Archive for July, 2011

IMMUNE POWER DIET: AMINO ACIDS AND PAIN

Saturday, 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*

SUPPORTIVE CARE OF CHILDREN WITH CANCER: DIAGNOSIS AND TREATMENT OF CHEMOTHERAPY-INDUCED PULMONARY TOXICITY

Tuesday, 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*

UNDERSTANDING TESTS FOR HIV: WHO SHOULD GET TESTED-BEHAVIORS THAT RUN THE RISK OF EXPOSURE TO HIV

Tuesday, 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*