FOODS PROMOTING CANCER: FAT AND FLESH FOODS

Fat
Scientific studies show that people with higher rates of cancer, consume excessive animal fat in their daily diet. Additionally, widely used omega-6 polyunsaturated fats, such as corn oil, are potential cancer threats. For instance, feeding animals corn oil greatly increases cancer rates in those exposed to carcinogens.
Fat increases the risk of cancer in a variety of ways. It acts as a fuel to promote tumour growth. If fat is not used, cancer-prone cells might remain relatively inactive. Fat also stimulates bile acids in the colon that can help drive cells towards cancer. Additionally, eating too much fat, both animal and omega-6 vegetable oils, can depress the immune system’s tumour surveillance mechanism. This has been proved by the studies conducted at the American Health Foundation and St. Luke’s-Roosevelt Hospital Center, in New York.
Flesh Foods
Racial groups and nations whose diet contains less meat, show less cancer incidence than groups consuming high-meat diets. Hospital records show that Seventh Day Adventists, Mormons and Navajo Indians, who eat little or no meat, suffer far less from cancer than the average meat-eating Americans. Recently, a link between excessive meat-eating and cancer has been explained by Dr. Willard J. Visek, research scientist at Cornell University. Dr. Visek says that the highprotein diet of Americans is linked to the high incidence of cancer in the U.S. The villian, according to Dr. Visek, is ammonia, the carcinogenic by-product of meat digestion. Of all meats, pork is especially harmful. It has been noted that in places where pork is the principle diet, cancer seems to be most prevalent.
Our actual daily protein requirement is only between 20 and 30 grams, as shown by numerous studies around the world. Protein eaten in excess above the actual need cannot be properly digested or utilized and acts in the body as a poison and carcinogen. In addition, over consumption of protein, taxes the pancreas and causes chronic deficiency of pancreatic enzymes, which are required for proper protein metabolism.
Moreover, flesh is often a carrier of disease germs. Diseases of many kinds are on the increase in animals, making flesh foods more and more unsafe. People are continually eating flesh that may contain tuberculosis and cancerous germs. Often animals are taken to the market and sold for food when they are so diseased that their owners do not wish to keep them any longer.
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WOMEN’S HEALTH DURING PREGNANCY: X-RAYS, ALCOHOL AND DRUGS

Alcohol and Drugs
A woman should avoid all types of drugs during pregnancy. Even common over-the-counter medications such as aspirin and beverages such as coffee and tea can damage a developing fetus.
During the first three months of pregnancy, the fetus is especially subject to the teratogenic (birth defect-causing) effects of some chemical substances. The fetus can also develop an addiction to or tolerance for drugs that the mother is using.
Of particular concern to medical professionals is the use of tobacco and alcohol during pregnancy. Women who are heavy drinkers may have normal first babies but subsequently deliver children having fetal alcohol syndrome. The symptoms of fetal alcohol syndrome (FAS) include mental retardation, slowed nerve reflexes, and small head size. The exact amount of alcohol necessary to cause FAS is not known, but researchers doubt that any level of alcohol consumption is safe. Therefore, total abstinence from alcohol during pregnancy is recommended.
Cigarette smoking during pregnancy has more predictable effects than does alcohol. Studies have shown a 25 to 50 percent higher rate of fetal and infant deaths among women who smoke during pregnancy compared with those who do not. Women who smoke more than 10 to 15 cigarettes a day during pregnancy have higher rates of miscarriage, stillbirth, premature births, and low-birth-weight babies than do non-smokers. Smoking restricts the blood supply to the developing fetus and thus limits oxygen and nutrition delivery and waste removal. It appears to be a significant factor in the development of cleft lip and palate, and a significant relationship has been shown between both smoking and “secondhand” smoke and sudden infant death syndrome. Fetal research on the effects of secondhand or side-stream smoke (inhaling smoke produced by others) is inconclusive, but babies whose parents smoke can be twice as susceptible to pneumonia, bronchitis, and related illnesses as other babies. Recent statistics for the United States show that tobacco use among pregnant women has steadily fallen since 1989, when about 20 percent of pregnant women smoked. In 1996, that rate had declined to 13.6 percent.
X-rays   X-rays present a clear danger to the fetus. Although most diagnostic tests produce minimal amounts of radiation, even low levels may cause birth defects or other problems, particularly if several low-dose x-rays are taken over a short time period. Pregnant women are advised to avoid x-rays unless absolutely necessary.
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REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: EATING FOR BETTER HEALTH – HOW TO INTERPRET FOOD LABELS – STANDARDIZED SERVING SIZES

Standardized serving sizes: Tighter regulations will make serving sizes shown on labels more realistic and consistent.
For the first time, relative terms will be defined: Until now, there have been no consistent definitions for terms such as “light,” “reduced,” “low,” and “lean.” Under the new regulations there are uniform definitions:
low fat: 3 grams or less per serving
low saturated fat: 1 gram or less per serving
low sodium: less than 140 milligrams per serving
very low sodium: less than 35 milligrams per serving
low cholesterol: less than 20 milligrams per serving
low calorie: 40 calories or less per serving
“Light” has been one of the most overused and confusing terms. In the past, “light” could mean anything from light in color, light in texture, to fewer calories or less sodium. The consumer was usually left guessing. Now, “light” can be used only on products that contain one-third fewer calories or half the fat of a similar product. “Light” can also mean that the sodium content of a food has been reduced by at least 50 percent. If it is used in any other way, the label must be more specific about what characteristic is “light,” such as the color, the flavor, the texture.
Look beyond the one-word descriptors   and   eye-catching  advertising hype. Actually, the most meaningful parts of a food label are the ingredient list and the figures shown for calories, fat, cholesterol, and sodium in a serving. Once you know what your limits are in terms of fat, cholesterol, calories, and sodium, you will be in a much better position to compare products and to choose those that fit your desire to eat more healthfully.
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KNEE FRACTURE: COMPLETE FRACTURES

When a bone actually breaks into two or more pieces, it is called a complete fracture. A complete fracture can be caused by any type of trauma, including a fall off a bicycle, a car accident, or even a sports injury. Complete fractures are very painful. Some fractures are more serious than others. In a simple or closed fracture, the bone does not break through the skin. However, in an open or compound fracture, bone fragments protrude through the skin, which are more prone to infection in both the wound and the bone. Even in the case of a closed fracture in which the bone does not puncture the skin, the sharp, jagged edges of a severed bone can cut a nerve or slice through a blood vessel, which can lead to serious complications. Therefore, complete bone fractures require immediate medical attention. However, chances are, if you have a serious fracture, you will be in so much pain that no one is going to have to tell you to see a doctor. You will probably not be able to walk on your own and will need to be taken to your physician or nearby emergency room for treatment.
There are several types of complete fractures that may affect the knee bones.
Transverse. A transverse fracture, which is the most common fracture among adults, occurs when the bone is sliced into two pieces straight across the width of the bone. The ends of the bone may be jagged, and there is often soft-tissue damage.
Comminuted. In this type of fracture, the bone is smashed into little pieces like a shattered eggshell. A comminuted fracture may occur in a car accident if the knee smashes into the dashboard, and the patella gets broken up into tiny splinters.
Oblique. In an oblique fracture, the bone is broken on a slant, which is often a result of rotational force.
Spiral. In a spiral fracture, the break literally spirals around the bone, creating a long, curved fracture.
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K

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SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – NEW NONINVASIVE RESEARCH APPROACHES TO LOCALIZATION

Positron emission tomography (PETscanning). Recent technical developments (CT, MRI, grids) have dramatically altered our ability to identify the source of certain children’s seizures. Even newer techniques are beginning to improve our ability to study the pathophysiology (the chemical abnormalities) of the seizure areas themselves, rather than just the electrical or anatomic abnormalities. Progress in these areas is awesome.
Positron emission tomography (PET) scanning uses the same principles as CT scanning, but rather than using x-rays as the energy source, derives its images from radioactive particles (positrons), derived from chemicals injected into the body that reach the brain. Thus it is now possible to study, for example, how parts of the brain use glucose (sugar) by giving the body a form of glucose with the radioactive label. The portion of the brain actively using the glucose takes up more of the radioactivity and looks different in the picture produced. We are beginning to be able to study other chemicals and neurotransmitters associated with epilepsy. Positron emission tomography is a research technique we hope will eventually become useful in the clinical management of children with seizures.
Single photon emission computerized tomography (SPECT scanning). SPECT scanning, a variation of PET scanning, is less expensive and requires less equipment, but, at present, is far less precise in defining the abnormal area. However, since it is far faster than a PET scan, it may ultimately be better for identifying the changes that occur during a brief seizure. As the equipment improves, SPECT may become more useful and more widely available.
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LIVING WITH TYPE II DIABETES: WAYS TO LOOSE WEIGHT

An important step for successful weight loss is writing down your food eating habits. Ask yourself these questions:
•   Do I use food to reward myself when I have accomplished something?
•   Do I use food as a comforter when I’m feeling blue or angry or disappointed?
•   Do I serve family style and encourage everyone at the table, including myself, to clean his or her plate and take a second portion?
•   Do I eat a five- or six-course dinner, including dessert, whether I’m hungry or not?
•   Do I nibble while preparing foods for my family?
•   Do I finish the leftovers from the meal before they can be packaged for another day?
•   Do I raid the refrigerator every night?
• Do I feel guilty when I look in a mirror and then take out a tub of ice-cream and finish it to calm my guilt feelings?
If you answer yes to any of these questions, plus any other ones you ask yourself about your eating habits, then you need to make some behaviour changes in your approach to food. A counselor can be of great help when you want to eliminate these bad habits and substitute some healthy ones.
Your weight loss goal should be about one quarter of a kilogram a week. To do this you need to cut 7,350 kilojoules from your weekly intake. That will produce a one-kilogram weight loss each month – eleven kilograms a year. This slow, steady weight loss will be something you can sustain, without feeling deprived.
When you start eliminating high-kilojoules foods from your diet, keep in mind that the foods you keep represent a proper balance of nutrients – carbohydrates, proteins, fats, vitamins and minerals. The fibre content should be high and the saturated fat content low. If you’re salt-sensitive, the foods you use should be low-salt or salt-free. (In addition to watching sodium content on labels, be careful about using salt in preparation or at the table.)
The so-called diabetic diet of today is a “prudent” diet that can be followed by anyone interested in maintaining good health, whether or not that person has diabetes.
This is where a professional dietitian can be of great help. The dietitian, particularly one who is experienced in dealing with people with diabetes, can construct an individualized diet plan that will help you lose weight, control your diabetes and fit your budget and lifestyle.
Your diet may require that you learn how to count kilojoules or calculate dietary exchanges. Fortunately, there are a number of source books that explain the different diet approaches and many, many cookbooks that fit these approaches.
As you begin to lose weight, you will look better and feel better. You will start to see changes in your blood glucose levels when you lose just a few extra kilos. A weight loss of ten to twenty per cent will often result in a “curing” of the symptoms of Type II diabetes. You don’t have to go down to the weight you were at age twenty to get this kind of result. If you weigh ninety kilograms now, you only have to get down to seventy-two to eighty-two kilograms to gain some benefits in your diabetes control.
Still another approach to weight loss is the use of “formula”, very low kilojoules diets. These are not the powders you can buy in the supermarket but nutritionally balanced formulas prescribed by a physician. This type of diet requires frequent monitoring of electrolytes and other body substances by the prescribing doctor.
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SUPPORTIVE CARE OF CHILDREN WITH CANCER: PREVENTION AND TREATMENT OF URINARY TRACT TOXICITY (RENAL TOXICITY TO BE EXPECTED WITH SPECIFIC CHEMOTHERAPEUTIC AGENTS)

A. Toxicity
1. 5-Azacytidine
5-Azacytidine can produce proximal tubular dysfunction with acidosis, hypokalemia, and hypophosphatemia.
2. Diaziquone (AZQ)
AZQ given in high doses commonly leads to proteinuria and renal tubular dysfunction.
Carmustine (BCNU)/ Lomustine (CCNU) BCNU/CCNU, along with other nitrosoureas, can cause a progressive chronic nephropathy. The renal tubular disease frequently occurs after the completion of chemotherapy and can be irreversible.
Busulfan/melphalan
Busulfan and melphalan have been associated with hemorrhagic cystitis and can increase the risk of hemorrhagic cystitis in patients who receive cyclophosphamide.
5. Carboplatin
a. The nephrotoxic potential of carboplatin appears to be
less than that of cisplatin.
b. Hyponatremia secondary to increased urinary loss can occur but is reported rarely.
c. Renal tubular damage has followed treatment with carboplatin.
d. Carboplatin has not resulted in proteinuria.
6. Cisplatin
Proximal and distal renal tubular damage, hemolytic uremic syndrome, and decreased GFR (acute and chronic) have been associated with cisplatin.
a. Hypomagnesemia, hyponatremia, and hypocalcemia due to renal tubular damage have been documented.
b. Renal tubular damage is exacerbated by coincident hyperuricemia, hypoalbuminemia, amphotericin B, iodinated intravenous contrast dyes, abdominal radiation, and, perhaps, aminoglycoside therapy
c. Cisplatin can increase nephrotoxicity related to ifosfamide or methotrexate.
d. The extent of GFR or renal tubular damage recovery after the completion of cisplatin is uncertain. In some patients, deterioration of renal function continues after the completion of treatment.
7. Cyclophosphamide
a. Hemorrhagic cystitis (microscopic to gross, life-threatening) is frequently associated with cyclophos-phamide therapy.
i. The cystitis is accompanied by irritative voiding complaints. It can be diminished or prevented with vigorous hydration.
ii. Radiation to the bladder can increase the risk of hemorrhagic cystitis. Vesicoureteral reflux and hydronephrosis have also been reported.
iii. Symptoms frequently recur, with and without further exposure to cyclophosphamide or related compounds, radiation, or other radiomimetic therapy. The risk of recurrence is higher and the symptoms more severe with additional bladder-toxic treatments.
b. Transient dilutional hyponatremia and oliguria can occur 8-12 hours after moderate- to high-dose cyclophosphamide treatment.
8. Ifosfamide
a. Ifosfamide has been associated with proximal renal tubular dysfunction (impaired reabsorption of glucose, amino acids, sodium, and inorganic phosphate).
b. Nephrotoxic effects on the proximal tubule appear to be more severe in younger children, particularly increased urinary excretion of phosphate and glucose.
c. Distal renal tubular dysfunction is less common, and glomerular toxicity has not been reported without associated severe tubular dysfunction.
d. Fanconi syndrome (glucosuria, aminoaciduria, low fractional excretion of phosphate, and elevated fractional excretion of sodium bicarbonate) secondary to ifosfamide therapy has been reported. High urinary excretion of sodium in the presence of impaired concentrating ability can lead to significant dehydration.
e. Although the acute effects of each treatment are generally partially to completely reversible between courses of treatment, there is evidence that the capacity to
recover from acute tubular damage is increasingly impaired after each course of therapy. Tubular damage, once established, may persist long term. Progression of renal toxicity can continue after the completion of treatment.
f. The incidence of ifosfamide-related nephrotoxicity increases with increasing cumulative doses.
g. The nephrotoxicity of ifosfamide and cisplatin may be additive. Ifosfamide nephrotoxicity is increased after abdominal irradiation or nephrectomy.
h. The onset of laboratory and clinical nephrotoxicity may occur during or years after the completion of treatment.
i. Hematuria resulting from bladder wall damage is common without the use of the uroprotective agent Mesna.
i. The use of Mesna gives a false-positive result for ketones on urine dipstick measurements.
ii. Mesna does not prevent nephrotoxicity.
j. Rarely, renal toxicity has led to a syndrome resembling that of inappropriate antidiuretic hormone, clinical nephrogenic diabetes insipidus, hypophosphatemic rickets, or renal tubular acidosis.
k. One study found decreased bone mineral density in 20% of children receiving ifosfamide. 9. Methotrexate
a. Precipitation of methotrexate in renal tubules or collecting ducts, direct biochemical damage of renal tubules, or a pharmacologic effect on proliferating cells resulting in renal failure can occur with high-dose methotrexate, especially in patients with acidic urine.
b. In general, renal failure secondary to methotrexate resolves within 14-21 days. Proteinuria and enzymuria frequently have resulted from treatment with methotrexate. These laboratory changes are usually clinically insignificant.
c. Systemic complications of methotrexate are increased in the presence of a decreased GFR. Patients with ileal conduits are at increased risk of methotrexate-induced renal complications. Patients receiving both methotrexate and cisplatin are at increased risk of nephrotoxicity.
10. Aminoglycosides
a. Aminoglycosides can induce renal tubular dysfunction, decreased GFR, proteinuria, and urinary renal casts.
b. Most patients with aminoglycoside nephrotoxicity develop nonoliguric azotemia.
c. An occasional patient develops Fanconi renal syndrome or electrolyte wasting of calcium, magnesium, and potassium.
d. Aminoglycosides may potentiate the renal damage of other nephrotoxic treatments.
e. Usually, the renal effects of aminoglycosides reverse after the discontinuation of the drug. There is a range in the degree of renal toxicity caused by aminoglycosides.
f. Gentamicin is associated with the greatest renal toxicity.
11. Amphotericin B
a. Nephrotoxicity occurs to some degree in 80% of patients receiving amphotericin B.
b. Amphotericin B decreases GFR through toxic effects on the renal vasculature.
c. Decreases in GFR and renal plasma flow occur almost universally.
d. These changes may be mediated by sodium status and intrarenal glomerulotubular feedback. Adequate hydration and sodium loading can decrease nephrotoxicity.
e. Damage to proximal and distal renal tubules by amphotericin B frequently results in excess loss of potassium, magnesium, and protein.
f. Renal tubular acidosis without systemic acidosis can develop.
g. Patients receiving amphotericin B are predisposed to nephrocalcinosis.
h. Alkalinization of the urine can decrease the risk of nephrocalcinosis and permanent renal damage.
i. Hyposthenuria can precede azotemia
j. Nephrotoxicity is increased in the presence of baseline renal dysfunction, hypovolemia, and the use of diuretics and concomitant nephrotoxic medications.
k. The nephrotoxic effects of amphotericin B usually resolve over several months after the drug is discontinued.
B. Symptoms
1. Hypocalcemia
Symptoms associated with hypocalcemia include vomiting, muscle weakness, irritability, tetany, ECG changes (prolonged QT interval), and seizures. Long-term consequences include ricketic changes.
2. Hypokalemia
Symptoms associated with hypokalemia include fatigue, neuromuscular disturbances (weakness, hyporeflexia, paresthesia, cramps, restless legs, rhabdomyolysis, paralysis), gastrointestinal disorders (constipation and ileus), cardiovascular abnormalities (orthostatic hypotension, worsening of hypertension, and arrhythmias), ECG changes (T wave flattening, prominent U waves, and ST segment depression), and renal abnormalities (metabolic alkalosis, polyuria, polydipsia, and glucose intolerance).
3. Hypomagnesemia
Symptoms related to hypomagnesemia include lethargy, confusion, tremor, fasciculations, ataxia, nystagmus, tetany, seizures, and ECG changes (prolonged PR and QT intervals, and arrhythmias). Hypomagnesemia can cause hypokalemia or hypocalcemia.
4. Hyponatremia
Symptoms may occur if hyponatremia develops rapidly. These signs/symptoms can include lethargy, muscle cramps, anorexia, nausea and vomiting, agitation, disorientation, hypothermia, and seizures. The manifestations of hyponatremia depend on whether the hyponatremia results from water overload or sodium deficiency.
5. Hypophosphatemia
a. Etiology of hypophosphatemia can be related to:
i. Inadequate input (i.e., starvation, continuous vomiting, or impaired absorption)
ii. Excessive losses (tubular reabsorptive defect, acidosis, massive diuresis, glycosuria, ketonuria, and catabolic states).
iii. Acute volume expansion (syndrome of inappropriate antidiuretic hormone).
iv. Redistribution (respiratory alkalosis, metabolic alkalosis, carbohydrate load, corticosteroids, and insulin). Hypophosphatemia can be exaggerated by hypomagnesemia.
b. Symptoms associated with hypophosphatemia result from decreased availability of phosphate for synthesis of adenosine triphosphate and 2,3-diphosphoglycerol. Superimposition of an acute shortage of inorganic phosphate on cells with disturbed energy metabolism may result in clinical symptoms. Hypophosphatemia can lead to osteomalacia, paresthesia, paralysis, irritability, malaise, seizures, coma, myalgias, bone pain, increased oxygen binding by hemoglobin, dysfunctional granulocytes, increased platelet aggregation, hypercalcuria, anorexia, cardiac arrhythmias, metabolic acidosis, and poor diaphragmatic function.
6. Metabolic acidosis (secondary to urinary bicarbonate losses)
Symptoms/signs of metabolic acidosis include tachypnea, hyperventilation, abdominal pain, vomiting, fever, and lethargy.
C. Grading of renal, genitourinary, and other toxicities
Grading toxicities caused by therapeutic interventions allows an assessment of an individual patient’s response and comparison of complications of one treatment program with another.
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HOW BDD AFFECTS LIVES: ALCOHOL AND DRUG USE

More commonly, people try to cope with BDD by using alcohol or drugs. The intent is to decrease the preoccupation, dull the emotional pain, and lessen anxiety and self-consciousness in social situations. The percentage of people with BDD who’ve had a problem with alcohol or drugs is high: 20% of the people in my first BDD series, and 43% of the second series, had an alcohol problem (abuse or dependence) at some time in their life. Seventeen percent of the first series, and 34% of the second series, had a drug problem (abuse or dependence) at some point in their life. You may recall that the Minnesota study I previously mentioned found that 26% of people who were hospitalized on a psychiatric unit with a substance use disorder (drugs or alcohol) had BDD.
A very high percentage—70%—of people with BDD who have an alcohol or drug problem (abuse or dependence) say that BDD contributed to their drug or alcohol problem. In 26%, BDD is the main reason or a major reason for their drug or alcohol use. In 27%, it’s somewhat of a reason, and in 17% it’s a minor reason. Only 30% say that their drug or alcohol problem is unrelated to BDD.
BDD was the main cause of Adam’s alcohol and drug problem. He’d had a serious problem with alcohol and drugs for many years, and he’d been in and out of more than 30 detoxification and rehabilitation programs. “You might not believe this,” he said to me, “but my alcohol and drug abuse problems were totally and completely due to my appearance problem. A lot of counselors have told me that’s just an excuse, but I think they’re wrong. It was a crazy way I tried to block the pain of my obsessions, and it never worked. I tried to numb myself to my perception of my body, but it didn’t change. It actually made the pain over my appearance worries worse.”
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HIV: SKIN PROBLEMS-EXCESSIVE BLEEDING

Excessive bleeding from nosebleeds, cuts, and injuries may; be a symptom of idiopathic thrombocytopenic purpura (ITP). Other symptoms are easy bruising and bloody or tarry stools that result from intestinal bleeding. Some people will have many small red dots about the size of a pinhead on the lower legs and feet, called petechiae, that are tiny hemorrhages. Others have larger hemorrhages into the skin, called purpura. Unlike other red rashes, these hemorrhages do not disappear when pressure is applied to them. In other words, if you push on the red spot, the spot does not clear for several seconds but remains red.
Idiopathic thrombocytopenic purpura means low numbers (penia) of blood platelets (thrombocytes) that promote blood clotting, causing bruises or hemorrhages in the skin (purpura) for reasons that are unexplained (idiopathic). The cause of ITP is unknown: for some reason, the body produces antibodies that attack blood platelets. ITP can occur in people who do not have HIV infection. It can occur in people with HIV infection either when the CD4 count is high or when it is low. Most people who have ITP are unaware of it; ITP is usually discovered with
routine laboratory testing. ITP is usually diagnosed when a complete blood count (a CBC) shows that the number of blood platelets is low. The usual count in healthy persons is 150,000 to 300,000 platelets per milliliter of blood. People with HIV infection often have slightly lower counts—80,000 to 120,000 platelets per milliliter—though these counts cause no problem. People with ITP often have counts that are lower yet—5,000 to 30,000 platelets per milliliter.
Treatment of ITP may consist of drugs like corticosteroids that suppress the antibodies attacking the platelets. Other treatments include AZT, interferon, or gamma globulin given intravenously. Occasionally, people have surgery to remove the spleen. All these treatments seem to be beneficial, but not always so. Some people respond to one treatment but not another, and some don’t seem to respond to anything. Other people do well with no specific treatment, despite the low platelet count. The worry with ITP is the possibility of internal bleeding, during which large amounts of blood could be lost, or vital organs like the brain or lungs could be damaged. Obviously, the person with extremely low platelet counts should be extremely careful to avoid cuts and injuries.
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COMMON SKIN DISORDERS: TINEA AND ITS TREATMENT

Tinea feet
Scaly, itchy skin on the soles of the feet is usually the first sign of tinea. White, soggy skin between the toes and discolouration of the toe nails can also point to tinea. It generally begins on one foot then spreads to the other, and is transmitted from person to person. It does survive in water and is readily picked up at swimming pools, shared showering facilities and gymnasiums. Wearing thongs in communal showers will not prevent tinea. Once it occurs it proliferates in warm, sweaty conditions.
Wearing open leather sandals or shoes allows sweat to evaporate and should be encouraged in those whose feet tend to sweat. On the other hand, runners, gym shoes and vinyl footwear encourage tinea. Cotton socks are preferable to wool or nylon ones as they also absorb perspiration. Nylon pantyhose can also promote tinea. After showering, the skin between the toes should be dried thoroughly (hair dryers work better than towels). Antiperspirants can be used on the feet if there are no open cracks or sores. Driclor and Hidrasol are particularly effective.
Tinea groin
Itchy, red skin in the groin spreading to the thighs is a common manifestation of tinea, especially in men. Many red, scaly, oval-shaped rashes on the body are called tinea, but are often due to eczema. Unless a correct diagnosis is made by a doctor, incorrect treatment may worsen the condition. Like tinea of the feet, tinea of the groin can be transmitted from person to person and can also be picked up at swimming pools, gymnasiums and the like.
Tinea groin can be prevented by wearing loose, cotton underwear and loose trousers or loose, cotton shorts. Tight-fitting jeans cause sweat retention and so promote tinea. Likewise, lycra bike shorts and gym tights are particularly likely to produce tinea. Tinea of the groin can also occur in women who wear nylon pantyhose. Changing to either stockings or pantyhose is helpful if this is the case.
Tinea scalp
Tinea scalp produces patchy hair loss and hair breakage, especially in children. It is transmitted from cats and dogs when children cuddle their pets.
Tinea scalp can be prevented by treating pets for itchy skin ‘ rashes.
Tinea body
This is a common problem, especially in tropical climates. It can produce a white, scaly rash on the chest, back and neck, which worsens when the weather becomes warmer. Traditionally, Selsun shampoo was used to treat this tinea infection but recurrences were common. A newer drug, called Ketoconazde (Nizoral), which is taken orally, is far more effective.
Treating tinea
For mild cases of tinea, a cream such as Canestan, Daktarin or Lotremin can be used. These newer anti-fungal creams are more effective than the old-fashioned preparations such as Tinaderm. In more severe cases, oral medication is necessary. The main one currently available is Griseofulvin, which is safe and moderately effective.
Unfortunately, tinea of the toe nails is extremely difficult to treat, responding poorly to topical anti-fungal creams and to Griseofulvin. A drug called terbinafine will soon be available and looks extremely promising for the treatment of tinea in the toe nails.
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