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.
Sexual activity has been extensively investigated as a factor in the cause of certain cancers, particularly cancer of the neck of uterus. Certainly, the number of sexual partners appears to be
an association. In a woman with only a single lifelong sexual partner, the number of partners that her one sexual partner has had also seems to affect her risk. How this leads to a cancer, and particularly whether the cancer is caused by transfer of a virus, is the subject of current research focusing particularly on the human papilloma virus. The transfer of infectious agents which give rise to AIDS must also be considered under this heading because people with AIDS can get unusual types of cancer.
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What are the elements of a good rehabilitation program? What should I look for?
First, the goals should be realistic. The rehab specialist should carefully explain exactly what the plan of action is and what should be accomplished with this plan. Your program should be based on you and you alone. Everybody is different. Second, the period to achieve these goals of rehabilitation should be realistic. If it is going to take two years, you need to know that. Third, the rehabilitation specialist should consult with your arthritis specialist to make sure your program will not cause you further pain and deterioration. Fourth, you should be able to report your progress accurately and not overdo it. The doctor and you have to come to some agreement on your progress.What is deconditioning?
Deconditioning is the effect that disuse has on your body. Often those affected with RA stop using affected body parts due to pain or depression. As a result, muscles become weaker and bones begin to deteriorate. Rehabilitation medicine is directed to prevent you from deconditioning.What kind of team is involved in my rehabilitation?
Your rehabilitation team will consist of a rehabilitation physician; your rheumatologist, of course; a rehabilitation nurse; an occupational therapist (ОТ) to help you with your activities of daily living; and a physical therapist (PT). A social worker, a psychologist, and even a speech therapist can be brought in if needed. All of these people may work with you to help improve your quality of life.What are some of the pain-relieving modalities that might be used?
Both heat and cold can decrease joint pain. Heat can be given by way of paraffin baths, application of moist hot packs, or even immersion in warm water. Cold therapy can be given via ice packs or immersion in cold water. This helps reduce swelling, raise the pain threshold, and decrease muscle spasm.
Topical creams and liniments can be applied to relieve pain. One example is a cream containing capsaicin (an extract of paprika), which is very helpful in relieving the pain of RA.
Electrical nerve stimulation is another method used to relieve pain. This method, called transcutaneous electrical nerve stimulation (TENS), is good for bone pain and even nerve pain in certain sites. Electrodes that transmit mild electrical impulses are attached to the skin. These electrical impulses are thought to relieve pain by interrupting the pain pathway, by increasing the production of endorphins, or by increasing the blood supply to the affected area. Though this procedure is relatively painless, a mild tingling or massaging sensation is felt as the electrical impulses are emitted.Are there specific treatments for different parts of the body?
Absolutely. Rehabilitation therapy can strengthen each area with specific exercises and assist devices. One such device to aid function is the splint. There are resting splints, which basically immobilize a part of the body like the hand or the wrist, and functional splints, which are designed to support a limb during activities, such as the hands during exercises or the knees while walking.
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Acute varicella (chickenpox) may be severe, particularly in adults, and can complicate travel and delay return home. Travelers may be exposed to this highly communicable virus (varicella-zoster virus) while traveling to their destination or through exposure to local populations after arrival. The status of varicella immunity should be reviewed in long-term travelers as well as in those whose activities bring them into contact with children in schools, day care centers, refugee camps, or health care settings. Adults who give no history of varicella or prior immunization should be tested for the presence of antibodies, since 71% to 93% of adults without a reliable history are actually immune. Adults who grew up in tropical or subtropical countries are more likely to be at risk, since varicella infection is rare in childhood in these locations. Children 1 to 12 years of age should receive a single dose of vaccine (Varivax, Merck), and those 13 years of age or older should receive two doses of vaccine 4 to 8 weeks apart. Varicella vaccine may be administered concurrently (but at different sites) with any other vaccine. Pregnant and immunocompromised individuals should not receive this live attenuated vaccine. Immunization should occur prior to the initiation of anti-malarial chemoprophylaxis, since these drugs will interfere the effectiveness of the vaccine.
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Chromium (Cr)FunctionsIntegral part of many enzymes and hormones. Co-factor with insulin to remove glucose from the blood into cells. Important in cholesterol metabolism. Essential for proper utilization of sugar. Involved in the synthesis of heart protein. Contains so-called Glucose Tolerance Factor.Deficiency symptomsSevere deficiency may be a contributing cause of diabetes, high or low blood sugar, hardening of arteries and heart disease.Natural sourcesNormally present in natural waters, particularly in hard (highly mineralized) water. The natural complex of the chromium, the Glucose Tolerance Factor, is present in whole grain bread, mushrooms, liver, brewer’s yeast, raw sugar and cane juice.RDA (Recommended Daily Allowances)Not known. Needed in minute quantities. White sugar in the diet contributes to the loss of chromium from the body and consequent deficiency.Molybdenum (Mo)FunctionsIntegral part of certain enzymes, particularly those involved in oxidation processes. Considered to be an antagonist to copper, thus may have protective action in copper poisoning. Involved with proper carbohydrate metabolism.Deficiency symptomsUnknown.Natural sourcesWhole cereals, especially brown rice, millet and buckwheat, brewer’s yeast, legumes, naturally hard water.RDA (Recommended Daily Allowances)Not known. Needed in minute quantities.*165/103/5*
Tags: CHROMIUM, General health, MOLYBDENUM
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Silicon (Si)FunctionsEssential for building strong bones and for normal growth of hair, nails and teeth. Beneficial in all healing processes and protects body against many diseases, such as tuberculosis, irritations in mucous membranes and skin disorders.Deficiency symptomsSoft brittle nails, aging symptoms of skin such as wrinkles, thinning or loss of hair, poor bone development, insomnia, osteoporosis.Natural sourcesYoung green plants, such as horsetail, common nettle and alfalfa; kelp, flaxseed, steel-cut oats, apples, strawberries, grapes, beets, onions, parsnips, almonds, peanuts, sunflower seeds.RDA (Recommended Daily Allowances)Fluorine (F)FunctionsEssential for bone and tooth building. Protects against infections. Acts as an internal antiseptic. Excessive fluorine, especially in form of sodium fluoride (as in fluoridated water) causes mottled teeth and can be toxic.Deficiency symptomsUnknown.Natural sourcesOrganic fluorine is found in steel-cut oats, sunflower seeds, milk and cheese, carrots, garlic, beet-tops, green vegetables and almonds. Also, normally present in sea water and naturally hard water.RDA (Recommended Daily Allowances)Not known. May be needed in minute quantities.*164/103/5*
Tags: FLUORINE, General health, SILICON
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Millions dread the coming of winter, not because it’s cold but because the darkness of the night lasts too long. Daytime also carries a somber cloak. Many respond with moodiness, and some with frank mental depression that needs treatment. The treatment: sitting in front of bright, artificial light radiating from a box.It may sound like quackery, like something out of science fiction or ancient myths, but, in fact, it does work. By shining intense light on the eyes of people suffering from deep depression in the winter season, psychiatrists have lifted the spirits of uncounted patients.This light treatment, called phototherapy, has real effects on the minds of human beings. It has opened up a new way to treat the depression that affects millions of Americans from September, when days begin to shorten, through the winter and into March, when they begin to lengthen again.A team of scientists at the National Institute of Mental Health in Bethesda, Maryland, began to focus on the link between mood and illumination. Dr. Norman E. Rosenthal, a chief psychiatric researcher at the institute, was one of them.“There is not only winter depression – people get depressed in summer, too,” says Dr. Rosenthal. “We think for summer it’s the intolerance to heat. But we’re not sure.”In the United States, Dr. Rosenthal estimates, 10 million people get clinically or dangerously depressed with the coming of winter. A smaller number become depressed with the advent of summer. All are suffering from what doctors now call seasonal affective disorder, or SAD.Helen Smith, a housewife from New York City, says she finally realized she was starved for light. “Since puberty,” she recalls, “depression was constant. I had no focus or goals. It took me 7 years to finish college. You can’t just pick yourself up and make it better. Depression robs you of everything.”The families of people like Helen Smith often believe that the patient can simply overcome the depression by an act of will. But the person no more can eject the depression from the mind than you can cure cancer by thinking about it. Mrs. Smith’s doctor sent her to Dr. Michael Terman, director of the Winter Depression Program at the New York State Psychiatric Institute in Manhattan.“I’ve kept journals since the age of 9 or 10,” says Mrs. Smith. “September 15 was always the day in my journals when I would crash. But I did not see the pattern until I met Dr. Terman.” He took her off depression drugs and had her sit in front of a light box with six fluorescent tubes for 3 to 4 hours each morning and for 2 hours before bedtime. As she sat, she read, did needlepoint, or wrote in her journal. Within 3 weeks, she was feeling really good, she reports.“I’ve had three winters depression-free,” Mrs. Smith exults. “I have a future. I have a family now. I belong to the human race.” Since being treated by Dr. Terman, she has married and has a baby girl. As do most SAD patients, she says she still hungers for light. “But now,” she adds, “half an hour in the morning is all I need.”In less than 10 years, scientists have recognized that SAD is a mental disorder and that light plays a big part in its origin and treatment. The progress began when Dr. Rosenthal, then a young physician from South Africa, went to work in 1979 with Dr. Thomas A. Wehr, who was studying biological clocks in animals at the National Institute in Bethesda. The biological clock triggers many daily activities, each at about the same time every day – hunger, going to sleep and getting up, among others. Generally, your biological clock lags behind real time. With no cues from daylight, traffic noises, or temperature changes, you would feel sleepy later and later each day. Eventually, you could end up 12 hours out of step with real time.*80/266/5*GENERAL HEALTH
Tags: General health
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Aging is a process that covers the entire life-span. The metabolic changes that characterize aging are poorly understood. Gerontology is the study of the aging process. Geriatrics is the branch of medicine concerned with the prevention and treatment of diseases in older persons.There is, of course, no specific age that characterizes a person as “old”; some people are “old” at 50 years, and others are “young” at 70 years. About 24 million people in the United States today are over 65 years old. Most of these people are productive, live in their own homes, and enjoy good health. Good nutrition, heredity, and environment play dominant roles in the maintenance of health.Nutritional needsAs you well know, it is altogether too common for people to gain weight as they become older. This weight gain is explained in part by a progressively lower basal metabolism after 25 years of age. In addition, older men and women are usually less active than they were in their youth.The recommended energy allowance at 51 to 75 years for men is 2400 kcal and for women is 1800 kcal. The allowances for thiamin, riboflavin, and niacin are slightly lower to correspond to these lower calorie requirements. The allowances for protein and most minerals and vitamins are the same as for younger adults. Provided that she does not have an anemia, the woman who reaches 51 years can meet her iron needs with a daily intake of 10 mg.Problems of food intakePeople over 65 years of age are no more like one another than teenagers are like one another. The nurse is likely to encounter a great variety of problems concerned with adequate nutrition of older persons. She needs to be alert to these problems, and to use ingenuity, patience, and kindness in solving them.1. Inability to chew is a frequent source of difficulty because of poorly fitting dentures or absence of teeth.2. Appetite usually declines in later years because the senses of smell and taste are less acute, the secretion of saliva and gastric juices may be reduced, and the satisfactions of sociability with family and friends may be lacking. Chronic disease and medications often interfere with the appetite.3. Complaints of heartburn, belching, indigestion, and flatulence are frequent. Specific foods, especially fruits, vegetables, and spicy foods, are often blamed for these effects, but no firm rules can be given that apply to all persons. Thus, one individual experiences discomfort every time he eats onions, and another enjoys onions and tolerates them well. Concern for the individual would omit onion for the former and include them for the latter.4. Constipation is a common problem of the older individual and is related to the reduction of muscle tone of the gastrointestinal tract and to lessened activity. It is aggravated by eating too many soft, low-fiber foods and failing to drink sufficient fluid.5. Chronic diseases of the heart, kidney, circulatory system, gastrointestinal tract, and joints impose needs for modified diets or interfere with tolerance for foods and ability to manage one’s own diet.6. A lifetime of poor dietary habits contributes to signs of nutritional deficiency including fatigue, anemia, fragility of bones, poor wound healing, and reduced resistance to infection.7. Living alone, physical handicaps, inability to shop, poor cooking facilities, low income, frustration, boredom, and fear of the future all reduce the desire to eat or the capacity to prepare adequate meals.8. Faddism and misinformation are responsible for much poor nutrition. Older people are especially likely to fall prey to the food quack that makes promises of good health, vigor, and even cure of disease.*80/234/5*GENERAL HEALTH
Tags: Diabetes
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COLOUR BLINDNESS
Colour blindness occurs more commonly in boys than in girls. It is estimated that up to 5% of males have some degree of colour blindness. People with colour blindness perceive colours in a different way to normal. The colours most involved are green and red. Otherwise, vision is normal. If you suspect that your child is colour blind, see your doctor who will organise special tests. There is no cure for colour blindness. It is not a serious condition, as children learn colours by association. It is dangerous for people who are colour blind to undertake certain occupations.
DISCHARGE FROM THE EYES
We all wake up in the morning with a little discharge in the corner of our eyes, which we call ‘sleep’. When present in small amounts, this is normal. If your child wakes with his eyes stuck together, or the discharge is sticky and green, he may have an eye infection. An eye swab is advisable to determine the cause of the infection.
If your child complains persistently of seeing double, it may be due to a squint. Very occasionally it may be a sign of a neurological condition. It is always wise to consult your doctor.
EYE PATCH
Certain visual problems may require your child to wear an eye patch for a period of time.
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Tags: General health
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There are two types of girls in school. Some have a lot of sex and talk about it and everything. The other girls are nice, and they don’t do it or talk about it much. If you get to be like a bad one, the boys know it and flock around you like flies, but the good girls will stay away from you and you won’t have nice friends.
If there are a thousand girls at your school, then there are a thousand types of girls, because everyone is different. During our school years, and even when you are an adult, it seems easier to classify or put people into categories, especially if someone else is seen as less or worse than we are. That seems to keep us safe from being on the wrong side of things, looking bad ourselves. We are all insecure. Some girls and boys use sex to be popular, to get friends, or to get noticed, even if it is bad notice. Good girls will never draw boys like flies, but you won’t want to. You will want to have a lot of friends and sooner or later just one boy. Remember, boys and girls make up a lot of stories about sex because they don’t get to talk with their parents. A lot of that is wishful thinking or even fear coming out. And you know what? I have never met a really bad girl or a bad boy, just sometimes troubled, angry, frightened boys and girls who make up stories because they are confused. The more confused they are, the more they have to make things up.
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Tags: General health
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Every time I try to touch my husband anywhere else than his penis when we are having sex, he directs me back to his penis. It’s like a magnetic rod.
WIFE
The penis is not the most sensitive part of the body for psychasm. It is the most important part of the body for ejaculation, and you have already learned the difference.
One of my paraplegic patients reported, “I know now that I never really came, not like this. I have a neckasm now. She licks the side of my neck and it’s rocket city!”
This patient’s report is on videoptape, and when I show it during my lectures to medical students, I notice some of the males moving their hands to their necks in disbelief. The women nod in agreement. Usually, a physician will say, “This is impossible.” When I ask in turn if it is not true that orgasm is neurologically different from ejaculation, they agree, but the psychological factors of sex are not taught in most medical schools’ curricula.
I receive hundreds of letters following my lectures. While most are positive, some husbands write with anger. One man wrote, “You have ruined everything. I had a good thing going. Now she asks how I feel, what is happening, all kinds of questions. She wants me to have a fingergasm or something. Let me tell you something, Dr. Pearsall, I was in the navy and ten thousand sailors can’t be wrong.” The point is that ten thousand sailors can be wrong, very wrong. It was not long ago that army and navy training films taught that sexually transmissible disease was carried by immoral women to victimized men. It seems that men are either victims of women, totally responsible for sex with them, miserable failures when compared to female response capacity, or generally oversexed. We fail to be real benefactors in mutual intimacy when we embrace the phallocentrism of the early perspectives of human sexuality.
Men still go to massage parlors for “local massage.” One man
reported, “I couldn’t believe I could get taken like that. I went in to get a massage, you know, and that is what I got. A damned massage. She didn’t touch my cock once. All I got was this hour-long touching all over me. She didn’t even speak English. I asked her once if she touched genitals. She said yes, but she had been massaging mostly Jews lately. What a rip-off.” Men rip themselves off when they believe that sexual feelings focus or even originate in vascular and muscular genital response.
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Tags: General health
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