WHY HAVE RESEARCHERS HAD SUCH A DIFFICULT TIME DETERMINING THE PREVALENCE AND EFFECTS OF ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER) MONG ADULTS WHO HAD IT IN CHILDHOOD?

2011-03-30T08:36:14+0000">March 30, 2011 – 8:36 am

It’s only in the last decade or so that doctors have come to accept that ADHD is not just a childhood problem. In fact, until recently, most studies and most physicians did not followADHD sufferers beyond adolescence. As a result, there have been very few long-term followup studies. And as with any scientific investigation, the studies that have been done have shown similar but not identical results.
Most studies currently available are what are termed retrospective (“looking back”) studies. In one method, researchers check old clinic records and find a population of children previously diagnosed with ADHD perhaps ten to twenty years before. After attempting to contact these subjects, the researchers study those they succeed in finding who agree to participate. Various methods (such as questionnaires, rating scales, interviews, and checking medical, academic, and police records) are used to evaluate current symptoms of ADHD and life achievements, as well as the psychiatric, social, and emotional variables of these grown-up subjects.
Another method of retrospective study is to find a group of adults diagnosed with adult ADHD and to try, through history taking and looking through old school and medical records, to trace the history of their condition and to determine the presence or absence of various symptoms at earlier stages.
For example, a controlled twenty- to twenty-five-year retrospective study conducted by B. L. Borland and H. K. Heck-man analyzed twenty of thirty-seven men who had been diagnosed as hyperactive in childhood. Nineteen brothers were used as a control group. The researchers found that the majority of the men who had earlier been diagnosed as hyperactive were living normal and productive lives, though more than half continued to show symptoms of hyperactivity and a noticeable number demonstrated clear antisocial behavior. They also found that the hyperactive subjects had not done quite as well as their brothers socially or economically.
A similar followup study conducted in Rhode Island analyzed eighty-one adults, averaging twenty-one years of age, who had been diagnosed with ADHD in childhood. Thirty-two older brothers were used as a control group. The researchers found results similar to those of Borland and Heckman, but with a lower percentage of antisocial problems among the ADHD subjects.
Several other studies have strived to analyze the impact and occurrence of ADHD in adults of varying ages and socioeconomic status, with interesting results. Most importantly, nearly all follow-back studies have concluded that symptoms of ADHD continue into adulthood and can predispose individuals to alcoholism and certain psychiatric problems, most notably character disorders.
There are obviously many problems with trying to reconstruct a clinical picture that may be from twenty years before. A more accurate form of study is the prospective study. The researchers begin with a group of children who have been diagnosed as having ADHD and match them with a group of control subjects, i.e., children matched in age, socioeconomic variables, and intelligence, but with no evidence of ADHD or behavioral problems. These two groups are then followed extensively over many years, with intermittent interviews of the child and family, testing, and so on. These studies necessarily take a long time to complete, and since it is only recently that ADHD in adulthood was recognized, there are not yet many groups of studied children with ADHD who have reached adulthood.
Drs. Gabrielle Weiss and Lily Hechtman of the Montreal Children’s Hospital have published the fifteen-year followup data of an ongoing study of, originally, 104 hyperactive children. They have studied many aspects of these young adults’ lives, including the persistence of ADHD symptoms; psychiatric status; personality pathology, including antisocial behavior; educational and vocational status; socioeconomic status; beliefs and values; as well as general life course and achievements.
They have found that hyperactives had greater difficulties as young adults in several areas when compared with a group of normal controls. Among these are the following.
The hyperactive young adults had more impulsive personality traits.
They were more likely to have been involved in traffic and other accidents.
They were likely to have some persistence of hyperactivity, distractibility, and attentional problems.
They also had a significantly lower level of education and were more prone to leaving school because of poor grades and expulsion.
They were more likely to have a diagnosable psychiatric condition; in particular, a significant number fulfilled the criterion for antisocial personality disorder.
They had much lower self-esteem.
They had less successful social and emotional relationships.
Many questions remain unanswered in the study of adult ADHD, and obviously much more research is needed in this area. The most obvious questions include; Why does ADHD afflict some adults who had it as children, but not others? And to what degree does ADHD in childhood predict personality and psychiatric disorders in adulthood? Which treatment measures can most improve the long-term outcome?
These questions and others are now being addressed. Over 600 children have been enrolled in a six-site NIMH study undertaken with the U.S. Department of Education. This study will compare medication, behavior therapies, psychotherapy, and other clinical treatments available in the child’s community. The first data from that study will be available in fall 1997. But the NIMH intends to continue the study over a long period, providing a look at the long-term course of ADHD and the influence of various treatments on its course and outcome.
*27\173\2*

By admin | Posted in Anti-Psychotics | Comments (0)

HOW BDD AFFECTS LIVES: VIOLENCE AND ILLEGAL ACTIVITIES

2011-03-26T08:35:32+0000">March 26, 2011 – 8:35 am

BDD can also cause anger. Anger has many sources: frustration over looking abnormal, not being able to improve one’s appearance or stop it from further deteriorating, lack of control over the perceived defect, or a belief that others are being rejecting or mocking the defect. “I get angry because it isn’t fair that I’m the one with the small penis,” a college student told me. “And I get very angry at the people who laughed at me in the locker room in high school about my penis size.” Some people with BDD smash mirrors when feeling extremely angry about their reflection. Others have violent outbursts.
Research shows that, on average, people with BDD have higher levels of hostility than healthy control subjects or people with another psychiatric disorder. After treatment with an SRI, however, hostility levels drop dramatically. And while most people with BDD aren’t violent, 28% say they’ve been violent at some point in their life because of BDD. (Violence is defined as behavior that damages property or harms a person.)
Some people get so frustrated, despairing, and angry over their symptoms that they throw heavy objects like a brick or put their fist through a wall or door. Others are so certain people are mocking them that they physically harm the person. Violence can also be triggered by the belief that surgery or dermatologic treatment didn’t fix the problem, or even made it worse. A young man I saw, who believed face cream created dark spots on his face, went on a rampage around his parents’ house, attacking their furniture and splintering it with a hammer.
*141\204\8*

By admin | Posted in Anti Depressants-Sleeping Aid | Comments (0)

ASTHMA: SHOWERING MAY BE A HEALTH HAZARD

2011-03-16T08:34:54+0000">March 16, 2011 – 8:34 am

If, like most of us, you take regular showers, make them cold ones and don’t linger under the spray of water for more than a couple of minutes. After your shower, shut the bathroom door tightly and put on the extractor fan or open the window.
This is the message coming from recent research on water pollution. All domestic water supplies contain a number of chemicals. Two of the most common ones are trichloroethylene (TCE) and chlorine. Both are highly volatile and, when heated, evaporate out of the water, so that they are then inhaled by anyone around. In a shower, 50 per cent of chlorine becomes chloroform vapour. This chemical has been shown to be carcinogenic (cancer producing) in animals. As much as 80 per cent of TCE can permeate the steam vapour and the hotter the shower, the more chemicals build up in the air. Because of the compound effect, a shower lasting 10 minutes can cause you to breathe four times as much of a toxin as one of 5 minutes.
Scientists now estimate that people may take in anything up to 100 times more chemicals by breathing the air around showers, baths, dishwashers and washing machines than they would by drinking the water.
TCE is used as a dry-cleaning fluid and can linger on in dry-cleaned clothes for hours. The advice is clear. Air any dry-cleaned clothes for at least six hours before wearing them.
After smoking and filling up a car with leaded petrol, taking a long, hot shower is the activity most commonly associated with high levels of pollution. When you take a shower you should close the bathroom door and open the window, so that any vapour or outgassing chemical does not enter the rest of the house and permeate fabric furnishings.
*26\145\2*

By admin | Posted in Asthma | Comments (0)

ALTERNATIVE APPROACHES TO EPILEPTIC SEIZURE CONTROL: VIDEORECORDING

2011-02-20T08:34:18+0000">February 20, 2011 – 8:34 am

No one ever sees themselves during a seizure. Even if you have epilepsy yourself, you may never have seen anyone else have a seizure. Videorecording can be helpful if one of your main worries about having a seizure is what you look like, how you appear to onlookers and what they think of you. People who have been shown videotapes of their seizures during treatment sessions have found that they tend to have significantly fewer seizures afterwards. Imagination usually far outstrips reality, and what you see — the reality of what actually happens in a seizure — is probably much less disturbing than you had imagined it would be.
If you want to try this technique, you will again need a co-therapist with a video camera who spends enough time with you to make it likely that they will be around to capture a seizure on camera. Obviously it makes it much easier to arrange for them to be there at the right time if you know there are some situations in which you are especially likely to have a seizure.
*41\193\2*

By admin | Posted in Epilepsy | Comments (0)

UNDERSTANDING DIABETES: WHETHER OR NOT WE HAVE IT?

2011-02-13T08:33:41+0000">February 13, 2011 – 8:33 am

Actually, most people with a diabetic problem are discovered before the disease produces marked symptoms. Doctors in routine examinations of any type check at least the urine for excess sugar, and many times they also do screening tests on the blood to detect diabetes. In particular, if a person goes to a doctor with symptoms suggesting diabetes mellitus, or if he has any symptom that is not easily explained, tests are run to determine whether or not this disease is operative. When persons are admitted to hospitals for any reason, illness or an operation, tests for diabetes are run as a routine part of the admission laboratory work-up.
Should the disease happen not to be picked up in this manner, then the person involved may at first experience only a general feeling of ill health. He does not have the stamina that he used to have. He may have a problem with recurrent infections of any type, especially skin infections, such as boils. Women may encounter repeated bladder infections or vaginal infections. If diabetes is advanced, the urine contains large amounts of sugar, and bacteria grow best in an environment rich in sugar. This is the reason for the infection problem.
When the disease is advanced, the classical symptoms of diabetes appear. The person is very thirsty, drinking unusual quantities of fluids. He also urinates more than usual. In addition, his appetite may be markedly increased, despite the fact that he is losing weight.
These cardinal symptoms have a simple explanation. The diabetic person cannot use sugar and other foods properly. He wastes them. This explains his appetite and loss of weight. If the sugar content of the blood is too high, then sugar appears in the urine. The release of sugar by the kidneys is accompanied by a flow of excess water. This explains the increased thirst and excess urination.
This brings up a common misconception. People say, “I can’t have diabetes because I don’t have any sugar in my urine.” There is normally a certain quantity of sugar in the bloodstream. This is used to supply energy to various parts of the body. The kidneys usually do not allow any of this sugar to filter out into the urine. This would be a waste of body foodstuffs. Only when the level of sugar in the blood reaches very high levels do the kidneys allow it to spill over into the urine. A person may have diabetes mellitus and an elevated blood sugar for some time before it thus appears in the urine.
The diagnosis of the disease rests primarily upon determining whether the level of sugar in the blood is higher than normal. Certainly, if sugar appears in the urine, this will prompt blood tests to confirm whether or not this represents diabetes mellitus. The presence of sugar in the urine does not necessarily indicate diabetes. In some persons, especially pregnant women, sugar may be spilled by the kidneys without a diabetic state being present. This is due to a temporary or permanent alteration in kidney function that may be unrelated to any type of diabetic process. The most exact way to determine the status of sugar management by the body is to check the level of sugar (glucose) in the blood before eating and at various time intervals after eating ordinary foods or foods high in sugar content. If the pancreas is functioning properly and producing adequate amounts of insulin, then the sugar will rise to only certain levels, but if the insulin mechanism is defective, then the blood sugar level will become very high.
*5/309/5*

By admin | Posted in Diabetes | Comments (0)

HEART DISEASE: EXERCISE FOR HOME TREATMENT – UNDERWEAR

2011-02-06T08:33:04+0000">February 6, 2011 – 8:33 am

For several good reasons, it is advisable to have no woollen clothing immediately against the skin. Woollen underclothing in particular, because of its close fit and close weave, has a markedly depressant effect upon skin activity. It forms a barrier to the escape of perspiration and to the access of fresh air. (In our practices, which often involve manipulation along the spinal column, the unpleasant texture in the skin of patients accustomed to woollen underwear is unmistakable. The skin feels greasy, looks greyish and has a doughy deadness between the fingers, contrasting with the silken, pink elasticity of skins which have been more healthily clad.)
Apart from the effects upon the skin itself, woollen underclothing irritates nerve-endings, and this — as we have already noted—can have comparably strong constricting effects on heart and vessels.
Linen, cotton and rayon — or any mixtures of these — are entirely satisfactory materials for underwear. A small content of nylon may give better wear without seriously impeding vital function, but is undesirable as a sole or major constituent. Should the immediate discarding of woollen underwear be found too drastic, it may be retained for a time as a second layer, with light cellular cotton against the skin.
*84\253\8*

By admin | Posted in Cardio & Blood-Cholesterol | Comments (0)

CANCER: SKIN, SUNLIGHT AND MELANOMA

2011-01-18T08:32:28+0000">January 18, 2011 – 8:32 am

Sunlight causes cancer of the skin. Fortunately, the evidence suggests that we can cope with this tact quite easily without retiring to darkened rooms for most of our lives.
In discussing this matter it is important to distinguish between two quite different types of skin cancer. The first kind is the common cancers of skin that arise from the cells which make up most of the body’s covering, the epithelial cells of the skin. Although common, such skin cancers are among the most minor kinds of cancer and are usually recognized relatively easily and treated effectively by simple means. These common cancers occur in the sun-exposed areas of the body (the head, neck and hands) and tend to occur in elderly people. The second kind of skin cancer is quite different. This is known as malignant melanoma and arises from the pigmentation cells within the skin (melanocytes). These are responsible for producing the dark colour of the skin by manufacturing a material called melanin. They are distributed mainly in the deep parts of the skin, although small numbers of melanocytes are found in the eyes and in internal organs. In the body’s development, melanocytes have a quite different origin from the main skin cells. Melanocytes may be collected together in the skin in the form of moles. While moles are in themselves quite innocent, they can occasionally be the focus of the development of malignant melanoma which carries with it much more serious import than other kinds of skin cancer. When a malignant melanoma develops many people can be cured simply by having the tumour excised from the skin, an operation which often leaves only a minor scar. Early detection leads to curt. However, for a proportion of patients who have melanoma, particularly those diagnosed late, the disease will persist and recur and spread to other pans of the body. It is then a serious and life-threatening condition and unlike other kinds of skin cancer.
Before going on to talk about the link between melanoma and sunlight it is worth talking a little bit about the radiations that are included in sunshine. Sunshine is made up of electromagnetic radiation of various wavelengths that include light itself. These are quite different from the radiations that we think of in association with nuclear energy or nuclear bombs, which are called ionizing radiations and are discussed in a later chapter. In sunshine the part of the electromagnetic irradiation which is of concern in relation to melanoma is called ultraviolet irradiation (or UV). This is divided into UVA, UVB and UVC. UVA causes the skin to darken and tan, and docs not burn the akin, although too much of it can do damage at deep levels. UVB has a shorter wavelength and is therefore of greater energy. UVB ultra violet irradiation causes redness and burning, and if you get too much UVB irradiation it causes blistering. UVC irradiation is short-wavelength, high-energy ultraviolet irradiation and is extremely damaging to skin. Fortunately, we and everything else on earth are shielded from UVC irradiation by the ozone layer – a gas layer around the earth. The ozone layer protecting us against UVC is vital to our health and that of other animals and plants. At this stage it is enough to say that there is serious concern about the damage being caused by man-made gases.
*38\194\4*

By admin | Posted in Cancer | Comments (0)

SYMPTOMS OF RHEUMATOID ARTHRITIS (RA): CHEST AND LUNGS

2011-01-12T08:31:48+0000">January 12, 2011 – 8:31 am

RA can prod-ice breathing discomfort in two ways. The first occurs when the joints between the collar bones (clavicles) and chest bone (sternum) develop arthritis. In this situation, which about 30 percent of people with RA develops, pain can occur when deep breaths are taken or when the shoulders are moved. The condition improves with treatment of the arthritis.
Between 10 and 20 percent of people develop breathing discomfort from the other source at some point while they have RA. The origin of this breathing discomfort is pleurisy, which causes discomfort deep in the chest and results from inflammation in the lining of the lungs (pleura). A complication of this inflammation is pleural effusion, or fluid around the lungs, which less than 5 percent of people with RA develop. This fluid generally produces few symptoms, and its presence is determined only by x-ray. Pleurisy and pleural effusion frequently improve with effective treatment of RA. If significant symptoms appear from pleural effusion, drainage of the fluid with a needle can be performed as an outpatient procedure. Temporary treatment with oral corticosteroids may be required.
Rarely, rheumatoid nodules develop in the lungs; these nodules are similar to those on the skin. They generally cause no symptoms and are diagnosed only by x-ray. The greatest difficulty is determining whether the nodule is a result of RA or another, unrelated, condition. A biopsy of the nodule may be required to determine its cause.
In only 1 or 2 percent of individuals with RA, a more serious lung problem known as pneumonitis arises. Cough and shortness of breath are indications that this problem may exist. Because the lung tissue is inflamed in pneumonitis, anti-inflammatory medications are administered promptly to decrease inflammation and prevent scarring (fibrosis).
Sometimes, but rarely, RA causes severe breathing difficulty, and the person requires hospitalization and urgent treatment to recover. If you ever experience difficulty breathing, be sure to consult your physician.
*30/209/5*

By admin | Posted in Arthritis | Comments (0)

LOVE GIFTS FILL MY JOY ROOM

2011-01-06T08:31:13+0000">January 6, 2011 – 8:31 am

In addition to all the handmade love gifts that decorate every inch of my Joy Room, I get a lot of poems and sayings from our SPATULA family. One I especially like is called “Home Rules.” It was taken from a church bulletin and the original source is unknown to me.
If you sleep on it . . . make it up.
If you wear it . . . hang it up.
If you eat out of it . . . put it in the sink.
If you step on it . . . wipe it off.
If you open it . . . close it.
If you empty it . . . fill it up.
If it rings . . .answer it.
If it howls . . . feed it.
If it cries . . . love it.
One of the occupants of my Joy Room reminds me that sometimes you need to have tough love for your children. He’s a little porcupine who actually looks more like a groundhog, but he reminds me that when you love your kids, they may send back responses as hurtful as porcupine quills. That’s what happened when Larry disowned us and changed his name, saying he never wanted to see us again. But all the time he was gone, we kept loving him unconditionally.
Parents must remember they can’t change anybody. Billy Graham’s wife, Ruth, says, “It’s my job to love Billy and God’s job to make him good.” I’ve adapted that idea, and I say it’s my job to love my kids, and it’s God’s job to touch their lives.
As someone said, we spend the first three years of a child’s life teaching him to walk and talk and the next fifteen teaching him to sit down and be quiet! But, ultimately, there are only two things you can do for your kids—love them and pray for them. So I keep my little porcupine in my Joy Room to remind me that, even though our kids may send back quills— that is, they may do or say things that sting and hurt, it’s our job to love them with unconditional love, not “sloppy agape,” but with a tough love that has some edges on it.
*25\316\2*

By admin | Posted in Anti-Psychotics | Comments (0)

INFECTIOUS DISEASES: MENINGITIS

2010-12-26T08:30:39+0000">December 26, 2010 – 8:30 am

Infection and inflammation of the meninges. Many forms of meningitis are known, depending on the infecting germ, the portion of the meninges that is involved and the pathological condition that develops. Most common is cerebrospinal meningitis which occurs in epidemic form, and which is due to a special germ that attacks the meninges. The symptoms arise from the changes that the germs and their poisons produce in the tissues of the nervous system. Meningitis begins, as do most infectious diseases, with sore throat, dullness, fever, chills, rapid pulse, and general soreness of the body. A delicate pinpoint-sized red rash may be found on the chest or even large spots over the body. This condition spreads rapidly, when it begins in areas where people are overcrowded. The discovery of a serum against meningitis resulted in cutting down the death rate greatly. More recently, use of sulfonamides and antibiotics has been found more effective than serum, and is the method of control commonly employed. Bear in mind that meningitis may be caused, however, by other germs, such as the germs of tuberculosis, of pneumonia, the various streptococci, and even rarely seen germs. The method of treatment is definitely related to the causative organism. For the tuberculous germs, streptomycin is more effective than some of the other antibiotic drugs.
*31/318/5*

By admin | Posted in Anti-Infectives | Comments (0)