance of this chronic disability, so that he or she can live with this disease. The OT may also provide stress management techniques so that the person’s tension can be released in more positive ways rather in a harmful manner towards himself/herself or towards others.

The OT may also promote the person to participate in more social activities to get him or her to feel more competent and increase one’s self-esteem. Persons with arthritis often do not comply with treatment and management routines, so the Occupational therapist may need to provide him or her with good learning or teaching techniques. The OT must also share with the patient the expectations about treatment and management, encourage personal responsibility for his or her care, and maintain a relaxed environment to encourage communication with other professionals and loved ones.

The OT must also be cautious of any other health concerns that may arise due to the progression of the illness or even side effects from the medications. There are so many affected by Rheumatoid Arthritis and it is a growing illness that has been seen across the United States. In the future of medicine, more and more research will be done to find the cure to this illness, but for now, such treatment like Occupational therapy will further advance the lives of those living with RA.

Gene Manipulation Essay

Throughout time, man has always questioned science. Man has been curious about life, space, our bodies, and our existence. Man has gone as far as to the moon, and cloning. Everyday there are new developments being researched. Along with these developments come the peoples opinion. Many people question the positive outcomes and negative outcomes of procedures such as gene manipulation, cloning, in vitro fertilization and fetal tissue implants. To this day, scientists are researching and developing ways to design their children by selecting their sex, height, intelligence, and color of eyes.

People question the morality of gene manipulation. Is it right to design our children? What are the consequences? The practice of gene manipulation is seen as Frankenstein-ish, but it is solely to benefit all humans with longer and healthier lives. Gene manipulation is able to screen disorders of the fetus, prevent diseases from occurring to the following generations and allows parents to design their children. Prenatal testing is a very common procedure that is done . Nine out of ten pregnant women submit to some type of prenatal screening. (Golden)

Dominant disorders such as Down Syndrome, which is a form of retardation, can be detected from a fetus. Since 1996, gene therapy has been the cure for patients suffering from a genetic disease. This is done by slipping a healthy gene in the cells of one organ of the patient. (Begley) Parents of this fetus can then decide on the procedures that will be done on their baby to cure him/her. Not only will the parents of the baby prepare for the surgeries but they can prepare themselves emotionally. This is helpful because during labor the parents will not be in shock when told that their child has complications.

Older pregnant women who sually have more complications during pregnancy benefit from genetic screening. Doctors usually recommend more invasive procedures in which actual fetal cells are collected from the wombs amniotic fluid or placenta . (Golden) Receiving the results from the tests, she can determine whether it is safe for her to continue with the pregnancy, especially since some tests provide accuracy as high as ninety-nine percent. (Golden) Unfortunately, not all test results come out positive. Approximately ninety-five percent of couples who receive bad news from genetic screening, decide to have an abortion.

Abortion is legal but still many view it as a sin. But why should a woman continue to carry a child knowing that it will not live after it is born? Why should she suffer an extra nine months? But with further developments of gene manipulation, when couples receive bad news, they can cure the disorder by gene therapy, thus, abortion will no longer be the answer to the negative results of genetic screenings. Genetic screening allows parents to contribute more to the health of their child by knowing the complications beforehand.

Not only can the fetus be cured of disorders, but it also decrease the probabilities f the offspring obtaining such diseases. For instance, if a woman is bearing a boy of a father with the history of prostate cancer, then the baby will probably develop that cancer. But with the cell-suicide gene inserted to the fetus, it will make his prostate cells self-destruct. He will not die of the cancer and neither will his sons since the gene that the doctors gave him copied itself into every cell in his body, including the sperm cells. Begley)

If this happens, the genetic change would affect that childs offspring and the following generations. Life would enter a new phase, says biophysicist Gregory Stock f UCLA, one in which we seize control of our own evolution. (Begley) Another case would be where the mother can carry hemophilia, a disease in a persons blood, and not suffer from it. She could now have the choice to screen her childs blood to see if he or she has healthy blood. She could also choose a procedure in where she could destroy the bad genes from her fetus.

This can again destroy the chances of the following generations to obtain the disorder. (Grunewald ) Because gene manipulation allows to eliminate diseases, we will grow to become a healthier society. No longer will people have to orry about the major diseases, such as cancer or diabetes, in which millions of people struggle with today. People will live longer and more prosperous lives without worrying about diseases or about getting sick. In addition, people will not have to stress over the health of the babies, since most diseases will not be obtained by the child.

With gene manipulation, parents will be able to design the perfect image of their children. The first steps to design children has already been taken since parents can choose the sex of their children . (Frantz) In Fairfax, Virginia, Monique and Scott Collins ave experienced delight with their two year old daughter, Jessica, who was long-wished for. She was born after genetic prescreening at a fertility clinic. (Lemonick) But gender selection does raise knotty issues as well. Many may believe that society values boys more highly than girls, thus, creating boys to often end up being assertive and more dominant than girls. Lemonick)

They also believe that gender selection will make it even harder to rid society of gender role stereotypes. However, recent studies prove otherwise. William and Catherine Reed, another couple from Virginia, who tried the same treatment o select the gender of their child, said We believe family balancing is something that can bring great joy. William has six sons and will now have a daughter due to the fertility procedure. He wants to balance his family and believes that it will create a happier family. In the five years of this procedure, the lab finds the demand for boys and girls is about equal.

In fact, there re more chances to get a girl than a boy. Of the parents wanting a girl, ninety-two percent got one and of those wanting boys, sixty-nine got one. (Joyce) Many say this is just the beginning. Within a decade or two, parents will be able o determine the height, eye color, body type, hair color, possibly their IQ and personality type before they are born. The Bishop of Edinburgh wants to stop parents from being able to do this because he believes that genetic engineering should only be done for medical reasons . To him, the idea of designer babies with good looks and a high IQ is Frankenstein-ish. Wright)

But what is the difference? Doctors and therapists consider learning disabilities to be medical problems, and if there is a way to diagnose and cure them before birth, then we will be able to raise IQ scores. Parents will also be more pleased with having healthy children, but good looking as well. In doing this children will have less chances in being discriminated against by not looking a certain way. Children, thus, will have a higher self-esteem. The cost of procedures are a major concern to insurance companies as well as economically challenged families.

Since most parents want the best for their children, there will be a popular demand for gene manipulation. This will create problems for insurance companies because many people would want them to cover the procedures. There will also be problems for those who do not have insurance but need the procedures to be done. Suzi Billings, a thirty-seven year old pregnant woman, not only opted for amniocentesis, which would check for Down syndrome, an increased risk for children of mothers her age– but also for a neuromuscular disease. The procedure was straight forward and valid by their doctor.

But the Blue Cross adamantly refused to pay the bill, even though it was only three hundred dollars, says Billings. (Golden) Many insurance companies will not pay since it is not a necessary procedure. But many people will now sk for the tests and will pay for them on their own since they will be the ones designing their child. Regardless of price, there will always be people with enough money or a high enough limit on their credit card, to pay for what they want. (Lemonick) Gene manipulation such as destroying down syndrome should be covered by insurance because it is relating to the health of the patient.

Genetic screening is just another precaution taken during prenatal care. For example, in the fifth month of pregnancy, a woman can have the alpha-feto protein (AFP) test, which is a screening evice used to check for the possibility of Down Syndrome or spinal bifida in the unborn child. It is a simple blood test given to the mother which checks the levels of three hormones in the blood. This test is over ninety-five percent accurate. Presently the State of California requires all doctors to offer this test to pregnant women, however the women may refuse to take it.

The State of California, in addition, pays for the test which is approximately one hundred dollars. Insurance companies will not have to worry about those one hundred dollars per pregnant woman. On the other hand, gene selection such as electing the babys color of eyes and hair should be paid by the parents. Although the cost may be an obstacle, gene manipulation will benefit many people with genetic diseases. Like any medical procedure, the cost is not attainable by everyone, but with time it will lower. Economically, gene manipulation can be a disadvantage to many.

The concern people have is that they may not afford to test their children for diseases. If you are going to disadvantage even further those who are already disadvantaged, says bioethicist Ruth Maiklin of Albert Einstein College of Medicine, then that does raise erious raise serious concern. (Begley) With the good, must come the bad. For example, when plastic surgery came out, only the economically privileged could afford the surgeries. However, with time, more and more people get plastic surgery done to themselves regardless if they are rich or poor.

The price of plastic surgery was also extremely high but with the years it has lowered to where people are not being disadvantaged. Holly Lagalante, a patient who has undergone many plastic surgeries, states Its been tough on me financially, but its worth every penny. Its life-changing. Kalb) Unlike plastic surgery, gene manipulation is really life changing. Gene manipulation will really change the life for a child for the better. The one realistic way to avoid this nightmare, says Robert Wright, a reporter of Time Magazine, is to ensure that poor people will be able to afford the same technologies that the rich are using. Wright)

What people have to realize is that something as beneficial as gene manipulation, needs time to become available to everyone. We can not expect for any new type of procedure to be inexpensive. Neither is gene manipulation occurring overnight. Little by little, with further genetic screenings, other procedures will be developed. But with time, gene manipulation will be a common procedure done to fetuses. Being able to design our children will occur in a few years and people support the research.

Aside from gender, the only traits that can now be identified at the earliest stages of development are about a dozen of the most serious genetic diseases. Gene therapy in embryos is at least a few years away. The gene or combination of genes responsible for most of our physical and mental attributes has not even been identified et, making controversial the idea of engineering genes in or out of a fetus. Besides, most clinicians say that even if techniques for making designer babies are perfected within the next decade, they should be applied in the service of disease prevention. Lemonick)

Just last year, the first artificial chromosome was created. By 2003, the Human Genome Project will have decoded all three billion chemical letters that spell out our seventy thousand or so genes. (Begley) Animal experiments designed to show that the process will not create horrible mutants are underway. No law prohibits germline engineering. As ong as there are no laws forbidding it, scientists will still continue to further researches. People view gene manipulation as a new method to improve the health of our following generations.

In a recent poll done in Time Magazine, sixty-two percent of the people say they want to know through genetic profiling, what harmful diseases they may suffer from later in life. Again, sixty-four percent said they would like to know what their children might suffer from. (Golden) People were also asked what traits they would choose: sixty percent said they would rule out a fatal disease, thirty-three percent said to nsure greater intelligence, twelve percent said they would influence height overweight, and eleven percent said to determine the sex.

People believe that genetic screening prepares them emotionally for the disorders that their children will be born with. Forty-eight percent of the people said that they would not consider ending the pregnancy through abortion even if the test results would show that the baby has a disease. (Lemonick) The importance of gene manipulations that people do support it and are willing to go through the procedures. Gene manipulation will create an ideal society in which there will be no more eople suffering from diseases such as cancer or disorders such as Down Syndrome.

People will live longer lives and eventually die naturally from old age. But until then, we must prepare people and educate them about the possible procedures and consequences, especially because of genetic screening. Many people may not be prepared to know nor prepared to want to know about the negative results of the tests. Should we then be ignorant about the situation and pretend not to know? Ignorance is not bliss. The more we know about curing people, the closer we get to improving our society. It may not happen now, but it will real soon.

Melanoma, a type of cancer

Many people think that is it possible to achieve a healthy tan, but this thought has been proven wrong. Overexpose to UV-A and UV-B rays from the sun lead to premature aging of the skin, as well as the possible formation of skin cancer, know as melanoma. An appearance of a tan is actually a stage of burning and damage to the skin. Although a tan may be desirable to many, the fact remains that more people need to be educated on the dangers of the suns harmful rays, and the possible health complications of overexposure. There are three main types of skin cancer.

These are malignant melanoma, basal cell carcinoma, and squamous cell carcinoma. While melanoma is the most life-threatening of the three, it is also the most common. Melanoma will usually appear as a large mole or lesion on the skin, and usually suddenly. It generally tends to appear on the lower-backs of men and the lower-legs of women, though in elderly, sun-damaged persons, it is also prone to forming on the head and neck. While treatment is very successful when caught in the early stages, waiting too long can dramatically decrease the success rate of treatments.

Catching the cancer early can result in simply having the mole-looking cancer removed, but if a patient delays treatment for any reason the cancer may spread to other (possibly vital) organs such as the digestive tract, lungs, eyes, or lymph nodes. The number of cases of melanoma in America is on the rise. According to the American Cancer Society, 6 in every 100,000 people had melanoma in 1973, but the rate has doubled to 12 in 100,000 in 1999. In 1998 alone, the disease claimed 7,300 people, which is a rate of one person every hour.

Populations at a higher risk of developing skin cancer are those with strong sunlight all year round. Places such as Arizona have higher numbers of persons who develop skin cancers because they have a greater chance of overexposure to UV rays. Melanoma has been reported to be the most common form of cancer in America, and has also been shown to occur more frequently in superficial situations. Places such as tanning beds only emit UV-A rays, which is what causes skin to tan and was also once thought to be less harmful than UV-B rays.

Research has now shown that it is the UV-A rays that actually aid in the formation of skin cancers. There is also a percentage of the population who is held to be at a higher risk for developing skin cancer. It has recently been stated that short, intense exposure to the sun is a trigger for the formation of melanoma. Those who may spend the vast majority of their week indoors but go to the beach on the weekends or outside on vacations are much more likely to develop a skin cancer than those who spend regular time outdoors. There are also risk factors that put some people at a higher risk for developing skin cancers, as well.

These include: * Fair skinned people; blonde, red, or light brown hair, and blue, green or gray eyes, Those with family pasts of skin cancers, * Those who experienced several blistering sunburns as children or teenagers, * People with moles irregular in shape or color, * People with a large number of moles on their body, * Individuals with many freckles and/or who burn before tanning, * People living in high altitudes, and *People who live on/near the equator. Distinguishing melanoma may seem hard to do, but is not so once a person is informed on what they should be looking for.

They may appear similar to moles, and may be blue or black in color. Though they will usually lack the symmetry and border regularity of a common mole, and may have variance in their coloring. Melanomas can either appear suddenly, or develop slowly near a preexisting mole. In rare cases, melanomas may form on top of previously formed moles or birthmarks, but will also come with the effects of pain, itching, or bleeding. These moles may begin to exhibit new and/or strange characteristics such as variegated color, irregular border or asymmetry, or a diameter of more than 6mm (which is about the size of the common pencil eraser).

Other characteristics of skin cancers may include pearly, translucent, or multicolor in skin lesions, as well as scabbing or erosion of the lesion. Anyone can be at risk for developing skin cancer, although taking the right precautions can decrease ones risk greatly. The first, and most obvious way, to protect oneself is to limit the hours of exposure to the sun. A person should be especially cautious during the hours of 10:00 AM and 4:00 PM, when the suns rays are at their harshest. People are often exposed to the sun without realizing it, such as when driving a car.

Another easy yet very important precaution to take in skin cancer prevention is employing the use of sun block with a SPF of at least 15. SPF stands for Sun Protection Factor, and will tell you how long the sun block will protect you while outside. The average persons skin can last about 15 minutes outside without damage, and a sun block with a SPF of 15 will protect a person for about three and a half-hours. Those persons who perspire heavily or exhibit one or more of the traits on the previously mentioned list, should opt for a sun block with a higher SPF, and everyone should reapply sun block throughout the day.

Sun block should be applied at least 30 minutes before sun exposure in order for optimal protection. Babies under 6 months of age should never be placed in direct sunlight, but those over 6 months should always be protected by sunblock, even in dappled sunlight, even on cloudy days when UV rays can travel through the clouds, though the sunlight may not. Because survival of skin cancer is dependent on how early it is detected, people should examine their bodies on a regular basis. People who have regularly examined themselves have a reported 63% reduced risk of death from melanoma.

Those with a large number of moles on their body should give themselves a full examination once every month. A mirror may be helpful for people in checking hard-to-see areas of the body, including the back, behind the ears, and between the toes. Most people tend to have a sense about what is normal and not normal in relationship to the own bodies, and anyone suspicious of a mark on their body should have it checked out by a dermatologist. Once a person has been diagnosed with melanoma, the condition is irreversible, although the cancer can be surgically removed, thus curing the patient.

But this is if, and only if, the cancer has not metastasized to other parts of the body. One who has been treated for skin cancer will continue to be at a high risk for developing it again later in life, and may pass to their offspring a predisposition to increased UV sensitivity. In conclusion, melanoma is a very serious and possibly fatal form of skin cancer. There are many risk factors that may help determine who is at a greater risk for developing the cancer, but no one is immune.

One should perform regular full body examinations approximately once a month, during which people should be looking for any irregular skin lesions or raised portions that have a dark blue, brown or black coloration that may be varied throughout. This may look like a mole, but will lack the symmetry of a mole, and will probably have an ill-formed border. Most people will know which moles have always been on their bodies, and which may be new growths, but when and if one comes across something strange or unfamiliar, they should see a doctor as soon as possible for a diagnosis, so that the cancer may be treated as early as possible.

While many people view tan skin as desirable, it can truly kill, and those people need to be further educated on the dangers of tanning. Everyone should take preventative measures to save the health of their skin. Using a sun block and reapplying as needed, as well as limiting time spent in the sun are very important in aiding to the longevity of anyones life. It is important to remember the factors that may put someone at greater risk, but also that everyone and anyone can succumb to the potentially fatal disease that is melanoma.

Battered Women’s Syndrome

In 1991, Governor William Weld modified parole regulations and permitted women to seek commutation if they could present evidence indicating they suffered from battered women’s syndrome. A short while later, the Governor, citing spousal abuse as his impetus, released seven women convicted of killing their husbands, and the Great and General Court of Massachusetts enacted Mass. Gen. L. ch. 233  23E (1993), which permits the introduction of evidence of abuse in criminal trials.

These decisive acts brought the issue of domestic abuse to the public’s attention and left many Massachusetts residents, awyers and judges struggling to define battered women’s syndrome. In order to help these individuals define battered women’s syndrome, the origins and development of the three primary theories of the syndrome and recommended treatments are outlined below. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), known in the mental health field as the clinician’s bible, does not recognize battered women’s syndrome as a distinct mental disorder.

In fact, Dr. Lenore Walker, the architect of the classical battered women’s syndrome theory, notes the syndrome is not an llness, but a theory that draws upon the principles of learned helplessness to explain why some women are unable to leave their abusers. Therefore, the classical battered women’s syndrome theory is best regarded as an offshoot of the theory of learned helplessness and not a mental illness that afflicts abused women. The theory of learned helplessness sought to account for the passive behavior subjects exhibited when placed in an uncontrollable environment.

In the late 60’s and early 70’s, Martin Seligman, a famous researcher in the field of psychology, conducted a series of experiments in which dogs were laced in one of two types of cages. In the former cage, henceforth referred to as the shock cage, a bell would sound and the experimenters would electrify the entire floor seconds later, shocking the dog regardless of location. The latter cage, however, although similar in every other respect to the shock cage, contained a small area where the experimenters could administer no shock.

Seligman observed that while the dogs in the latter cage learned to run to the nonelectrified area after a series of shocks, the dogs in the shock cage gave up trying to escape, even when placed in the latter cage and hown that escape was possible. Seligman theorized that the dogs’ initial experience in the uncontrollable shock cage led them to believe that they could not control future events and was responsible for the observed disruptions in behavior and learning.

Thus, according to the theory of learned helplessness, a subject placed in an uncontrollable environment will become passive and accept painful stimuli, even though escape is possible and apparent. In the late 1970’s, Dr. Walker drew upon Seligman’s research and incorporated it into her own theory, the battered women’s yndrome, in an attempt to explain why battered women remain with their abusers. According to Dr. Walker, battered women’s syndrome contains two distinct elements: a cycle of violence and symptoms of learned helplessness.

The cycle of violence is composed of three phases: the tension building phase, active battering phase and calm loving respite phase. During the tension building phase, the victim is subjected to verbal abuse and minor battering incidents, such as slaps, pinches and psychological abuse. In this phase, the woman tries to pacify her batterer by using techniques that have worked reviously. Typically, the woman showers her abuser with kindness or attempts to avoid him.

However, the victim’s attempts to pacify her batter are often fruitless and only work to delay the inevitable acute battering incident. The tension building phase ends and the active battering phase begins when the verbal abuse and minor battering evolve into an acute battering incident. A release of the tensions built during phase one characterizes the active battering phase, which usually last for a period of two to twenty-four hours. The violence during this phase is npredictable and inevitable, and statistics indicate that the risk of the batterer murdering his victim is at its greatest.

The batterer places his victim in a constant state of fear, and she is unable to control her batterer’s violence by utilizing techniques that worked in the tension building phase. The victim, realizing her lack of control, attempts to mitigate the violence by becoming passive. After the active battering phase comes to a close, the cycle of violence enters the calm loving respite phase or “honeymoon phase. ” During this phase, the batterer apologizes for his abusive ehavior and promises that it will never happen again.

The behavior exhibited by the batter in the calm loving respite phase closely resembles the behavior he exhibited when the couple first met and fell in love. The calm loving respite phase is the most psychologically victimizing phase because the batterer fools the victim, who is relieved that the abuse has ended, into believing that he has changed. However, inevitably, the batterer begins to verbally abuse his victim and the cycle of abuse begins anew. According to Dr. Walker, Seligman’s theory of learned elplessness explains why women stay with their abusers and occurs in a victim after the cycle of violence repeats numerous times.

As noted earlier, dogs who were placed in an environment where pain was unavoidable responded by becoming passive. Dr. Walker asserts that, in the domestic abuse ambit, sporadic brutality, perceptions of powerlessness, lack of financial resources and the superior strength of the batterer all combine to instill a feeling of helplessness in the victim. In other words, batterers condition women into believing that they are powerless to escape by subjecting them to a continuing attern of uncontrollable violence and abuse.

Dr. Walker, in applying the learned helplessness theory to battered women, changed society’s perception of battered women by dispelling the myth that battered women like abuse and offering a logical and rationale explanation for why most stay with their abuser. As the classical theory of battered women’s syndrome is based upon the psychological principles of conditioning, experts believe that behavior modification strategies are best suited for treating women suffering from the syndrome. A simple, yet effective, behavioral strategy consists of two stages.

In the initial stage, the battered woman removes herself from the uncontrollable or “shock cage” environment and isolates herself from her abuser. Generally, professionals help the victim escape by using assertiveness training, modeling and recommending use of the court system. After the woman terminates the abusive relationship, professionals give the victim relapse prevention training to ensure that subsequent exposure to abusive behavior will not cause maladaptive behavior.

Although this strategy is effective, the model offered by Dr. Walker suggests that battered women usually do not ctively seek out help. Therefore, concerned agencies and individuals must be proactive and extremely sensitive to the needs and fears of victims. In sum, the classical battered women’s syndrome is a theory that has its origins in the research of Martin Seligman. Women in a domestic abuse situation experience a cycle of violence with their abuser. The cycle is composed of three phases: the tension building phase, active battering phase and calm loving respite phase. A gradual increase in verbal abuse marks the tension building phase.

When this abuse culminates into an acute battering episode, the relationship nters the active battering phase. Once the acute battering phase ends, usually within two to twenty-four hours, the parties enter the calm loving respite phase, in which the batterer expresses remorse and promises to change. After the cycle has played out several times, the victim begins to manifest symptoms of learned helplessness. Behavioral modification strategies offer an effective treatment for battered women’s syndrome. However, Dr. Walker’s model indicates that battered women may not seek the help that they need because of feelings of helplessness.

Down Syndrome Essay

Have you ever been in a situation where you were confronted by a child who has Down Syndrome and were unsure of how to act around that child? I’m sure many of us have experienced the awkwardness that accompanies such a situation. Many people feel guilt or pity for these children, I believe these reactions result from a lack of knowledge about the condition. Which is why I have chosen this topic. Down Syndrome is a condition that cannot be physically passed on from one person to the next. It is a genetic disorder that is inherited through our parents when something goes wrong during pregnancy.

As a result, they have a combination of features typical of Down Syndrome, including some degree of cognitive disability, as well as other developmental delays. One thing we should always keep in mind is that they are children and having Down Syndrome comes second. In 1866 British doctor John Langdon Down defined and described the characteristic symptoms of Down Syndrome but was unsure of the cause. It wasn’t until 1959 that Dr. Lejeunne and his team in Paris showed that people with Down Syndrome have an additional chromosome. We normally have 23 pairs of chromosomes, each made up of genes.

The cells of people with Down Syndrome include three chromosome #21 instead of two. The extra 21st chromosome causes an extra dose of proteins. These Page proteins cause the typical features of Down Syndrome. While the fetus with Down Syndrome is developing, its body cells do not reproduce as fast as usual. That is the main reason why these babies are smaller than average after birth and their brain not as big as those of other newborn children. A child who has Down Syndrome will have exclusive individual characteristics which they have inherited from their parents.

The child may resemble their father, mother, grandmother, or aunt. This is true not only for their outward appearance but also for their temperament and physical and intellectual abilities. Children with Down Syndrome have different traits, for instance some can be easy-going while other are stubborn, some may like music while others show no interest. matter what, each of these children are unique and special in their own way. Children with Down Syndrome have distinct physical characteristics. They are short in stature and have a small, round face with a high flattened forehead and fissured, dry lips and tongue.

Another typical feature is a fold of skin, on either side of the bridge of the nose, between the corner of the eyes. The hands are often broad and the fingers short. The feet are compact with a gap between the first and second toe, and their hair is soft and sleek. Such persons are also subject to congenital heart defects, many of which can be corrected surgically. They are also more likely to develop leukemia than other members of the general population. There are three common types of Down Syndrome, the most common one being trisomy 21, which is found in about 95% of people with Down Syndrome.

During pregnancy the formation of the egg or sperm, from a woman’s or a man’s pair of Page chromosomes normally split, so that only one chromosome is in each egg or sperm. In trisomy 21, the 21st chromosome pair does not split and a double-dose goes to the egg or sperm. The second type is known as translocation, found in about 3% to 4% of people with Down Syndrome. With this type an extra part of the 21st chromosome gets “stuck” onto another chromosome. The third type, mosaicism, is found in about 1% to 2% of people with Down Syndrome. With this type an extra 21st chromosome is found in only some of the cells.

There are two tests that can be done to detect if the child you are carrying has any type of Down Syndrome, they are diagnostic and screening tests. A diagnostic test samples fetal cells and gives a definitive diagnosis. This test is usually done between 14 and 18 weeks of pregnancy. Although fairly safe, there is a small risk of miscarriage with this test. Screening tests, on the other hand, are relatively simple tests that find most of the fetuses with Down Syndrome, but they also find some without. It is because of this that screening tests must be confirmed by a diagnostic test.

In addition to these tests, a maternal blood test can suggest the presence of a fetus with Down Syndrome when levels of alphafetoprotein are lower than usual. It is said that one out of every 700 babies will be infected with Down Syndrome. However, these odds may vary depending on the age of the mother. A child born to a woman 25 years of age has approximately a 1 in 1200 chance. A child born to a woman 40 years of age and over has a 1 in 120 chance. Children who are born with this condition can neither be cured with medical treatment nor can they outgrow the condition.

Their life expectancy is generally reduced by 10 to 20 years. However, some people with Down Syndrome have been known to live into their 80’s. The effects of Down Syndrome can be Page modified by providing good medical care, good education, and good parental support, all of which, unlike long ago when these children were called “mongols” and institutionalized, are provided for most children today with Down Syndrome. In conclusion to my studies I have found Down Syndrome to be a rare, yet present condition that can be found in all parts of the world.

Most people might look at the individual infected and tell themselves how lucky they are , not to have to go through what most of them do. But tell me this, how many will actually take the time to better understand the situation and actually see what makes them who they are? It’s human nature to ignore or criticize the unknown, this will always be true to a certain point. Just as the truth will always remain the same, in that these people are beautiful human beings that deserve the same respect and rights as anyone else.

Mental Illness Essay

Wisconsin has a problem on its hands and it is not being dealt with in the right manner. The problem keeps getting bigger and bigger everyday. Instead of giving treatment to the mentally ill, hospital facilities have pushed thousands of mentally ill people on to the street. The idea behind this is to give those with mental illness, a freedom that has been taken from them since they were institutionalized. This plan has a lot of great qualities that would help a lot of people. But there are some serious repercussions because of it.

The problem is simple; the law that released thousands of mentally ill people is too vague. The law should have put the individual hospital in charge of stating who is safe to live in the general public, and who is not yet ready. The term mental illness stands for a vast variety of illnesses. This could be anything from chronic depression, schizophrenia, or even posttraumatic stress; the list goes on and on. Some disorders cause people to have unexpected mood swings. Collins a Lt on the police force said We dont know what they will do from one minute to the next(14a)

This causes a cycle to start forming in which the individual(s) goes in and out of prisons. Like it did to Karen Grayson who is expects to get out sometime this month. She blames her crimes on her disease along with two psychiatrists, a judge, and three psychologists. Collins states We take them out to the county health complex to get them some help, only to be turned away. They say theyve got no room. Often, we have no choice but to arrest them(14a). This only makes the situation that much worse. Karen sits there, growing sicker and sicker(Gene Braaksma 14a)

Now theyre stuck in a place that not only makes their disease worse but also doesnt have the right facilities or staff to help control the illness. The 42% of mentally ill prisoners held in Wisconsins maximum-security prisons receive limited care for their dieses. One of the worst things you can do for a mentally ill person is take them out of society. This will only cause the illness to worsen at a quicker pace. Chances are if you stick a mentally ill person in todays prison they will spend less time interacting with others and more time by themselves. Statistics will show that this cycle keeps growing and growing.

This is a huge factor of overpopulation in prisons. Politicians had the right idea but jumped to quickly on the matter, rather then thinking through all the repercussions. Many of the patents released are doing well I would think, enjoying their new freedoms. I think the law should have taken into consideration each disease and its affect on the individual. What I mean by this is, two individual can react differently to the same disease. This is depending on the strength of the disease, the individuals background, and if the individual has any other mental illnesses.

Schizophrenia – Mental Disorder

When I lived in Germany, I had a friend who played on my High School tennis team. On a sunny afternoon after our tennis lessons we decided to drink an ice tea and have a little snack at the tennis snack bar. We started talking about tennis strategies, but my friend, Thomas, was kind of depressed and sad. When I asked him what was really bothering him, he started tell me about his sick mother. He tried to explain her disease to me, but I could not understand it. He said, ” my mother is suffering from persecution mania and in addition, she sometimes talks about things that make no sense.

Nevertheless, I saw Thomas again after the summer holidays and I asked him how his mother was doing now. He responded with a very sad voice and also had tears in his eyes because his mother committed suicide and the doctors told him that she had schizophrenia. Schizophrenia is a mental disorder marked by the loss of contact with reality. When a person’s thinking, feeling, and behavior is abnormal, it interferes with his or her ability to function in everyday life. Delusions, hallucinations, and irregular thinking and emotions are produced. If these signs are present, he or she may have the mental illness called schizophrenia.

About one hundred years ago, schizophrenia was first recognized as a mental disorder and researchers have been searching for a cure ever since. The cause of schizophrenia is still unknown today and scientists have concluded that schizophrenia has more than one cause. Scientists have developed dozens of theories to explain what causes this disease, but researchers are focusing on four leading theories: the Genetic Theory, the Environmental Theory, the Biochemical Theory, and the Bio-Psycho-Social Theory. The Genetic Theory argues that schizophrenia is caused by traits in a person’s genetic makeup.

A normal person has twenty-three pairs of chromosomes. Each pair contains one chromosome from each parent. In corresponding locations called loci of each chromosome, the genes for specific traits are located. Some researchers believe that mutations with these genes can cause schizophrenia. We inherit our genes from our parents, but this does not mean that the parents of a schizophrenic are mentally ill. Problems in a person’s genetic make up could come from mutated chromosomes or recessive genes. In an attempt to prove this theory, scientists study identical twins.

Due to the fact that identical twins have identical genetic make up, researchers are able to determine if heredity is the main cause of schizophrenia. However, evidence seems to disprove this theory. In some instances, both identical twins are schizophrenics and other times only one is affected. To defend this theory, it should be noted that this research is complicated. Identical twins are relatively rare, especially twins who are both diagnosed with schizophrenia. Studies have also shown that children with one parent diagnosed with schizophrenia have a ten percent chance of suffering from schizophrenia.

When both parents are schizophrenic, their risk raises to approximately forty percent. Little is known about the Environmental Theory. The theory is built mainly on the effects of stress on human behavior. Most researchers agree that stress alone cannot be the main cause of schizophrenia. Most researchers agree that stress could possibly trigger or worsen the symptoms when the illness is already present. Other researchers focus on drug abuse. Like stress, certain drugs such as amphetamines can make psychotic symptoms worse if a person already has schizophrenia. Furthermore, these drugs can, in a sense, create schizophrenia.

Other researchers that support the Environmental Theory believe that “slow viruses” may be to blame. Slow viruses are viral infections that go undetected for long periods of time. Signs and symptoms are delayed and may occur many years after the first infection. The Bio-Chemical Theory suggests that schizophrenia is caused by mixed up signals to the brain. When something acts upon one of our senses, electrical impulses are sent to the brain. These impulses allow us to feel, smell, taste, hear, see, and they also manage our thought processes. In our body we have a complex nervous system.

For example, there is not simply a single nerve that travels from our feet to our brain. In order for information to be sent to the brain, the nerves must interact with each other, translating the messages from one nerve to the next. Because the system is so complex, it is possible for the signal to get mixed up. When this happens, our brain may misinterpret the signal or may not receive it at all. If the signal does get mixed up on the way to the brain, the make up of the impulse can undergo a chemical change, resulting in irregular thought processes and abnormal behavior.

Scientists have undergone in-depth studies on a chemical in the brain called dopamine. They believe that schizophrenics have higher levels of this chemical than a mentally sound person does. To experiment this theory, researchers have injected animals and humans with amphetamines increasing the amount of dopamine reaching the brain. Following the injection, the animals exhibit the same type of behavior as humans who have been diagnosed with schizophrenia, such as standing still for long periods of time or continuously pacing.

In humans, research has shown that when given small doses of amphetamines the amount of dopamine in the brain slightly increases. Although the increase is small it still causes delusions and hallucinations. In conclusion, researchers believe that an increased amount of dopamine to the brain causes abnormal behavior, however, they cannot safely say that this is the sole cause of schizophrenia. The Bio-Psycho-Social Theory combines all of the previous theories. Some researchers believe that bio-chemical abnormalities are a contributing factor but that other events must also occur.

They suggest that environmental and social problems have to be considered along with biological problems. Social scientists believe that no chemical factors are involved, instead they believe “mental disorders are described as a consequence of human motivations, drives, and unconscious forces. ” (Schizophrenia, Douglas W. Smith). These scientists suggest that people become overloaded with stress, information, and stimulation. When this happens they lose their ability to cope with the anxiety which accompanies these stressors. Instead of dealing with their problems they seek peace in their own world.

For example, it is common for individuals to return to “happy times” in their life such as infancy and they begin to act like a child. Scientists have asked if there is a particular nationality that suffers more than any other. Studies have been done in Ireland and it appears that one in every twenty-five people show signs of schizophrenia, opposed to one in every hundred in the United States. E. Fuller Torrey has spent a great deal of time researching a number of schizophrenics in Ireland. Torrey has discovered that the population of schizophrenics has been rising since the 18th Century.

After he made his findings public other scientists began asking questions as to why the Irish are suffering so badly. The basis of their research has focused around their diet, mainly potatoes. If potatoes are exposed to too much sunlight they produce an alkaloid called solanine. Solanine has the ability to induce gastro-intestinal problems and psychotic symptoms such as hallucinations. The idea that schizophrenia in Ireland is caused by the potato is not as far fetched as people might believe. Closer to home, a mental disease that afflicted southerners, pellagra, was caused solely from the lack of the vitamin niacin.

This may lead us to believe that a mental disorder can be caused by too much exposure or lack of a certain type of food. Another possibility, is the amount of insecticides the Irish consume from the potato. At planting time farmers use high amounts of chemicals on their potatoes to protect them from insects. When an insect ingests the chemicals they are easily killed because the chemicals interfere with the normal functioning of the nervous system by disrupting the transmission of nerve impulses. If large doses of these chemicals have the same affect on humans as they do on insects this could answer the Irish dilemma.

These toxins could be especially dangerous to women who are pregnant by damaging the fetal nerve tissue. Despite all these theories, it is quite evident that the cause of schizophrenia is still a mystery. It also seems clear that this disease is not caused by any one factor. As of now, researchers are leaning toward the Bio-Chemical theory. The brain is the most complex organ in the human body and an imbalance of the brain’s chemical system has been suspected as the main cause of schizophrenia for a long time. As previously mentioned, some researchers point to an excess of or lack of dopamine a chemical substance in the brain.

Others suspect different neurotransmitters which are substances that allow communication between nerve cells. The area of the brain thought to be affected in most cases of schizophrenia is the limbic system. This is the area of the brain that acts like a gate for incoming stimuli or messages. In any case, it appears that all schizophrenics have some sort of abnormal chemicals that are not found in healthy people. Schizophrenia is a complicated and difficult disease. It is hard to diagnose mental disorders because there are no physical indications. In the case of schizophrenia, a person can be mistaken for a shy child or person.

They are not in touch with their surroundings. Besides recognizing these symptoms, other methods of diagnosing schizophrenia is with the use of pictures and drawings. The doctor will listen to what the patient “sees” and analyze it. In doing this it is possible to determine their state of mind. Another process used in the diagnosis is Rorschach, better known as inkblots. These inkblots are used worldwide and Doctors have analyzed normal and abnormal answers. By listening to answers a doctor can determine what a common answer from a schizophrenic is. A normal persons answer would be something ordinary like a person or a mountain.

A person suffering from schizophrenia would see something weird like a beast or some conflict. In the past individuals have schizophrenia were labeled as crazy and families were embarrassed to have a mentally ill person in their family. These people would be isolated in a mental institution with bars on the windows, the building being dark and desolate. Also a common treatment for schizophrenia was insulin shock treatment. A patient would receive enough insulin to induce a seizure. This treatment worked for very few patients. The environment that these patients lived in was more damaging to them than helpful.

Mental illness was not accepted or thought of as a disease. When patients were taken to the hospitals it was common for them to be left there. Family would generally desert them because the environment was terrible, family and friends dreaded visiting. The modern day treatment for schizophrenia has many aspects. It involves medicine, counseling, electro-convulsive therapy and hospitalization. The medications most commonly used are; anti-psychotics which are used to help calm agitation, diminish destructive behavior and hallucinations and may help correct disturbed thought processes.

Secondly are anti-depressants, normally slow acting drugs but if no improvement occurs within three weeks, they may not be effective at all. Thirdly, are mood normalizers such as lithium carbonate used in manic depressive states to help stabilize mood swings which are part of the condition. Lastly, tranquilizers are used for calming agitation and anxiety. Unfortunately, along with these medications come some side effects such as inability to concentrate, and tiredness. However, there are side effect controls available. Electro-convulsive therapy is the application of electrical currents to the brain.

It is mainly used for patients suffering from extreme depressions who are suicidal and who seem unable to shake the depression under any circumstances. Unlike in the past, hospitals now have a happy environment. The family is involved with the treatment of the patient. The family themselves try to cope. They learn how things can change when the patient returns home. After the patient is released it is possible for them to go on living a normal life. A schizophrenic will most likely have to take doses of medication for the rest of their life.

Side effects will be felt and unreasonable fears may still be evident but their life will be basically normal. Researchers anticipate massive progress on the treatment for schizophrenia in the future. They believe hospitalization will be a thing of the past. Patients will be injected with medications monthly and attend group therapy with their family. The disease is detected early because of education and research. The drugs used for treatment have few side effects. Scientists hope that in the years to come treatment for schizophrenia will be non-existent.

Researchers hope to pinpoint the cause and eliminate it at birth through screening. With this treatment schizophrenia could be wiped out. Although it may surprise some people, schizophrenia is a common disorder, striking one person in every hundred. For most people, young adulthood means leaving home, starting a job and starting a family. For most schizophrenics, young adulthood means first admission to a psychiatric hospital. An unfortunate reality for young schizophrenics is the need for hospitalization during their most vibrant and productive time.

The age of the first admission is younger for men than women, early twenties for males and mid-twenties for women. The reasoning behind this variation is not exactly known but there is speculation. One biological theory that exists is the help of the female sex hormones. Scientists speculate that these hormones may help delay the horrifying symptoms that afflict schizophrenics. Another question raised is who gets schizophrenia more commonly, men or women? Studies have shown there is no great variation in the numbers but in the severity of the symptoms. Men seem to suffer more severely.

Scientists have attempted to explain this through differences in the brain. Research has shown schizophrenia tends to affect the left side of the brain. Males are generally “left- brained” or “right-brained” while females have less specialization on either side of the brain. Yet another startling fact about schizophrenia is the amount of schizophrenics who are winter born. A scientific explanation for this is seasonal viruses, which may have infected the fetus but remain dormant or not as active until many years later. This fact was discovered as early as 1929 but was ignored for about forty years.

By the late 1960’s studies were being done in six countries using over 125,000 people in their research. Another theory is the lack of nutrition, babies developing during the summer months do not seem to receive as much protein, thus causing abnormalities in the child. Although schizophrenia is a serious and devastating disease the outcome is not always bad. At least 25% of the treated schizophrenics recover fully to live a normal life in every aspect. Another group are not so well off and remain severely psychotic, this occurs in about 10% of the treated schizophrenics.

The History Of Vitamins

A Vitamin is any organic compound required by the body in small amounts for metabolism, to protect health, and for proper growth in children. Vitamins also assist in the formation of hormones, blood cells, the chemicals of the nervous-system, and genetic material. The various vitamins are not chemically related, and most differ in their physiological actions. They generally act as catalysts, combining with proteins to create metabolically active enzymes that in turn produce hundreds of important chemical reactions throughout the body. Without vitamins, many of these reactions would slow down or stop.

The intricate ways in which vitamins act on the body, however, are still far from clear. The 13 well-identified vitamins are classified according to their ability to be absorbed in fat or water. The fat-soluble vitamins A, D, E, and K are generally consumed along with fat-containing foods, and because they can be stored in the body’s fat, they do not have to be consumed every day. The water-soluble vitamins, the eight B vitamins and vitamin C, cannot be stored and must be consumed frequently, preferably every day. The body can manufacture only vitamin D, all others must be derived from the diet.

Lack of them causes a wide range of metabolic and other dysfunction’s. In 21″the U. S. , since 1940, the Food and Nutrition Board of the National Research Council has published recommended dietary allowances for vitamins, minerals, and other nutrients”. Expressed in milligrams or international units for adults and children of normal health, these recommendations are useful guidelines not only for professionals in nutrition (Pg 18) but also for the growing number of families and individuals who eat irregular meals and rely on prepared foods, many of which are now required to carry nutritional labeling.

A well-balanced diet contains all the necessary vitamins, and most individuals who follow such a diet can correct any previous vitamin deficiencies. However, persons who are on special diets, who are suffering from intestinal disorders that prevent normal absorption of nutrients, or who are pregnant or lactating may need particular vitamin supplements to bolster their metabolism. Beyond such real needs, vitamin supplements are also often believed to offer ocureso for many diseases, from colds to cancer; but in fact the body uickly eliminates most of these preparations without absorbing them.

In addition, the fat-soluble vitamins can block the effect of other vitamins and even cause severe poisoning when taken in excess. Vitamin A is a pale yellow primary alcohol derived from carotene. It affects the formation and maintenance of skin, mucous membranes, bones, and teeth, vision, and reproduction. An early deficiency symptom is night blindness which is the difficulty in adapting to darkness.

Other symptoms are excessive skin dryness, lack of mucous membrane ecretion, causing susceptibility to bacterial invasion, and dryness of the eyes due to a malfunctioning of the tear glands, a major cause of blindness in children in developing countries. The body obtains vitamin A in two ways. One is by manufacturing it from carotene, a vitamin precursor found in such vegetables as carrots, broccoli, squash, spinach, kale, and sweet potatoes. The other is by absorbing ready-made vitamin A from plant-eating organisms.

In animal form, vitamin A (Pg 19) is found in milk, butter, cheese, egg yolk, liver, and fish-liver oil. Although one-third of American children are believed to consume less than the recommended allowance of vitamin A, sufficient amounts can be obtained in a normally balanced diet rather than through supplements. Excess vitamin A can interfere with growth, stop menstruation, damage red blood corpuscles, and cause skin rashes, headaches, nausea, and jaundice. Known also as vitamin B complex, these are fragile, water-soluble substances, several of which are particularly important to carbohydrate metabolism.

Thiamine, or vitamin B1, a colorless, crystalline substance, acts as a catalyst in arbohydrate metabolism, enabling pyruvic acid to be absorbed and carbohydrates to release their energy. Thiamine also plays a role in the synthesis of nerve-regulating substances. Deficiency in thiamine causes beriberi, which is characterized by muscular weakness, swelling of the heart, and leg cramps and may, in severe cases, lead to heart failure and death. Many foods contain thiamine, but few supply it in concentrated amounts.

Foods richest in thiamine are pork, organ meats such as liver, heart, and kidney, brewer’s yeast, lean meats, eggs, leafy green vegetables, whole or enriched cereals, wheat germ, berries, uts, and legumes. Milling of cereal removes those portions of the grain richest in thiamine; consequently, white flour and polished white rice may be lacking in the vitamin. Widespread enrichment of flour and cereal products has largely eliminated the risk of thiamine deficiency, although it still occurs today in nutritionally deficient alcoholics.

Riboflavin, or vitamin B2, like thiamine, serves as a coenzyme, one that must combine with a portion of another enzyme to be effective, in the metabolism of carbohydrates, fats, and, especially, respiratory proteins. It Pg 20) also serves in the maintenance of mucous membranes. Riboflavin deficiency may be complicated by a deficiency of other B vitamins; its symptoms, which are not as definite as those of a lack of thiamine, are skin lesions, especially around the nose and lips, and sensitivity to light.

The best sources of riboflavin are liver, milk, meat, dark green vegetables, whole grain and enriched cereals, pasta, bread, and mushrooms. Niacin, or vitamin B3, also works as a coenzyme in the release of energy from nutrients. A deficiency of niacin causes pellagra, the first symptom of which is a sunburnlike eruption hat breaks out where the skin is exposed to sunlight. Later symptoms are a red and swollen tongue, diarrhea, mental confusion, irritability, and, when the central nervous system is affected, depression and mental disturbances.

The best sources of niacin are liver, poultry, meat, canned tuna and salmon, whole grain and enriched cereals, dried beans and peas, and nuts. The body also makes niacin from the amino acid tryptophan. Megadoses of niacin have been used experimentally in the treatment of schizophrenia, although no experimental proof has been produced to show its efficacy. In large amounts it reduces levels of cholesterol in the blood, and it has been used extensively in preventing and treating arteriosclerosis. Large doses over long periods cause liver damage.

Pyridoxine, or vitamin B6, is necessary for the absorption and metabolism of amino acids. It also plays roles in the use of fats in the body and in the formation of red blood cells. Pyridoxine deficiency is characterized by skin disorders, cracks at the mouth corners, smooth tongue, convulsions, dizziness, nausea, anemia, and kidney stones. The best sources of pyridoxine re whole (but not enriched) grains, cereals, bread, liver, avocados, spinach, green beans, and bananas. (Pg 21) Pyridoxine is needed in proportion to the amount of protein that is consumed.

Cobalamin, or vitamin B12, one of the most recently isolated vitamins, is necessary in minute amounts for the formation of nucleoproteins, proteins, and red blood cells, and for the functioning of the nervous system. Cobalamin deficiency is often due to the inability of the stomach to produce glycoprotein, which aids in the absorption of this vitamin. Pernicious anemia results, with its characteristic symptoms of ineffective production of ed blood cells, faulty myelin (nerve sheath) synthesis, and loss of epithelium the membrane lining of the intestinal tract.

Cobalamin is obtained only from animal sources such as liver, kidneys, meat, fish, eggs, and milk. Vegetarians are advised to take vitamin B12 supplements. Folic acid, or folacin, is a coenzyme needed for forming body protein and hemoglobin; its deficiency in humans is rare. Folic acid is effective in the treatment of certain anemias and sprue. Dietary sources are organ meats, leafy green vegetables, legumes, nuts, whole grains, and brewer’s yeast. Folic acid is lost in foods stored at room temperature and during cooking.

Unlike other water-soluble vitamins, folic acid is stored in the liver and need not be consumed daily. Pantothenic acid, another B vitamin, plays a still-undefined role in the metabolism of proteins, carbohydrates, and fats. It is abundant in many foods and is manufactured by intestinal bacteria as well. Biotin, a B vitamin that is also synthesized by intestinal bacteria and widespread in foods, plays a role in the formation of fatty acids and the release of energy from carbohydrates. Its deficiency in humans is unknown.

This well-known vitamin is important in the formation and maintenance of collagen, the protein that supports many body structures and plays a major (Pg 22) role in the formation of bones and teeth. It also enhances the absorption of iron from foods of vegetable origin. Scurvy is the classic manifestation of severe ascorbic acid deficiency. Its symptoms are due to loss of the cementing action of collagen and include hemorrhages, loosening of teeth, and cellular changes in the long bones of children. Assertions that massive doses of ascorbic acid prevent colds and influenza have not been borne out by carefully controlled experiments.

In other experiments, however, ascorbic acid has been shown to prevent the formation of nitrosamines which are compounds found to produce tumors in laboratory animals and possibly also in humans. Although unused ascorbic acid is quickly excreted in the urine, large and prolonged doses can result in the formation of bladder and kidney stones, interference with the effects of blood-thinning drugs, destruction of B12, and the loss of calcium from bones. Sources of vitamin C include citrus fruits, fresh strawberries, cantaloupe, pineapple, and guava.

Good vegetable sources are broccoli, Brussels sprouts, tomatoes, spinach, kale, green peppers, cabbage, and turnips. This vitamin is necessary for normal bone formation and for retention of calcium and phosphorus in the body. It also protects the teeth and bones against the effects of low calcium intake by making more effective use of calcium and phosphorus. Also called the sunshine vitamin, vitamin D is obtained from egg yolk, liver, tuna, and vitamin-D fortified milk. It is also manufactured in the body when sterols, which are commonly found in many foods, migrate to the skin and become irradiated.

Maintaining A Healthy Weight

Data collected from more than 20,000 people by the third National Health and Nutrition Examination Survey reveal a distressing picture of excessive weight and obesity in American Society( These increases have been caused by greater daily caloric consumption and a relatively low level of consistent physical activity. Today the average American man consumes 2,684 calories per day compared to 1,531 calories in 1980. Additionally only 22 percent of adults engage in thirty minutes of moderately intense activity for the recommended number of days per week.

This increase in weight occurs, however, only when the body is supplied with more energy than it can use and the excess energy is stored in the form of adipose tissue, or as we know it fat. The continuos buildups off adipose tissue leads to excess weight and eventually turns into obesity. Obesity is so closely associated with chronic conditions, that medical experts now recommended that obesity itself be defined and treated as a The most prevalent forms of malnutrition in the more affluent countries of the world are overweight and obesity.

Most people think of malnourishment as a shortage of certain types of essential nutrients. In developing countries, food deprivation forms the basis of malnutrition. However, malnutrition can also be a disease of plenty. Due to the fact that our food supply exceeds the needs of our population, people are able to eat more than is required for healthy living. They often consume more calories than they expend. They can then become overweight and eventually may become obese.

There is one big question that people ask a lot and really do not understand, when obesity and overweight are discussed. That is, How can people tell the difference between obesity and being overweight? Nutritionist have said that obesity is apparent when fat accumulation produces a body weight that is more than twenty percent above an ideal or desirable weight. On the other hand, people are said to be overweight if their weight is between one percent and nineteen percent above their desirable weight, the more likely they are to be labeled obese.

The word obesity requires further refinement. When people are between twenty percent and forty percent above desirable weight, their obesity is said to be muled, whereas excessive weight in the forty- one percent to ninety nine percent above desirable weight is defined as moderate obesity, and finally, weight of one hundred percent or more above desirable weight is defined as severe, gross or morbid obesity. Experts continue to question the origins of obesity. As you might expect, the many theories focus on factors within the individual, as well as from the environment.

Recently the role of genetic contribution has been defined, somewhat by the discovery of fat genes in mice and an obesity gene in humans. Research reveals that this protein, leptin, would be found in lower levels of overweight mice, than normal mice. They also suspected that leptin would be found in lower levels in obese humans compared with those of average weight. It is now said that faulty receptors for leptin might exist in the some obese people, causing a second gene to restrict the production of GLP-1, a protein that also plays an important role in the signaling of society, or fullness ( ).

Due to this new information about genetic genes, researchers have identified centers for the control of eating within the hypothalamus of the central nervous system (CNS). These centers, which consist of the feeding center for fullness, tell the body when it should begin consuming food and when food consumption should stop. These centers are thought to monitor continuously a variety of factors regarding food intake, including factories and visual cues, the bodys store of stomach distention, information regarding basal metabolic rate, gastrointestinal hormone level and as mentioned before, GLP-1 levels.

An inheritance basis for obesity could involve the interplay of somatotype (body build up) and other unique energy- processing characteristics passed in from parents to their children. In the ectomorphic body type, a tall slender body seems to virtually protect individuals from difficulty with excessive weight. Ectomorphs, usually have difficulty maintaining normal weight for their hieght. The shorter, more heavily muscled, athletic body of the mesomorph represents a genetic middle ground in inherited body types.

Mesomorphs have their greatest difficulty with obesity during childhood, when eating habits fail to adjust to a decline in physical activity. Finally , endomorphs have body types thst tend to be round and soft. Many endomorphs have excessively large abdomens and report having had weight problems since childhood. Any calories consumed beyond those that are used by the body are converted to fat stores. People gain weight when their energy input exceeds their energy output. Conversely, they lose weight when their energy output exceeds their energy input.

Weight remains constant when caloric input and caloric output are identical. In such a situation, our bodies are said to be in caloric balance. Each persons caloric activity requirements vary directly according to the amount of daily psyical work completed. Even within a given general job type, the amount of caloric expenditure will vary according to the psyical effect required. For example, a police officer who walks a neighborhood, will usually expend many more calories than the typical police dispatchik or motorcycle officer.

What is Dementia

Dementia is an organic brain syndrome which results in global cognitive impairments. Dementia can occur as a result of a variety of neurological diseases. Some of the more well known dementing diseases include Alzheimer’s disease (AD), multi-infarct dementia (MID), and Huntington’s disease (HD). Throughout this essay the emphasis will be placed on AD (also known as dementia of the Alzheimer’s type, and primary degenerative dementia), because statistically it is the most significant dementing disease occurring in over 50% of demented patients (see epidemiology).

The clinical picture in dementia is very similar to delirium, except for the course. Delirium is an acute transitory disorder. By contrast Dementia is a long term progressive disorder (with the exception of the reversible dementias). The course of AD can range anywhere from 1. 5 to 15 years with an average of about 8. 1 years (Terry , 1988). AD is usually divided into three stages mild, moderate, and severe. Throughout these stages a specific sequence of cognitive deterioration is observed (Lezak, 1993).

The mild stage begins with memory, attention, speed dependent activities, and abstract reasoning dysfunction. Also mild language impairments begin to surface. In the moderate stage, language deficits such as aphasia and apraxia become prominent. Dysfluency, paraphasias, and bizzare word combinations are common midstage speech defects. In the severe stage the patient is gradually reduced to a vegetative state. Speech becomes nonfluent, repetitive, and largely non-communicative. Auditory comprehension is exceedingly limited, with many patients displaying partial or complete mutism.

Late in the course of the disease many neuropsychological functions can no longer be measured. Also primitive reflexes such as grasp and suck emerge. Death usually results from a disease such as pneumonia which overwhelms the limited vegetative functions of the patient. Dementia is commonly differentiated along two dimensions: age and cortical level. The first dimension, age, distinguishes between senile and presenile dementia. Senile dementia is used to describe patients who become demented after the age of 65, whereas presenile dementia applies to patients who become demented prior to that age.

Late onset AD (LOAD) also known as senile dementia Alzheimer’s type (SDAT) is the predominant cause of senile dementia. Early onset AD (EOAD) is the most frequent cause of presenile dementia, but HD, Pick’s disease and Creutzfeldt-Jakob disease though not as frequent are also important causes in presenile dementia. The second dimension, cortical level, differentiates between cortical and subcortical dementia. Cortical dementia is used to describe dementia which results from brain lesions at the cortical level, whereas subcortical dementia describes dementia resulting from subcortical brain lesions.

AD and Pick’s disease are the best known examples of cortical dementia; whereas HD, Parkinson’s disease (PD), and progressive supranuclear palsy (PSP) are good examples of subcortical dementia (Mayke, 1994). Dementia with both cortical and subcortical features is also possible, in that case the term mixed dementia is used. MID is a common example of mixed dementia. Historical developments in dementia Pre-Modern Developments The use of the term dementia dates back to Roman times. The Latin word demens did not originally have the specific connotation that it does today.

It meant ‘being out of one’s mind’ and, as such, was a general term for insanity (Pitt, 1987). It was the encylopedist Celsus who first used the word dementia in his De re medicina, published around AD 30. A century later the Cappadocian physician Aretaeus first described senile dementia with the word dotage (i. e. , “The dotage which is the calamity of old age… dotage commencing with old age never intermits, but accompanies the patient until death. “). Curiously, dementia was mentioned in most systems of psychiatric classification throughout pre-modern times, though the precise meaning of the word is often unclear (Pitt, 1987).

Nineteenth Century It can be argued that the origins of the scientific study of dementia date back to the early nineteenth century. The initial steps were undertaken by the great French psychiatrist Pinel at the beginning of that century. Pinel’s observations led him to the conclusion that the term dementia should be applied in relation to the “progressive mental changes seen in some idiots” (Pitt,3). Furthermore, Pinel thought that dementia was a distinct abnormal entity, and thus he used the term dementia to designate one of the five classes of mental derangement.

However, by applying the term dementia to ‘idiots’, Pinel failed to differentiate between dementia and mental subnormality. This was accomplished by Pinel’s student Esquirol in his 1838 textbook Mental maladies-A treatise on insanity. Esquirol summed up the difference between the demented and the mentally handicapped in the following epigram: “The dement is a man deprived of the possessions he once enjoyed, he is a rich man who has become poor. But the defective has been penniless and wretched all his life” (Mahendra, 10). Furthermore, Esquirol was also instrumental in the popularization of the term senile dementia.

Remarkably, his description of senile dementia is very similar to our present day definition. Interestingly, in 1845 Griesinger proposed that senile dementia was due to a disease of the cerebral arteries, a faulty view which persisted until Alzheimer’s time. Much of today’s basic knowledge about dementia was accumulated throughout the second half of the nineteenth century, and the first decade of the twentieth century. 1872 saw Huntington present a paper called “On chorea”, in which he discussed a typical case of what is now known as Huntington’s disease.

Twenty years later in 1892 two significant events occurred. First Pick in a paper called “On the relation between aphasia and senile brain atrophy” described the case of August H. a 71 year old patient with senile dementia. Although the case is not typical of our present day conception of the disease Pick was given credit for discovering a new disease. The other more significant event in 1892 was Blocq and Mariensco’s description of scattered silver staining plaques in the cortex of senile patients.

These plaques were subsequently named senile plaques (SP) by Simchowitz in 1911. The year 1894 saw Alzheimer’s first major contribution , a differentiation between senile and vascular (arteriosclerotic)dementia. Alzheimer described the specific changes observed in arteriosclerotic atrophy of the brain, which resemble what we might call vascular dementia. In 1898 another milestone occurred when Binswanger introduced the term presenile dementia. Thus by the twentieth century significant changes were taking place in our understanding of dementia.

The nineteenth century view that there was only one mental disease-insanity-and that dementia was its terminal stage was dispelled by Kraepelin in the 6th edition of his textbook Psychiatrie, published in 1899 (Pitt, 4). Kraepelin separated dementia praecox (a concept he proposed in 1898 in relation to Schizophrenia) from the other dementias (paralytica and organic), and Senile dementia was included under another category called involution psychosis (Pitt, 4). Twentieth Century In 1907 Alzheimer published his landmark case “A unique illness involving the cerebral cortex” in which he described a fifty-five year old demented woman.

The case was very unusual for two reasons its clinical course, and the discovery of a striking microscopic lesion in the woman’s brain (Beach, 1987). The clinical course was unusual because of the young age of the patient and the rapidity of degeneration (the patient died within four and a half years of symptom onset). At autopsy neuropathological findings were even more unusual. One quarter to one third of cerebral cortical neurons had disappeared, and many of the remaining neurons contained thick, coiled masses of fibers within their cytoplasm (Beach, 1987). Alzheimer speculated that a chemical change had occurred in the neurofibrils.

Thus Alzheimer described for the first time neurofibrillary tangles (NFT), which togther with SP are considered to be the neuropathologocal halmarks of AD (See Appendix 1 for Alzheimer’s original drawing of NFT). Alzheimer concluded that he discovered a unique entity separate from senile dementia as it was known at that time. However, it was not until 1910 when Kraepelin discussed the condition in the 8th edition of his textbook Psychiatrie that AD gained official recognition. The second decade of the twentieth century witnessed the end of the golden period in dementia research (this only lasted until the 1960’s when a renaissance occurred).

U’Ren cites two reasons as the principal causes (Pitt, 6). First the rise of Freud’s Psychodynamic theory caused American psychiatry to swerve in the direction of psychological explanations. Second Kraepelin’s descriptions and classifications seemed to leave little room for therapeutic efforts or optimism. Notwithstanding, several key contributions have been made in the ‘Dark Ages’ of dementia research. In 1920 Creutzfeldt, and in 1921 Jakob, described cases of dementia with pyramidal and extrapyramidal signs.

Although it is now thought that only Jakob’s case was typical of the disease the Creutzfeldt-Jakob disease (CJD) was given to the world. The year 1936 saw an important change with regards to the diagnosis of AD. Before 1936 it was common practice to provide a diagnosis based on both clinical and pathological characteristics. However, when it became clear that many non-demented people had some senile plaques and neurofibrillary tangles, Jervis and Soltz advised that only clinical criteria would suffice for a diagnosis of AD (Mahendra, 14).

In 1948 Jervis published his landmark paper called “Early senile dementia in Mongoloid idiocy. ” Jervis described three individuals with Down’s syndrome (DS), aged 37, 42 and 47 years, each of whom had shown a profound emotional and intellectual deterioration in the last few years of life. At autopsy, all were found to have SP and two also displayed NFT (Beach, 39). This was the first demonstration of NFT in DS and the first full clinical and pathological correlation supporting an Alzheimer- like syndrome in DS (Beach, 39). Research in dementia began to revive in the early sixties.

New causes of the dementia syndrome have been recognized including, depression, which in the form of psuedodementia may mimic dementia (Kiloh, 1961), progressive supranuclear palsy (Steele et al, 1964) and normal pressure hydrocephalus (Adams et al, 1965) , (cited in Pitt, 6). Prior to the 1960’s dementia was still viewed as a chronic, irreversible and untreatable condition (Mahendra, 14). Accordingly, in the 1960s, several writers in Europe called for a revision of the concept and emphasized that irreversibility should not be viewed as an essential feature of dementia.

Another important change that took place in the 1960’s concerned epidemiology. Prior to the sixties arteriosclerosis was thought to be the predominant cause of dementia, whereas AD was thought to be rare (Pitt, 12). However, arteriosclerosis was decisively challenged as the prime cause of dementia by several reports between 1960 and 1970 (i. e. ,Tomlinson, Blessed, and Roth, 1968 and 1970). These reports demonstrated that arteriosclerosis was greatly overestimated as a cause of dementia, and that the majority of patients dying with dementia in fact showed the characteristic plaques and tangles of AD.

Furthermore, Katzman, in 1976 argued that because of similarity in the clinical picture and the identical nature of the histopatholgy, distinctions between AD and senile dementia were arbitrary and no longer useful (Pitt, 12). Thus when it was understood that AD and senile dementia are similar, it was clear that AD is a common illness. In the mid-1970’s two important contributions were made. First, Butler in his 1975 book Why survive? Being old in America criticized the widespread notion that senility was a normal part of aging.

Butler argued that, senility, was a result of brain disease or depression and was potentially treatable. The extension of this view was that senility was abnormal, and that its usual causes were diseases, not just aging (Pitt, 1987). Second, three different labs (Bowen et al, 1976; Davies & Maloney, 1976; and Perry et al, reported low levels of choline acetyltransferase, the marker enzyme for acetylcholine 1977) (ACh), in the brains of patients who died from AD. ACh deficiency has since been the target of most therapeutic efforts in AD (see treatment). Throughout the 1980’s and 1990’s two trends emerged.

First, with regards to diagnosis, criteria have been made stricter. Classification systems like the Diagnostic and Statistical Manual have evolved towards a more precise and comprehensive definition of dementia. Moreover, neuoroimaging techniques are becoming more and more standard, allowing in some cases for a more accurate diagnosis. Second, the past fifteen years have witnessed a substantial growth in genetically based research. For instance one of the genes involved in AD, the amyloid precursor protein (APP), has been localized to a specific segment of chromosome 21 (see risk factors).

The Truth on Dieting and Weight Loss

About one-third of Americans are extremely over-weight, which may be why crash dieting is beginning to plague America. It’s estimated that Americans alone spend 80-100 billion dollars on weight loss tactics. People go on these diets to get quick results but are these results hurting them more than helping? The answer is Yes! The only way to safely and effectively lose weight is through old-fashioned exercise and the right diet. You cannot successfully lose weight by simply cutting food from your diet or taking some pills, it is necessary to work for your results.

Without depriving your body of necessary nutrients through dieting, you can lose fat and get the body you’ve always dreamed of, or at least one you’re more comfortable with. The quote “The effects of the current obsession with dieting can be devastating”, said by Mr. Woodworth, a long time exercise and nutrition expert, summarizes the dangers of dieting. The many dangerous methods of losing weight: so called “dieting” or starvation/fad diets, pills and drugs, over-exercising, surgery, and eating disorders, have taken many casualties.

Many people go on “diets”, a word so commonly misused, to get quick results of weight loss. Perhaps the most common is minor starvation and fad dieting. This method is when people become over concerned with calorie intake. Many deaths have been associated with low calorie diets. By trying to shed pounds simply by cutting all fat from the diet greatly increases the risk of getting cancer, heart disease, and other health problems. That “low-fat” trap gets people hooked on reduced-fat snacks or possibly not eating at all.

So now the body is being deprived of necessary nutrients not available in any pill or liquid form. Yes cutting fat and cholesterol reduces the risk of heart disease and diabetes, but nutrient poor diets have an even larger risk of getting those diseases along with many others. Of course a large percent of dieters will lose weight but they will feel depressed afterward and gain back even more than before they started the diet. The reason why is because they are losing “healthy” weight along with the fat they were hoping to rid of.

In an infomercial with Tony Little, he showed a graph of what the body loses when someone goes on a diet. By cutting back on foods, the body becomes deprived of very important nutrients. Then when it seems you are losing weight, what you are actually losing is fat AND MUSCLE. Many times, more lean muscle than fat will be lost. And although they may look slimmer because their size is smaller, they are actually weaker and more susceptible to injuries due to losing “healthy” weight. Healthy weight is muscle and bone weight, the things that support your structure and enable you to perform rigorous activities.

A lot of the time “healthy” weight is misinterpreted, especially in females. Which leads to an amazing fact that 62% of women and 44% of men that are dieting aren’t even overweight! But they are misled when they step on the bathroom scale and “My God” look what it says! They are not realizing that muscle outweighs fat over 2:1. Therefor, many people may think they are fat even though they may be healthy. I myself am an example of that. On a height and age chart it says my ideal weight for my height is 155 pounds. I am 168, so does that mean that I am overweight? Not necessarily.

Charts and stuff are made for averages and trends because when doing a body fat testing I had only 10. 8% body fat which is below the average for people my age and size. So the bathroom scale scares many people into believing that they need to lose weight when it may not be necessary. On top of overweight people dieting we also have healthy people dieting, both of which are extremely dangerous. Thus, the fad diet/starvation method should be completely avoided because simple “dieting” is just a stepping stone that may lead to much more serious things that become life changing or life threatening..

What started as a simple “diet” may have progressed into another dangerous way of losing weight through pills or drugs and eating disorders. How wonderful it would be if we could all take a couple of pills a day and not worry what else we may eat all while obtaining that body we yearn for. Unfortunately, we don’t have that pill and probably never will so avoid the dangerous imitations out there. What is not told about these miracle pills that make you have the body of your dreams is that they cause fatigue, hyperphagia, insomnia, mood changes, irritability and if really abused psychosis.

While claiming to boost your metabolism, reduce fat, and suppress your appetite they may become addicting and your body may eventually depend upon them. Many of these pills contain untested chemicals and slip by the FDA by claiming that they are food supplements not drugs. And while each year many deaths are due to these products they are still being used by seven percent of adolescent girls in the U. S. and thirty-four percent have at least tried them. Furthering the risk of complications in life and leading many times to death along with dieting.

People with eating disorders are believed to be the result from the 70 million Americans who diet each year, lose the weight, regain the weight, and then diet again. They, instead of going back to dieting once more, become anorexia nervosa or bulimia nervosa. Anorexia is when an individual is more than 15 percent under expected weight, fears gaining weight, females have amenorrhea (males lose sex drive) and abnormal eating habits. They simply restrict food because the pleasure in eating food is overwhelmed by guilt and anxiety.

About 1 in every 100 girls between 12-18 years of age are affected. The complications of anorexia are dehydration, gastrointestinal bleeding, chest pain, low heart rate, abnormal temperature, bone growth retardation or osteoporosis, infertility, dry skin and hair, constipation, epileptic seizures, the list still goes on. An awful lot just to lose some weight don’t you think? Many people who simply use the fad diet method get the urge to lose more weight and that is when they resort to the life threatening disorder of anorexia. Approximately one-third of anorexics become bulimia nervosa’s.

These are people who binge eat then purge themselves by vomiting. They become isolated and depressed and have a low self-esteem. What’s worse though is that physically these people seem healthy but if you look close they develop finger calluses or lesions, puffy cheeks , and erosion of enamel on their teeth due to the stomach acids so frequently eating away at it. It is in everyone’s best interest to avoid dieting and the other methods of losing weight that come with it because there is a major difference between dieting and having a healthy diet (food choice).

To overcome these weight problems and lead a healthier life you need look no further than a couple isles over from where you usually shop in the market and a little bit of good old exercise. First off there is one important thing you must know abut trying to lose weight the correct way, it’s just like trying to become a millionaire, it takes some work and some time. Losing weight the correct way will take longer than a crash diet but it is a much safer method not to mention more permanent. This may be the tricky part for most people, laying of the junk food.

It is ok to have junk food occasionally but making it an everyday thing will really lengthen the weight loss process especially if you are older. The main entre needs to be starchy foods. It has been said that breads are fatty but they contain no more calories per gram than lean meat. These foods tends to expand once in your stomach making you feel a little more full and giving you less of an urge to eat and really stuff yourself. When you stuff yourself your stomach grows just like when you exercise a muscle, the next time you will need more food to satisfy it.

Avoid the breads made with lots of oil or butter and ones you need to put spreads on for flavor. It is wise to include a variety of fresh fruits and vegetables into your diet. Greener foods tend to help metabolism (the chemical that helps you break down food) better and are recommended. Although McDonalds has Americas favorite fries, you better avoid that and any other type of fried potato including potato chips. Even though they are vegetables they have been doused with fatty oils. Dairy products are necessary foods so opt for the skim milk, nonfat yogurt, and low-fat cheese.

You’ll acquire a taste for them and appreciate it in the long run. Protein is another necessary food that you must watch carefully. Trim all visible fat off before steaming, grilling, baking or poaching. Notice I did not say frying! Frying requires oil and oil is a main ingredient you want to avoid. Cutting down on fats is the best approach when you are attempting to make an appropriate diet. You do not want to eliminate all fats but minimizing them helps. Calories are too often worried about. It’s like saying, don’t fill up the car past of a tank because it might not run as well.

Calories are energy and energy is necessary. Now that doesn’t mean fill up the car so much it starts spilling out on the ground and flooding the parking lot. With the exercise you plan to incorporate in this weight loss program you will use all of those calories and burn the existing “fat” calories stuck on you body. By adapting this plan into your meal plan you are very unlikely to put on any more weight unless all you do is sit on your couch all day watching TV (it burns calories just not enough). Fat calories are the calories you want to avoid.

Any snacks that are high in saturated fat and have a lot of total calories from fat. Now, to rid of your existing excess weight there is one and only one way, by continuous aerobic exercise. In order for the body to begin burning fat calories, which have a different make up of carbohydrate and protein calories, the body must believe it needs to use the larger amount of calories. For most activities in life your body uses calories from carbohydrates or proteins for quick energy.

Once you have been performing an activity using your legs, i. e. gging, biking continuous swimming, etc. , for 12 minutes your body begins to use the fat calories to conserve on carbohydrates. Thus, after 12 minutes of aerobic exercise (which is defined as having your heart rate between 80-110 b. p. s) you begin to burn fat from your body and sweat it through your skin cells. So recommended duration for exercise is 20 minutes for beneficial results. Performing this activity once a day would probably show results more rapidly but it is recommended you do it 3-5 times a week especially if you don’t regularly exercise.

There is a note of caution for people who are extremely over weight to not try and over do it. Over exercising can cause heart attacks so you should ease your way into exercising. Maybe start just by walking, then a combination of walking and jogging, don’t try and over do it hoping to get results instantly. All good things take time. So with determination and persistency you can be on your way to a healthier lifestyle by incorporating a healthy and plentiful diet with essential exercise.

Without dieting, you’re capable of sculpting a body more desirable for yourself and staying in good health. Without buying pills and drugs and little gimmicks you can make it much cheaper to take of that unwanted fat. Take yourself out of that statistic that one-third of Americans are extremely over-weight driving them into crash dieting. Through daily exercise and the right diet gradually lose the weight which doesn’t put you at such great risks. The truth is dieting destines you for death, while dedication destines you for doggedness.

Insulin Infusion Pump

Insulin infusion pump technology has been around for quite a few years but has been very slow to gain popularity among the diabetic community. In the past several years however it has caught on, and many who have chosen to make the investment have discovered an enormous advantage, in terms of health and well-being. A simple device that more closely mimics natural pancreatic cycles than traditional insulin injections can make a huge difference in a person’s life when constant disruptions from high and low blood sugars are quickly removed.

Unfortunately, even as the popularity of the insulin pump is spreading, not veryone who could potentially benefit from insulin pump therapy has access to it. An insulin pump costs $4000. 00, and most insurance companies do not cover it, and with accompanying medical supplies costing an average of $187. 00 per month, pump therapy is not financially feasible to most diabetics. The pump as a technology is incredibly innovative and cost efficient, because the increased control over blood sugars prevents complications from diabetes and costly surgeries to fix them.

Technically, the device is not very complicated and shouldn’t be expensive to manufacture. The high cost f a pump is largely due to the fact that the company who developed it, Minimed, must pay for its years of research and development, clinical trials, as well as turn a profit, and Minimed is also one of only two companies in the world who produce insulin pumps. Minimed as a company and the insulin pump as a technology are not very different from other biotechnology development firms and other new medical technologies.

The trends in the industry are essentially the same; huge amount of capital are necessary to fund the prolonged process of developing, testing, and getting FDA approval on new medical technologies; hence private firms have merged as lead developers of biotechnology. In the following discussion, I will use Minimed and the insulin pump as a sort of case study, or platform for which to discuss medical technology and its facets; the industry, development, government approval and regulation, technology assessment and ultimately, distribution.

Unlike other types of technological innovations, medical technology is subject to strict regulation by the Food and Drug Administration. Beginning with the Medical Device Amendments of 1976 and subsequent Congressional mandates, new medical technologies have been subjected to the ame strict regulations that all other new medicines and food additives are, if not even stricter review, since technological innovation is difficult to asses. The FDA has in fact created a department specifically devoted to medical devices, The Center for Devices and Radiological Health (CDRH).

Currently under review by the CDRH is a exciting new and greatly improved insulin pump, one that will actually continuously measure blood glucose, administer insulin and automatically adjust insulin dosage to the level of blood glucose (as opposed to the insulin pump that is currently on the market, which only administers insulin). This new device will be, in effect, an artificial external pancreas. The CDRH has published a guideline for medical device manufacturers to provide information to the administration during pre-market release review2.

Devices will receive extra scrutiny by the administration when they meet one or more of the following criteria: Device features or methods of using it are new Information provided by the device is crucial to the safety of the patient Device performs tasks which are crucial to patient safety Evidence exists of errors with similar devices (or device components) Device operation or characteristics is complex, unusual or otentially dangerous, or, Device will be used by patients or lay-users These criteria were adopted by the CDRH’s Division of Device User Programs and Systems Analysis in order to weigh human error likelihood of a new device into the approval or rejection decision.

A recent report of patient death by accidental morphine overdose highlights the importance of incorporating human factors3 and user interface4 considerations into the design of medical devices. The device which the patient was using was similar in concept to an insulin pump: a patient-controlled subcutaneous morphine infusion device. The error apparently occurred when the patient was programming the pump; when entering the concentration of morphine, the device’s default concentration was set at the lowest possible concentration. Thus, if a patient accidentally left the programmed concentration at 0. 1 mg/mL, when in fact the actual concentration of morphine was 1 mg/mL, the patient would receive a ten-folddose of morphine.

Speaking from the perspective of someone with personal experience with infusion pumps, this type of error is very easy to make (in fact I’ve made the same error myself), however it is completely voidable by setting defaults so that an error in programming would have less disastrous effects. Such foresight involves paying careful attention to user interface which is exactly the kind of precaution that criteria number six is intended to address. Of the criteria that is listed above the new glucose-monitor-and- insulin- pump-in-one meets all six; hence, while the technology for an artificial external pancreas exists now, such technology will probably not be on the market for at least another five years.

Federal regulations are not the only factor that has sl owed down the development and introduction of medical technologies. The technology to develop the modern insulin pump for example, has been around since the late 70’s5. The medical technology industry however has faced unique challenges that developers of other types of technology have not had to deal with. The first is the one discussed above: the fact that developers of medical technology face far more stringent regulations than those of nonmedical technology. A second challenge unique to the medical technology industry is that development requires multidisciplinary expertise. That is, medical devices are not usually developed by an entrepenuar who single- handedly invents and patents something.

Development of the insulin pump for example probably involved a doctor or scientist, who foresaw the medical utility and specifications of the device; an electronics engineer, who designed the motor, circuitry and perhaps casing; a software engineer, who programmed the device to respond to commands as well as programmed the device to be programmed, and perhaps a human factors expert, who specified the user interface. Some technologies however, are so complex and advanced that at least part of the design of the device must be contracted out to specialized firms that are leaders in specific types of technology (but not necessarily edical technology). One such company, LRE Technology Partner GmbH (Nrdlingen, Germany) specializes in building products around optical components; such products have both non medical and medical applications6.

The technology LRE developed is used in machines such as blood-sugar measurement devices, which use the color of a blood sample to determine a patient’s blood glucose level; LRE applied the same technology to develop a water-purity monitor. Development firms like LRE run up against additional roadblocks when they take on medical technology projects, especially as mall companies encounter unfamiliar regulations written specifically for the medical field. For example, ground leakage current has to be lower on medical instruments that on commercial equipment to reduce danger to the patient. Development of medical technology is substantially set back when different parties from different professional cultures are forced to interact with one another and participate simultaneously in the design process.

The sort of conventional method of technology development has traditionally been that engineers would come up with paper-and-pencil sketches that would be tossed to others for feedback; physicians however ay not comprehend such highly technical drawings. One solution development firms have begun to employ is to contract consulting services from other medical device manufactures who have more experience with medical device regulations. Another strategy is to use 3-D CAD, which allows all groups involved in the design phase of a project to have the same picture of the developing product. In the US, approval of a new device by the FDA by no means guarantees that it will be offered those who could benefit from it.

Although the US leads the world in expensive diagnostic and therapeutic procedures7, urrently we have no comprehensive universal health care system; 43. 4 million Americans, or 16. 1 percent of the total population have no health coverage8. Industrialized nations have basically two policy options on how to treat health care. The first is to regard health care like any other commodity in a free market, such as housing, and the second is to universalize health care and control expenditure via central government. The policy option one believes in depends largely on whether one regards health care as a good or service like any other, or one regards health care as a fundamental service that should be guaranteed.

The US is the last highly developed industrialized nation to not have some sort of universal or near universal health care plan in place; Canada, France, Japan, Sweden, and the United Kingdom, all cover over 98% of their populations via public health care, and Germany covers 92. 2% of its population. Suprisingly even though only 84% of the population is covered by some form of health insurance, health care expenditure as a percentage of gross domestic product is far higher in the U. S. (13. 5% in 19949) than in the countries listed above. The gap between the US’s expenditure and that of other ountries has been growing since the 1960’s, and the gap is expected to widen further, with expenditure hitting over 16% of GDP in 2010, when the baby boomers hit retirement10. The US however is not alone in its trend of rising health care costs.

The pinch is being felt throughout industrialized nations, in part because of the growing size of the aging population, but according to the NY Times, “about half the growth in real per-capita health costs is associated with medical technology. “11 Paradoxically, while technological innovation is usually thought of as reducing cost and increasing efficiency, in health are, new technology is often less invasive and less costly, which results in the technology being applied to larger groups of people and raising overall costs. For all our spending on health care and technology, the health of the average American, as measured by life expectancy and infant mortality is actually lower than the nations listed above.

Even for the 84% of Americans counted as having health coverage, the fact alone does not guarantee access to new medical technologies that they could benefit from. HMO’s, the fastest spreading form of health insurance in the US, have ssentially no legal responsibility for providing the latest developed medical technology and procedures to their members. In deciding whether or not to approve new technologies for coverage, HMO’s typically rely on panels of experts for recommendations, but then weigh cost-effectiveness into the decision of whether or not to approve a new technology, and ultimately the HMO itself, not a government regulatory agency or any other centralized authority, has the discretion of whether or not to approve a new technology.

Under the free-market ideology of health care it is reasoned that embers (consumers) of health care plans will shop around and buy the plan that offers the best benefits at the lowest price, and this process will keep prices down and efficiency up. However health care differs from other consumer goods on a number of points. Many are excluded from buying health care altogether because of preexisting conditions. Also, it is often difficult to predict future illnesses; one cannot evaluate plans by examining each and every procedure they do and do not cover. In addition, many consumers have no choice over the plan they buy; the choice is made for them by their employer. For these reasons consumers are not as likely to shop for plans and hence, prices are not kept down and efficiency is not kept up.

Government subsidized health care such as Medicare is pretty straightforward: there is a list of approved medicines, technologies and procedures that are covered and those that are not on the list are not covered; additions to the list are passed by the Senate. On March 15, 1999, Senator Susan Collins (R-ME) introduced Senate Bill S. 2292,12 which will extend Medicare coverage to the insulin pump for seniors with type I diabetes. A similar House Bill HR. 3814 introduced in 1998 failed. Collins argues for her bill by asserting that coverage of the insulin pump will actually save Medicare money by preventing complications associated with poor blood sugar control in diabetics. Treatments for complications such as diabetic retinopathy, nueropathy, kidney and liver failure and gangrene can become very costly indeed.

The irony of Collins’ bill, indeed of the whole American health care system is this; an insulin pump for type I diabetic aged 65 or over is like throwing a dixie cup full of water on Hell. Type I diabetes means that a person has had diabetes at least since adolescence, and complications from diabetes arise from poor lood sugar control over a span of many years. Giving a senior type I diabetic and insulin pump will not prevent complications from arising if that person has had poor control all their lives; giving a newly diagnosed young person an insulin pump will save the government a fortune. But there is no comprehensive health care system in place to ensure that cost- effective technology will be delivered to those who need it at the appropriate time.

The same concept applies to many other forms of preventative health care, and is a major reason why health care costs in this country are so high. The government will pay to ensure that major ealth problems are treated, but it is much more effective and cost- efficient to prevent those problems from ever occurring in the first place. It has been suggested that perhaps the US, with its free-market system of healthcare, plays a major role in providing financial incentive to private firms to develop new medical technologies. Since HMO’s and health insurance companies in the US have far less bargaining power with biotech firms than do centrally planned universal health care systems in other industrialized nations.

In response to this I would like to point out that in most countries with universal systems, private care is still vailable to those who are willing to pay for it. However on the whole, compensations to biotech firms in countries with universal care is still far less than in the US Thus this is a valid argument, and the true answer to the dilemma requires a value judgement; that is, is it more important for us as a nation to continue developing high tech medical solutions that will only benefit a portion of the population, or is it better for us to guarantee health care to our citizens as a fundamental right while at the same time accepting a slower pace of medical technological innovation?

Threatening Interactions between HIV-1 Protease Inhibitors and MDMA and Hydroxybutrate (GHB)

In todays college society, with the ever-growing number of sexually active students, HIV is quickly spreading. College students are known for being curious, and it can be extremely common for a person to have several partners in one year. It can also be common for college students to experiment with many illicit designer drugs, such as MDMA (ecstacy). Upon reading the title of this article, I became intrigued.

Because both drugs and HIV affect the college student population, it could be very valuable information to the health of those persons who are infected with Hiv-1, who could possibly ingest such drugs as MDMA or GHB as a recreational activity. Summary A man with AIDS, age 29, ingested 2 pills of MDMA. Approximately 29 hours later, while still feeling the effects of the amphetamine, the man ingested about ½ teaspoon of GHB, known as a sedative, to help counter the persisting effects of MDMA. About six hours later, the man ingested another ½ teaspoon of GHB.

Within twenty minutes after taking the second dose, EMS reported the man became unresponsive and exhibited a brief episode of clonic contractions of both legs and then the left side of his body. ” EMS found the subject responsive only to painful stimuli, with shallow breathing, and a heart rate of 40/bpm. With the patients history of Pneumocystis carinii pneumonia, cutaneous Kaposis sarcoma, thrush, and neutropenia, he was beeing treated at the time with protease inhibitors, ritonavir and saquinavir. These protease inhibitors have reports of helping the prognosis of HIV.

The journal continues to try and prove, these inhibitors may cause an acceleration or deceleration of the bodys metabolism due to their effect on the cytochrome P450 system. Before being treated by these protease inhibitors, the subject had ingested similar quantities of MDMA and GHB without having the same adverse effects. Also during the time prior to administration (PTA), other persons had consumed similar quantities of the same solution GHB without these life-threatening effects. Critique The work was a peer reviewed health journal in which a few medical doctors and pharmacist wrote about a single case and their findings.

The study was done at the Dept. of Medicine, School of Medicine, Dept. of Pharmacy, and School of Pharmacy at the University of Washington, Seattle. Because the study was done on-campus, the funding probably came from grants and off-campus sources. This could lead to a potential bias if limited in funds or time by the source of the promoter. On the other hand, with proper funding the most exact results and conclusions could be drawn. Because the study was only started after the man accidentally had these effects occur, I assume the researchers used what information and equipment already available rather than seeking further funding.

All authors names are accompanied by an MD, or PharmD, therefore, the journal article was created by a fairly knowledgeable source. The study was experimental, as it wasnt planned and all information was gathered after the fact. Only one case was reported and studied, therefore the sample size to be investigated is extremely limited. I believe that the authors of this article are most likely correct. There could possibly be an interaction between HIV protease inhibitors affecting metabolic rate, and the prolonged or shortened effects of many illicit drugs.

Although the authors could possibly be correct about the relationship between the drugs, with such a limited sample size, it is hard to defend the evidence. Many of the conclusions are simply inconclusive. Many of the same results could have been mimicked by other conditions. For instance, in the journal, the exact milligram count of MDMA ingested is never discussed. It states that prior to taking protease inhibitors the man had ingested similar amounts of the same drugs without feeling the same effects, but the amount of milligrams could be altered from pill to pill.

It also does not discuss how much food the subject had eaten, which would also effect the metabolic rate severely. Many combined conditions could have caused this reaction. The conclusions of the study are extremely logical, almost too logical in fact. This leads one to believe that this most simple conclusion was drawn from the inconclusive evidence. The conclusions from the study are limited. The information provided is only useful to those taking protease inhibitors, and illicit drugs (MDMA, GHB). Personally, this information is useless to me, as I am neither taking protease inhibitors, infected with HIV, nor taking MDMA or GHB.

When I first started this study, it was always a premonition to never take two drugs at once, especially if one of them is considered an illegal, “illicit” one. After reading the study and finding that the subjects episode may have been caused by the reaction between the two drugs, I would certainly never take two drugs together. I would like to continue living a healthy lifestyle, and I do not feel that I will have to change any health behaviors as I am neither infected with HIV or taking illicit drugs.

Importance and Effects of Health drinks and Soft drinks in 21st century

Here we are going to discuss about the relevance and effects of health drinks and soft drinks like coke. We have explained in our study the advantages and disadvantages of these drinks. What are the ingredients of these drinks? How are they affecting every age group in the 21st century? Should they be used or not and if used in what amounts. The importance of these drinks help us to peep into their world and the drinking habits developed by people. According to a study 33% of U. S. adults that are 20 years of age or older are estimated to be overweight.

Furthermore, over 58 million Americans weigh at least 20% or more than their ideal body weight. With exhaustion and high stress levels due to hectic lifestyles, many people are relying on energy drinks to give them that second wind. Whether they help to stay awake through a test that day, or revive you for a party that night, energy drinks are much appreciated, and are becoming quite popular. With energy drinks increase in popularity, and high demand, many companies have decided to come out with one. Companies such as SoBe, have SoBe Adrenaline Rush, Starbucks DoubleShot espresso and cream, and Mountain Dews AMP energy drink.

Other popular energy drinks include, Red Bull and Rockstar. SoBe Adrenaline Rush has the familiar tangy taste of a grapefruit with a light yellow color. It contains 1000 mg taurine, 500 mg d-Ribose, 250 mg L-Carnitine, 100 mg Inositol, 50 mg Guarana, and 25 mg Panex Ginseng. This drink including many others is not recommended for children, pregnant women, or persons sensitive to Caffeine. Starbucks DoubleShot espresso and cream in caramel in color, and tastes very similar to the coffee frappuccinos Starbucks has in the glass bottles.

It is definitely a great drink to waken up with in the morning. AMP energy drink (from Mountain Dew) contains matodextrin, Ginseng, Taurine, B vitamins and Guarana. It is sour and tangy and tastes like fruit snacks. Like mountain dew, AMP is a lime green color. Red Bull is a yellow drink with a sour, tart taste. that includes, 1000 mg taurine, 600 mg glucuronolactone, and 80 g of caffeine. The benefits you get from drinking a Red Bull include, improving your performance, concentration, and reaction speed, vigilance, emotional status.

It stimulates your metabolism as well. Rockstar tastes and looks very similar to Red Bull. However, according to the can, not only is Rockstar bigger, stronger, and faster, but one is able to party like a rockstar too. It is the most healthy out of the five energy drinks, and contains the least amount of calories and sugars. Now the problems with the consumption of regular soda beverages like coca-cola and Pepsi. Americans drink more soda pop than ever before: These popular beverages account for more than a quarter of all drinks consumed in the United States.

More than 15 billion gallons were sold in 2000. That works out to at least one 12-ounce can per day for every man, woman and child. Kids are heavy consumers of soft drinks, according to the U. S. Department of Agriculture, and they are guzzling soda pop at unprecedented rates. Carbonated soda pop provides more added sugar in a typical 2-year-old toddler’s diet than cookies, candies and ice cream combined. Fifty-six percent of 8-year-olds down soft drinks daily, and a third of teenage boys drink at least three cans of soda pop per day.

Nearly everyone by now has heard the litany on the presumed health effects of soft drinks: Obesity Tooth decay Caffeine dependence Weakened bones Obesity: One very recent, independent, peer-reviewed study demonstrates a strong link between soda consumption and childhood obesity. One previous industry-supported, unpublished study showed no link. Explanations of the mechanism by which soda may lead to obesity have not yet been proved, though the evidence for them is strong. Many people have long assumed that soda — high in calories and sugar, low in nutrients — can make kids fat.

Researchers found that schoolchildren who drank soft drinks consumed almost 200 more calories per day than their counterparts who didn’t down soft drinks. That finding helps support the notion that we don’t compensate well for calories in liquid form. Tooth Decay: Here’s one health effect that even the soft drink industry admits, grudgingly, has merit. In a carefully worded statement, the NSDA says that “there’s no scientific evidence that consumption of sugars per se has any negative effect other than dental caries.

But the association also correctly notes that soft drinks aren’t the sole cause of tooth decay. In fact, a lot of sugary foods, from fruit juices to candy and even raisins and other dried fruit, have what dentists refer to as “cariogenic properties,” which is to say they can cause tooth decay. But sugar isn’t the only ingredient in soft drinks that causes tooth problems. The acids in soda pop are also notorious for etching tooth enamel in ways that can lead to cavities. “Acid begins to dissolve tooth enamel in only 20 minutes,” notes the Ohio Dental Association in a release issued earlier this month.