By A. Javier. Pacific University.
Inflammation at the site of infection may be treated externally with Yu Lu San (Jade Dew Extract) or Expected results Jin Huang San (Golden Yellow Powder) order kamagra soft 100mg free shipping. Specific Chi- nese herbs and treatments can be used for specific If aggressive antibiotic therapy is given early buy kamagra soft 100 mg, and symptoms. For examples, for systemic bacterial infec- the patient cooperates fully and sticks to the medica- tion, one may use honeysuckle flower, forsythia, isa- tion schedule, recovery should be complete. Acupuncture and small percentage of Lyme disease patients fail to re- ear acupuncture treatments are also utilized. Co-infection with other nacea species) to clear infection and boost the immune infectious organisms spread by ticks in the same areas system, goldenseal ( Hydrastis canadensis) to clear in- as Bb (babesiosis and ehrlichiosis, for instance) may fection and boost the immune system, garlic to clear be responsible for treatment failures or more severe bacterial infection, and spilanthes (Spilanthes species) symptoms. The joint pain associated with Lyme ported with Lyme disease involved patients coinfected disease can be treated with hydrotherapy. A vaccine for Lyme disease known as LYMErix was • See a physician for any sort of rash or patchy discol- available from 1998 to 2002, when it was removed from oration that appears 3–30 days after a tick bite. The decision was influenced by reports that LYMErix may be responsible for neuro- Resources logic complications in vaccinated patients. Researchers from Cornell-New York Hospital presented a paper at the BOOKS annual meeting of the American Neurological Associa- “Bacterial Diseases Caused by Spirochetes: Lyme Disease tion in October 2002 that identified nine patients with (Lyme Borreliosis). Whitehouse Sta- April 2003, the National Institute of Allergy and Infec- tion, NJ: Merck Research Laboratories, 2002. Surviving Lyme Disease Using Alternative searchers at Yale University School of Medicine to de- Medicine. Coping With Lyme Disease: A Prac- 2003, the best prevention strategy is through minimizing tical Guide to Dealing With Diagnosis and Treatment. Minimizing risk of exposure Precautions to avoid contact with ticks include PERIODICALS moving leaves and brush away from living quarters. GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1255 National Institute of Neurological Disorders and Stroke (NINDS) KEY TERMS Fact Sheet. Babesiosis—A disease caused by protozoa of the genus Babesia characterized by a malaria-like Belinda Rowland fever, anemia, vomiting, muscle pain, and en- Rebecca J. Definition Blood-brain barrier—A blockade of cells separat- Lymphatic drainage is a therapeutic method that ing the circulating blood from elements of the uses massage-like manipulations to stimulate lymph central nervous system (CNS); it acts as a filter, movement. Lyme disease that has progressed be- yond the stage of localized EM is said to be dis- The use of massage and compression techniques to seminated. These techniques were refined during the 1930s one of the first signs of Lyme disease in about 75% by Danish massage practitioner Emil Vodder into what is of patients. During the Lyme borreliosis—Another name for Lyme dis- 1980s, German physician Michael Foldi combined ease. The bac- Lymphatic drainage is said to beneficially effect the teria that cause Lyme disease and syphilis, for ex- nervous, immune and muscular systems. Description Zoonosis (plural, zoonoses)—Any disease of ani- mals that can be transmitted to humans under nat- Lymphatic drainage is accomplished by gentle, ural conditions. Lyme disease and babesiosis are rhythmic massage following the direction of lymph flow. Mild stretching movements are used on the walls of lymph collectors to redirect the flow away from blocked areas into other vessels that drain into the veins. This massage action is often combined with other elements of OTHER complex decongestive therapy, which include: Centers for Disease Control and Prevention, Division of Vec- • bandages tor-Borne Infectious Diseases. It is also known Any patient who has undergone cancer surgery and through out the world as salicaire, braune, and rother. Treatment should also be stopped if infection of the bitter taste, with astringent properties. National Lymphedema Network recommends that patients taking anticoagulants Lysimachia is a perennial found throughout Europe, for vascular disease be first checked for blood clots using Russia, central Asia, Australia, and North America. It is ultrasound or other technology, and followed closely dur- an attractive low-growing plant, with a creeping habit, ing the treatment. Some species can grow to about 4 ft may not be able to tolerate excessive movement of lymph (1. It flowers from June to Au- lymphatic drainage, the treatment should stop until either gust. The species known commonly as yellow loosestrife the source is discovered or the pain goes away. The flowers, which can be either yellow or purple, Side effects are very pretty, and are generally about 1 in (2. The leaves of sociated techniques could cause cancer to spread in pa- the loosestrife species are downy, yellowish, and about 1 tients with recurrent or metastatic disease. Research & general acceptance All species of lysimachia are commonly used as an ornamental plant. They prefer shade, but all grow and Lymphatic drainage has enjoyed widespread accep- multiply readily. Purple loosestrife is so successful, that tance in Europe for several decades, and is gaining accep- in parts of the United States, it has been declared a dan- tance within the North American medical establishment. Training & certification Lymphatic drainage therapy procedures are most com- General use monly done by osteopaths, chiropractors, physical thera- pists, occupational therapists, massage therapists, and nurs- Loosestrife was once widely used as a medicinal es. Training is available from a number of institutions, and herb, but it has become less popular in modern times.
Interferons also induce the production of lowing repeated dosing and for certain preparations discount kamagra soft 100 mg without a prescription, in- inﬂammatory cytokines and biological oxidants that travenous administration purchase kamagra soft 100 mg on line. Viral fami- cause urticaria, angioedema, fever, and injection site re- lies differ with respect to the step or steps at which in- actions. High doses of immune globu- lins have been associated with rare cases of aseptic Natural interferons produced by human leukocytes, re- meningitis syndrome. A possibility of infection by combinant interferons produced in bacteria, and recom- blood-borne pathogens exists with immune globulin binant interferons conjugated to monomethoxy polyeth- and other human blood products. Although prepara- ylene glycol (PEG; pegylated interferons) are available tions are screened for contamination and viral inactiva- in the United States. The various preparations may be tion processes are used, the risk of transmission of new administered subcutaneously, intramuscularly, intra- or undetected pathogens cannot be eliminated. Treatment with immune globulin can interfere with Natural or recombinant interferons typically achieve the response to live virus vaccines (e. Maximal plasma con- tion, agitation, insomnia, and anxiety occur with regu- centrations of pegylated interferons are reached 15 to 44 larity. Depression is a common side effect of interferon- hours after subcutaneous or intramuscular injection and and interferon-. Suicidal behavior, although rare, can are sustained for much longer than nonpegylated prepa- arise in depressed patients; therefore, these individuals rations (48 to 72 hours). Gastrointestinal symptoms such combination of cellular uptake and catabolism in the as nausea, vomiting, diarrhea, and anorexia are com- kidney and liver. Minimal amounts of intact protein are mon; however, ulcerative colitis, pancreatitis, hyper- excreted in the urine or feces. Elevation of hepatic enzymes can occur but rarely necessitate dis- Clinical Uses continuation of treatment. Injection site reaction is common, as is alopecia, for certain interferon prepara- Interferon- -2a (Roferon-A) is approved for the treat- tions. Interferons can decrease fertility and may cause ment of chronic hepatitis C, hairy cell leukemia, AIDS- miscarriage at high doses. Interferon uncontrolled thyroid disease, severe cardiac disease, se- alfacon-1 (Infergen) is a recombinant interferon con- vere renal or hepatic impairment, seizure disorders, and structed from the sequences of several naturally occur- CNS dysfunction. Interferons should contains the most frequently observed amino acid in be used with caution in persons who have myelosup- each position of the sequence and exhibits in vitro pression or who are taking myelosuppressive drugs. Interferon alfacon-1 and peg inter- with neurotoxicity, organ failure, and death in neonates feron- -2b (PEG-Intron) are approved for the treat- and infants and therefore are contraindicated in this ment of chronic hepatitis C. Interferons should be used during preg- Interferon -1a (Avonex) and interferon -1b nancy only if the potential beneﬁt justiﬁes the potential (Betaseron) are used in the treatment of multiple scle- risk to the fetus. Interferon -1b (Actimmune) is used to prevent Interferons reduce the activity of hepatic cy- and diminish the severity of infections associated with tochrome P450 enzymes and decrease the clearance of chronic granulomatous disease and for delaying the drugs such as theophylline. Adverse Effects, Contraindications, and Drug Interactions Ribavirin Flulike symptoms, including fever, chills, weakness, fa- tigue, myalgia, and arthralgia, are the most common Ribavirin is a synthetic guanosine analogue that pos- side effects of interferon therapy. These symptoms oc- sesses broad antiviral inhibitory activity against many cur in more than 50% of patients given injections of in- viruses, including inﬂuenza A and B, parainﬂuenza, RSV, terferons either intravenously, intramuscularly, or sub- HCV, HIV-1, and various herpesviruses, arenaviruses, cutaneously. Following absorption, host cell enzymes Interferons are associated with a diverse range of convert ribavirin to its monophosphate, diphosphate, common adverse effects. Ribavirin monophosphate 580 VI CHEMOTHERAPY inhibits the guanosine triphosphate (GTP) synthesis tration have reported adverse effects including head- pathway and subsequently inhibits many GTP-depend- ache, conjunctivitis, rash, and rarely, bronchospasm. Ribavirin triphosphate inhibits the 5 cap- Oral and intravenous ribavirin are associated with ping of viral mRNA with GTP and speciﬁcally inhibits additional adverse effects. Ribavirin may also ribavirin can produce hemolytic anemia that is re- act by increasing the mutation rate of RNA viruses, lead- versible following dosage reduction or cessation of ther- ing to the production of nonviable progeny virions. When given in combination with interferon-, rib- Ribavirin resistance has not been documented in clinical avirin increases the incidence of many of its side effects, isolates. Absorption, Metabolism, and Excretion Ribavirin is mutagenic, teratogenic, and embryotoxic in animals at doses below the therapeutic level in humans. Ribavirin can be administered as an aerosol using a It is contraindicated in pregnant women and in the male small-particle aerosol generator. Women of childbearing by this route, the drug has only minimal systemic ab- potential and male partners of these women must use sorption, with drug concentrations in respiratory tract two effective forms of contraception during ribavirin secretions approximately 100 times as high as those treatment and for 6 months post therapy. Similarly, persons with Ribavirin is reversibly phosphorylated by all nucle- coronary disease should not use ribavirin, because ated cells. In vitro, ribavirin inhibits the phos- Clinical Uses phorylation reactions that are required for activation of Ribavirin aerosol (Virazole) is indicated in the treat- zidovudine and stavudine. Lamivudine Treatment is most effective if begun within 3 days of the Lamivudine is a synthetic cytidine analogue used in the onset of symptoms. Its acti- Although ribavirin monotherapy is ineffective vation requires phosphorylation by cellular enzymes. Intravenous ribavirin may be useful in the ther- mammalian DNA polymerases with a much lower po- apy of Hantaan virus infection, Crimean or Congo virus tency. Mutations in the DNA Adverse Effects, Contraindications, polymerase of HBV are associated with decreased and Drug Interactions lamivudine efﬁcacy and have been documented in pa- tients treated with this agent for 6 months or more. Pulmonary function may decline if aerosol rib- Absorption, Metabolism, and Excretion avirin is used in adults with chronic obstructive lung dis- ease or asthma. Deterioration of pulmonary and cardio- Lamivudine is rapidly absorbed from the gastrointesti- vascular function has also been seen in severely ill nal tract and has an oral bioavailability of approxi- infants given this preparation. Health care changed by the kidney and has an elimination half-life workers exposed to aerosol ribavirin during its adminis- of 5 to 7 hours. Palivizumab neutralizes RSV and inhibits its ability to fuse with host Lamivudine is indicated for the treatment of HIV when cell membranes. A rived in vitro but have not been found in clinical isolates lower dose than that used to treat HIV is approved for to date. Although lamivudine initially improves histological and biochemical measures of he- Absorption, Metabolism, and Excretion patic function and reduces HBV DNA to below the lim- its of detection, withdrawal of the drug usually results in Palivizumab is administered prophylactically as a disease recurrence.
Contact lenses offer several benefits over Group) glasses purchase kamagra soft 100 mg on line, including: better vision buy 100mg kamagra soft mastercard, less distortion, clear peripheral vision, and cosmetic appeal. In addition, con- tacts will not fog up from perspiration or changes in tem- RADIAL KERATOTOMY Radial keratotomy (RK), the first of these procedures made available, has a high asso- perature. It was first developed in Japan and the Soviet Union, and was introduced into the United States in Refractive eye surgery 1978. The surgeon uses a delicate diamond-tipped blade, For people who find glasses and contact lenses a microscope, and microscopic instruments to make sev- inconvenient or uncomfortable, and who meet selection eral spoke-like “radial” incisions in the non-viewing criteria regarding age, degree of myopia, general health, (peripheral) portion of the cornea. The PRK procedure manently changing the shape of the cornea so that light flattens the cornea by vaporizing small amounts of tissue rays focus properly on the retina. As of early 2001, only two performed on an outpatient basis and generally take 10- excimer lasers are approved by the FDA for PRK, although 30 minutes. It is important to make sure GALE ENCYCLOPEDIA OF GENETIC DISORDERS 783 the laser being used is FDA approved. Photorefractive ker- Prognosis atectomy can treat mild to moderate forms of myopia. The Glasses and contact lenses can (but not always) cor- cost is approximately $2,000 per eye. Refractive surgery can LASER-ASSISTED IN-SITU KERATOMILEUSIS Laser- make permanent improvements for the right candidates. It is recommended for moderate to sion and severity of myopia cannot be changed, some envi- severe cases of myopia. They include reducing LASIK uses lasers and a cutting tool called a microker- close work; reading and working in good light; taking fre- atome to cut a circular flap on the cornea. The flap is quent breaks when working at a computer or microscope flipped back to expose the inner layers of the cornea. The for long periods of time; maintaining good nutrition; and cornea is treated with a laser to change the shape and practicing visual therapy (when recommended). Eye strain can be prevented by using sufficient light Risks for reading and close work, and by wearing corrective lenses as prescribed. Everyone should have regular eye All of these surgical procedures carry risks, the most examinations to see if their prescription has changed or if serious being corneal scarring, corneal rupture, infection, any other problems have developed. In addition, a study pub- important for people with high (degenerative) myopia lished in March 2001 warns that mountain climbers who who are at a greater risk of developing retinal detach- have had LASIK surgery should be aware of possible ment, retinal degeneration, glaucoma, or other problems. The lack of oxy- gen at high altitudes causes temporary changes in the Resources thickness of the cornea. Optometric Management of Nearpoint 20/20 vision, it is important to have realistic expectations Vision Disorders. The Myopias: Basic Science and Clinical ducted by the National Eye Institute between 1983 and Management. Even if the patient gains near-perfect vision, how- Eyecare, Eyeglasses, and Contact Lenses. Hollywood, FL: ever, there are potentially irritating side effects, such as Lifetime Books, 1996. PO Box 7424, San Electromyography (EMG)—A test that uses elec- Francisco, CA 94120-7424. The information gathered is used to diagnose neu- American Optometric Association. Muscular dystrophy—A group of inherited dis- International Myopia Prevention Association. Frey, PhD Risa Palley Flynn Genetic profile Myotonia atrophica see Myotonic dystrophy The most common type of DM is called DM1 and is caused by a mutation in a gene called myotonic dystro- phy protein kinase (DMPK). IMyotonic dystrophy Some families with symptoms of DM do not have a Definition mutation in the DMPK gene. As of early 2001, scientists have found that the DM in many of these families is Myotonic dystrophy is a progressive disease in caused by a mutation in a gene on chromosome 3. Description Trinucleotide repeats Myotonic dystrophy (DM), also called dystrophia In the DMPK gene, there is a section of the genetic code where the three letters CTG are repeated a certain myotonica, myotonia atrophica, or Steinert disease, is a number of times. DM is an inher- repeated too many times—more than the normal number ited disease, affecting both males and females. Symptoms This enlarged section of the gene is called a trinucleotide may appear at any time from infancy to adulthood. It slowly progresses to will not develop DM1 and cannot pass it to their children. Having repeats numbers greater than 1,000 causes con- Congenital means that the condition is present from birth. GALE ENCYCLOPEDIA OF GENETIC DISORDERS 785 TABLE 1 Relationship between phenotype and CTG repeat length in myotonic dystrophy Phenotype Clinical signs CTG repeat size Age of onset (Years) Average age of death (Years) Premutation None 38 to 49 Normal Normal Mild Cataracts mild myotonia 50 to 150 20–70 60–normal Classical Weakness myotonia Cataracts Balding Cardiac arrhythmia Others 100 to 1000–1500 10–30 48–55 Congenital Infantile hypotonia Respiratory deficits Mental retardation 1000 to 2000 Birth to 10 45 In general, the more repeats in the affected range that on whether the trinucleotide repeat becomes further someone has, the earlier the age of onset of symptoms expanded. DM occurs in about one of 20,000 people and has Exactly how the trinucleotide repeat expansion been described in people from all over the world. The disease somehow blocks the flow of electrical impulses across the muscle cell membrane. Signs and symptoms Without proper flow of charged particles, the muscle can- There is a range in the severity of symptoms in DM not return to its relaxed state after it has contracted. Anticipation Myotonic dystrophy causes weakness and delayed Sometimes when a person who has repeat numbers muscle relaxation called myotonia. Symptoms of DM in the affected or premutation range has children, the include facial weakness and a slack jaw, drooping eyelids expansion grows larger.
The premature closing of one or more of these cra- normal in the front-to-back orientation discount 100mg kamagra soft with amex. Individuals nial sutures leads to skull deformations buy generic kamagra soft 100mg on-line, a condition affected with sagittal craniosynostosis also have narrow called craniosynostosis. There are seven types of cran- but prominent foreheads and a larger than normal back of iosynostosis depending on which cranial suture or the head. The so-called soft-spot found just beyond the sutures are affected: sagittal, bicoronal (both coronal hairline in a normal baby is very small or absent in a baby sutures), unicoronal (one coronal suture), coronal and affected with sagittal craniosynostosis. Individuals bicoronal craniosynostosis, is characterized by a wide GALE ENCYCLOPEDIA OF GENETIC DISORDERS 205 A further complication of bicoronal craniosynosto- KEY TERMS sis is water on the brain (hydrocephalus), which increases pressure on the brain. Most individuals Acrocephalopolysyndactyly syndromes—A col- affected with this condition also have an abnormally high lection of genetic disorders characterized by cone- and arched palate that can cause dental problems and shaped abnormality of the skull and partial fusing protrusion, the thrusting forward of the lower jaw. Coronal and sagittal craniosynostosis are characterized by a cone-shaped head (acrocephaly). Individuals with Carpenter syndrome often have Cranial suture—Any one of the seven fibrous webbed fingers or toes (cutaneous syndactyly) or partial joints between the bones of the skull. These indi- Craniosynostosis—Premature, delayed, or other- viduals also tend to have unusually short fingers (bracy- wise abnormal closure of the sutures of the skull. Cutaneous syndactyly—Fusion of the soft tissue between fingers or toes resulting in a webbed Approximately one third of Carpenter syndrome appearance. These may include: narrowing of the artery that delivers blood from Gene—A building block of inheritance, which the heart to the lungs (pulmonary stenosis); blue baby contains the instructions for the production of a syndrome, due to various defects in the structure of the particular protein, and is made up of a molecular heart or its major blood vessels; transposition of the sequence found on a section of DNA. Each gene is major blood vessels, meaning that the aorta and pul- found on a precise location on a chromosome. In some persons diagnosed with Carpenter syn- Scaphocephaly—An abnormally long and narrow drome, additional physical problems are present. Individuals are often short or overweight, with males Syndactyly—Webbing or fusion between the fin- having a disorder in which the testicles fail to descend gers or toes. Another problem is caused by parts of the large intestine coming through an abnormal opening near the navel (umbilical hernia). This is measured as a decrease in the A-P diameter, which indicates that look- ing down on the top of the skull, the diameter of the head Diagnosis is less than normal in the front-to-back orientation. Individuals affected with this condition have poorly The diagnosis of Carpenter syndrome is made based formed eye sockets and foreheads. This causes a smaller on the presence of the bicoronal and sagittal skull mal- than normal sized eye socket that can cause eyesight formation, which produces a cone-shaped or short and complications. These complications include damage to broad skull, accompanied by partially fused or extra fin- the optic nerve, which can cause a loss of visual clarity; gers or toes (syndactly or polydactyly). Skull x rays bulging eyeballs resulting from the shallow orbits and/or a CT scan may also be used to diagnose the skull (exophthalmus), which usually damages the eye cornea; malformations correctly. Other genetic disorders are also widely spaced eyes; and a narrowing of the sinuses and characterized by the same types of skull deformities and tear ducts that can cause inflammation of the mucous some genetic tests are available for them. Thus, positive membranes that line the exposed portion of the eyeball results on these tests can rule out the possibility of (conjunctivitis). In the most severe cases of Carpenter to produce pictures of the fetus, is generally used to syndrome, it may be necessary to treat feeding and respi- examine the development of the skull in the second and ratory problems that are associated with the malformed third months of pregnancy, but the images are not, as of palate and sinuses. Obesity is associated with Carpenter 2000, always clear enough to properly diagnose the type syndrome and dietary management throughout the of skull deformity, if present. Extra fingers or toes (polydactyly) may often be surgically removed shortly Treatment and management after birth. Surgical procedures also exist to correct some of the Operations to correct the skull malformations asso- heart defects associated with Carpenter syndrome, as ciated with Carpenter syndrome should be performed well as the testicles disorder of affected males. This is because abnormal opening of the large intestine near the navel modifying the skull bones is much easier at that age and (umbilical hernia or omphalocele) can also be treated by new bone growth, as well as the required bone reshaping, surgery. Also, the facial features are still highly mental delays are available for affected patients. Follow-up support by pediatric, Prognosis psychological, neurological, surgical, and genetic spe- Carpenter syndrome is not usually fatal if immediate cialists may be necessary. In all but the most severe and inoperable vision problems that require consultation with an oph- cases of craniosynostosis, it is possible that the affected thalmologist, or doctor specialized in the treatment of individual may attain a greatly improved physical appear- such problems. Depending on damage to the nervous system, the necessary if the ears and the brain have been affected. If rapidity of treatment, and the potential brain damage the palate is severely malformed, dental consultation may from excess pressure on the brain caused by skull mal- GALE ENCYCLOPEDIA OF GENETIC DISORDERS 207 formation, certain affected individuals may display vary- possibly oats. The phy of the fetal brain: detection of abnormal morphology type of inheritance pattern that celiac disease follows is and circulation. First, the patient must have a genetic predisposition to ORGANIZATIONS develop the disorder. PO Box 280297, Dallas, ment acts as a stimulus to “trigger” their immune system, TX 75243-4522. For conditions with multifactorial inheritance, people Craniosynostosis and Parents Support. Or, they may require more exposure to the stimulus WEBSITES before developing the disease than someone with a Craniosupport. Cat cry syndrome see Cri du chat Demographics syndrome Celiac disease may be discovered at any age, from infancy through adulthood. The disorder is more com- monly found among white Europeans or in people of European descent.
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