FitSugar

Adam Levine: Songs About Yoga

FitSugar — Wed, 02 Jul 2008 09:00:00 -0700

Adam Levine of Maroon 5 has always made it clear that he's not only a rocker, but he's also a yogi. I've always found it a little hard to believe until I read a recent interview that Women's Health did with him on how this front man turned to yoga and never looked back. Here are highlights:

How'd you wind up at yoga?
A year and a half ago, my trainer recommended I try working with L.A. yoga instructor Alanna Zabel to help with my flexibility issues. I'm naturally very tight in lower back and my hips and hamstrings too. My first class felt like someone was ripping my body apart. It wasn't what you'd call peaceful. But I was excited by the idea that the more dedicated I became the more effortless it would become to relax and give in to that tightness. Yes, the torture subsided a bit over time.

How did your body change?
Physically I have always been on the slender side. When I started practicing I instantly felt more sculpted. Yoga carves you into a different person-and that is satisfying physically.

There's more, including his advice for yoga newbies so read more.

Did it change how you work out?
I had been lifting weights for years. After our first yoga session, I vowed never to lift another weight again.

Do you believe in the mind-body connection?
I was skeptical, to say the least. I was wary of the cliche's associated with yoga: spirituality used as a marketing tool or Eastern philosophy sold at Starbucks to disenchanted lawyers and accountants looking for meaning. What I soon realized is that yoga welcomes everyone-that's extremely appealing.

How do you maintain your practice on tour?
Being a traveler, yoga is by far the most convenient way to exercise while I'm on the road. You don't need anything but a few feet of space and a mat. And I can always find at least an hour a day to practice. (Levine made videos with his teacher to take on the road with him.)

What is your advice to people who think they are too inflexible to do yoga?
Start simple. Yoga will drastically improve you in every way imaginable. But let's face it, I only practice yoga because the classes are always packed with beautiful women. (I am totally kidding.)

Source

Atherosclerosis

FitSugar — Wed, 08 Oct 2008 17:34:56 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Atherosclerosis is a slow disease in which arteries become clogged and hardened. Fat, cholesterol, calcium, and other substances form plaque, which builds up in arteries. Hard plaque narrows the passage that blood flows through and causes arteries to become hard and inflexible (atherosclerosis is also known as hardening of the arteries). It leads to cardiovascular disease, which is the leading cause of death in people over 45. Soft plaque is more likely to break free from the artery wall and cause a blood clot, which can block blood flow to vital organs.

The effects of atherosclerosis differ depending upon which arteries in the body narrow and become clogged with plaque. If the arteries that bring oxygen-rich blood to your heart are affected, you may have coronary artery disease, chest pain, or a heart attack. If the arteries to your brain are affected, you may have a transient ischemic attack (TIA) or a stroke. If the arteries in your arms or legs are affected, you may develop peripheral artery disease. You may also develop a bulge in the artery wall (aneurysm).

Lowering blood pressure and LDL ("bad") cholesterol levels, quitting smoking, losing weight, and getting more exercise can prevent atherosclerosis.

Signs and Symptoms

Often, there are no symptoms of atherosclerosis until a significant percentage (40%) of an artery becomes clogged with plaque. Symptoms vary depending upon which arteries are affected.

Coronary Artery Disease

Symptoms of coronary artery disease (obstruction of the heart arteries) are usually triggered by physical exercise, sexual activity, exposure to cold weather, anger, or stress. The most common symptoms include:

Chest pain (generally a heavy, squeezing, or crushing sensation with possible burning or stabbing pains)
Abdominal, neck, back, jaw, or shoulder/arm pain
Weakness
Perspiration
Shortness of breath

Cerebrovascular Disease

Cerebrovascular disease (obstruction of the arteries that supply the brain with blood) can cause transient ischemic attack (a sudden loss of brain function with complete recovery within 24 hours) and stroke. Symptoms may include:

Weakness or paralysis on one side of the body
Trouble speaking or understanding speech
Loss of vision in one eye
Muscle weakness
Sudden trouble walking
Dizziness
Loss of balance or coordination
Sudden severe headache

Peripheral Artery Disease

Peripheral artery disease affects the arteries that supply the arms and legs with oxygen-rich blood. Symptoms may include:

Pain, aching, cramps, numbness or sense of fatigue in the leg muscles (intermittent claudication)
"Bruits" (blowing sounds your doctor can hear with a stethoscope that indicate turbulence in blood flow)
Hair loss
Thickened nails
Smooth, shiny skin surface
Skin that is cold to the touch
Gangrene

What Causes It?

No one knows the exact cause of atherosclerosis. Many researchers believe it begins with an injury to the innermost layer of the artery, known as the endothelium. The following factors are thought to contribute to the damage:

High blood pressure
Elevated LDL ("bad") cholesterol
An accumulation of homocysteine (an amino acid produced by the human body, thought to be a risk factor for heart disease, stroke, osteoporosis, diabetes, and dementia)
Smoking
Diabetes
Inflammation

Once the artery is damaged, blood cells called platelets accumulate there to try and repair the injury. Over time, fats, cholesterol, and other substances also build up at the site, which thickens and hardens the artery wall. The amount of blood that flows through the artery is decreased, and the oxygen supply to organs also decreases. Blood clots may form, blocking the artery or entering your bloodstream and blocking blood supply to other organs.

Because many people do not have the classic risk factors of atherosclerosis (such as cigarette smoking and high blood pressure), it is possible that there may be other causes, such as an infection. Research is continuing to find the causes.

Risk Factors

Being male
If female, being past menopause
High blood pressure
High LDL ("bad) cholesterol or triglycerides (fats in the blood)
Diabetes
Being overweight
Smoking
A family history of heart disease
Elevated homocysteine levels
Sedentary lifestyle
Diets high in saturated fat and trans fatty acids (trans fats)
Depression

What to Expect at Your Provider's Office

Your doctor can determine your risk for heart disease by conducting a variety of tests. Blood tests can detect high levels of cholesterol, homocysteine, and blood clotting factors. A stress test (otherwise known as an exercise tolerance test) monitors your heart rate and blood pressure while you walk on a treadmill or ride a stationary bicycle. An electrocardiogram (ECG) is used during a stress test to detect abnormal heart rhythms, scar tissue in the heart muscle from a prior heart attack, and areas of decreased blood flow to the heart. Imaging techniques used during a stress test (such as an ultrasound) can determine precise areas where blood flow to the heart may be decreased. An angiogram (or angiography), where your doctor injects a dye into your arteries and then performs a chest x-ray, can reveal areas of damage and plaque buildup.

Preventive Care

Atherosclerosis can be prevented by adopting health lifestyle choices.

Stop smoking.
Exercise at least 30 minutes a day, 6 days a week.
Eat healthy foods, such as fruits, vegetables and whole grains that are low in saturated fat and high in fiber.
Maintain a normal weight (or lose weight if you need to).
Reduce stress.
If you have high blood pressure, high cholesterol, diabetes or another chronic condition, work with your doctor to keep it in check.

Treatment Options

Healthy lifestyle choices (see "Preventive Care" section) are important in preventing and treating atherosclerosis. Your doctor may prescribe drugs to lower cholesterol or blood pressure and to prevent complications. Nutrition and dietary supplements may be helpful when used in addition to certain medications. Some herbs have also shown promise in lowering cholesterol levels and reducing the risk of heart disease.

Drug Therapies

Cholesterol-Lowering Drugs

If, after making adjustments to your diet and exercise habits, your LDL ("bad") cholesterol remains high, your doctor may prescribe medications to lower it. If your cholesterol is extremely elevated (more than 200 mg/dL), you may start drug therapy at the same time you make lifestyle changes. Drugs commonly used to treat high cholesterol include:

Statins (such as lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin, and fluvastatin) -- These are usually the drugs of choice as they are easy to take and have few interactions with other drugs. People who are pregnant or have liver disease should not take statins.
Niacin (nicotinic acid) -- in prescription form, is sometimes used to lower cholesterol. Dietary supplements of niacin should not be used instead of prescription niacin, as it can cause side effects. Take niacin for high cholesterol only with your doctor's supervision.
Bile acid sequestrants (such as cholestyramine, colestipol, and colesevelam) -- People who have high levels of triglycerides (fats in the blood) should not take bile acid sequestrants.
Fibric acid derivatives (such as gemfibrozil and clofibrate) -- effective at lowering triglyceride levels, and moderately effective at lowering LDL.

If you do not respond to one class of drugs, you doctor may use a combination of drugs from two classes.

Blood Pressure-Lowering Drugs

If, after making adjustments to your diet and exercise habits, your blood pressure remains high, your doctor may prescribe medications to lower it. Among the drugs used to lower blood pressure are:

Beta-blockers (such as acebutolol or Sectral, atenolol or Tenormin, bisoprolol or Zebeta, carteolol or Cartrol, metoprolol or Toprol XL, nadolol or Corgard, and propranolol or Inderal) -- slow the heart rate, thus lowering blood pressure.
Angiotensin-converting enzyme (ACE) inhibitors (such as benazepril or Lotensin, captopril or Capoten, enalapril or Vasotec, fosinoprol or Monopril, lisinopril or Prinivil, and ramipril or Altace) -- expand blood vessels, allowing blood to flow more freely and decreasing the burden on the heart.
Diuretics (chlorothiazide or Diuril, furosemide or Lasix, hydrochlororthiazide or Esidrix/Hydrodiuril, indapamide or Lozol) -- rid the body of excess fluid and sodium, lowering blood pressure.
Angiotensin-2 (AT-2) receptor agonists (such as candesartan or Atacand, eprosartan or Teveten, irbesartan or Avapro, losartan or Cozaar, telmisartan or Micardis) -- have results similar to ACE inhibitors but have fewer side effects.
Calcium-channel blockers (such as amlodipine or Norvasc, bepridil or Vascor, diltiazem or Cardizem, felodipine or Plendil, nifedipine or Procardia, nisoldipine or Sular, and verapamil or Calan/Isoptin/Verelan) -- block calcium from moving into the heart and blood vessels.

Sometimes drugs from these classes may be combined.

Blood-Thinning Drugs

Blood-thinning drugs -- antiplatelet agents and anticoagulants -- are used to keep blood clots from forming.

Aspirin -- reduces risk of transient ischemic attack (TIA), stroke, and heart attacks
Ticlodipine -- for people who cannot take aspirin (due to allergies, for example) or do not improve from aspirin; has more side effects than aspirin
Dipyridamole -- not as effective as aspirin when used alone but may be used in combination with aspirin or warfarin (another blood thinner)
Clopidogrel -- reduces risk of heart attacks
Glycoprotein IIb/IIIa receptor agonists (such as abciximab, eptifibatide, lamifiban, and tirofiban) -- used when awaiting or just following an angioplasty
Heparin -- anticoagulant; given by injection
Warfarin (Coumadin) -- often used after a heart attack

Surgery and Other Procedures

Several different procedures (surgical and non-surgical) may be performed depending upon the location and severity of atherosclerosis.

Non-surgical techniques

Angioplasty -- used to widen narrowed arteries. A surgeon inserts a catheter with a deflated balloon into the narrowed part of the artery. The balloon is inflated, widening the blood vessel so blood can flow more easily. The balloon is then deflated, and the catheter is removed. A permanent stent (wire mesh) may be inserted to hold the artery open and improve blood flow.
Atherectomy -- a procedure to remove plaque from the arteries using a laser catheter or a rotating shaver.

Surgical Procedures

Bypass surgery -- A surgeon uses a blood vessel from another part of your body or an artifical tube to reroute blood around clogged arteries.
Minimally invasive bypass surgery -- uses a small incision rather than the broad opening in the chest wall created during regular bypass surgery.
Endarterectomy -- used to remove plaque in the carotid (neck) or peripheral arteries.

Complementary and Alternative Therapies

Nutrition and Supplements

Healthy eating habits can help reduce high cholesterol, high blood pressure, and overweight -- three of the major risk factors for heart disease. The American Heart Association (AHA) has developed dietary guidelines that help lower fat and cholesterol intake and reduce the risk of heart disease. The AHA does not recommend very low-fat diets, because research shows that people benefit from unsaturated ("good") fats, such as those found in olive oil, in their diet.

Many fad diets are popular, but they may not help you lose weight and keep it off -- and in some cases, they may not even be healthy. Any healthy diet will include a variety of foods. If a diet bans an entire food group (such as carbohydrates), it's probably not healthy.

The AHA recommends the following for healthy eating:

Grains: 6 - 8 servings per day (half should be whole grains)
Vegetables: 3 - 5 servings per day
Fruits: 4 - 5 servings per day
Fat-free or low-fat dairy: 2 - 3 servings per day
Lean meat, poultry, seafood: 3 - 6 oz. per day (about the size of a deck of cards)
Fats and oils: 2 - 3 tbsp. per day (use unsaturated fats such as olive oil or canola oil)
Nuts, seeds, legumes: 3 - 5 servings per week
Sweets, sugars: 5 or fewer servings per week (the fewer, the better)

In addition, the AHA also recommends eating 2 servings of fatty fish (such as salmon or lake trout) per week; holding sodium (salt, including salt already added to food) to less than 2,400 mg per day; and limiting alcohol intake to one drink a day for women and two for men.

Diets for People with High Blood Pressure

People with high blood pressure especially need to lower the amount of sodium in their diet. The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes a diet rich in fruits, vegetables, and low-fat or non-fat dairy products that provide high intake of potassium, magnesium, and calcium sources. Sodium intake should be between 1,500 - 2,400 mg per day (the lower, the better). Weight loss, regular physical activity, and limiting alcohol are also very important factors for lowering blood pressure.

Mediterranean Diet

The Mediterranean style siet concentrates on whole grains, fresh fruits and vegetables, fish, olive oil, and moderate, daily wine consumption. The Mediterranean style diet is not low-fat. Instead, it is low in saturated fat but high in monounsaturated fat. It appears to be heart-healthy: In a long-term study of 423 patients who had a heart attack, those who followed a Mediterranean style diet had a 50 - 70% lower risk of recurrent heart disease compared with people who received no special dietary counseling.

Supplements and Vitamins

Talk with your doctor before taking any of these vitamins, minerals, or supplements to make sure they are right for you; to establish the proper dose for your condition; and to make sure they do not interact with any prescription drugs, or herbs or supplements you also might be taking.

Folic acid (400 mcg per day), vitamin B6 (25 - 100 mg per day), vitamin B12 (2 - 100 mcg per day) -- The B vitamins help the body break down homocysteine, an amino acid that's been linked to increased risk of heart disease and stroke. Researchers believe that homocysteine may also contribute to atherosclerosis by damaging artery walls, thus causing blood clots to form -- but so far they haven't found a definite link. Researchers also don't yet know whether taking B vitamins reduces the risk of atherosclerosis or heart disease, nor do they know how much might have an effect. If you have a number of risk factors for heart disease, talk to your doctor about checking your homocysteine levels and whether your doctor would recommend a B complex vitamin supplement. In the meantime, be sure to get enough B vitamins through your diet by eating fruits and leafy green vegetables every day.

Omega-3 fatty acids, found in fish oil (1 - 4 g per day) -- There is good evidence that omega-3 fatty acids (namely EPA and DHA) found in fish oil can help prevent and treat atherosclerosis by preventing the development of plaque and blood clots. Omega-3s can also help prevent heart disease, lower blood pressure, and reduce the level of triglycerides (fats) in the blood. The AHA recommends that people eat at least two servings of fatty fish (such as salmon) per week. For people with heart disease or those who need to lower triglycerides, fish oil supplements may be necessary. Because fish oil at high doses can increase the risk of bleeding, talk to your doctor before taking a high dose (more than 1 g per day), especially if you already take blood-thinning medication.

Beta-sitosterol (800 mg to 6g per day in divided doses about 30 minutes before meals) -- Beta-sitosterol is a plant sterol, a compound that can stop cholesterol from being absorbed by the intestines. A number of well-designed scientific studies have shown that beta-sitosterol does lower LDL ("bad") cholesterol levels in the body. Beta-sitosterol may lower the amount of vitamin E and beta-carotene absorbed by the body, so you may want to ask your doctor if you need to take extra E or beta-carotene.

Potassium -- Potassium is necessary to keep the electrolyte balance in the body and for nerves to function properly. Some diuretics may cause the body to get rid of too much potassium. If you take a prescription diuretic, your doctor may also recommend a potassium supplement.

Policosanol (5 - 10 mg two times per day) -- Policosanol is a mix of waxy alcohols usually derived from sugar cane and yams. Several studies have indicated it may lower LDL ('bad") cholesterol and possibly even raise HDL ("good") cholesterol. One study found that policosanol was equivalent to fluvastatin (Lescol) and simvastatin (Zocor) in lowering cholesterol levels. It may also inhibit blood clots from forming. However, most studies have been conducted in Cuba by a research group that uses a proprietary form of policosanol and is funded by the manufacturer, so it is hard to evaluate the evidence. Policosanol may increase the risk of bleeding, and should not be taken by people who also take blood-thinning medication.

Antioxidant vitamins (beta-carotene, C, E) -- Some large, observational studies have suggested that people who consume more antioxidant vitamins have a lower risk of heart disease than those who consumer lower amounts. However, no studies have shown a cause-and-effect relationship.

Beta-carotene -- While some studies suggest that eating a diet high in beta-carotene (found in yellow, orange, and dark green vegetables) may protect against atherosclerosis, other studies show it may increase the risk for people who smoke or drink a lot of alcohol. Researchers theorize that eating vegetables with beta-carotene also provides the body with other carotenoids (similar antioxidants) that may have the protective effect, while simply taking a supplement does not.
Vitamin C -- Several studies suggest that eating a diet high in vitamin C can help protect against heart disease, but evidence is lacking that taking extra vitamin C through a supplement will help.
Vitamin E -- One recent randomized, placebo-controlled study failed to show any reduction in heart disease among people who took vitamin E.

Selenium (100 - 200 mcg per day) -- Some studies show that people who consume more selenium in their diet have a lower risk of heart disease, but again, researchers haven't shown a cause-and-effect relationship. Talk to your doctor before taking extra selenium.

Coenzyme Q10 (CoQ10) -- Researchers believe that CoQ10 may inhibit blood clot formation and boost levels of antioxidants. One study found that people who received daily CoQ10 supplements within 3 days of a heart attack were much less likely to experience subsequent heart attacks and chest pain and were also less likely to die of the condition than those who did not receive the supplements. Still, more research is needed to say whether CoQ10 has any role in preventing or treating atherosclerosis. People who take statins may have lower amounts of CoQ10 in their bodies and may consider taking a supplement. If you take statins, ask your doctor if you need a CoQ10 supplement.

Polyphenols -- Polyphenols are chemical substances found in plants that have antioxidant properties. Test tube, animal, and some population-based studies suggest that the flavonoids quercetin, resveratrol, and catechins (all found in high concentration in red wine) may help reduce the risk of atherosclerosis by protecting against the damage caused by LDL cholesterol. However, more studies in humans are needed to confirm these findings.

One study of resveratrol in mice found that it protected against age-related damage to vital organs, including the heart and liver, even when the mice ate a high-fat diet. Although this study is promising, researchers need to confirm its findings and to determine whether resveratrol would have the same effect in humans. To equal the rate at which the mice were given resveratrol, humans would have to consume enormous quantities. In addition, resveratrol may have estrogen-like effects, and researchers don't yet know whether it would pose the same risks as estrogen supplements.

Vitamin D -- Some preliminary studies suggest that vitamin D may also help protect against heart disease, but researchers aren't sure why. One observational study found that women over the age of 65 who took vitamin D supplements to protect against osteoporosis had one-third less risk of dying from heart disease as women who did not take the supplements.

Herbs

Hawthorn (Crataegus monogyna, 160 - 1,800 mg per day in two or three divided doses) -- Hawthorn contains the polyphenols rutin and quercetin, and was used traditionally to treat cardiovascular diseases. Animal and laboratory studies show that hawthorn has antioxidant properties that help protect against the formation of plaques and may help lower high cholesterol and high blood pressure. Talk to your doctor before taking hawthorn, as it can interact with other drugs taken for heart disease and high blood pressure.
Garlic (Allium sativum, 900 mg per day of garlic powder, standardized to 0.6% allicin) -- Some clinical trials have shown that fresh garlic and garlic supplements may lower cholesterol levels, prevent blood clots, and destroy plaque. However, other studies show mixed evidence, and one 2007 study showed no effect at all. Garlic can increase the risk of bleeding and should not be taken if you are also taking blood-thinning medication.
Red yeast (Monascus purpureus, 1,200 mg two times per day with meals) -- Several studies indicate that a proprietary form of red yeast (Cholestin) can lower cholesterol levels, and that the herb acts like the prescription drugs statins (See "Medications" section). For that reason, you should not take red yeast without a doctor's supervision, especially if you already take statins to lower cholesterol.
Psyllium (Plantago psyllium, 10 - 30 g per day in divided doses taken 30 - 60 minutes after meals) -- Taking psyllium, a type of fiber, helps lower cholesterol levels as well as blood sugar levels. If you take medicine for diabetes, talk to your doctor before taking psyllium.
Guggul (Commiphora mukul, 3 - 6 g per day) -- Guggul is used in Ayurvedic medicine to treat high cholesterol levels. Scientific studies have found mixed results -- guggul appears to work in Indian populations, but not in people who eat Western-style, high-fat diets.

Acupuncture

Acupuncture may be useful for reducing risk factors for heart disease. It can help people who wish to quit smoking and some studies indicate that it may aid in weight loss as well as lowering cholesterol and blood pressure.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic remedies, professional homeopaths would recommend appropriate treatments to reduce the risk of atherosclerosis based on their knowledge and experience. Homeopathic prescriptions for atherosclerosis would include remedies to lower high blood pressure and cholesterol. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath would assess all of these factors when determining the most appropriate remedy for each individual.

Other Considerations

Prognosis and Complications

Some complications of atherosclerosis include:

Heart disease
Heart failure
Abnormal heart rhythms
Stroke
Heart attack
Inadequate blood supply to certain parts of the body (such as the legs or intestines)
Kidney failure
Death

The outlook for atherosclerosis varies from person to person. People with atherosclerosis should work closely with their doctor to make sure they make the right lifestyle changes and, if needed, take the proper medications to control their condition and avoid complications.

Supporting Research

Ackermann RT, Mulrow CD, Ramirez G, Gardner CD, Morbidoni L, Lawrence VA. Garlic shows promise for improving some cardiovascular risk factors. Arch Intern Med. 2001;161:813-824.

Alpha-Tocopherol Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994;330:1029-1035.

Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr. 1999;70:466-73.

Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. N Engl J Med. 1995;333:276-282.

Bleys J, Miller ER 3rd, Pastor-Barriuso R, Appel LJ, Guallar E. Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2006 Oct;84(4):880-7.

Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. JAMA. 1995;274:1049-1057.

Brown BG, Zhao XQ, Chalt A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med. 2001;345(22):1583-1592.

Castillo-Richmond A, Schneider RH, Alexander CN, et al. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke. 2000;31(3):568-573.

Chan MM, Mattiacci JA, Hwang HS, Shah A, Fong D. Synergy between ethanol and grape polyphenols, quercetin, and resveratrol, in the inhibition of the inducible nitric oxide synthase pathway. Bio Pharm. 2000;60(10):1539-1548.

Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol. 2002;42:605-12.

Chiu YJ, Chi A, Reid IA. Cardiovascular and endocrine effects of acupuncture in hypertensive patients. Clin Exper Hypertens. 1997;19(7):1047-1063.

Collaborative Group of the Primary Prevention Project. Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Lancet. 2001;357:89-95.

Connor SL and Connor WE. Are fish oils beneficial in the prevention and treatment of coronary artery disease? Am J Clin Nutr. 1997;66(suppl):1020S-1031S.

Davis N, Katz S, Wylie-Rosett J. The effect of diet on endothelial function. Cardiol Rev. 2007 Mar-Apr;15(2):62-6. Review.

Diaz MN, Frei B, Vita JA, Keaney JF. Antioxidants and atherosclerotic heart disease. N Engl J Med. 1997;337(16):408-416.

Eikelboom JW, Lonn E, Genest J, Hankey G, Yusuf S. Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence. Ann Intern Med. 1999;131:363-375.

Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497.

Fernandez JC, Mas R, Castano G, et al. Comparison of the efficacy, safety and tolerability of policosanol versus fluvastatin in elderly hypercholesterolaemic women. Clin Drug Invest. 2001;21:103–13.

Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007 Feb 26;167(4):346-53.

GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999;354:447-455.

Gokce N, Keaney JF, Frei B, et al. Long-term ascorbic acid administration reverses endothelial vasomotor dysfunction in patients with coronary artery disease. Circulation. 1999;99:3234-3240.

Goldberg A, Alagona P, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in management of hyperlipidemia. Am J Cardiol. 2000;85:1100-1105.

Guyton JR. Effect of niacin on atherosclerotic cardiovascular disease. Am J Cardiol. 1998;82:18U-23U.

Hasty AH, Gruen ML, Terry ES, Surmi BK, Atkinson RD, Gao L, Morrow JD. Effects of vitamin E on oxidative stress and atherosclerosis in an obese hyperlipidemic mouse model. J Nutr Biochem. 2007 Feb;18(2):127-33.

Hayek T, Fuhrman B, Vaya J, Rosenblat M, Belinky P, Coleman R et al. Reduced progression of atherosclerosis in apolipoprotein E-deficient mice following consumption of red wine, or its polyphenols quercetin or catechin, is associated with reduced susceptibility of LDL to oxidation and aggregation. Ateriosclerosis, Thrombosis, and Vascular Biology. 1997;17(11):2744-2752.

Heart Outcomes Prevention Evaluation Study Investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med. 2000;342:154-160.

Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999;69:231-6.

Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med. 1996;334:1145-1149.

Hu FB, Stampfer MJ, Manson JE et al. Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women. Am J Clin Nutr. 1999;69:890-897.

Koenig W. Inflammation and coronary heart disease: an overview. Cardiol Rev. 2001;9(1):31-35.

Koscielny J, Klubendorf D, Latza R, Schmitt R, Radtke H, Siegel G, Kiesewetter H. The antiatherosclerotic effect of Allium sativum. Atherosclerosis. 1999;144:237-249.

Krauss RM, Eckel RH, Howard B, et al. AHA dietary guidelines. Revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation. 2000;102:2284-2299.

Kris-Etherton P, Eckel RH, Howard BV, St. Jeor S, Bazzarre TL. Lyon diet heart study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association Step I dietary pattern on cardiovascular disease. Circulation. 2001;103:1823-1825.

Levine GN, Frei B, Koulouris SN, Gerhard MD, Keaney FJ, Vita JA. Ascorbic acid reverses endothelial vasomotor dysfunction in patients with coronary artery disease. Circulation. 1996;93:1107-1113.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Malinow MR, Bostom AG, Krauss RM. Homocyst(e)ine, diet, and cardiovascular disease. A statement for healthcare professionals from the nutrition committee, American Heart Association. Circulation. 1999;99:178-182.

Mashour NH, Lin GI, Frishman WH. Herbal medicine for the treatment of cardiovascular disease. Arch Intern Med. 1998;158:2225-2234.

Neil HA, Meijer GW, Roe LS. Randomised controlled trial of use by hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread. Atherosclerosis. 2001;156:329-37.

Nyyssonen K, Parviainen MT, Salonen R, Tuomilehto J, Salonen JT. Vitamin C deficiency and risk of myocardial infarction: prospective population study of men from eastern Finland. BMJ. 1997;314:634-638.

Osganian SK, Stampfer MJ, Rimm E, Spiegelman D, Hu FB, Manson JE, Willett WC. Vitamin C and risk of coronary heart disease in women.. J Am Coll Cardiol. 2003 Jul 16;42(2):246-52.

Pruthi S, Allison TG, Hensrud DD. Vitamin E supplementation in the prevention of coronary heart disease. Mayo Clin Proc. 2001;76:1131-1136.

Rimm EB, Willett WC, Hu FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA. 1998;279:359-364.

Robinson K, Arheart K, Refsum H, et al. Low circulating folate and vitamin B6 concentrations. Risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation. 1998;97:437-443.

Serebruany VL, Ordonez JV, Herzog WR, et al. Dietary coenzyme Q10 supplementation alters platelet size and inhibits human vitronectin (CD51/CD61) receptor expression. J Cardiovasc Pharmacol. 1997;29:16-22.

Singh I, Mok M, Christensen AM, Turner AH, Hawley JA. The effects of polyphenols in olive leaves on platelet function. Nutr Metab Cardiovasc Dis. 2007 Mar 6; [Epub ahead of print]

Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drug Ther. 1994;8:659-664.

Singh RB, Wander GS, Rastogi A,. et al. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drug Ther. 1998;12:347-353.

Suarna C, Wu BJ, Choy K, Mori T, Croft K, Cynshi O, Stocker R. Protective effect of vitamin E supplements on experimental atherosclerosis is modest and depends on preexisting vitamin E deficiency. Free Radic Biol Med. 2006 Sep 1;41(5):722-30.

Tribble DL. Antioxidant consumption and risk of coronary heart disease: emphasis on vitamin C, vitamin E, and beta-carotene. Circulation. 1999;99:591-595.

Vermeulen EGJ, Stehouwer CDA, Twisk JWR, et al. Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial. Lancet. 2000;355:517-522.

Virtamo J, Rapola JM, Ripatti S, et al. Effect of vitamin E and beta carotene on the incidence of primary nonfatal myocardial infaction and fatal coronary heart disease. Arch Intern Med. 1998;158:668-675.

Von Schacky C, Angere P, Kothny W, Theisen K, Mudra H. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. Ann Intern Med. 1999;130:554-562.

Walker SE, Adams MR, Franke AA, Register TC. Effects of dietary soy protein on iliac and carotid artery atherosclerosis and gene expression in male monkeys. Atherosclerosis. 2007 Mar 14; [Epub ahead of print]

Watson KE, Abrolat ML, Malone LL, et al. Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation. 1997;96(6):1755-1760.

Zhao G, Etherton TD, Martin KR, Gillies PJ, West SG, Kris-Etherton PM. Dietary alpha-linolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholesterolemic subjects. Am J Clin Nutr. 2007 Feb;85(2):385-91.

Review Date:
3/26/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Jennifer Aniston's Favorite Yoga Poses Are . . .

FitSugar — Thu, 18 Dec 2008 12:00:00 -0800

I'm really happy that yoga is gaining in popularity these days, because it's so good for everybody. Whether you're training for a marathon, recovering from an injury, dealing with chronic back pain, are pregnant, or just need to de-stress, the ancient practice of yoga can help. Apparently it's also good for celebs too. Madonna, Brooke Shields, Adam Levine, Drew Barrymore, and Naomi Watts are all into practicing yoga.

So is Jennifer Aniston. When asked about her favorite yoga poses, Jennifer said in a recent interview with People, "I'm so terrible with names . . . Child pose. And it's a mix between that and Tree pose. [Tree] has good balance and I like how it feels."

These two poses are basic poses you'd learn in a beginner yoga class, but they're poses that you'll continue to do until you're an experienced yogi. To find out the benefits of these tranquil poses read more.

Child's Pose is one of my favorites too because it's so relaxing. Lowering your head below your heart has this calming effect on your mind, and it's a great pose to do if you're feeling stressed or tired. Child's Pose is recommended for people with lower back pain. It's also the perfect pose to do in a yoga class if your arms need a break, or if you feel your breathing becoming too erratic.
Tree is a wonderful balancing pose because it doesn't require a ton of muscular strength. When your bent leg is resting on the inner thigh of your straight leg, it's actually quite stable. So you can stay in this position for a while, just breathing and feeling your connection with the ground.

To learn how to do more yoga poses, check out these Strike a Yoga Pose posts.

Source and Source

Multiple sclerosis

FitSugar — Wed, 08 Oct 2008 17:35:11 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis/Possible Complications
Following Up
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Multiple sclerosis (MS) is an unpredictable disease of the nervous system in which communication between the brain and other parts of the body is disrupted. Its effects can range from relatively mild in most cases to somewhat disabling to devastating. The symptoms may mysteriously occur and then disappear. In the worst cases, a person with MS may be unable to write, speak, or walk. About 350,000 Americans have MS, with most cases occurring between 20 - 45 years of age.

During an MS attack, inflammation occurs in areas of the white matter (pale-colored nerve tissue)of the central nervous system in random patches called plaques. This is followed by destruction of myelin, the fatty covering that protects nerve cell fibers in the brain and spinal cord. Myelin allows for the smooth, high-speed transmission of electrochemical messages between the brain, the spinal cord, and the rest of the body. When myelin is damaged, neurological transmission of messages may be slowed or blocked completely, resulting in diminished or lost function.

Signs and Symptoms

MS is accompanied by the following signs and symptoms:

Weakness in motor skills and loss of muscle coordination
Tingling, numbness, dizziness
Blurred vision
Pain
Heat sensitivity
Loss of bladder control
Memory loss, problem-solving difficulties
Mood disturbances

What Causes It?

The cause of MS is unknown. Theories include a childhood virus that primes the immune system for an attack against myelin in early adulthood.

Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing MS:

First-degree relatives with MS
Age between 20 and 40
Living in the northern latitudes for the first 15 years of life
North European, North American, or Scandinavian ancestry
Immune response genes

What to Expect at Your Provider's Office

If you or someone you care for are experiencing symptoms associated with MS, you should see your health care provider. Your health care provider will take a history of clinical symptoms, check for neurological problems, and refer you for lab tests, such as a cerebrospinal fluid exam and agar gel electrophoresis, and imaging procedures, such as a computed tomography scan (CT scan) and magnetic resonance imaging (MRI).

Treatment Options

Treatment Plan

The primary goal of a treatment plan is to reduce the severity of attacks through the use of certain medications and to extend the individual's physical functioning for as long as possible.

Drug Therapies

Your health care provider may prescribe the following medications:

Steroids with anti-inflammatory properties to reduce severity of attacks
Beta interferon to decrease myelin destruction, reduce frequency and severity of attacks, and slow progression of disease
Immunotherapy, antigen-targeting, cytokines, and remyelination are experimental therapies that may alter the course of the disease

Surgical and Other Procedures

Surgery may be used to treat severe and disabling tremors or to reduce severe spasms.

Complementary and Alternative Therapies

A comprehensive treatment plan for MS may include a range of complementary and alternative therapies.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

Eliminate all suspected food allergens, including dairy, wheat (gluten), soy, chocolate, corn, preservatives, and food additives. Your health care provider may want to test you for food allergies.
Eat more antioxidant-rich foods (such as green, leafy vegetables and peppers) and fruits (such as blueberries, tomatoes, and cherries).
Avoid refined foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in such commercially baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise moderately, if tolerated, at least 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tbsp. of oil one to two times a day, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources.
Evening primrose oil (EPO), 500 mg to 8 grams daily, for symptoms of MS. Consult with your health care provider for the best dosage for your body.
A multivitamin daily, containing the antioxidant vitamins A, C, D, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.
Calcium and vitamin D supplement, 1 - 2 tablets daily, for support of muscle and skeletal weakness.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, immune, and muscular support.
N-acetyl cysteine, 200 mg daily, for antioxidant effects.
Acetyl-L-carnitine, 500 mg daily, for antioxidant and muscle protective activity.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your acidophilus products.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily, for antibacterial or antifungal activity and immunity.
L-theanine, 200 mg one to three times daily, for nervous system support.
Melatonin, 2 - 5 mg 1 hour before bedtime, for sleep and immune protection.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily, for antioxidant and immune support.
Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Rhodiola (Rhodiola rosea) standardized extract, 100 - 600 mg daily, for antioxidant, antistress, and immune activity.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
Bromelain (Ananus comosus) standardized, 40 mg three times daily, for pain and inflammation.

Homeopathy

Combination remedies may be used for fatigue, spasm, and to help rid the body of impurities.

Carboneum sulphuratum
Causticum
Lathyrus sativus
Phosphorus

Acupuncture

Acupuncture may alleviate symptoms. Acupuncture may help enhance immune function, normalize digestion, and address disease conditions.

Massage

Massage is important for maintaining flexibility and reducing spasticity, as well as improving the overall sense of well-being.

Prognosis/Possible Complications

About 70 percent of patients experience attacks and remissions, and about half of these undergo a chronic, progressive worsening after about 10 years. Ten to 15%% of patients experience a chronic, progressive worsening of the disease from the initial onset. Fifteen to 20% of patients have a relatively mild course of disease. Most MS patients live for 30 years or more, many still working and mobile.

Following Up

Patients need lifelong monitoring, especially during flare-ups.

Supporting Research

Adams RD, Victor M. Principles of Neurology. 6th ed. New York, NY: McGraw-Hill; 1997: 902–921.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers;1995:299-300.

Branch WT. Office Practice of Medicine. 3rd ed. Philadelphia, PA: Saunders;1994: 721, 766–767.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Conn RB. Current Diagnosis. Philadelphia, PA: Saunders; 1991: 988–991.

Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm. 2004;54(3):243-50.

Das M, Sur P, Gomes A, Vedasiromoni JR, Ganguly DK. Inhibition of tumor growth and inflammation by consumption of tea. Phytother Res. 2002;16 Suppl 1:S40-4.

Dorchies OM, Wagner S, Vuadens O, et al. Green tea extract and its major polyphenol (-)-epigallocatechin gallate improve muscle function in a mouse model for Duchenne muscular dystrophy. Am J Physiol Cell Physiol. 2006;290(2):C616-25.

Fauci AS, et al. Harrison's Principles of Internal Medicine. 14^th ed. New York, NY: McGraw-Hill; 1997: 2409–2419.

Gaby AR. The role of coenzyme Q10 in clinical medicine: Part 1. Alt Med Rev. 1996; 1(1):11-17.

Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol. 2005;5(4):783-93.

Huntley A. A review of the evidence for efficacy of complementary and alternative medicines in MS. Int MS J. 2006 Jan;13(1):5-12, 4.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnson SK, Diamond BJ, Rausch S, et al. The effect of Ginkgo biloba on functional measures in multiple sclerosis: a pilot randomized controlled trial. Explore (NY). 2006;2(1):19-24.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Kelley WN, et al. Textbook of Internal Medicine. 3^rd ed. Vol 2. Philadelphia, PA: Lippincott-Raven; 1997: 2385–2387.

Kormosh N, Laktionov K, Antoshechkina M. Effect of a combination of extract from several plants on cell-mediated and humoral immunity of patients with advanced ovarian cancer. Phytother Res. 2006;20(5):424-5.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Mark BL, Carson JA. Vitamin D and autoimmune disease--implications for practice from the multiple sclerosis literature. J Am Diet Assoc. 2006;106(3):418-24.

[No authors listed]. L-theanine . Monograph. Altern Med Rev. 2005;10(2):136-8.

Taylor RB, et al. Family Medicine: Principles and Practice. 5th ed. Berlin, Germany: Springer; 1998: 589–591.

Rosen P, Barkin R, et al. Emergency Medicine: Concepts and Clinical Practice. Vol 3. St. Louis, MO: Mosby; 1998: 2219–2221.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Whitmarsh TE. Homeopathy in multiple sclerosis. Complement Ther Nurs Midwifery. 2003;9(1):5-9.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

Review Date:
8/6/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Viral encephalitis

FitSugar — Wed, 08 Oct 2008 17:35:11 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment Approach
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Encephalitis is an inflammation of the brain caused, most often, by a viral infection. The specific viruses that cause encephalitis vary. Exposure to viruses that cause encephalitis occur mostly through insect bites. The virus enters through the blood stream and spreads to the brain, causing inflammation of the nerve cells (encephalitis) or the surrounding membranes (meningitis). Encephalitis is different from meningitis, but these two brain infections often occur together. Although the vast majority of individuals with encephalitis recover after a long period of time, inflammation may cause irreparable damage to the brain, bleeding within the brain, and even death. An estimated 10,000 - 20,000 cases of encephalitis are reported annually in the United States.

Signs and Symptoms

Ninety percent of people with encephalitis have flu-like symptoms, such as fever, sore throat, cough, and malaise.
If meningitis accompanies encephalitis, an individual may experience headache, stiff neck, intolerance to light, and vomiting.
A change in the level of consciousness, ranging from mild confusion to coma, develops in most people with encephalitis, often including disorientation and delusion with possible hallucinations, agitation, and personality changes.
Seizures occur in up to 50% of individuals with encephalitis.
Other signs and symptoms of encephalitis depend on which area of the brain is most affected. These may include an impaired ability to use or comprehend words or coordinate voluntary muscle movements, muscle weakness or partial paralysis on one side of the body, uncontrollable tremors or involuntary movements, and an inability to regulate body temperature.

Causes

Arboviruses, or viruses carried by insects, are among the most common causes of viral encephalitis. Some of the major arboviruses include:

Eastern equine encephalitis -- transmitted by mosquito, primarily affecting individuals along the eastern seaboard of the United States. One-third of infected individuals die of the condition, and many others suffer permanent brain damage.

European and Far Eastern (Russian) encephalitis -- transmitted by ticks. Although vaccine against this type of encephalitis is available in Europe, there is speculation that it may cause serious side effects.

Japanese encephalitis -- transmitted by mosquito and is widespread in Asia. Between 10 - 30% of infected individuals, primarily children, die of the condition.

La Crosse encephalitis -- transmitted by mosquito, and primarily affecting children under 16 years of age in the upper Midwestern United States. About 1% of infected individuals die of the condition.

St. Louis encephalitis -- transmitted by mosquito. Individuals in rural Midwestern and southern United States are primarily affected, with 7% of infected children and 30% of infected elderly dying of the condition.

Venezuelan equine encephalitis -- transmitted by mosquito and primarily affects individuals in Central and South America. Fatalities rare in humans but common in horses, with epidemics in people occasionally occur after an outbreak in horses.

West Nile encephalitis -- transmitted by mosquito, primarily affecting individuals in Africa and the Middle East, but outbreaks have also been recorded in the United States (New York City area and parts of New England). Infections are most common in children and the elderly, and as many as 10% of infected individuals die of the condition.

Western equine encephalitis -- transmitted by mosquito, primarily affecting individuals in western United States and Canada. It usually causes a mild infection in people, except in children under 1 year of age, who often suffer permanent complications. Almost % of infected individuals die of the condition.

Other viruses that commonly cause viral encephalitis include:

Herpes simplex virus type 1 (HSV1)
Measles
Enteroviruses (viruses that typically occur in the gastrointestinal tract)
Mumps

Less common causes include:

Cytomegalovirus
Epstein-Barr virus (EBV)
Human immunodeficiency virus (HIV)
Varicella-zoster virus (VZV)
Rabies virus

Not all cases of encephalitis are caused by viruses. Some nonviral causes of encephalitis include:

Bacterial infection
Fungal infection
Parasitic infection
Noninfectious causes, such as allergic reactions or toxins

Risk Factors

The following factors may increase your risk of becoming infected with viral encephalitis:

Very young or very old age
Exposure to mosquitoes or ticks
Compromised immune system
Not being immunized against measles, mumps, and rubella
Traveling to areas where viral encephalitis is prevalent
Handling potentially infected animals

Diagnosis

Encephalitis is a serious condition, so diagnosis and initial treatment usually take place in a hospital setting. After performing a physical exam, a doctor may take the following steps to diagnose the condition:

Blood test -- detects viruses in the blood
Spinal tap -- detects viruses in the cerebrospinal fluid
MRI and CT scan -- determines whether bleeding is present in the brain
Electroencephalogram (EEG) -- detects abnormal brain waves

Preventive Care

The most effective way to prevent encephalitis is to avoid contracting viruses that lead to encephalitis:

Take protective measures when working or playing outside, such as using insect repellant and wearing long pants and long sleeves. Some insect repellants are very toxic, so check with your health care provider about some alternatives.
Immunize against viruses that lead to encephalitis with vaccines such as the measles, mumps, rubella (MMR), and rabies.
Maintain a balanced diet to keep the immune system healthy.
An infectious disease specialist may recommend a particular Japanese encephalitis vaccine for those traveling to Asia during the summer, but serious allergic reactions have been reported with its use.

Treatment Approach

Viral encephalitis is a serious medical condition. Because encephalitis can cause severe complications, treatment usually occurs in the hospital and sometimes requires intensive care. Generally, there are no specific medications to treat the viruses causing encephalitis. HSV1, VZV, and EBV are exceptions to this rule, however, as acyclovir is an excellent treatment. Often, people with symptoms of encephalitis are treated with this medication until the virus causing the condition is identified. Behavioral techniques, such as those used to treat people with traumatic brain injury, have been recently explored in the treatment of those recovering from viral encephalitis. Although complementary and alternative therapies have not been extensively studied for the treatment of encephalitis, some studies indicate that scalp acupuncture, combined with proper medication, may aid the healing process. Careful observation and supportive care, including rest, proper nutrition, and fluids are a mainstay of treatment for encephalitis and allow the body to fight the infection.

Always tell your health care provider about the herbs and supplements you are using or considering using, as some supplements may interfere with conventional treatments.

Medications

Medications used to treat viral encephalitis include:

Acyclovir -- treats encephalitis caused by HSV, VZV, and EBV
Ganciclovir or foscarnet -- treats encephalitis caused by cytomegalovirus and HSV1
Anticonvulsant medications -- prevent and treat seizures associated with encephalitis

Nutrition and Dietary Supplements

Following these nutritional tips may help improve general health and well-being:

Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Avoid refined foods, such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.
Use healthy oils in foods, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week.

You may address deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals, such as magnesium, calcium, zinc and selenium.
Omega-3 fatty acids, such as fish oil, one to two capsules or one to three tablespoonfuls oil, one to three times daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources but not substitutes for supplementation.
Vitamin C, 500 - 1000 mg one to three times daily, as an antioxidant and for immune support.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, immune, and muscular support.
Acetyl-L-carnitine, 500 mg daily, for antioxidant and antiviral activity.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
L-glutamine, 500 - 1000 mg three times daily, for support of gastrointestinal health and immunity.
Resveratrol (from red wine), 50 - 200 mg daily, for antioxidant and antiviral effects.
L-theanine, 200 mg one to three times daily, for nervous system support.
Melatonin, 2 - 5 mg 1 hour before bedtime, for sleep and immune protection. Ask your health care provider about potential drug interactions with the use of melatonin.

Herbs

Green tea ( Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support and antiviral effects.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation and antiviral activity.
Garlic (Allium sativum), standardized extract, 400 mg two to three times daily, for antibacterial or antifungal and immune activity.
Astragalus (Astragalus membranaceus) standardized extract, 250 – 500 mg four times daily for immune support and antiviral activity.
Maitake mushroom (Grifola frondosa) standardized extract (D-fraction), 600 mg twice daily, for immune and antiviral effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Phyllanthus (Phyllanthus amarus) standardized extract, 200 mg two to four times daily for antiviral effects.
Elderberry (Sambucus nigra), one to two teaspoonfuls of standardized liquid extract two to four times daily, for immune support and antiviral activity.

Acupuncture

A study of a small number of people with complications from encephalitis suggests that acupuncture delivered to the scalp may lessen the severity of the complications and reduce the symptoms of the condition. Some researchers believe that scalp acupuncture is effective for people with encephalitis because all meridians converge at the head, and the method can stimulate and regulate qi (energy) throughout the entire body. More research is necessary.

Massage and Physical Therapy

Behavioral and Physical Training

Behavioral and physical training techniques recently have been explored in the treatment of individuals recovering from encephalitis. In one case, a woman experiencing poor short-term memory and decreased muscle coordination as a result of viral encephalitis began to improve significantly after participating in a behavioral rehabilitation training program. As a result of the program, she gained a high level of independence and was able to return home from the hospital with only minimal assistance from a caregiver. More studies are needed.

Other Considerations

Pregnancy

The most common cause of encephalitis in newborns is vaginal delivery by a mother who is infected with herpes simplex virus 2 (HSV2). This infection in newborns is often severe and fatal. For this reason, cesarean section may be advised for pregnant women with a history of HSV2, even if there is no sign of an active infection.

Prognosis and Complications

Full recovery from encephalitis can take weeks or months, during which time many individuals experience complications ranging from fatigue and difficulty concentrating to tremors and personality changes. The most severe problems associated with encephalitis result from the destruction of nerve cells in the brain that do not regenerate. The severity of complications depends on the condition of the immune system (whether it is healthy or weak) and the infection causing the encephalitis. For example, 80% of those infected with Eastern equine encephalitis, St. Louis encephalitis, and Japanese encephalitis have permanent neurologic impairments (such as memory, speech, vision, hearing, muscle control, and sensation) and a very low survival rate. Those infected with EBV or Venezuelan equine encephalitis rarely experience any serious complications. The long-term outlook for those with HSV encephalitis depends primarily on how quickly the condition is treated.

Between 80 - 95% of people infected with viral encephalitis will survive the condition, but 20% will experience debilitating side effects or complications, such as memory loss or severe personality changes. The survival rate for those with HSV encephalitis increases dramatically from 30 - 70% when the condition is detected early and treated with antiviral medications.

Supporting Research

Abe T, Kojima K, Shoji H, et al. Japanese encephalitis. J Magn Reson Imaging. 1998;8(4):755-761.

Adams RD, Victor M, Ropper AH. Principles of Neurology. 6th ed. New York, NY: McGraw-Hill; 1997:749-755.

Arribas JR, Storch GA, Clifford DB, Tselis AC. Cytomegalovirus encephalitis. Ann Intern Med. 1996;125(7):577-587.

Bale JF Jr. Viral encephalitis. Med Clin North Am. 1993;77(1):25-42.

Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. 2001;12(2):290-6.

Bhat KPL, Kosmeder JW 2nd, Pezzuto JM. Biological effects of resveratrol. Antioxid Redox Signal. 2001;3(6):1041-64.

Ben-Nathan D, Maestroni GJ, Lustig S, Conti A. Protective effects of melatonin in mice infected with encephalitis viruses. Arch Virol. 1995;140(2):223-230.

Bonilla E, Valero-Fuenmayor N, Pons H, Chacin-Bonilla L. Melatonin protects mice infected with Venezuelan equine encephalomyelitis virus. Cell Mol Life Sci. 1997;53(5):430-434.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.

Clancy RL, Gleeson M, Cox A, et al. Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus. Br J Sports Med. 2006;40(4):351-4.

Clifton ER. Herpes simplex encephalitis: an overview. J Miss State Med Assoc. 1991;32(12):437-440.

Eo SK, Kim YS, Lee CK, Han SS. Antiviral activities of various water and methanol soluble substances isolated from Ganoderma lucidum. J Ethnopharmacol. 1999;68(1-3):129-36.

Evansa RW: Diagnostic Testing in Neurology. Philadelphia, Pa: W.B. Saunders Company; 1999:187-188.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. Vol 1. New York, NY: McGraw-Hill; 1998:1136-1139, 2442-2445.

Feign RD, Cherry JD. Textbook of Pediatric Infectious Diseases. 3rd ed. Vol 1. Philadelphia, Pa: W.B. Saunders Company; 1992:445-452.

Gaby AR. The role of coenzyme Q10 in clinical medicine: Part 1. Alt Med Rev. 1996; 1(1):11-17.

Gorbach SL, Bartlett JG, Blacklow NR: Infectious Diseases. 2nd ed. Philadelphia, Pa: W.B. Saunders Company; 1998:1408-1414.

Gresikova M, Kaluzova M. Biology of tick-borne encephalitis virus. Acta Virol. 1997;41(2):115-124.

Irani MT, Singh AR, Udwadia AD, Merchant RH. Neonatal herpes simplex virus-2 encephalitis. Indian Pediatr. 1995;32(4):476-480.

Johnson RT. Acute encephalitis. Clin Infect Dis. 1996;23(2):219-224.

Kajimura K, Takagi Y, Ueba N, et al. Protective effects of Astragali radix by intraperitoneal injection against Japanese encephalitis virus infection in mice. Biol Pharm Bull. 1996;19(6):855-859.

Katzmann S, Mix C. Improving functional independence in a patient with encephalitis through behavior modification shaping techniques. Am J Occup Ther. 1994;48(3):259-262.

Kimura K, Ozeki M, Juneja LR, Ohira H. l-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2006 Aug 21.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 452-454.

Levitz RE. Herpes simplex encephalitis: a review. Heart Lung. 1998;27(3):209-212.

Liang D. Treatment of the sequelae of viral encephalitis by needling Sishencong (Extra). J Chinese Med. 1996;50:26.

Liu J, Lin H, McIntosh H. Genus Phyllanthus for chronic hepatitis B virus infection: a systematic review. J Viral Hepat. 2001;8(5):358-66.

Luft BJ, Remington JS. Toxoplasmic encephalitis in AIDS. Clin Infect Dis. 1992;15(2):211-222.

Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hepat. 2005;12(6):559-67.

Mrak RE, Young L. Rabies encephalitis in humans: pathology, pathogenesis, and pathophysiology. J Neuropathol Exp Neurol. 1994;53(1):1-10.

O'Meara M, Ouvrier R. Viral encephalitis in children. Curr Opin Pediatr. 1996;8(1):11-15.

Patrick L. Nutrients and HIV: part three - N-acetylcysteine, alpha-lipoic acid, L-glutamine, and L-carnitine. Altern Med Rev. 2000;5(4):290-305.

Pointer JE, Mulligan-Smith DA. Genital infections. In: Rosen P, Barkin R, eds. Emergency Medicine: Concepts and Clinical Management. 4th ed. St. Louis, Mo: Mosby-Year Book; 1998.

Roos KL.Encephalitis. Neurol Clin. 1999;17(4):813-833.

Rosen P, et al. Emergency Medicine: Concepts and Clinical Practice. 4th ed. Vol 3. St. Louis, Mo: Mosby; 1998:2198-2209.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47.

Rubeiz H, Roos RP. Viral meningitis and encephalitis. Semin Neurol. 1992;12(3):165-177.

Rust RS, Thompson WH, Matthews CG, Beaty BJ, Chun RW. La Crosse and other forms of California encephalitis. J Child Neurol. 1999;14(1):1-14.

Samuels MA, Feske S. Office Practice of Neurology. New York, NY: Churchill Livingstone; 1996:401-408.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Skoldenberg B. Herpes simplex encephalitis. Scand J Infect Dis Suppl. 1996;100:8-13.

Sparling PF. Introduction to sexually transmitted diseases and common syndromes. In: Cecil RI, Plum F, Bennett JC, eds. Cecil Textbook of Medicine. 20th ed. Philadelphia, Pa: W.B. Saunders Co; 1996.

Toltzis P. Viral encephalitis. Adv Pediatr Infect Dis. 1991;6:111-136.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

Whitley RJ, Kimberlin DW. Viral encephalitis. Pediatr Rev. 1999;20(6):192-198.

Williams JE. Review of antiviral and immunomodulating properties of plants of the Peruvian rainforest with a particular emphasis on Una de Gato and Sangre de Grado. Altern Med Rev. 2001;6(6):567-79.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

Zupanc ML, Handler EG, Levine RL, et al. Rasmussen encephalitis: epilepsia partialis continua secondary to chronic encephalitis. Pediatr Neurol. 1990;6(6):397-401.

Review Date:
10/27/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Eczema

FitSugar — Wed, 08 Oct 2008 17:34:55 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Prevention
Treatment
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Eczema is a chronic, inflammatory skin disorder. Its main features are blisters that dry to become scaly, itchy rashes. The skin becomes dry and itchy because too much moisture is lost from its upper layer. This leaves the skin without protection, making it easy for bacteria and viruses to penetrate. The disease occurs episodically; in other words, there may be periods when symptoms are severe (flares) and times when there are no symptoms at all (remission). Although eczema is not contagious, it is very common -- estimates are that more than 15 million people in the United States have eczema. People with eczema often have a personal or family history of allergic conditions like asthma or hay fever. There is no cure, but treatments can reduce symptoms and help prevent outbreaks.

Signs and Symptoms

Symptoms of eczema occur repeatedly. The most common signs of eczema are:

Dry, extremely itchy skin
Blisters with oozing and crusting
Redness of the skin around the blisters
Raw areas of the skin from scratching which may even lead to bleeding
Dry, leathery areas with more or less pigment than their normal skin tone (called lichenification)

Eczema in children under 2 years old generally begins on the cheeks, elbows, or knees. In adults, it tends to be located on the inside surfaces of the knees and elbows.

Causes

The cause of eczema is thought to be a combination of hereditary (genetic) and environmental factors. This means that factors such as allergies can cause eczema in susceptible people. Exposure to certain irritants and allergens in the environment can worsen symptoms, as can dryness of the skin, exposure to water, temperature changes, and stress.

Risk Factors

Young age -- infants and young children are most affected by eczema (about 65% of cases occur before age one, and about 90% occur before age 5)
Skin exposure to harsh conditions
Living in a climate with low humidity
Personal or family history of allergies to plants, chemicals, or food
Deficiencies of certain vitamins and minerals (for example, zinc)
Stress can make eczema worse

Irritants that may worsen eczema include:

Wool or synthetic fibers
Certain soaps and detergents as well as perfumes and some cosmetics
Dust or sand
Cigarette smoke

Diagnosis

Your doctor will most likely base a diagnosis on both the appearance of the skin and on personal and family history. To find the cause of your rash, your doctor may ask about stress in your life, your diet, drugs you are taking, soaps and detergents you use, and chemicals or materials you may be exposed to at work. A skin lesion biopsy (removal of a small piece of skin for examination in a laboratory) may be performed, but is not always required to make the diagnosis.

Prevention

Control of stress, nervousness, anxiety, and depression may help prevent flares of eczema. Mind-body techniques that have shown some success include cognitive-behavioral therapy and autogenic training. These two techniques can also be combined with learning about eczema.

Dietary restrictions that may help avoid flare ups include eggs, fish, peanuts, and soy. This is very individual and should be discussed with your health care provider. A doctor, dietitian, or naturopath, for example, can help you make these dietary changes and determine if the lack of these foods in your diet is reducing the incidence and severity of your eczema.

Although somewhat controversial, some studies have shown that children who are exclusively breast-fed for at least 4 months are less likely to get eczema. This is particularly true when the nursing mother has avoided cow's milk in her own diet.

Similarly, recent studies suggest that babies whose mothers used probiotics during pregnancy and while breastfeeding were less likely to have eczema at up to 2 years of age.

Preliminary studies suggest that pretreatment of skin with creams containing omega fatty acids can reduce the severity of eczema or prevent eczema entirely.

Treatment

The goals when treating eczema are to heal the skin, reduce symptoms, prevent skin damage, and prevent flares. Treatment may vary depending on age, symptoms, and general health. Developing skin care routines, identifying factors that trigger flares, and avoiding these triggers are a large part of any treatment plan.

Lifestyle

Avoid anything that aggravates the symptoms, such as allergens (substances to which the immune system overreacts) and irritants to the skin. Common allergens include pollen, dust mites, and animal dander. Common skin irritants include wool, synthetic fibers, soaps and detergents, perfumes, cosmetics, lanolin, certain chemicals such as chlorine and solvents (including mineral oil), cigarette smoke, dust, and sand.
Avoid scratching or rubbing affected areas.
Protect skin from rough clothing and irritants.
Be aware of emotional stress, and try stress-reducing techniques.
Keep your environment cool, with stable temperature and humidity.

Dry skin often makes the condition worse. Remember to:

Avoid hot baths or showers; lukewarm water is best.
Wash or bathe as quickly as possible to lessen water contact.
Use a mild soap or a nonsoap cleanser, or less soap than usual.
Moisturize. After bathing, it is important to trap the moisture in the skin by applying lubricating cream on the skin while it is damp (within 3 minutes of bathing).

Parents can help their children by:

Providing distractions to prevent them from scratching.
Keeping fingernails short to reduce chances of infection from scratching.
Being aware that there may well be social and emotional stress associated with visible skin lesions; additional support and encouragement may be needed.

Medications

Mild anti-itch lotions (Caladryl or Calamine) or topical corticosteroids (hydrocortisone) may soothe less severe or healing areas, or dry scaly lesions.
Chronic thickened areas may be treated with ointments or creams that contain tar compounds (such as Psoriasin), corticosteroids (medium to very high potency), and ingredients that lubricate or soften the skin.
Systemic corticosteroids may be prescribed to reduce inflammation in some severe cases. Examples include prednisone (Deltasone) and methylprednisolone (Medrol). In very rare instances, medications that suppress the immune system (called immunosuppressants), such as cyclosporine, may be considered in adults with extremely severe eczema who do not respond to oral steroids.
Antihistamines, such as diphenhydramine (Benadryl), may be recommended for nighttime use to prevent scratching. These medications may cause drowsiness. Topical (on the skin) antihistamines preparations are also available.
New treatments -- the latest treatment for eczema is a new class of skin medications called topical immunomodulators (TIMs). These medications are steroid-free. The most common are tacrolimus (Protoptic) and pimecrolimus (Elidel). Clinical studies have reported as high as an 80% success rate using these new medications.

Surgery and Other Procedures

Phototherapy and Photochemotherapy

Treatment with ultraviolet light waves may effectively treat mild-to-moderate cases of eczema in children over age 12 and adults. If phototherapy is ineffective alone, it may be combined with a drug called psoralen. It is then called photochemotherapy.

Nutrition and Dietary Supplements

Nutritional deficiencies may be addressed with the following supplements:

Eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities. Identifying and treating hidden food allergies along with stress management are often the cornerstones of effective complimentary medical treatment of eczema.
A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil (1 - 2 capsules or 1 tablespoonful oil 2 - 3 times daily), to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources, but supplementation is recommended.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements may need to be refrigerated for best results. Your child may also take probiotic supplements. Consult with your health care provider before giving your child any dietary supplements.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
Vitamin C, 500 - 1,000 mg 1 - 3 times daily, as an antioxidant and for immune support.
L-glutamine, 500 - 1,000 mg 3 times daily, for support of gastrointestinal health and immunity.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) 3 times daily when needed, for antibacterial, antifungal, and antiviral activity, and for immunity.
Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.

Herbs

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant and anti-inflammatory effects. Use caffeine free products. You may also prepare teas from the leaf of this herb.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg 3 times a day, for inflammation and antibacterial, or antifungal activity.
Reishi mushroom (Ganoderma lucidum), 150 - 300 mg 2 - 3 times daily, for inflammation and for immunity. You may also take a tincture of this mushroom extract, 30 - 60 drops 2 - 3 times a day.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg 1 -3 times daily, for antibacterial or antifungal activity and immunity. You may also prepare teas from the leaf of this herb.
Evening primrose (Oenothera biennis) standardized oil extract (EPO), 500 mg - 8 grams daily in divided dosages, depending upon severity of symptoms. Ask a health care provider for more information on proper dosages of EPO.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg 2 - 3 times daily, for detoxification support.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of eczema based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. Any remedy that causes aggravation of symptoms should be discontinued right away.

Calendula -- applied to the skin, particularly if the affected area is inflamed; this remedy soothes but does not cure the skin condition.
Sulphur -- for redness, burning, itching, and hot skin that tends to worsen with washing and scratching.
Urtica urens -- for large, red rashes (particularly those related to allergies) that itch and burn intensely.
Rhus toxicodendron -- used as a remedy for inflamed skin resulting from direct contact with an irritating substance; some homeopaths use it to treat eczema.

Massage and Physical Therapy

One clinical study evaluating essential oils for treating children with eczema concluded that massage with and without essential oils was effective in improving the dry, scaly skin lesions. Children with this scaly, itchy skin problem seem to experience less redness, scaling, and other symptoms if receiving massage between flares. Massage should not be used when this skin condition is actively inflamed. The essential oils most often chosen by the mothers in the study included sweet marjoram, frankincense, German chamomile, myrrh, thyme, benzoin, spike lavender, and Litsea cubeba.

Exercise

In one clinical study it was found that regular group sporting activities improved symptoms in those who participated for 3 weeks. The therapeutic effect of exercise may be related to the positive impact it has on the emotions. Sports should be avoided during the worst stages of an outbreak.

Climatotherapy

Climatotherapy is the use of sunlight and water (such as the ocean) as therapy. The Dead Sea in Israel is known for its healing properties, and many people with eczema go there to sit in the sun and swim in the water. Clinical studies suggest that this is a successful treatment for eczema. One clinical study looked at the experience of more than 1,500 people with eczema and found that 95% of skin was cleared in people who had previous stays at the Dead Sea and stays longer than 4 weeks.

Mind-Body Medicine

Flares of eczema are associated with anxiety and stress. Several clinical studies have shown that relaxation techniques to reduce stress and anxiety can successfully decrease the number of occurrences and relieve symptoms of eczema. Biofeedback seems to be a particularly useful technique.

Other Considerations

Starting an infant on solid foods conservatively and gradually may help prevent the food sensitivities that can cause eczema. Those who are allergic to ragweed, chrysanthemums, asters, echinacea, or feverfew should avoid chamomile because it is in the same plant family.

Pregnancy

Avoid the use of burdock and sulfur during pregnancy.

Warnings and Precautions

Although Chinese herbal treatments for eczema have been gaining popularity in both the United States and the United Kingdom, caution must be exercised when considering such remedies for this skin condition. Many of the Chinese herbal creams available in these two countries have been tested, and high amounts of steroid medications have been discovered. This is worrisome and potentially dangerous because the amount of the medication in such creams is not standardized or regulated. In a few rare instances, the use of oral Chinese herbs (like a tea) for eczema has led to kidney damage.

Prognosis and Complications

Although there may be complications of eczema, such as bacterial infections of the skin and permanent scar formation, eczema is usually just an annoyance that is easily controlled with treatment and by avoiding irritants. Call for an appointment with your health care provider if it does not respond to treatment or if signs of infection (such as fever, redness, pain) occur. Children with eczema, after a certain period of time, often go into remission for the rest of their lives, although skin may remain sensitive and dry.

Supporting Research

Abrahamsson TR, Jakobsson T, Bottcher MF, et al., Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2007;119(5):1174-80.

Anderson C, Lis-Balchin M, Kifk-Smith M. Evaluation of massage with essential oils in childhood atopic eczema. Phyother Res. 2000;14(6):452-456.

Berger MM, Shenkin A. Vitamins and trace elements: Practical aspects of supplementation. Nutrition. 2006; 22(9):952-5.

Billmann-Eberwein C, Rippke F, Ruzicka T, Krutmann J. Modulation of atopy patch test reactions by topical treatment of human skin with a fatty acid-rich emollient. Skin Pharmacol Appl SkinPhysiol. 2002;15(2):100-104.

Borrek S, Hildebrandt A, Forster J. Gamma-linolenic-acid-rich borage seed oil capsules in children with atopic dermatitis. A placebo-controlled double-blind study [Article in German]. Klin Padiatr. 1997;209(3):100-104.

Bruno EJ Jr, Ziegenfuss TN, Landis J. Vitamin C: research update. Curr Sports Med Rep. 2006; 5(4):177-81.

Byremo G, Rod G, Carlsen KH. Effect of climatic change in children with atopic eczema. Allergy. 2006;61(12):1403-10.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.

Cooper R, Morre DJ, Morre DM. Medicinal benefits of green tea: Part I. Review of noncancer health benefits. J Altern Complement Med. 2005; 11(3):521-8.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006; 4(2):261-75.

Dryden GW Jr, Deaciuc I, Arteel G, McClain CJ. Clinical implications of oxidative stress and antioxidant therapy. Curr Gastroenterol Rep. 2005;7(4):308-16.

Ernst E, Huntley A. Tea tree oil: a systematic review of randomized clinical trials. ForschKomplementarmed Klass Naturheilkd. 2000; 7(1):17-20.

Ernst E. Adverse effects of herbal drugs in dermatology. Br J Dermatol. 2000;143(5):923-929.

Fleischer AB Jr, Abramovits W, Breneman D, Jaracz E; US/Canada tacrolimus ointment study group. Tacrolimus ointment is more effective than pimecrolimus cream in adult patients with moderate to very severe atopic dermatitis. J Dermatol Treat. 2007;18(3):151-7.

Harari M, Shani J, Seidl V, Hristakieva E. Climatotherapy of atopic dermatitis at the Dead Sea: demographic evaluation and cost-effectiveness. Int J Dermatol. 2000;39(1):59-69.

Hederos CA, Berg A. Epogam evening primrose oil treatment in atopic dermatitis and asthma. Arch Dis Child. 1996;75(6):494-497.

Horrobin DF. Essential fatty acid metabolism and its modification in atopic eczema. Am J Clin Nutr. 2000;71(1 Suppl):367S-72S.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Kalliomaki M, Kirjavainen P, Eerola E, Kero P, Salminen S, Isolauri E. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol. 2001;107(1):129-134.

Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomized placebo controlled trial. Lancet. 2001;357(9262):1076-1079.

Karamfilov T, Elsner P. Sports as a risk factor and therapeutic principle in dermatology [article in German]. Hautarzt. 2002;53(2):98-103.

Langan SM, Williams HC. What causes worsening of eczema? A systematic review. Br J Dermatol. 2006;155(3):504-14.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Linde K, Hondras M, Vickers A, ter Riet G, Melchart D. Systematic reviews of complementary therapies - an annotated bibliography. Part 3: homeopathy. BMC Complement Altern Med. 2001; 1:4.

Magin PJ, Adams J, Heading GS, Pond DC, Smith W. Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients' experiences and perceptions. J Altern Complement Med. 2006;12(5):451-7.

McMenamy CJ, Katz RC, Gipson M. Treatment of eczema by EMG biofeedback and relaxation training: a multiple baseline analysis. J Behav Ther Exp Psychiatry. 1988;19(3):221-227.

Morse NL, Clough PM. A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries? Curr Pharm Biotechnol. 2006;7(6):503-24.

Osborn DA, Sinn J. Soy formula for prevention of allergy and food intolerance in infants. Cochrane Database Syst Rev. 2006;(4):CD003741.

Prescott SL, Bjorksten B. Probiotics for the prevention or treatment of allergic diseases. J Allergy Clin Immunol. 2007;120(2):255-62.

Rainone F. Milk thistle. Am Fam Physician. 2005 Oct 1; 72(7):1285-8.

Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. J Allergy Clin Immunol. 2002;109(1):119-121.

Schmitt J, Schakel K, Schmitt N, Meurer M. Systemic treatment of severe atopic eczema: a systematic review. Acta Derm Venereol. 2007;87(2):100-11.

Schulz P, Bunselmeyer B, Brautigam M, Luger TA. Pimecrolimus cream 1% is effective in asteatotic eczema: results of a randomized, double-blind, vehicle-controlled study in 40 patients. J Eur Acad Dermatol Venereol. 2007;21(1):90-4.

Sezer E, Etikan I. Local narrowband UVB phototherapy vs. local PUVA in the treatment of chronic hand eczema. Photodermatol PhotoimmunolPhotomed. 2007;23(1):10-4.

Siddiqui IA, Afaq F, Adhami VM, Ahmad N, Mukhtar H. Antioxidants of the beverage tea in promotion of human health. Antioxid Redox Signal. 2004; 6(3):571-82.

Simopoulos AP. Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Biomed Pharmacother. 2006;60(9):502-7.

Vlaski E, Stavric K, Isjanovska R, Seckova L, Kimovska M. Overweight hypothesis in asthma and eczema in young adolescents. Allergol Immunopathol (Madr). 2006;34(5):199-205.

Williams HC. Established corticosteroid creams should be applied only once daily in patients with atopic eczema. BMJ. 2007;334(7606):1272.

Worm M, Henz BM. Novel unconventional therapeutic approaches to atopic eczema. Dermatology. 2000;201(3):191-195.

Review Date:
8/23/2007
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

9 Month Miracle

FitSugar — Wed, 08 Oct 2008 17:34:52 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

A baby's development is an incredible process. Watch the full-color animations in Pregnancy TV to see how a baby develops from a single cell! Read the 9 Month Newsletter for weekly tips and additional information on what is happening in your body.

Your Baby's Development

Your baby's growth over 40 weeks.

Where's my baby on the ultrasound?

Fun Facts

Around the 20th week of your pregnancy, you should begin to feel the baby kick!

Review Date:
2/20/2007
Reviewed By:
Douglas A. Levine, MD, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Pregnancy Center Links

Glomerular filtration rate

admin — Thu, 04 Sep 2008 19:21:16 -0700

Overview

Definition
Alternative Names
How the test is performed
How to prepare for the test
How the test will feel
Why the test is performed
Normal Values
What abnormal results mean
What the risks are
Special considerations
References

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Glomerular filtration rate (GFR) is a test used to check how well the kidneys are working. Specifically, it estimates how much blood passes through the tiny filters in the kidneys, called glomeruli, each minute.

Alternative Names

GFR, Estimated GFR; eGFR

How the test is performed

Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is sent to a lab, where the creatinine level is tested. The lab specialist uses combines your creatinine level with several other factors to estimate your glomerular filtration rate (GFR). Different formulas are used for adults and children. The formula will include some or all of the following:

Age
Creatinine measurement
Gender
Height
Race
Weight

How to prepare for the test

Certain drugs can interfere with test results. Tell your doctor about all medicines you are taking, including over-the-counter ones.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there might be some throbbing.

Why the test is performed

The GFR test measures how well your kidneys are filtering a waste called creatinine, which is produced by the muscles. When the kidneys aren't working as well as they should, creatinine builds up in the blood.

Your doctor may order this test if there are signs that your kidneys are not working properly. It may also be done to see how far kidney disease has progressed.

The test is recommended for people with chronic kidney disease and those at risk for it due to:

Diabetes
Family history of kidney disease
Frequent urinary tract infections
Heart disease
High blood pressure
Urinary blockage

Normal Values

According to the National Kidney Foundation, normal results range from 90 - 120 mL/min. Older people will have lower normal GFR levels, because GFR decreases with age.

Normal value ranges can vary slightly among different laboratories. Talk to your doctor about what your specific test results mean.

What abnormal results mean

Levels below 60 mL/min for 3 or more months are a sign of chronic kidney disease. Those with GFR results below 15 mL/min are a sign of kidney failure.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but can include:

Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)

Special considerations

The creatinine clearance test, which involves a 24-hour urine collection, can also provide an estimate of kidney function. However, this method is not always accurate.

GFR can increase during pregnancy.

References

K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis. 2002;39(2 Suppl 1):S1-246.

Johnson CA, Levey AS, Coresh J, Levin A, Lau J, Eknoyan G. Clinical practice guidelines for chronic kidney disease in adults: Part II. Glomerular filtration rate, proteinuria, and other markers. Am Fam Physician. 2004;70:1091-1097.

Snyder S, Pendergraph B. Detection and evaluation of chronic kidney disease. Am Fam Physician. 2005;72:1723-1732, 1733-1734.

Review Date: 10/12/2007

Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Also reviewed by Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_007305

Hypothalamus

admin — Thu, 04 Sep 2008 18:55:30 -0700

Overview

Definition
References

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

The hypothalamus is an area of the brain that produces hormones that control:

Body temperature
Hunger
Moods
Release of hormones from many glands, especially the pituitary gland
Sex drive
Sleep
Thirst

References

Hadley ME, Levine JE. Endocrinology. 6th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2007:111-133.

Coll AP, Farooqi IS, O’rahilly S. The hormonal control of food intake. Cell 2007; 129(2):251-262.

Review Date: 3/18/2008

Reviewed By: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002380

Colon cancer screening

admin — Thu, 04 Sep 2008 18:51:22 -0700

Overview

Alternative Names
Information
References

Illustrations

Colonoscopy

Sigmoid colon cancer, X-ray

Large intestine anatomy

HEALTH GUIDE REFERENCE FROM A.D.A.M

Alternative Names

Screening for colon cancer

Information

How do you screen for colon cancer?

Answer:

Colon cancer screening can detect polyps and early cancers. Such screening can detect changes that can be treated before symptoms develop. Regular screenings may decrease deaths and prevent pain caused by colorectal cancer. Colon cancer screening is as effective as breast cancer screening when it comes to saving lives.

There are three ways to screen for colon cancer:

The first is a stool test that examines your bowel movements to check for blood.
The second method is a sigmoidoscopy exam. This test uses a flexible small scope to look at the lower part of your colon. Because it only looks at the large intestine, it may miss some cancers. Most health care providers recommend that the stool test and the sigmoidoscopy be used together.
The third method is a colonoscopy exam. A colonoscopy is similar to a sigmoidoscopy, but it allows the entire colon to be viewed. You will usually be mildly sedated during a colonoscopy.

The American Cancer Society makes the following recommendations:

Beginning at age 50, both men and women should have a screening test. Some recommend that African Americans begin screening at age 45. People with certain digestive diseases (such as ulcerative colitis) or a family history of colon cancer may need earlier and more frequent testing.

Screening options for patients with an average risk for colon cancer:

Colonoscopy every 10 years
Double-contrast barium enema every 5 years
Fecal occult blood test (FOBT) every year - if results are positive, a colonoscopy is needed
Flexible sigmoidoscopy every 5 years
Virtual colonoscopy every 5 years
Yearly FOBT plus sigmoidoscopy every 5 years - this combination is preferred over the two tests alone

There is not enough evidence to determine which screening method is best. Colonoscopy is the most thorough method, but it takes longer, requires sedation, is slightly riskier (rarely, the bowel can be perforated), and is much more expensive than a sigmoidoscopy.

Recently there has been interest in several new screening tests for colon cancer, including checking DNA in stool samples and the fecal immunochemical test (FIT). Capsule endoscopy is also being studied but it is not yet recommended by the American Cancer Society for standard screening at this time.

References

Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. CA Cancer J Clin. 2006;56:11-25.

Institute for Clinical Systems Improvement. Health Care Guideline: Preventive Services for Adults. 13th ed. October 2007.

Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130-160.

Mandel JS. Screening for colorectal cancer. Gastroenterol Clin North Am. 2008;37:97-115.

Review Date: 3/24/2008

Reviewed By: Stephen Grund, MD, Ph.D., Chief of Hematology/Oncology and Director of the George Bray Cancer Center at New Britain General Hospital, New Britain, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002071