Health Issues is a general health based blog concentrating on multiple health topics.

SOME CONSTRUCTIVE CRITICISM OF ARTHRITIS TREATMENT:

Thursday, April 23rd, 2009

COMMERCIAL INTERESTS

Consider a company researching a new substance which has potential for treating a particular disease. Several factors influence the progress of this substance and its eventual destiny.

If the disease for which it is indicated is a serious one, the; product is likely to be a big money spinner. The project will then probably go ahead with maximum effort. If the disease is serious but not likely to involve good sales for the product (perhaps a disease of relatively low incidence), then the whole project may be abandoned in favour of another substance which is effective for some less serious condition, but still has good sales potential. This is straight commercialism and, of course, is quite justified in private enterprise where survival depends on sales.

Suppose, however, that the first case applies and the company proceeds to put the substance through all the trial procedures demanded by governmental agencies. These procedures can involve five to eight years of research and trials. The costs to the company will be enormous. Another company may also be progressing with research on a similar substance with indications for the same disease. Neither company will know of the other’s work and it then becomes a matter of who will gain official approval and the consequent prize – ‘the market’. Should one of the companies learn of the possibility of being ‘pipped to the post’ by another research project they may well decide to cut their losses and abandon the project. It could be that the product which would have resulted from this company’s research would have been an excellent one; due to a combination of circumstances it is, however, lost to the consumer.

A feature which comes into decisions regarding the acceptance of new substances officially classed as ‘drugs’, involves a comparison with other drugs used for the same disease. This brings the second aspect into play; that is, the basis of comparison involved in the acceptance of new ‘drugs’, or therapeutic substances.

It is valid to criticize a system which judges (and possibly rejects) new therapeutic substances by their comparative effectiveness with an exsiting substance. There are so many other factors which can be influential here, including, obviously, the difference in side-effects between the new substance and the existing one. Thus, a material which was only a quarter as potent or effective as another but which displayed an absence of serious side-effects would be a more valuable substance – for the patient. Furthermore, the new material may be more easily assimilated by patients than the one with which it was being compared. The effectiveness of a product involves a more widespread manifestation than just the speed by which it changes the course of a disease.

*24/48/5*

Tags: Arthritis
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BREAST CANCER: ADJUVANT THERAPY. CLINICAL TRIALS

Thursday, April 23rd, 2009

Adjuvant therapy

Following surgery for breast cancer, you may be referred to a cancer specialist – an oncologist – for further treatment. Treatment that is auxiliary to the main form of treatment – in this case surgery – is known as adjuvant therapy, and its aim in treating women with breast cancer is to destroy any cancer cells that may remain in the body after the tumour has been surgically removed.

Following an operation for breast cancer, the adjuvant therapy may be with X-rays (radiotherapy), drugs (chemotherapy), or hormones. You will see a consultant in clinical or medical oncology, and may be given one of these forms of treatment or a combination of any of them. You may receive the adjuvant treatment at the same hospital at which your operation was done, or you may have to go to a cancer centre at another hospital.

Some time before your treatment starts, the oncologist will examine you and look at the results of your operation and of any investigations that have been done. You may need to have further investigations, such as a liver or bone scan, to determine whether the cancer has spread beyond your breast. The oncologist will then discuss the proposed treatment plan with you, and you will be able to ask questions.

Clinical trials

To be able to improve the treatment given to women with breast cancer, new drugs need to be tested, and currently used drugs and radiotherapy regimes need to be tried in different ways. Therefore, many women are asked to take part in clinical trials to compare a new treatment with an existing one.

If your doctor is involved in a trial of this sort, you may be asked if you would be willing to take part. The details of the trial will be explained to you, and you should make sure you fully understand what is entailed before you make a decision. You are under no obligation to agree to be involved, and if you refuse, the quality of the treatment you receive will not be affected in any way.

*50/39/5*

Tags: Cancer
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DANAZOL AS A DRUG USED FOR ENDOMETRIOSIS TREATMENT

Thursday, April 23rd, 2009

How Danazol works

It is thought that Danazol eradicates endometrial implants in several ways. The net result is that the production of oestrogen is suppressed and the levels of oestrogen in the body decrease to the low levels found in women following the menopause. Hence, Danazol treatment is sometimes referred to as pseudo-menopausal treatment because it mimics the hormonal condition of menopause.

The low levels of oestrogen mean that the endometrial implants are no longer stimulated to grow and break-down each month. Therefore, they become inactive and begin to gradually waste away.

Ovulation and menstruation usually cease by the end of the second month of treatment though this may depend on the dosage being taken. The symptoms of endometriosis usually begin to decrease by the end of the second month of treatment and then continue to improve throughout the course of treatment.

Dosages of Danazol generally used

The dosage and length of your treatment will depend on a variety of factors including the severity of your disease, your response to the treatment and your gynecologist’s preferences.

Most gynecologists recommend that you start with a dosage of 600 to 800 milligrams per day (three or four 200 milligram capsules per day). Some research studies have suggested that Danazol is equally effective at lower dosages if your periods are suppressed. Your gynecologist may decrease your dosage to 600 milligrams or even 400 milligrams per day once your periods have stopped.

In order to increase the effectiveness of the drug it is best to take the capsules at fairly evenly spaced times throughout the day — in other words one capsule every eight hours if you are on 600 milligrams per day or every six hours if you are on 800 milligrams per day.

The usual length of a course of treatment with Danazol is three to nine months — the average length being about six months. A further course of Danazol may be used if you have a recurrence of your endometriosis as there is no evidence to suggest that the implants become resistant to the drug. Because so little is known about the effects of repeated or long-term use of Danazol you should probably only have two or three courses in your lifetime and you should not have a prolonged course of treatment beyond twelve months.

You should start your course of Danazol on the first day of your period to minimize the likelihood of taking the drug while you are pregnant. If you do not begin the treatment at the start of a period you should have a pregnancy test to make sure that you are not pregnant.

Although it is unlikely that you will conceive during your course of treatment with Danazol every care should still be taken to avoid pregnancy. The manufacturers of Danazol recommend that some form of barrier contraception (e.g. condom or diaphragm) be used while taking the drug, particularly during the first two months of treatment or if you are taking less than 800 milligrams per day. The oral contraceptive (the Pill) should not be taken at the same time as Danazol.

You should see your gynecologist about six to eight weeks after beginning your course of Danazol to discuss how the treatment is progressing and any problems that you may be having. Thereafter, you should see him or her every two to three months for the remainder of your course of Danazol.

*34 /41/5*

Tags: Women’s Health
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TREATMENT OF EATING DISORDERS: IN OR OUT OF THE HOSPITAL?

Thursday, April 23rd, 2009

One crucial decision is whether the patient should be hospitalized or whether she can be managed as an outpatient. There are advantages and drawbacks to either approach.

It’s generally better if treatment can take place outside the hospital. The patient won’t be snatched out of her familiar surroundings and plunked down into a strange environment. Yet sometimes those “familiar surroundings” are contributing to her disorder.

And, of course, it’s easier to monitor and control behavior in the hospital. Often the hospital provides a kind of safe haven in which a patient and her family can begin to gain control of the problem.

Realistically, you can’t “cure” an eating disorder in the hospital. People have to eat every day for the rest of their lives. They have to learn how to function on their own, in the “outside world,” without supervision. A bulimic woman usually has to keep wrestling with the urge to binge and purge even after she leaves the hospital. In follow-up counseling, we continue to work on controlling these urges.

Inpatient care is required when:

• There is a medical emergency-the patient is severely emaciated, has a severe electrolyte imbalance or arrhythmia, is blacking out, or is otherwise unable to function

• She can’t keep any food down

• She is unable to break the binge-purge cycle

• She is severely depressed or suicidal

• She is so obsessed with food that she can’t function

• She is a substance abuser and can’t break the habit

• She is a severe laxative or diuretic abuser and can’t stop as an outpatient

• She has a severe personality disorder that complicates her ability to be treated outside the hospital

• Her personal situation is so unstable that treatment outside of the hospital is impossible

• Her family can no longer cope with the problem

• A careful program of outpatient care fails to work

• Adequate outpatient care isn’t available

Although hospitalization is expensive, it is certainly more effective-in terms of both symptom improvement and cost – than a prolonged, unsuccessful outpatient treatment.

*58/35/5*

Tags: Weight Loss
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WIN THE FAT WAR: SMALL STEPS LEAD TO BIG WIN

Thursday, April 23rd, 2009

Just one change is all that 36-year-old Julie May needed to kick start her weight-loss program. And she eventually took off 50 stubborn pounds, one change at a time.

Julie, a case manager for a hospital in Shreveport, Louisiana, ^ had been trapped in a cycle of dieting, depression, and weight gain for most of her adult life. Stung by each failed attempt to slim down, she sought solace in food … and put on a pound or two more. Inevitably, she launched new diets, starting the cycle all over again. When her weight reached 190 pounds, she decided that she’d had enough of her destructive eating pattern.

In search of a solution to her weight-loss woes, Julie picked up a copy of Oprah Winfrey’s best-seller Make the Connection. As she read about Winfrey’s struggle to slim down, Julie made a connection of her own. “I had tried and failed on so many diets that I no longer believed that I could lose weight,” she says. “I had to prove to myself that I could succeed.” She would do that by making one change at a time.

Julie decided to work on her activity level first since she knew that her eating habits would be harder to change. She set a goal of walking for about 20 minutes, 4 days a week. As her fitness improved, she found that she could go longer. Within a matter of weeks, when she actually looked forward to her regular walks, she knew that she had succeeded in making exercise a part of her life.

Excited by her progress, Julie felt ready to tackle her eating habits. Her first step was to phase out the candy, cookies, and desserts that had once been her comfort foods. She didn’t tell herself that she couldn’t have sweets; instead, when she indulged, she reminded herself that what she was eating could impede her weight-loss efforts. Within a month, she was making conscious decisions to not eat the chocolate cake or lemon ice-box pie that she had once thought she couldn’t pass up.

Julie continued to improve her eating habits, eating more fruits and vegetables, paring her fat intake and portion sizes, and drinking more water. She made one change at a time, allowing herself time to adapt before moving on to something new. “I never felt overwhelmed,” she says. “And each success made me more and more confident that I could lose weight.”

Julie did lose weight—50 pounds, to be exact. And she has kept off the weight for a year and a half. As a bonus, her attitude and energy are at an all-time high.

WINNING ACTION

Make one change and give it a chance. As Julie illustrated so well, one small achievement will lead to the next. In fact, weight-loss experts have observed that it takes about 6 weeks for any lifestyle change to become a habit. So allow yourself the time to adjust. If you slip up by eating a dozen doughnut holes in one sitting or skipping your workout for 2 days in a row, don’t beat yourself up over it. Just pick up where you left off. Before you know it, your healthy new behavior will seem like second nature to you.

*112\89\8*

Tags: Weight Loss
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