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SEXUAL FUNCTION OF WOMEN AFTER SPINAL CORD INJURY: PRACTICAL PREPARATIONS FOR SEX

Posted: July 27th, 2011 | Author: | Filed under: Healthy bones Osteoporosis Rheumatic | Comments Off

Sexual activity after a spinal cord injury is usually more successful if you do some advanced planning. You need to consider mobility issues, such as transferring and positioning, and muscle spasms. More importantly, you probably want to minimize the risk of a bowel or bladder accident during sex. Emptying your bladder before sexual activity will help. If you are on a regular bowel program, the chance of a bowel accident is small. But if your bowels are not regular, you may want to empty them before sex. Protective pads on the bed make quick clean up easier in the event of an accident. Keeping towels on hand is also useful. Avoiding eating or drinking just before sex, or limiting your fluid intake for several hours before sex, can help minimize bladder and bowel accidents.If you use intermittent catheterization, you can catheterize just before sex to empty your bladder. Both men and women can have sex with an indwelling catheter in place. A woman should tape the catheter to her abdomen with surgical tape to avoid dislodging it during sex. A man can fold the catheter back along the side of his penis and cover both with a condom before intercourse. Of course, if you prefer, the catheter can be removed before sex and then reinserted.A woman using a diaphragm for birth control may need help from her partner to insert it. You may want to include this in your sexual encounter, or prepare ahead by inserting the diaphragm yourself or getting assistance.If you have any questions about how to make physical preparations for sex, how to minimize accidents, or how to avoid spasms during sex, ask your doctor. Once you are fully informed, communicate with your partner about the necessary preparations, who will perform them, and the possibility of accidents and how you’ll deal with them. The better you prepare your partner, the more relaxed both of you will be and the greater the likelihood of a pleasurable experience.
*123/156/5*


ALCOHOLISM TREATMENT: GENERAL CONSIDERATIONS IN WORKING WITH ADOLESCENTS

Posted: July 18th, 2011 | Author: | Filed under: Anti Depressants-Sleeping Aid | Comments Off

In working with an adolescent, it is wise to avoid obvious authority symbols, such as white coats, framed diplomas dripping off the walls, and a remote clinical attitude. Adolescents are probably already having some degree of difficulty with authority figures anyway, and they don’t need you added to that list. Being somewhat informal in dress and setting can remove one barrier. On the other hand, spiked hair, playing tapes, sitting on a floor cushion, and sucking on a “roach” when they arrive won’t go down very well either. They want you to know about those things, but not be into them; unless, of course, you really are (even then, leave the roach at home). An attempt to fake out the adolescent will fail. They are a hard group to fool, and they place a high premium on honesty. Respect this and honestly be yourself. This means asking for a translation of their vocabulary if you are not familiar with the lingo.Empathy rather than sympathy is the goal. This is true of all therapeutic relationships. Sympathy is feeling like the other person. Empathy is knowing how the person feels, understanding it, but not feeling like he does at the moment. For instance, it is simply not helpful to be depressed along with the person.In general, three types of therapy are done with adolescents. One involves manipulation of the environment. This can include arranging for the father to spend more time with his child, getting the kid who hates Shakespeare into a different school program, or organizing a temporary placement for the child whose parents are nonsupportive at the time. These can be very valuable interventions.Standard insight therapy—psychological, psychiatrically oriented traditional therapy—is not often used. Not many adolescents are ready for, or even could benefit from, this kind of therapy. The ones who can benefit from it tend to be “bright,” advantaged young people, who seem more capable and older than their peers or their chronological age would suggest.The most commonly productive therapy is what could be termed a relational approach. This requires time for you to become well acquainted and for the adolescent to feel comfortable with you. The counselor is supportive of the person without doing it for him. The counselor is a neutral person, available to the adolescent in a very different way than are parents or peers.The issue of confidentiality always comes up. It can be a mistake to guarantee that “nothing you say will ever leave this room.” The counselor does have the responsibility for others as well as the adolescent client. Given blanket protection, what happens when the kid announces he plans to rob the local deli, or another says she plans to drive the family car off the road at the first opportunity? A different approach was suggested by Dr. Hugh MacNamee. His practice was to tell whomever he saw that though most of what they said would be held in confidence, if they told him anything that scared him about what they might do, that would be harmful to themselves or others, he was going to blow the whistle. He made it clear he would not do so without telling them; nonetheless, he would do it. In his experience, adolescents accept this, maybe even with relief. It may help to know that someone else is going to exert some control, especially if they are none too sure about their own inner controls at the moment.In a similar vein, Dr. MacNamee would suggest keeping the adolescent posted on any contacts you have with others about him. If a parent calls, start off the next session by informing the adolescent, “Hey, your Dad called me, and he wanted….” If a letter needs to be written to a school, probation officer, or someone else, share what you are writing with the adolescent. The chances are fairly good his fantasy about what you might say is worse than anything you would actually say, no matter what the problem. Because trust is such an issue with adolescents, it is important that you be willing to say to them what you would say about them behind their backs.Although the aforementioned is a good general approach to the issue of confidentiality, you may need to be aware of other complicating factors. In particular, we refer to the legal issues of a child’s right to care versus parental rights to be informed. There may be circumstances in which an adolescent has a legal right to be seen and treated without parental knowledge or consent. In any case, the ground rules you are following must be clear to the adolescent client.*150\331\2*


DISEASES OF THE VEINS: WHO IS AFFECTED BY PULMONARY HYPERTENSION? HOW SERIOUS IS PULMONARY HYPERTENSION?

Posted: July 8th, 2011 | Author: | Filed under: Cardio & Blood- Сholesterol | Comments Off

Who Is Affected by Pulmonary Hypertension? Individuals with previous pulmonary embolism, chronic emphysema, and certain types of congenital heart disease are at higher risk for the development of pulmonary hypertension. Primary pulmonary hypertension is rare; it occurs most often in young adults, but it can occur at any age. It affects about twice as many women as men.How Serious Is Pulmonary Hypertension? Pulmonary hypertension is usually a very debilitating problem; however, the symptoms and life expectancy are extremely variable, even for people with the same degree of pulmonary blood pressure elevation. People with Eisenmenger’s complex seem to be able to endure very severe pulmonary hypertension for years, although they may be limited in their activities. In people with primary pulmonary hypertension, symptoms tend to develop more rapidly and life expectancy is shorter.*214\252\8*


LOGICAL ANALYSIS OF POSTURE: DUALITY OF CONTROL

Posted: June 21st, 2011 | Author: | Filed under: Pain Relief-Muscle Relaxers | Comments Off

Therefore, the subconscious brain as well as the conscious brain plays a major role in maintaining posture and an erect position. In an unconscious state or in sleep the body will collapse. A person sleeping in a train cannot keep the head up and it sways in all possible directions in jerks. Similarly during a fainting attack the body collapses even though the subconscious brain functions quite well. A person who has fainted has normal breathing and pulse rate even though the consciousness is not there.The ultimate example of elongating muscle fibres occurs during transcendental meditation (TM). All meditation creates a link between the conscious and subconscious mind, but TM has a physical manifestation. Its exponents adopt a sitting posture in such perfect balance that even the posture-maintaining muscles are not needed. There comes a point where the subconscious brain suddenly becomes aware that their support is missing and these muscles abruptly extend in synchronism, resulting in the sudden elongation of the spine by a matter of inches, like the marbles suddenly being squeezed. The jerk is so powerful that it lifts the body off the floor in a small leap. Some people refer to this as ‘levitation’. It is, however, neither magic nor supernatural. It happens, it is well documented and easily explainable. I defy anyone, however, to explain it in a world in which muscles only contract.*54\330\8*


IBS AND EVERYDAY POISONS: STOPPING SMOKING – WHICH SUPPLEMENTS WILL HELP?

Posted: June 15th, 2011 | Author: | Filed under: Gastrointestinal | Comments Off

Vitamin C has long been known to aid detoxification, strengthen the immune system and ease withdrawal symptoms. Vitamin B3 -niacin – has also been found to be helpful. This chemical, which can also be bought in the form of nicotinic acid, is similar in structure to nicotine. Niacin is also thought to resemble endogenous benzodiazepine – a tranquillizing substance similar to Valium made naturally in the brain. In the United States large quantities of niacir are used in detoxification programmes. Its use is combined with saunas and exercise and seems to have wonderful results, and there appear to be few toxic effects even at very high dosages. The usual recommended dose is to build up to 100 mg morning and 100 mg Ј night. Don’t be surprised if your skin pricks and you go bright red twenty minutes or so after taking it; this is a harmless flush and is beneficial. Niacin improves circulation to the extremities (it is used for chilblains and Raynaud’s Disease, a condition characterized by cold, white or blue fingers, caused by spasm in the arteries in the hands), and acts like an internal sauna. It is also known to be essential to the health of the bowel. People who are always cold often find this supplement helpful and many people say that after the first few doses they feel very much calmer. The only thing to remember is to take all the B vitamins if you take this; no B vitamin should be taken in isolation because it depletes the store of the others.*40\326\8*


DIETS AND ASTHMA: VITAMIN B6 (PYRIDOXINE)

Posted: June 4th, 2011 | Author: | Filed under: Asthma | Comments Off

Probably the most important supplement for the prevention of heart disease, pyridoxine is now seen as one of the main factors in the prevention of cardiovascular disease because of its role in the breakdown of homocysteine, a chemical derived from dietary methionine, which is known to cause vascular damage that can lead to the formation of clots and hardening, as well as narrowing of blood vessels. This vitamin is also a natural tranquilliser and, in conjunction with zinc and magnesium, is helpful in reducing premenstrual symptoms and fluid retention. It is very valuable in the treatment of asthma. High doses of this vitamin have been reported to cause reversible neurological problems in a few people. Side EffectsUnless it is specifically prescribed in higher amounts by your doctor, you should limit your daily supplemental intake to 500 milligrams or less.While vitamin B6 can be used in conjunction with vitamin C as an antidepressant, if the depression is associated with vivid dreams and nightmares, additional pyridoxine could make the depression worse.Lactating mothers should note that large amounts of vitamin B6 can interfere with breast milk secretion and therefore they should not take more than 100 milligrams of this vitamin per day as a supplement.There have been several reports of neurological side effects with very large doses of vitamin B6, in particular the loss of peripheral nerve sensations similar to those experienced by sufferers of multiple sclerosis. Most of the cases reported in the literature involved daily doses of 2000-10 000 milligrams, taken regularly for several years, but a few reports have appeared of similar effects at 500 milligrams per day over two years.If you are taking medications containing L-Dopa (anti-Parkinson’s disease), phenytoin (such as Dilantin) or phenobarbital (anticonvulsants), you should avoid formulas with this vitamin as it interferes with such medications, rendering them less useful.On the other hand, some medications increase the need to take vitamin B6 in supplement form. The most common are birth control pills, Cycloserine (an antibiotic), Hydralazine (to lower blood presure), Isoniazid (used to treat tuberculosis) and Penicillamine. This last is not a type of penicillin, as its name may suggest, but a drug used to treat rheumatoid disease, some rare genetic disorders and toxic chemical overload.*46\145\2*


BACH FLOWER REMEDIES:CHERRY PLUM – HOW TO GET A CLEAR CONCEPTION OF MIND LOSING CONTROL OVER ACTION

Posted: May 25th, 2011 | Author: | Filed under: Herbal | Comments Off

To get a clear conception of mind losing control over action : CHERRY PLUM stands for (1) fear of mind losing control over action like thinking of suicide, or of killing some body or of mutilating somebody’s limbs etc. (2) Mind actual losing control of the action of the body like acting on impulse without thinking of the consequences i.e. grievously hurting his child or wife or breaking utensils in a fit of anger. WHITE CHESTNUT stands for the mind losing control of thoughts i.e. involuntary thought actions, repetition of thoughts, despite effort to forget them.To differentiate on the basis of acute anxiety in “Rock Rose” and “Cherry Plum”.In Rock Rose, the extreme terror & anxiety are writ large on the face of the sufferer. The extreme internal anxiety comes out on the surface.In CHERRY PLUM it is the internal fear/anxiety of the mind losing control over his actions. It is purely an internal affair – a mental conflict, which does not come on the surface unless he perpetrates some unbecoming act.*77\308\8*


CONTRACEPTIVE METHODS: MUCUS METHOD AND PHYSICAL OBSTRUCTION OF THE UNION OF SPERM AND EGG

Posted: May 14th, 2011 | Author: | Filed under: Women's Health | Comments Off

Mucus MethodA woman who uses the mucus method examines her cervical mucus throughout her menstrual cycle and records changes in it. Before and after ovulation, cervical mucus is viscous and yellow. Because of a drop in saline content and a rise in estrogen during ovulation, however, the cervical mucus becomes thinner, clearer, and more elastic with a consistency similar to that of an egg white. By charting the changes in her cervical mucus over several months, the woman will be able to estimate her time of ovulation. She and her partner should avoid sexual intercourse during and around this unsafe period.Even when a couple practices one or more of these fertility-awareness methods conscientiously, the rhythm method remains relatively unreliable since the precise time of ovulation is often very difficult to pinpoint. A couple may think that they have entered the safe, postovulatory period when they have not; and even if the partners have correctly identified the time of ovulation and avoid sexual intercourse during it, a woman may still become pregnant if one of her eggs joins with a sperm that has survived in her reproductive tract from a prior act of sexual intercourse. A failure rate of approximately 20 percent confirms just how difficult it is not only to predict ovulation accurately but also to control human sexual desire.Physical Obstruction of the Union of Sperm and EggMore reliable than coitus interruptus and the rhythm method are contraceptive methods such as the condom, the diaphragm, the cervical cap, and the sponge, which provide physical or chemical barriers to prevent the sperm from reaching the egg. In general, these methods work well with virtually no dangerous side effects, but they are not very convenient.*44\205\8*


BOTOX ALL AROUND: MIGRAINES

Posted: May 6th, 2011 | Author: | Filed under: Skin Care | Comments Off

One of the reasons why I’m such a believer in Botoxis because its immense versatility is unmatched. New uses for it seem to surface at a daily rate and it’s so satisfying when patients see results from Botox that they never dreamed of obtaining in such a short visit. Following are a few examples of Botox’s scope.MIGRAINESIt’s been proven that Botox helps with the debilitating condition of migraines. The reason isn’t exactly clear, but I suspect that the muscle-relaxing effects of Botox have something to do with it. Another theory is that Botox has a positive effect on the pain transmitters of the face. A few years ago I treated a patient whom I thought was exaggerating when she said her headache immediately disappeared after having Botox. Today, however, I’m a believer in this application. Recently another patient told me that her crippling headaches had kept her home from work for two weeks and that to her, Botox was truly heaven sent. Even one of my nurses in my Miami office uses Botox for this purpose; her headaches are so severe that she often has to turn off the lights in her office and rest her head. For many, the instant relief that Botox delivers in just a shot or two – with relief lasting as long as four months – is far more desirable than taking an endless stream of pain medication. Of course, no one complains about the side benefits!*52\82\8*


THE NEW GERM THEORY OF DISEASE: VENEREAL VACCINES

Posted: April 24th, 2011 | Author: | Filed under: HIV | Comments Off

The two-hundred-year history of vaccination has generated only one success story against a sexually transmitted pathogen: the hepatitis B vaccine. This program was put in action during the early 1990s. It looked good at the outset but is already showing signs of trouble. Hepatitis B, like HIV, can generate variation quickly through mutation. Recent data indicate that a massive hepatitis B vaccination program in Taiwan is causing the virus to evolve around the vaccine.Why have vaccines not been as successfully applied against sexually transmitted pathogens as against other kinds of pathogens? Each sexually transmitted pathogen has its own story, but there are some general reasons that the standard approach to vaccination is not particularly effective against venereal diseases.Sexually transmitted pathogens are the beneficiaries of several psychological idiosyncrasies. First there is morality. People have little control over whether they will inhale air laden with viruses, whether a mosquito will get lucky, or whether some of their food has been contaminated because of neglected hand washing. But people are supposed to have some control over whether they engage in sex. Treating syphilis with an antibiotic is remedying a past moral lapse, but vaccinating people against syphilis can be seen as encouraging immoral behavior. Allocating money for the development of venereal vaccines can be politically risky for the same reason.There is also the immunological problem. Sexually transmitted pathogens have to be able to avoid destruction by the immune system, and vaccines rely on the immune system to destroy sexually transmitted pathogens. This is the problem that seems to be making the hepatitis B vaccine program show hairline cracks. Hepatitis B stays ahead of the immune system by mutating its form. If the vaccine primes the immune system to combat one form of the virus, the door is left open to another form.Vaccines against cancer have generated much hope but little success in the way of disease control. If most cancers turn out to be caused by viruses, all of this might change. Consider cervical cancer. Once cervical cancer became recognized as an infectious disease, new opportunities arose. The papillomavirus that causes this cancer offers several distinct antigens that would not have been available as immunological targets if the cancer had been caused solely by mutations. Even with vi-rally caused cancer there is the problem of getting the immune system to knock out a lump of the body’s own cells, but at least there is a chance that the cells are hanging the virus’s body parts as a kill me sign for the immune system. Cells infected with the most deadly forms of papillomavirus do seem to post such signs using parts of the E6 and E7 proteins; and cells that were engineered to express these proteins were destroyed by the cytotoxic T cells that would need to be mustered to take care of these cells in the body. There is still the problem of killing a big lump of cells from the outside. Once the lump gets too big, no amount of immunological activity may be sufficient. But the immunological action triggered by an E6 or E7 vaccine may work much earlier in the course of infection, long before a distinct lump is seen.If such a vaccine does act against infected cells, it could have a much greater long-term punch than its developers suspect. The E6 and E7 proteins are the ones that sabotage the cell’s ability to control its division. A vaccine derived from them would therefore be a virulence antigen vaccine that might provide an extra evolutionary punch by tipping the competitive balance in favor of the papillomaviruses without the damaging form of these proteins. These mild strains of papillomavirus would then be left to generate additional protection against the harmful strains by triggering immunity to antigens that the mild arid harmful strains share.AIDS vaccines present a different set of problems and opportunities. On the positive side, the infected cells are not cloistered inside tumors. On the negative side, the virus is so mutation prone that a vaccine that would protect against all variants is probably unattainable. Still, the virulence antigen strategy may provide substantial protection if it is used early in the infection as a therapeutic vaccine. This kind of usage requires that the most damaging forms of HIV’s proteins be identified and used in the vaccine. When these forms then arise by mutation, they may be quickly knocked out before they have a chance to gain a foothold. The protein HIV uses to attach to and enter cells, for example, typically changes during the course of infection, allowing HIV increasingly to enter and damage the helper T cells. This change is critical because these T cells tend to be far more important to the orchestration of the immune response than are the other cells HIV infects when it does not have this altered form. If the altered form of this protein was used in a vaccine early during infection, the more damaging viruses might be controlled longer because the immune system would be ready for them when they arose. In this case the normal immunity generated by the less damaging HIV in the body is supplemented by a vaccine-induced immunity that specifically suppresses the more damaging form. The more of the harmful forms that could be included in such a therapeutic virulence antigen vaccine, the longer the delay in the breakdown of the immune system.*63\225\2*