Health related information and news from around the world.

Eating is not only a necessity, we also eat for other reasons — social, pleasure, habit and sometimes to satisfy a hunger for attention or to cope with our anxieties and depression.

We start off with a particular genetic make-up. This we can’t alter. We are destined to be either fat or thin. But then comes the influence of our environment and the behavior we learn. We can learn to avoid being overweight even if genetically we have that tendency.

Unfortunately, the seeds of obesity are often sown in childhood. A fat “healthy” baby is likely to grow into a fat child and a fat unhealthy adult.

It is now believed that the number of fat or adipose cells in the body are determined in childhood and that later in life the cells may increase in size but not in number. Being overweight in childhood means more adipose cells are formed and later in life they tend to fill up with fat and so we become obese.

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The cause of hardening of the arteries is unknown but it is associated with several factors. Diabetes, in which there is a relative lack of insulin, is a disorder in which there is a widespread metabolic disturbance, apart from an inability to metabolise sugar.

Diabetics are prone to develop atheroma in their arteries, more severely and at a younger age, than the rest of the population.

Atheroma is associated with high levels of fat in the blood. The blood fats consist of cholesterol and triglyceride. Cholesterol is produced in the body and is present in hormones and many tissues, and the blood level may be raised by a diet rich in animal fats.

A few cases with high triglyceride levels are due to an inherited disorder but most are the result of a diet high in carbohydrate which, in Australia, is usually due to beer or sugar.

High blood pressure may cause degenerative changes in the arteries and be associated with atheroma.

The other main factor is cigarette smoking.

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Unfortunately, this basic and obvious right is frequently violated in the case of people with cancer. Practitioners often reveal important facts about these people to close friends or relatives without the patient’s permission and, even worse, without giving the same information to the person with cancer. There can be no justification for this except where that person has completely lost his or her mental faculties. Such a person could not be reading this book, so the following applies to you.

You have the right to determine who is given information about you. Your doctor (and hopefully any other practitioner) is ethically obliged to get your permission before giving information to anyone else. It is usual to take your permission for granted in the case of other health professionals directly involved in your case. For example, other doctors, nurses, social workers, physiotherapists and so on who are personally involved in your care would not usually need formal permission to have medical and other relevant information about you. Each of these health professionals, however, is obliged to treat such information as completely confidential. They are not entitled to tell any of it to anyone else without your specific permission. The only other circumstance in which your doctor could take your permission for granted is when you bring a friend or relative into the consulting room with you. However, the doctor must still obtain your permission to give information even to these people when you ìØ not present.

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This is a common manifestation of excessive sun exposure in people of Celtic background and fair akin. It is extremely common in Australia, particularly on the backs of the hand and on the face; It is a precancerous, or premalignant, change in the epidermis. However progression to malignancy occurs in only a minority of these keratoses.

Features. Solar keratoses appears as small, rough patches on the skin surface. Usually they are skin coloured or red, and sting on exposure to sunlight. The scales may fall or be knocked off, but will invariably recur. Occasionally they spontaneously bleed. Some are very small, whereas others can be quite large and grow horny protuberances. Thickening of the base of the lesion, with increasing redness and tenderness, indicates activity and the possibility of malignant change.

Treatment.

1. Cryotherapy

This is the most popular treatment, using either solid carbon dioxide or liquid nitrogen.

2. Diathermy or curettage

When lesions are thick or if malignant change is suspected, this is the preferred treatment, the advantage being that microscopic examination can be performed on the suspect tissue.

3. Chemotherapy

More recently a cytotoxic chemical, 5 Fluououracil (5 F.U.) has been used in the destruction of solar keratoses. It is applied in the form of ointment or lotion twice dotty for 3-4 weeks. Where keratoses or other solar damage is present, acute inflammation followed by superficial erosion will occur. One or two weeks later, healing without scarring and without the return of the keratoses occurs. Frequently, patients observe that the cure is worse than the disease. As this form of treatment is not adequate for basal cell carcinomas, which could be mistaken for solar keratoses, careful diagnosis before treatment and follow-up afterwards is mandatory.

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While many women are happy to receive treatment for a condition that is bothering them now, far fewer want to take it to prevent something that may (or may not) happen some time in the future. This is a pity, because there are two serious conditions that are directly related to low levels of oestrogen after the menopause: arterial disease, which can lead to heart attack and stroke and is often fatal, and osteoporosis, which isn’t usually directly fatal, but which causes pain, deformity and a considerably reduced quality of life, and can be an indirect cause of death.

Neither of these diseases usually arises until several years after the ovaries have stopped producing oestrogen, but all women are potentially at risk from them the further they get in time from the menopause. The earlier you have the menopause (surgical or natural), the greater the proportion of your life without oestrogen, so the greater your risk of developing arterial disease and osteoporosis, and the more important it is that you are aware of these long-term consequences of low oestrogen and what you can do about it.

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One of the most important herbs used by herbal therapists for the treatment of hormone problems in women is Vitex agnus castus (also called Chaste Berry or Monk’s Pepper). It is derived from the ripe berries of a Mediterranean shrub but the chemical constituents said to be responsible for its actions in balancing the menstrual cycle have not been defined. Treatment is long-term over many months using doses of about 2 to 3 ml of a 1:5 tincture a day (this means that 5 ml of the final preparation is equivalent to one gram of the dried herb from which the preparation was made). It is common practice in England, and also recommended by German manufacturers, to take Vitex in a single dose each morning before breakfast throughout the cycle. Prolonged use of high doses is not advisable, but a course of six months treatment without a break is said to be necessary for full and lasting improvement. Headache is an occasional side-effect.

The first major clinical studies on Vitex, published in the 1950s, claimed significant improvements in over 60% of women treated for heavy or frequent bleeding. The average duration of bleeding was said to decrease from eight to five days. An English herbalist, Janet Hicks, claims that heavy and prolonged bleeding is best tackled by combining Vitex with muscle relaxants. When women experience symptoms of PMS such as irritability, and menopausal symptoms like hot flushes, she suggests they take Vitex. Then, as the PMS disappears, another herb, Chamaelirium luteum (Holonias), is recommended. Mrs Hicks considers Vitex unsuitable for post-menopausal women and women of any age using hormones such as the Pill, hormone therapy or danazol.

A host of other herbal and nutritional therapies are also in widespread use. The seeds of the horsechestnut are said to be helpful for painful periods; ginseng, motherwort, lime blossom, Cimicifuga racemosay vitamin E and evening primrose oil tablets are all capable of affecting hot flushes; and vitamin B6 (pyridoxine), evening primrose oil and Anemone Pulsatilla can apparently alleviate PMS in some women. At least part of the benefit of these treatments lies in a placebo effect, that is, an effect that is just the same when a harmless substance like a sugar pill is substituted for the substance being tested. This effect is not well-understood but it is well-documented with both orthodox and alternative medicines. It is said to occur in a third or more patients when most treatments are tested.6 It may be that people seek help from health practitioners when their symptoms are at their worst and, when they start to feel better, they put it down to the treatment — although they may have felt better in the same time regardless of whether or not they received treatment. Another possible explanation is that the brain releases chemicals that, for example, suppress pain as a conditioned reflex to receiving a pharmaceutical or alternative medication.

An important nutritional supplement for many women with heavy or prolonged bleeding is iron tablets, which can help to relieve anaemia and associated fatigue. A study of 380 women in the US State of Maine, whose fibroids, abnormal bleeding and chronic pelvic pain were managed without surgery, found that about 6% of those with abnormal bleeding or fibroids had anaemia. A comparison study also conducted in Maine found that 19% of women having hysterectomies for fibroids were anaemic. A measurement of blood haemoglobin (the pigmented substance that gives red blood cells their colour and also carries oxygen through the body) will show whether anaemia is a problem. The iron most easily absorbed by the human body is found in lean meat (especially liver and kidneys), seafoods (especially oysters) and poultry. Less-easily absorbed iron is present in cereals, legumes, vegetables (especially green leafy varieties) and eggs.

The commonly held view that vitamin B6 will cure symptoms of PMS has resulted in many women taking high doses of it (several hundred milligrams a day). Dosages above 25 mg a day are inadvisable as they can lead to damage of the nerve endings in the fingers and toes, as well as dependence. Rather than taking high doses of B,, it is worth considering boosting your intake of foods rich in this vitamin such as bananas, lentils, avocado, fish, eggs, turkey, chicken, tuna, salmon, walnuts and lean meat.

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From research conducted in sleep laboratories, we know that dream erections occur irrespective of the kinds of dreams a man is having, even if the dreams have nothing to do with sex. Male erections coincide with each period of REM sleep night after night without exception. It is difficult to explain with Freud’s theory why all males from young boys to geriatrics have exclusively sexual dreams every time. Dream erections are a basic physiological function of the body and have little to do with the psychology of the mind or the contents of dreams.

Whenever we want to understand the importance of some biological function of the body, we try to observe what happens if that function fails, as, perhaps, in some illness. In the case of dream erections, we look at the illnesses that prevent erections even during REM sleep. This condition is called secondary impotence, in which the patient is unable to have an erection at any time after a physical illness. W. Masters and V. Johnson of The Reproductive Biology Research Foundation in Missouri are leading sex therapists. In their book Human Sexual Response they state: ‘… data … suggest that the penis of the secondarily impotent male attains states of pathological hyperinvolution (when compared to previously established norms), after two to four years of unremitting impotence.’ In other words, the size of the penis begins to shrink. Many geriatric patients with secondary impotence have shrunken penises—some of them are nearly non-existent. Hence, if the penis is not in use for a period of time, it involutes and becomes functionless.

This in fact happens to other biological functions. If a part of our body is put out of use, it will waste away. Paraplegics, often the unfortunate victims of car accidents, completely lose the use of their legs. After a few years the muscles of the legs are wasted and shrunken because they have been unable to function for so long. However, the arms are very muscular and well developed, much more so than before the accident. This is because they have the regular exercise of pushing a wheelchair.

We read in the Bible how man first came to populate this planet. Adam ate the forbidden apple, and Eve got pregnant. From then on there were little Adams and little Eves. Of course, with the apple alone, Eve could not have got pregnant. Our Great Creator had developed a special exercise program for Adam’s penis. Whether Adam liked it or not, his penis was being exercised regularly night after night whenever he entered REM sleep. This regular exercise prepared Adam with a strong equipment, so that he could use it on the night he ate the apple.

Theory states that dream erections are physiological functions, important for the propagation of mankind. Further support for this theory could be obtained by studying other animals to see if they have dream erections during REM sleep, as this may be essential for the propagation of their populations. Of course one can still argue that the animal is having a sexual dream.

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It. is good to achieve mental relaxation and calm during the mental exercises. But we want more than this. We want the calm and ease of mind to carry through in all the aspects of our everyday life. So once we have mastered the relaxation of our body and the relaxation of our mind, the next step is to consciously sustain the feeling of mental relaxation. At first it is easiest to practise this when we are doing relatively simple things, such as walking slowly along the street. During the course of the day when we have to pause or wait for something, we can consciously practise our exercises by allowing ourselves to recapture the feeling of relaxation of our mind. Although we have to do this consciously at first, we soon find that it comes naturally of its own volition. Gradually this ease of mind begins to penetrate all through us, as it were, so that it is with us in all that we do.

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Biological medicine sees arthritis as a systemic disease caused by metabolic disorder and chemical imbalance in the organs, glands, and tissues of the body. The inflammatory and the degenerative changes in the functions of the joints and the surrounding tissues are brought about by the biochemical disturbance, hormonal imbalance, and weakened functions of the vital organs, effected by the prolonged physical and emotional abuses and stresses to which the body has been subjected.

The biological therapies, therefore, are directed at: (1) eradication and correction of the abnormal and health-destroying conditions which have led to the development of the disease; (2) assisting the body’s own healing forces in normalizing all the metabolic processes, cleansing the body of the accumulated toxins and wastes, strengthening the functions of all the vital organs, revitalizing the glandular activity, establishing a chemical balance in the tissues-or, in sum total, rebuilding and strengthening the general health of the patient.

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The EEG is the principal investigation used in epilepsy. Many patients with epilepsy will have an EEG performed, usually after a clinical diagnosis has been made, and before treatment is started. The EEG detects the brain’s electrical activity by sensitive sensors called ‘electrodes’ which are placed on the scalp; these electrodes detect the normal and abnormal electrical activity of the nerve cells within the brain. Most routine EEGs are recorded with the child or adult awake, but EEGs may be arranged after deprivation of sleep or during sleep (spontaneous or induced by drugs).

All hospitals with neurological or neurosurgical departments and some larger, non-specialized hospitals will have facilities for recording a routine EEG. The procedure is simple and painless and, in the case of a routine EEG takes only about 20-30 minutes to complete. The EEG detects and records the brain’s activity; at no time is there any electrical discharge passing from the equipment to the patient. The EEG should not be confused with electroconvulsive therapy or ECT, which is used to treat depressive illnesses, and has nothing to do with epilepsy.

The recording technician first measures the patient’s head for correct placement of the electrodes, which are then placed according to an international system based on the patient’s head size and on measurements taken from the bridge of the nose, and the bony protuberance at the back of the head. Silver electrodes are fastened to the head with a sticky substance called collodion. Alternative electrodes are gauze pads moistened with a salt solution and secured with a rubber cap. Sometimes the patient’s scalp is gently rubbed beneath the electrodes to reduce the electrical resistance of the skin which improves the recording. Twelve electrodes are used in small infants, 20 in older children and adults. Wires from each electrode are then connected to a junction box (head-box), connected in turn to the amplifiers of the EEG machine by a cable. After amplification, the EEG machine records the signals on tape or disc, or displays them directly by ink-jets, pens, or laser on to paper which moves at constant speed, usually 3 cm/second. It is this paper with the written waves that is known as ‘the EEG’ and which is examined and analysed by doctors. The advantage of recording the electrical signals from the different electrodes on to magnetic tape or disc is that they can be recombined in other ways for subsequent more detailed analysis. They can then of course be displayed on paper again at any subsequent time.

During an EEG the child or adult is asked to lie quite still. This is because movement of any part of the body may obscure, or make it difficult to detect the electrical activity of the brain. The technician also in the course of the recording will ask the patient to open and close the eyes (to look for normal patterns of activity which vary according to whether the eyes are opened or not), to breathe deeply for 3 minutes, and to look at a flashing light. Overbreathing (also called hyperventilation) and the flashing-light test (called photic stimulation) are useful ways of activating or provoking abnormal electrical activity from the brain, and are often important in helping to decide what type of seizure or what epilepsy syndrome a person has.

The appearance of the EEG is dependent upon the age of a patient because the brain is developing and maturing rapidly, particularly from birth to 7 or 8 years of age. Generally speaking, a normal adult EEG pattern is reached by the age of 10-12 years and there is then little change until the age of 60 or 70 years. Doctors who analyse EEGs must have some knowledge and understanding about EEG patterns (normal and abnormal) in infants and children, as well as in adults.

The hallmark or typical EEG finding in a patient with epilepsy between seizures is a ‘spike’ or ‘spike and slow wave’ or ‘sharp wave,. A ‘spike’ is a sudden change in voltage that shows up against the background activities. An example of a very abnormal EEG seen in infants with West syndrome. However, even in patients who have epilepsy these abnormalities are not always seen, and this is why the EEG must not be relied upon to make or exclude a diagnosis of epilepsy. The first 20 minute recording of an adult who has had an undoubted tonic-clonic seizure is normal in 40-50 per cent of cases.

For most people with epilepsy, a routine (20-30 minute) EEG is the only necessary test. However, this is only a short period to record the brain’s electrical activity, and it is unlikely that a clinical attack or seizure will occur in this time. If more information is required, then other types or systems of EEG recording may be performed.

(a) EEG after deprivation of sleep: In this situation a patient is asked to make sure they get only 4-5 hours sleep for two consecutive nights. This encourages the occurrence of seizure discharges. Deprivation of sleep may also lead the patient to drowse or to sleep during the recording, and again this encourages the appearance of abnormal EEG discharge.

(b) Drug-induced sleep EEG: A small dose of a sedative drug may encourage the patient to fall asleep during the recording, and again drowsiness and sleep may show abnormalities which may not be present whilst awake.

(c) Ambulatory EEG monitoring: This is a technique of recording an EEG for not just 20 or 30 minutes but for up to 24 or even 48 hours. The electrodes (six, eight or 12, rather than the twenty electrodes in a routine EEG) are wired up to a small tape recorder (like a Walkman cassette player) which is strapped to the waist. After this the child or adult can leave the EEG department, go home and carry on their normal activities, and then return to the EEG department after 24 hours to have the tape analysed or the tape replaced. This procedure is more likely, by the length of the recording alone, to pick up abnormal electrical activity, and is particularly valuable if the person has a fit or seizure during the 24 hours when the electrical activity is being recorded. The tape can be analysed in a special fast-pace display unit, so the doctor does not have to sit watching the EEG for 24-48 hours!

(d) Depth electrodes: On rare occasions, special depth electrodes are used. These are fine wires inserted under sterile conditions into areas of the brain thought possibly to be the site of origin of seizure discharge. This is an important test in those patients who are being considered for surgical treatment of their epilepsy.

(e) Video-telemetry: This is another way of obtaining an EEG over a longer period of time. In this technique the patient has to stay in a room in the hospital for 24 hours or longer. At the same time as the electrical activity is recorded on the EEG, a video camera records the activities of the patient. In this way it is possible to replay repeatedly both simultaneous video and EEG recordings and observe the pattern of the EEG during an attack or seizure. This provides valuable information on the type of epileptic seizure and from where within the brain the seizure may be starting. If no abnormalities are seen on the EEG during an ‘attack’, then almost certainly the attacks are not epileptic. Video-telemetry is really only of practical benefit if the patient is having frequent attacks, as it is otherwise impractical to keep the patient in hospital attached to expensive equipment on the remote chance that a seizure may occur.

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