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July 30th, 2011

Brand new research from England shows that an amino acid, d-phenylalanine, provides significant pain relief for patients with a variety of chronic pain conditions, including lower back pain, herpes, and post-surgical discomfort. (This is a different amino acid than the form of phenylalanine I discussed earlier.)TEAMWORK IS CRUCIAL FOR THE “DOUBLE A” TEAMTeamwork is the secret of using amino acids to boost your immune power. More than any other immune power nutrient, these substances must be perfectly balanced. In fact, many amino acids, like lysine and arginine, are meant to work in precisely paired ratios. To be effective as brain messengers, energy thermostat regulators and immune boosters, amino acids must be in a balanced equilibrium.However, these powerful immune enhancers can also create powerful problems if you take them carelessly. Improper self-dosing is bad medicine, a one-way road to real immune trouble.Disrupting amino acid balance is the chemical equivalent of dropping putty into the works of a fine Swiss watch—with even more serious results.This is the reason that all of the recipes, as well as the entire Immune Power Diet, use safe, complementary, balanced amino acids. For the few conditions where I prescribe separate amino acids, they are safe in the doses I have given.Some people have problems absorbing or making certain amino acids. One of the most frequent of these conditions, called phenylketonuria, occurs when the body is unable to break down the amino acid phenylalanine, which then builds up causing mental retardation. If you have any amino acid-related problems then any changes in your amino acids could be dangerous. Consult your physician.It is essential—absolutely vital—that you follow exactly the recommendations I’ve given here. Taking these chemicals willy nilly, in any way that throws off your body’s fine chemical balance, can be extremely dangerous. Remember, every time you pick up one of these powerful chemicals, you should treat it as though it were stamped: HANDLE WITH CARE.*64\242\2*

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July 19th, 2011

Pulmonary toxicity is a significant complication of bleomycin. Less frequently methotrexate, busulfan, and CCNU have been incriminated in acute lung syndrome, which is believed to be idiosyncratic and not predictable. Radiation therapy to the lung parenchyma reduces pulmonary toxicity thresholds.Pulmonary toxicity from radiation and chemotherapeutic agents may be partially reversible. Ultimately, enough damage to the parenchymal lung tissue could result in death. I. TOXICITY OF BLEOMYCINA. Diagnosis of bleomycin toxicitySlow inspiratory vital capacity and pulmonary capillary blood volume appear to be the proper lung function assessments that specifically reflect alterations induced by bleomycin.Diffusion capacity of carbon monoxide (DLCO) is not a suitable parameter to monitor pulmonary toxicity induced by bleomycin specifically when it is part of a multidrug regimen.a. Investigators have found a poor correlation betweenDLCO and lung toxicity, and DLCO fails to predict the development of serious bleomycin lung toxicity in the majority of patients. When a low DLCO is encountered, look at other parameters as well (see b. below).The clinician should decide to continue bleomycin when it is in the best interest of patient care.i. Bleomycin may be stopped inappropriately after low DLCO measurement. DLCO <65% has a high false positive incidence when used as the standard for withholding chemotherapy.ii. When a low DLCO is encountered, examine and consider other parameters of lung function before discontinuing bleomycin.b. It is important to monitor for respiratory system and chest x-ray abnormalities during bleomycin treatment, as these will be the earliest signs of lung toxicity inmost patients.i. The combination of respiratory symptoms and an abnormal chest x-ray is the earliest manifestation in many patients.ii. Therefore, a careful history of respiratory symptoms and regular chest x-rays is more likely to detect clinically significant bleomycin lung toxicity than the DLCO.iii. Diffuse infiltration with tumor, interstitial pneumonias, generalized pulmonary infections such as Pneumocystis pneumonia, and bleomycin nodularity may have similar signs and symptoms.iv. An aggressive approach is justifiable because the consequence of stopping bleomycin in a patient with a curable cancer may be as devastating as continuing bleomycin in one at risk of bleomycin lung damage.B. Factors contributing to bleomycin toxicityThe serum half-life of bleomycin can be increased in the presence of renal dysfunction such as that induced by cisplatin. Monitor renal function closely when patients are receiving both bleomycin and nephrotoxic chemotherapeutic agents.3. The administration of oxygen in high concentrations, (e.g., during general anesthesia) may cause fulminate respiratory failure in patients previously treated with bleomycin.C. Modifications for pulmonary toxicityBleomycin lung toxicity remains an unpredictable side effect by comparison with the toxicities of many other anticancer drugs. Therefore, it would be advisable to avoid bleomycin in situations in which other drugs can be substituted without compromising results.D. Late effectsBleomycin pulmonary toxicity may be reversible. A decreased force vital capacity and DLCO in the first 15 months after treatment, in terms of long-term follow-up, did not predict outcome.*39\168\2*

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July 5th, 2011

Some of the following behaviors run a high risk of exposure to HIV, and the people who engage in the behaviors will find it in their best interests to get tested. Other behaviors run a lower risk, and the people who engage in them might want to get tested.     High-risk behaviors. The behaviors that run the highest risk of exposure to HIV are injecting drugs and having sex with gay or bisexual men. Hemophiliacs who received clotting factors before 1986 also have had a high risk of exposure to HIV. Having sex regularly with anyone who injects drugs, has gay sex with men, or has hemophilia also runs a high risk.     Among people with these behaviors, the frequency of HIV infection ranges from 10 percent to 70 percent, meaning that somewhere between 1 out of 10 and 7 out of 10 are infected. People with these levels of risk of infection should be tested.     The risks of HIV infection, and the recommendation for getting tested, differ in different parts of the country. In the Northeast, 20 percent to 70 percent of those who regularly use drugs intravenously are infected. In such areas as Denver, Tampa, and Los Angeles, only 5 percent or fewer of those who regularly use drugs intravenously are infected, a risk of 1 in 20. The risk of infection among men who have gay sex is more consistent throughout the country, ranging from 20 percent to 50 percent. For people with hemophilia, the risk of infection was constant in different parts of the country. The reason is that the clotting factors used for therapy were prepared and distributed throughout the United States from a central location. (It should be emphasized that these clotting factors are now considered safe because the blood is screened and because the factors are treated to eliminate HIV.)     In any case, those who will find it in their best interests to get tested are people who use drugs intravenously; or people who have sex with gay or bisexual men; or hemophiliacs who received clotting factor before 1986; or people who regularly have sex with any of the above or with people known to have HIV infection.     People who have high rates of infection also have different levels of risk. Among people who use injected drugs regularly, the risk is substantially higher than among those who use these drugs only occasionally. The same is true for sexual exposure: no one knows exactly what the risk is with a single sexual episode, although the number of people who have been infected after a single episode appears to be small. Those who have had sex with a lot of people have higher risks of infection than those who have had sex with fewer people. Those who have had sex more frequently with an infected partner have a higher risk of infection than those who have had sex less frequently. The risk is somewhat higher for women exposed to infected men than for men exposed to infected women. The risk of infection is also substantially higher in those who fail to practice “safer sex” or who have genital ulcers. And there may be differences according to the type of sexual practice: anal sex and sex that results in injury may be more likely to risk infection. As above, the probability of HIV infection depends on many interrelated variables. The probability by risk category may be 10 percent or 70 percent, but for the one who is infected, it is 100 percent. It is important for people to know this information so they can protect others and can obtain the best medical care.     Lower-risk behaviors. Other behaviors, though they still risk exposure to HIV, have a substantially lower risk. These include having many sexual partners, having sex with prostitutes (prostitutes have had many sexual partners and are also likely to use drugs), and having had transfusions between 1978 and 1985.     The risk of exposure from these behaviors is relatively small, but it may be large enough to warrant testing, especially if a person is worried about the possibility of exposure.*256\191\2*

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June 29th, 2011

Another common, though not universal, feeling in response to spinal cord injury is anger, particularly for those injured in an accident or by violent crime. If your disability was caused by your own behavior, such as a one-car accident or diving into a shallow pool, you may be furious with yourself. If your injury is due to a tumor or disease over which you have no control, you may direct your anger at fate or at God. Or you may look for a cosmic reason for your injury, searching for the meaning of your survival rather than raging at destiny.Your anger about the accident or other event may last only a brief period, but you will be coming to terms with losses for a longer time. Anger is a normal response to losing something precious and to the frustration and dependence that you face daily as you struggle to perform what were once automatic and easy tasks.Unfortunately, many people consider anger an unacceptable, dangerous, or immature emotion. You may fear that anger will alienate the very people whose help you so much need. You may be concerned that anger is a sign of immaturity or weakness and fear having a childish “tantrum.” Or you may worry that your anger, because it feels so intense, will get out of control and become destructive.Tom broke his neck in an industrial accident. He was angry not only at the careless co-worker directly responsible for his injury, but also at the entire company for not better policing the plant. Tom was generally a friendly, easygoing man, and anger was an unusual emotion for him. He wished he could be forgiving. He felt guilty about his anger and thought his angry feelings made him a mean or bad person.Tom held in his anger for a long time, trying to pretend he didn’t feel it. This intensified his tendency to be depressed over his losses, increased his passivity and lack of initiative, and actually worsened his fear of losing control. He initially performed well in therapy, and the staff involved in his care had high hopes for his return to work, school, and social life. But Tom’s continuing inability to acknowledge and express his anger soon led to deterioration in his progress. He became extremely passive and apathetic and was unable to make important decisions. He couldn’t act on his own behalf to apply for financial assistance or stand up for himself in personal relationships.Tom’s biggest fear was that his anger would lead to aggression. Indeed, he harbored vicious fantasies of revenge against the person responsible for his accident. But he eventually saw that he was turning this aggression on himself by giving up control of his life, that he was undermining his own recovery and being emotionally used or abused by other people. Tom’s psychologist helped him validate his feelings of anger and rage and helped him see how he could turn this anger into constructive rather than destructive action.Tom gradually began to act more on his own behalf. He got in touch with his family, who lived out of state, and asked for their support. They responded with more frequent phone calls to his hospital room and praise for his progress. He called social service agencies and filled out applications for Medicaid, housing aid, and other benefits that he would need after discharge. He talked to his lawyer about suing his company for damages. He thought about his vocational plans in terms of what interested him, rather than what his counselor thought would be good for him. And he appropriately expressed his anger toward several people who had taken advantage of him or hurt his feelings during his most dependent and needy times.Tom felt a renewed sense of self-reliance and empowerment. He learned that anger turned into positive action and self-expression was not dangerous. In fact, his revenge fantasies subsided as he felt better about his own life. Getting the anger out in the open had helped him avoid depression, regain control, and direct his energy toward helping himself, and had prevented bitterness from setting in.Such disabling anger is common, but it can be avoided by expecting and recognizing anger as a normal response to spinal cord injury and by verbalizing anger openly, perhaps with fellow patients in informal gripe sessions. Anger is better expressed in words than by acting it out through hostility, withdrawal, or rebellion against the rehabilitation program.In the rehabilitation hospital, you can also get help in expressing your anger through therapy with a psychologist, social worker, or psychiatrist. Many spinal cord injury programs provide group therapy in which you can openly share feelings with fellow patients. Pastoral counselors may be helpful in dealing with anger at God. When possible, physical activity such as socking a punching bag, smashing a piece of clay, or bouncing a ball can be an outlet for anger. And like Tom, you can find ways to take control of your situation and turn your anger into positive action. You may need to call insurance companies and employers to obtain or maintain benefits. You may need to write to foundations for financial help or apply for vocational services. Acting on your own behalf to get the help you deserve is another way to transform your anger into constructive behavior.

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June 18th, 2011

“That sounds like a miracle. How does the diet work?”We don’t understand how the diet works. The results do not seem to be merely the effects of the dehydration, or of the ketosis, or of the acidosis (increased amount of acid in the blood) that accompany the diet. We clearly need more research to understand the effects of this diet on seizures.”How long will my child have to stay on the diet before we know that it is working?”Many children with frequent daily seizures will stop having seizures during the starvation phase of the diet. Most for whom the diet will be effective will cease having seizures during the first week. However, since some will respond later, we recommend continuing the diet for one to three months before giving up.”When can we stop the anticonvulsants?”If the child is on barbiturates, we often begin to taper them off during the starvation phase, since the barbiturate level may increase and make the child sleepy. We continue the other anticonvulsants until it is apparent that the diet is effective in controlling the seizures and that it is tolerated. Then we slowly taper the other anticonvulsants over several months.*147\208\8*

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June 2nd, 2011

Duration : Exercise should have wanning up and cooling down period of 5-15 minutes. The usual duration of exercise is 20-60 minutes.Frequency of Exercise: To get the desired benefits of exercise one should do exercise at least 4-5 days in a week.Intensity of Exercise: Exercise should be uninterrupted and should gradually increase the heart rate 70-80% of the Maximum Heart Rate.How to calculate Maximum Heart Rate ?MHR = 220 – Age of a person in years, eg. if person’s age is 80 years his MHR will be = 220 – 80 years = 140 beats/min.Sub Maximal HR = 80% of MHR = 112 beats/minutes.Patient should learn an art to count his own radial pulse and can perform exercises which can increase his HR to 112/minutes at 80 years of age.Brisk walking3.6Cycling4.5Jogging4.5Running5.0Swimming6.0Badminton (Single)6.0Volley-Ball6.0Tennis7.0*39\329\8*

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May 28th, 2011

The question the reader will ask at this point is ‘Given all this epidemiological study, do we know the causes of cancer?’ Broadly the answer is ‘yes’ in many circumstances and for many cancers, and the opportunities for prevention that this understanding generates are there to be taken. We do not always know how the factors that have been identified by the epidemiological studies discussed in this chapter link up to what is being learned in the laboratories of the molecular biologists. This connection is being made rapidly and will be increasingly clear by the end of the century. Epidemiology has been very successful in discovering or confirming which features of our lives in the Western world can be now identified as causes of cancer. Sunlight. Ultraviolet irradiation from the sun is the main cause of skin cancers, including melanoma. Alcohol. Alcohol contributes to cancers of the upper digestive tract, particularly in combination with smoking. It probably also contributes to cancers of the liver, mainly, but perhaps not exclusively, through causing cirrhosis of the liver. There is little doubt that advice on the avoidance of heavy drinking is sound if we wish to reduce cancer risk as well as the other risks with which drinking is associated.Occupations. Cancer epidemiology really began with Percival Pott and his chimney-sweeps, and, for many researchers, creating a safe workplace and eliminating risks is a central purpose of epidemiological studies. Chemical dyes and asbestos have been identified as causes of cancer and eliminated in the workplace, but constant vigilance is still in order. New and stringent regulations permitting only limited exposure to substances hazardous to health arc now in force in many Western European countries, and their extension to Eastern Europe represents a significant financial, political and medical challenge.Environmental Pollution. Most of the factors that are hazardous in the workplace arc found in lower concentrations in the general environment and may well contribute to cancer risk. Atmospheric pollution probably plays only a limited role in lung cancer, but asbestos in the general environment has undoubtedly contributed to the level of risk.*33\194\4*

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May 11th, 2011

A few words are in order on behalf of older children in an alcoholic family. In many cases, children’s problems are related to stress in the parents. Children may easily become weapons in parental battles. With alcoholism, children may think their behavior is the cause of the drinking. A child needs to be told that this is not the case. In instances where the counselor knows that physical or severe emotional abuse has occurred, child welfare authorities must be notified. In working with the family, additional parenting persons may be brought into the picture. Going to a nursery school or day-care center may help the child from a chaotic home.What cannot be emphasized too strongly is that children not be “forgotten” or left out of treatment. Sometimes parents consider a child too young to understand, or feel the children need to be “protected.” What this can easily lead to is the child’s feeling even more isolated, vulnerable, and frightened. Children in family sessions tend to define an appropriate level of participation for themselves. Sometimes the presence of children is problematic for adults not because they won’t understand, but because of their uncanny ability to see things exactly as they are: for example, without self-consciousness the child may say what the rest are only hinting at, or may ask the most provocative questions. Along the same line, while a parent is actively drinking, the inevitable concerns and questions of the child must be addressed. Children may not need all the details, but pretense by adults that everything is okay is destructive. When initially involving the family, consider the children’s needs in building a treatment plan. Many child welfare agencies or mental health centers conduct group sessions for children around issues of concern to children, such as a death in the family, divorce, or alcoholism. Usually these groups are set up for children of roughly the same age, and run for a set period, such as 6 weeks. The goal is to provide basic information, support, and the chance to express feelings the child is uncomfortable with or cannot bring up at home. The subliminal message of such groups is that the parents’ problems are not the child’s fault, and talking about it is okay. In family sessions you can make that message clear, too. You can provide time for the child to ask questions and also provide children with pamphlets that may be helpful for them.Occasionally a child may seem to be “doing well.” In fact, the child may reject efforts by others to be involved in alcohol discussions or treatment efforts. If the alcoholic parent is actively drinking, the resistance on the child’s part may be part of the child’s way of coping. Seeing you may be perceived by the child as taking sides; it may force the child to look at things he is trying to pretend are not there. (Resistance also may surface to joining the family treatment when the alcoholic has become sober, for many of the same reasons.) Listen to the child’s objections for clues to the child’s concerns. Feel free to seek advice from a child therapist if you feel you are in danger of getting in over your head. What is important here is not to let a child’s assertion that “everything is fine” pass without some question.*133\331\2*

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May 2nd, 2011

The dental problems common to all adults—diseases of the teeth and of the supporting structures of the teeth—seem to occur more frequently and more severely in people with HIV infection. See your dentist regularly. Floss and brush your teeth assiduously. Tell your dentist about your HIV infection: people who are prone to dental problems should probably see the dentist more frequently, and the dentist may change some of his or her normal recommendations. Some dentists may also wish to take additional precautions while working in your mouth, even though the standard recommendation is that all people receiving any kind of medical and dental care should be treated as though they have HIV infection.     Get Exercise-Aerobic exercise programs are widely advocated as a way of staying healthy and of preventing cardiovascular disease. Whether exercise is similarly helpful to people with HIV infection is unknown. Most people who exercise regularly, however, feel better both physically and emotionally. There is no reason for a person with HIV infection to avoid regular exercise as long as fatigue or other symptoms do not prevent it.

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April 22nd, 2011

Industrial chemicals Many industrial chemicals can produce allergic reactions. Chrome, which is present in cement, can be a major source of hand dermatitis in construction workers. This can be largely avoided by adding ferrous sulphate to the cement. Epoxy resins such as Aryldite can also cause serious reactions. Industrial chemicals will often penetrate rubber gloves; therefore special nitrile gloves may be necessary.Other than chrome, if the offending chemical is avoided, the dermatitis will disappear in most cases. Dermatitis caused by chrome allergy is often persistent and more difficult to treat. If you continue to become exposed to any chemical to which you are allergic, the dermatitis will become increasingly severe over time.
Clothing Chemicals used in the finishing of textile fabrics can produce allergic reactions which often go unrecognized. Many of these chemicals are formaldehyde resins, which make fabrics crease-proof. Clothing dyes can also cause allergic reactions.
Nail polish Nail polish is an extremely common cause of contact allergic dermatitis due to the resin it contains to make it durable and glossy. Interestingly, this dermatitis is rarely seen around the nail but rather on the eyelids, lips and neck. This is why people rarely suspect nail polish as the cause of their dermatitis. Special hypo-allergenic nail polishes, such as Almay, can be safely used, however the resin used in these nail polishes is less durable and less glossy.

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