Dietary Recommendations

. Wednesday, January 28, 2009
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As is the case with all other age groups, the elderly are best served by a varied diet drawn from the five basic foods groups. The National Institute on aging advises that a daily diet for elderly people should include:
  • At least two serving of milk (or dairy products low in lactose, such as aged hard cheeses and yogurt)
  • Two servings of high protein foods (lean, meat, poultry, fish, eggs, legumes, nuts, peanut butter)
  • Four servings of fruit and vegetables, which should include a citrus fruit (or juice) and a dark green leafy vegetable.
  • Four servings of bread or cereal products, whole grain or enriched.

Signs of Eating Disorders

. Tuesday, January 27, 2009
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To determine whether someone has anorexia nervosa, look for the following signs:
  • Loss of 20 to 25 percent of total body weight
  • Loss menstrual period
  • Compulsiveness about exercise
  • Compulsive eating behavior
  • Depression
  • Perception of self as fat
The bulimic exhibits the following signs.
  • Frequent weight fluctuation of 10 pounds in either direction
  • Massive consumption of high-calorie foods
  • Repeated attempts to lose weight by severely restrictive dieting or long term fasting
  • Awareness that eating pattern is abnormal
  • Fear being unable to control eating voluntarily
  • Depression
  • Self –deprecating behavior

SMOTHING OUT THE SCARS

. Saturday, January 24, 2009
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The next time the movie camera closes in on your Hollywood heartthrob, ask yourself: Has this guy ever had a pimple?

Actually, many people have acne that disappears without a trace. Others aren’t so lucky, and the deep, craterlike scars can leave a permanent record of the disease. The scars can rarely be eliminated, but they can be improved, says David W. Low, M.D., an assistant professor of plastic and reconstructive surgery at the University of Pennsylvania in Philadelphia.

The easiest technique is dermabrasion, in which your doctor planes the skin smooth with a high-speed brush or wheel. “What you’re doing is sanding the high spots,” Dr. Low explains. The procedure isn’t particularly painful, but there is significant postprocedure crusting and oozing. “Your face can look pretty bad during the first couple of weeks,” he says.

Dermabrasion is effective only for shallow scars, he says. If you have deep, “ice pick” scars, your doctor may decide simply to cut out the scar, then stitch the skin back together. The trick, of course, is making the surgical scar less visible than the acne scar.

A third technique is called punch excision. First the scar is removed, then a plug of skin is taken from another part of the body and inserted in the hole. Once the grafts takes, your doctor may use dermabrasion to make your skin even smoother.

Another option is to fill the scars with collagen, an absorbable gelatin protein. While collagen does improve the appearance of a scar, it will eventually be absorbed by the body. In most cases, the benefits will fade after six months to a year, Dr. Low says.

Regardless of the procedure, timing is important. Ideally, your doctor won’t operate until new scars aren’t being formed. It’s also important to have realistic expectations, Dr. Low adds. “If someone has really severe acne scars, there’s nothing you can do to remove all of the irregularities. You’re not going to make the skin smooth. You’re going to make it less rough.”

TREATMENT BREAKTHROUGH
CUTTING THE RISKS OF ACCUTANE

Doctors though they had the perfect cure for acne in the early 1980s with the discovery of the drug isotretinoin (Accutane), a synthetic derivative of vitamin A.

Isotretinoin has the ability to eliminate even the most severe cases of acne for months or even years at a time. Unfortunately, there is a rub: untoward side effects. Accutane, while giving you smooth skin, can give you headaches, itching and muscle pain and can even cause your hair to shed. But most alarming, it can cause birth defects if taken by pregnant women.

But there are some researchers in Europe who still believe that Accutane can be the end-all for acne––without the bad side effects. They feel that lower doses of the drug taken for longer periods can produce the same benefits but cause fewer problems.

Doctors in this country disagree, says Alan R. Shalita, M.D., professor and chairman of the Department of Dermatology at State University of New York Health Science Center in Brooklyn. “It is conceivable that one could come up with a low enough dose that wouldn’t cause birth defects, but this would be very difficult to prove,” he says. “Who’s going to take the chance of testing it?”

Another way to make the drug safer would be to simply limit the distance it travels, Dr. Shalita says. Today, isotretinoin is taken orally, which means it can reach––and perhaps cause problems in––many parts of the body. But researchers are investigating topical preparations that could be rubbed directly on the acne, putting the punch only where it’s needed. “it would be safer this way, because the absorption into the body would be minuscule,” he says.

RABIES

. Tuesday, January 20, 2009
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You’re following an old deer trail through the woods late one Sunday afternoon when, off to your left, behind a boulder, you catch a glimpse of something brown––an old raccoon, foraging through the bushes for his supper.

You’d like to reach out a hand and offer him some of the berries you’ve picked for a snack, but you hesitate, as all the headlines about wild animals carrying rabies flood your mind.

Could this raccoon have rabies?

Assessing the risk

Rabies, although rare among humans, is not so uncommon in the animal kingdom, says Makonen Fekadu, D.V.M., the top rabies specialist at the federal Centers for Disease Control (CDC) in Atlanta.

Not all species of wild animals––nor all animals in a species––carry the rabies virus, he adds. Those critters to look out for include, but are not limited to, raccoons along the East Coast, skunks in the north- and south-central states, dogs and coyotes along the border between Texas and Mexico, foxes in New York state an New England and bats throughout the United States.

Other animals––unless they attack you without provocation––should be judged innocent until proven guilty. Domesticated dogs are no longer a serious threat, since rabies vaccinations have virtually wiped out the disease in household pets, in 1990, only 148 dogs in the United States contracted rabies, and none transmitted it to humans. From 1980 to 1991, only 16 cases of human rabies were reported to the CDC, and only 7 of these are believed to have been acquired from animals within the United States.

A frightening disease

If so few cases of rabies are found in the United States each year, why does everyone seem to be so afraid of the virus?

Part of the answer may be that rabies is such a deadly disease once symptoms develop. The virus will kill anyone who has been infected unless they begin a series of five vaccinations before the symptoms appear, says Dr. Makonen. Around 30,000 of these postexposure vaccinations are given every year, and a testament to their effectiveness is the rarity of the disease in humans.

Rabies is usually transmitted through a bite or scratch. The virus stays in the area of the wound for several days or months while it multiplies. It’s that characteristic that can save your live, explains Dr. Makonen. It gives you an opportunity to get antirabies vaccinations from your doctor, and it gives the vaccine itself a chance to train your immune system to kill the virus before the virus can spread throughout your body.

Without the vaccinations, the virus would eventually move into the nerves, using them as highways to the spinals column and finally to the brain. There are no overt symptoms as this occurs, although those affected by it might begin to feel as through they’re getting a cold. Pain, cold, numbness, tingling or burning might also begin at the wound site.

When the virus actually reaches the brain, the possible symptoms include intermittent periods of anxiety, hyperactivity, hallucinations, convulsions and bizarre behaviors, such as biting or an overwhelming fear or water. After rabies symptoms develop, a person with rabies gradually becomes paralyzed and dies of respiratory failure within a few days.

Smart action

There is no way to tell if an animal has rabies just by looking at it. A raccoon walking slowly up the trail is just about as likely to have rabies as the one that’s snarling in the bushes. If you’re bitten by any animal:

Immediately clean the wound thoroughly with soap and water. Since the rabies virus tends to hang around the wound site, says Dr. Makonen, washing it out with soap and water is the single most effective means of preventing rabies that you have. You should wash even before you seek medical help, he says.

Scratched that do not break the skin rarely cause rabies, and if you are bitten or scratched by a dog or cat that has an up-to-date rabies tag, you are most probably safe. But if there’s no current tag, or if you are wounded by another kind of animal, give your local health department a call and find out if the type of animal that hurt you––skunk, raccoon, woodchuck, etc.––is carrying rabies in your area.

If it is, get yourself to a physician on the double to begin your vaccinations. In 1991, there people exposed to rabies decided they didn’t need the vaccinations. All three are dead.

Food Guide for the Nursing Mother

. Saturday, January 17, 2009
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Nutritional requirement for the lactating woman are higher that any other stage of the life cycle. One must account not only for the nutrient and energy value of the milk itself but also for the demand placed on the body to produce it. Other tips for the nursing mother include:

  • Caloric requirements are increased by 500 calories per day to compensate for calorie and nutrient loss with lactation. The increased nutritional needs of the lactating mother can be met by increased intake of nutrient –dense, high quality foods.
  • Drink plenty of fluids. In addition to four to five servings of milk, one and a half quarts of water and /or juice will help assure adequate hydration for you, as well as furnishing the needed fluid produce a good milk volume.
  • There is no need for iron supplementation while lactating and not menstruating because cessation of menstruation compensates of iron in breast milk.
  • Vitamin A requirement are increased by 400 to 500 RE to maintain maternal liver stores, to account for variations in milk volume and to provide a margin of safety.

Nutrition and The Eye

. Friday, January 9, 2009
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The value of dietary sources of vitamin A for the prevention of night-blindness was known to the ancient Egyptians. Since then dietary supplement have been shown to benefit the eyes in only a small number of additional situations.

Vitamin A is required for the synthesis of the pigments which absord light within the eye, as well as for the maintenance of the eye’s smooth surface. The initial sign of vitamin A deficiency is usually night-blindness, followed in severe cases by dry eyes, and ultimately, breakdown of the ocular surface. Fortunately, vitamin A is plentiful in most diets, and symptoms are rare. Nearly all of the cases in developed countries result from malabsorption of the vitamin due to an intestinal disorder. Oral or injectable supplement typically bring dramatic improvement. In developing countries, diets deficient in vitamin A remain a major cause of visual disability. Inexpensive supplementation programs have proven very effective.

Recently, it has been reported that vitamin A may be of some value in slowing the rate of loss of vision in retinitis pigmentosis, a rare, inherited disease of the retina. The effect was small, and the dosage used was nearly 60 percent of the potentially toxic dose. In the same study, vitamin E supplements appeared to slightly accelerate the loss of retinal function.

It has also been suggested that vitamins E and C, as well as Zinc and other antioxidant and macular degeneration. In one preliminary study, high does zinc supplements appeared to reduce the incidence of onset of macular degeneration, thought they had no effect on the progress of established disease. Confirmatory studies are in progress.

There is no convincing evidence that any vitamin or mineral supplement is of value in the prevention or treatment of cataract.(Scott E. Brodie, MD.,Ph.D.)

Strategies for Change in Health Behavior

. Monday, January 5, 2009
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  • Give careful thought to your motivation and reasons for wanting to make particular changes, make a conscious effort to think about them every day. Consider the long –and short-term advantages and disadvantages of changing.
  • Prepare for expected difficulties. Identify potential triggers for slips (i.e., an uncomfortable social engagement or physical illness). Avoid high-risk situations when possible.
  • Formulate a list of coping methods that can be used when the “old urge” arises (see other boxes in this chapter).
  • Don’t be overly compulsive or controlled in your new habits. Go with the 80 percent rule (if you can do so honestly). For example, 20 percent of the time, allow your self to eat taboo foods in limited quantities.
  • Develop and read a list of coping self-statement for times when you experience urges to slip, or following a slip. For instance: “Just because I don’t feel like jogging doesn’t means I shouldn’t, ” or “having that piece of cake wasn’t great, but it did taste good. I ‘m only human, so let me just go back to eating right and have no more cake today. “ practice and rehearse these types of statement, particularly while visualizing yourself in high-risk situations.
  • Practice deep breathing exercise and other relaxation skills when an acute craving episode occurs.
  • Develop a network of people who practice healthy behaviors to serve as good models and to provide support.

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