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EEG Neurotherapy
EEG Biofeedback or Neurofeedback, is a form of biofeedback which allows an individual
to learn voluntary control of their brainwave activity. Electrodes (sensors) are placed
on the surface of the scalp and are held painlessly in place with a paste. The process
is non-invasive. These sensors pick up the brainwave patterns (electrical activity of
the brain) and transmit them to a computer which analyzes them. Settings in the
computer program are individually tailored for the client based on what brainwave
patterns are desired.
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Electrocardiogram
An electrocardiogram (ECG or EKG, abbreviated from the German Electrocardiogram) is
a graphic produced by an electrocardiograph, which records the electrical activity of
the heart over time. Analysis of the various waves and normal vectors of depolarization
and repolarization yields important diagnostic information.
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It is the gold standard for the diagnosis of cardiac arrhythmia's
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It guides therapy and risk stratification for patients with suspected acute
myocardial infarction
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It helps detect electrolyte disturbances (e.g. hyperkalemia and hypokalemia)
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It allows for the detection of conduction abnormalities (e.g. right and left bundle
branch block)
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It is used as a screening tool for ischemic heart disease during a cardiac stress test
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It is occasionally helpful with non-cardiac diseases (e.g. pulmonary embolism or
hypothermia)
The electrocardiogram does not directly assess the contractility of the heart. However,
it can give a rough indication of increased or decreased contractility.
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Electromyography
Electromyography (EMG) is a medical technique for evaluating and recording
physiologic properties of muscles at rest and while contracting. EMG is performed using
an instrument called an electromyography, to produce a record called an electromyogram.
An electromyograph detects the electrical potential generated by muscle cells when
these cells contract, and also when the cells are at rest.
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Endogenous
Developing or originating within the organisms or arising from causes within the organism.
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Endometriosis
Endometriosis is a common medical condition affecting an estimated 89 million women
of reproductive age around the world. In endometriosis, the tissue that lines the
uterus (the endometrium, from endo, "inside", and metra, "womb") is found to be
growing outside the uterus, on or in other areas of the body. Normally, the endometrium
is shed each month during the menstrual cycle; however, in endometriosis, the
misplaced endometrium is usually unable to exit the body.
The endometriotic tissues still detach and bleed, but the result is far different:
internal bleeding, degenerated blood and tissue shedding, inflammation of the
surrounding areas, pain, and formation of scar tissue may result. In addition, depending
on the location of the growths, interference with the normal function of the bowel,
bladder, small intestines and other organs within the pelvic cavity can occur.
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Endotracheal Tube
An endotracheal tube (ETT) is used in anesthesia, intensive care and emergency medicine
for airway management and mechanical ventilation. It is regarded as the most
reliable available method for protecting a patient's airway.
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Enterovirus
The enterovirus are a genus of (+)ssRNA viruses associated with
several human and mammalian diseases. Historically the most significant has been
the Poliovirus (which is now nearly extinct).
Coxsackie viruses (a non-phylogenic group) are associated with human hand, foot and
mouth disease. Echo viruses are a cause of many of the non-specific viral infections.
It is mainly found in the intestine, and can cause nervous disorders.
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Epigallocatechin Gallate (EGCG)
Epigallocatechin gallate belongs to the family of catechins. It contains 3 phenol rings
and has very strong antixoidant properties. It is the main active component if green tea
leaves. Black tea leaves also contain epigallocatechin gallate but in much lower
quantities. That's because black tea leaves are fermented, during which many of the
cathechins are oxidized to darker coloured molecules (theaflavin and thearubigen).
Epigallocatechin gallate possess the most potent antioxidant activity of the catechins.
It may provide health effects by protecting our cells from oxidative damage from free
radicals. A number of chronic disease have been associated with free radical damage,
including cancer, arteriosclerosis, heart diseases and accelerated aging. Epigallocatechin gallate interferes with many enzyme systems: it inhibits fast-binding and reversible fatty acid synthase, increases tyrosine phosphorylation of the insulin receptor, activation of
ornithine decarboxylase.
Epigallocatechin gallate can protect the DNA in the human cells from ultraviolet and
visible radiation-induced damage. Epigallocatechin gallate may be effective in promoting
fat oxidation and lowering body weight.
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Epstein-Barr
Also called Human herpes virus 4 (HHV-4), is a virus of the herpes family
(which includes Herpes simplex virus and Cytomegalovirus), and is one of the most
common viruses in humans.
Most people become infected with EBV, which is often
asymptomatic but
commonly causes infectious mononucleosis. It is named after Michael Epstein and Yvonne
Barr, who together with Bert Achong discovered the virus in 1964. Thought at one time
to be associated with Chronic Fatigue Syndrome.
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Etiology
The science and study of the causes or origins of disease.
The cause or origin of a disease or disorder as determined by medical diagnosis.
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Etymologically
Etymology is the study of the history of words - when they entered a language,
from what source, and how their form and meaning have changed over time.
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Exacerbate
To increase the severity, aggravate.
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Excitatory
Tending to induce excitation.
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Exertion
Exertion is a concept describing the use of physical or perceived energy. It normally
refers to a strenuous or costly effort related to physical, philosophical actions and
work.
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Fatigue
A condition characterized by a lessened capacity for work and reduced efficiency
of accomplishment, usually accompanied by a feeling of weariness and tiredness.
Fatigue can be acute and come on suddenly or chronic and persist.
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Fibro-Fog
Fibro-fog or "brain-fog" is a commonly reported symptom of Fibromyalgia (FM). FM
patients often describe multiple sensations of fatigue and listlessness combined
with transitory states of confusion, poor attention and concentration, and short-term
memory loss. This fibro-fog tends to
exacerbate the deficits
in daily functioning that a FM sufferer must deal with.
What causes fibro-fog? There's no conclusive origin for this symptom of FM, nor
an explanation as to why it exists in varying degrees for different FM patients.
Sleep deprivation and significant difficulty in achieving and/or maintaining deep
level sleep, however, may very well point to the answer.
It is at the deeper levels of sleep (delta wave sleep) that a person's mind conducts
its internal "housekeeping". During this phase of sleep, newly acquired information
is assimilated and integrated. The inability to get enough restorative deep-level sleep
may have an impairing effect on an individual's ability to recall information or operate
at a normal level of mental efficiency.
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Fibromyalgia (FM)
FM is a poorly-understood chronic pain syndrome characterized by:
- Widespread Musculoskeletal Pain
- Non restorative Sleep
- Fatigue
- Psychological Distress
- Specific Regions of Localized Tenderness
People with FM may also have other symptoms such as:
- Morning stiffness
- Tingling or numbness in hands and feet
- Headaches, including migraines
- Irritable bowel syndrome
- Problems with thinking and memory (sometimes called "fibro fog")
- Painful menstrual periods and other pain syndromes
While the etiology of FM is unclear, accumulating data suggest that disordered central
pain processing likely plays a role in the pathogenesis of symptoms. Although
various pharmacological treatments have been studied and espoused for treating FM, no
single drug or group of drugs has proved to be particularly useful in treating FM
patients as a whole, and only one drug to date has earned U.S. Food and Drug
Administration (FDA)approval for treating the syndrome in the United States.
The earliest onset of FM can occur in childhood, however most people believe their
pain originated in their early 20's and 30's. Although genetic research is just
beginning, there is already evidence that FM runs in some families leading researchers
to believe it may be hereditary. Although men and women are both effected by FM, women
make up the majority of those effected. The reason is unknown.
While FM is one of the most common diseases affecting the muscles, its cause is
currently unknown. The painful tissues involved are not accompanied by tissue
inflammation. Therefore, despite potentially disabling body pain, patients with FM do
not develop body damage or deformity. FM also does not cause damage to internal body
organs. Therefore, FM is different from many other rheumatic conditions (such as
rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases,
tissue inflammation is the major cause of pain, stiffness and tenderness of the
joints, tendons and muscles, and it can lead to joint deformity and damage to the
internal organs or muscles.
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Gastrointestinal
The gastrointestinal tract (GI tract), also called the digestive tract, the alimentary
canal, or the entrails, is the system of organs within multi cellular animals that takes
in food, digests it to extract energy and nutrients, and expels the remaining waste.
The major functions of the GI tract are ingestion, digestion, absorption, and excretion.
The GI tract differs substantially from animal to animal. Some animals have
multi-chambered stomachs, while some animals' stomachs contain a single chamber. In a
normal human adult male, the GI tract is approximately 6.5 meters (20 feet) long and
consists of the upper and lower GI tracts. The tract may also be divided into
foregut, midgut, and hindgut, reflecting the embryological origin of each segment
of the tract.
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Genetic Predisposition
A genetic predisposition is a genetic effect which influences the
phenotype
of an organism but which can be modified by the environmental conditions.
Genetic testing is able to identify individuals who are genetically predisposed
to certain health problems.
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Granulocytes
Granulocytes are a category of white blood cells characterized by the presence
of granules in their cytoplasm. They are also called polymorphonuclear leukocytes
(PMN or PML) because of the varying shapes of the nucleus, which is usually lobed
into three segments.
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Greater Trochanter
The greater trochanter of the femur is a large, irregular, quadrilateral eminence,
situated at the junction of the neck with the upper part of the body.
It is directed a little lateralward and backward, and, in the adult, is about 1 cm.
lower than the head. Part of the skeletal system. It has two surfaces and four borders.
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Growth Hormone
Growth hormone is a 191-amino acid, single chain polypeptide hormone which is
synthesized, stored and secreted by the somatotroph cells within the lateral
wings of the anterior pituitary gland, which stimulates growth and cell reproduction
in humans and other animals.
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Headache
A pain in the head with the pain being above the eyes or the ears, behind the
head (occipital), or in the back of the upper neck. Headache, like chest pain
or back ache, has many causes.
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Hepatitis
Hepatitis is inflammation of the liver. The clinical signs, prognosis, and treatment
depend on the cause.
Types of hepatitis:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis B with D
- Hepatitis E
- Hepatitis F (discredited)
- Hepatitis G
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Herpes Simplex Virus
Herpes simplex virus 1 and 2 (HSV-1 and HSV-2) are two strains of the herpes virus
family, Herpes viridae, which cause infections in humans. HSV-1 and 2 are also
referred to as Human Herpes Virus 1 and 2 (HHV-1 and HHV-2).
After an initial, or primary, infection, HSV establishes latency, during which the
virus is present in the cell bodies of nerves which innervate the area of original
outbreak. During reactivation, the virus is produced in the cell and transported
outwardly via the nerve cell's axon to the skin. The ability of HSV to become latent
leads to the chronic nature of Herpes infection; after the initial infection subsides,
Herpes symptoms may periodically recur in the form of outbreaks of herpetic sores near
the site of original infection.
Herpes infections are marked by painful, watery blisters in the skin or mucous
membranes (such as the mouth or lips) or on the genitals. The blisters resemble those
seen in chickenpox - an infection caused by a third member of the
alpha-Herpes viridae subfamily, Varicella Zoster Virus (VZV), also known as Human Herpes
Virus 3 (HHV-3). Lesions heal with a crudescent scab, the hallmark of herpetic
disease. Herpes is contagious if the carrier is producing and releasing ("shedding")
virus. This is particularly likely during an outbreak, although individuals may shed
virus between outbreaks. Although no cure is yet available, treatments exist which
reduce the likelihood of viral shedding. An HSV infection on the lips is commonly
known as a "cold sore" or "fever blister" and should not to be confused with a canker
sore; canker sores are not caused by the HSV virus.
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Holistic
Holism is the idea that all the properties of a given system (biological, chemical,
social, economic, mental, linguistic, etc.) cannot be determined or explained by the
sum of its component parts alone. Instead, the system as a whole determines in an
important way how the parts behave.
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Homeopathy
Homeopathy is a system of alternative medicine that aims to treat "like with like."
Despite being widely discredited in scientific circles homeopathy has grown in popularity
in recent years.
Homeopathic remedies are extremely diluted agents. The first remedies used by homeopaths
were made from substances such as arsenic that, in undiluted doses, would have
produced similar symptoms in the healthy. The substances on which other, more
recent, remedies are based such as lac humanum (human milk), lac delphinum (dolphin milk)
and adamas (diamond), are not known to produce symptoms from the undiluted
form.
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Homeostasis
Homeostasis is the property of an open system, especially living organisms, to
regulate its internal environment to maintain a stable, constant condition, by
means of multiple dynamic equilibrium adjustments, controlled by interrelated
regulation mechanisms.
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Hormone
A hormone is a chemical messenger from one cell (or group of cells)
to another. The function of hormones is to serve as a signal to the target cells.
The action of hormones is determined by the pattern of secretion and the signal
transduction of the receiving tissue.
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Hyperalgesia
Hyperalgesia is an increased sensitivity to pain, which may be caused by damage to
nociceptors or peripheral nerves. Temporary increased sensitivity to pain also occurs as
part of sickness behavior, the evolved response to infection.
Hyperalgesia can be experienced in focal, discrete areas, or as a more diffuse, body-wide
form. Conditioning studies have established that it is possible to experience a learned
hyperalgesia of the latter, diffuse form. The focal form is typically associated with
injury, and is divided into two subtypes:
Opioid-induced hyperalgesia may develop as a result of long-term opioid use in the
treatment of chronic pain. Various studies of humans and animals have demonstrated that
primary or secondary hyperalgesia can develop in response to both chronic and acute
exposure to opioids. This side effect can be severe enough to warrant discontinuation of
opioid treatment.
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Hyperhidrosis
Primary hyperhidrosis is the condition characterized by
abnormally increased perspiration, in excess of that required for regulation of
body temperature. Some patients afflicted with the condition experience a distinct
reduction in the quality of life. Sufferers feel at a loss of control because
perspiration takes place independent of temperature and emotional state.
However, anxiety can exacerbate the
situation for many sufferers. A common complaint of patients is that they get nervous
because they sweat, then sweat more because they are nervous. Other factors can play a
role; certain foods & drinks, nicotine, caffeine, and smells can trigger a response.
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Hypochondria
Hypochondria refers to an excessive preoccupation or worry about having a serious
illness. Often, hypochondria persists even after a physician has evaluated a person
and reassured him/her that his/her concerns about symptoms do not have an underlying
medical basis or, if there is a medical illness, the concerns are far in excess of what
is appropriate for the level of disease.
Many people with unexplained illnesses, such as Fibromyalgia and Chronic Fatigue
Syndrome, are accused of being hypochondriacs, simply because the medical profession
is unable to properly diagnose these illnesses.
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Hypocretin
Hypocretin's, are the common names given to a pair of highly
excitatory
neuropeptide hormones that were simultaneously discovered by two groups of
researchers in rat brains.
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Hypoglycemia
Low blood sugar (glucose). When symptoms of hypoglycemia occur together with a
documented blood glucose under 45 mg/dl, and the symptoms promptly resolve with
the administration of glucose, the diagnosis of hypoglycemia can be made with some
certainty. Hypoglycemia is only significant when it is associated with symptoms.
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Hyponatremia
An electrolyte disturbance (disturbance of the salts in the blood) in which the
sodium concentration in the plasma is too low (in this case, below 135 mmol/L).
Severe or rapidly progressing hyponatremia can result in swelling of the brain
(cerebral edema), and the symptoms of hyponatremia are mainly neurological. Hyponatremia
is most often a complication of other medical illnesses in which either fluids rich in
sodium are lost (for example because of diarrhea or vomiting), or excess water
accumulates in the body at a higher rate than it can be excreted (for example in
polydipsia or syndrome of inappropriate antidiuretic hormone, SIADH).
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Hypothalamic-Pituitary-Adrenal
The hypothalamic-pituitary-adrenal axis (HPA axis) is a complex set of direct influences
and feedback interactions between: the hypothalamus, a hollow, funnel-shaped part of
the brain; the pituitary gland, a pea-shaped structure located below the hypothalamus;
and the adrenal or suprarenal gland, a small, paired, pyramidal organ located at the top
of each kidney.
The fine, homeostatic interactions between these three organs constitute the HPA axis,
a major part of the neuroendocrine system that controls reactions to stress and
regulates various body processes including digestion, the immune system, mood and
sexuality, and energy usage. Species from humans to the most ancient organisms
share components of the HPA axis. It is the mechanism for a set of interactions among
glands, hormones and parts of the mid-brain that mediate a general adaptation syndrome.
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Hypothalamus
The hypothalamus, also known as the "master gland," links the nervous system to the
endocrine system via the pituitary gland. The hypothalamus is located below the
thalamus, just above the brain stem.
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Hypothyroidism
Hypothyroidism is the disease state in humans and animals caused by insufficient
production of thyroid hormone by the thyroid gland.
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Hypoxemia
Hypoxemia is an abnormal deficiency in the concentration of oxygen in arterial blood.
A frequent error is made when the term is used to describe poor tissue diffusion as
in hypoxia. It is possible to have a low oxygen content (eg due to anemia) but a
high concentration of oxygen in arterial blood so incorrect use can lead to confusion.
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Immune
Protected against infection. The Latin immunis means free, exempt.
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Immune System
A complex system that is responsible for distinguishing us from everything foreign to
us, and for protecting us against infections and foreign substances. The immune system
works to seek and kill invaders.
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Immunological
A broad branch of biomedical science that covers the study of all aspects of the
immune system in all organisms. It deals with, among other things, the
physiological functioning of the immune system in states of both health and
disease; malfunctions of the immune system in immunological disorders
(autoimmune
diseases, hyper sensitivities (increased sensitivity), immune deficiency).
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Incontinence
Urinary incontinence is the involuntary excretion of urine from one's body. It is
often temporary, and it almost always results from an underlying medical condition.
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Infection
The growth of a parasitic organism within the body. (A parasitic organism is one that
lives on or in another organism and draws its nourishment there from.) A person with
an infection has another organism (a "germ") growing within him, drawing its nourishment
from the person.
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Insulin
Insulin is a polypeptide hormone that regulates carbohydrate metabolism. Apart from being
the primary agent in carbohydrate
homeostasis, it
has effects on fat metabolism and it changes the liver's activity in storing or
releasing glucose and in processing blood lipids, and in other tissues such as fat
and muscle. The amount of insulin in circulation has extremely widespread effects
throughout the body.
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Interphalangeal
Between the phalanges, or fingers.
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Interstitial Cystitis
Interstitial Cystitis is a urinary bladder disease of unknown cause characterized by
urinary frequency (as often as every 10 minutes), urgency, pressure and/or pain in
the bladder and/or pelvis.
Pain typically increases as the bladder fills and reduces after voiding however some
patients report pain with urination, often in the urethra. Patients may also
experience nocturia, pelvic floor dysfunction and tension (thus making it difficult to
start their urine stream), pain with sexual intercourse, discomfort and difficulty
driving, traveling or working. Research has determined that the quality of life of
IC patients is equivalent to end stage renal failure.
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Intravascular
Situated in, occurring in, or administered by entry into a blood vessel.
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Irritable Bowel Syndrome
Irritable bowel syndrome is a disorder characterized most commonly by cramping,
abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of
discomfort and distress, but it does not permanently harm the intestines and does not
lead to a serious disease, such as cancer. Most people can control their symptoms with
diet, stress management, and prescribed medications. For some people, however, IBS can
be disabling. They may be unable to work, attend social events, or even travel short
distances.
As many as 20 percent of the adult population, or one in five Americans, (4-70% of FM
patients), have symptoms of IBS, making it one of the most common disorders diagnosed by
doctors. It occurs more often in women than in men, and it begins before the age of 35
in about 50 percent of people.
Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms
can vary from person to person. Some people have constipation, which means hard,
difficult-to-pass, or infrequent bowel movements. Often these people report straining
and cramping when trying to have a bowel movement but cannot eliminate any stool, or
they are able to eliminate only a small amount. If they are able to have a bowel
movement, there may be mucus in it, which is a fluid that moistens and protect passages
in the digestive system. Some people with IBS experience diarrhea, which is frequent,
loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable
need to have a bowel movement. Other people with IBS alternate between constipation and
diarrhea. Sometimes people find that their symptoms subside for a few months and then
return, while others report a constant worsening of symptoms over time.
Researchers have yet to discover any specific cause for IBS. One theory is that people
who suffer from IBS have a colon (large bowel) that is particularly sensitive and
reactive to certain foods and stress. The immune system, which fights infection, may
also be involved.
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Normal motility, or movement, may not be present in a colon of a person who has IBS. It
can be spasmodic or can even stop working temporarily. Spasms are sudden strong muscle
contractions that come and go.
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The lining of the colon called the epithelium, which is affected by the immune and
nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the
epithelium appears to work properly. However, when the contents inside the colon move
too quickly, the colon looses its ability to absorb fluids. The result is too much fluid
in the stool. In other people, the movement inside the colon is too slow, which causes
extra fluid to be absorbed. As a result, a person develops constipation.
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A person's colon may respond strongly to stimuli such as certain foods or stress that
would not bother most people.
Recent research has reported that serotonin is linked with normal gastrointestinal (GI)
functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from
one part of your body to another. Ninety-five percent of the serotonin in your body is
located in the GI tract, and the other 5 percent is found in the brain. Cells that line
the inside of the bowel work as transporters and carry the serotonin out of the GI
tract. People with IBS, however, have diminished receptor activity, causing abnormal
levels of serotonin to exist in the GI tract. As a result, people with IBS experience
problems with bowel movement, motility, and sensation-having more sensitive pain
receptors in their GI tract.
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Joint
A joint is the area where two bones are attached for the purpose of motion of body
parts. It is usually formed of fibrous connective tissue and cartilage.
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Ketoacidosis
Ketoacidosis is a type of metabolic
acidosis which is
caused by high concentrations of keto acids, formed by the
deamination of
amino acids.
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Lability
Lability refers to something that is constantly undergoing change or something that
is likely to undergo change.
In medicine, the term "labile" means susceptible to alteration or destruction. For
example, a heat-labile protein is one that can be changed or destroyed at high
temperatures. The opposite of labile in this context is "stable."
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Latent
Latent means that something is dormant and may become active in the future, as in a
latent fault.
That is, potentially existing but not presently evident; also commonly used to
describe a medical condition that is present but not active or causing symptoms.
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Lateral Epicondyle
The lateral epicondyle of the humerus is a small, tuberculated eminence, curved a
little forward, and giving attachment to the radial collateral ligament of the
elbow-joint, and to a tendon common to the origin of the Supinator and some of the
Extensor muscles.
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Chronic Myelogenous Leukemia
Chronic Myelogenous Leukemia (CML) is a form of chronic leukemia characterized by
increased and unregulated clonal production of predominantly myeloid cells in the
bone marrow.
CML is a myeloproliferative disease associated with a characteristic
chromosomal translocation called the Philadelphia chromosome.
Historically, it has been treated with chemotherapy, interferon and bone
marrow transplantation, although targeted therapies introduced at the beginning of
the 21st century have radically changed the management of CML.
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Levothyroxine
Levothyroxine, also known as L-thyroxine, or synthetic T4 is a synthetic form of
thyroxine (thyroid hormone). The natural hormone is chemically in the L-form, as is
the pharmaceutical agent. Dextrothyroxine (D-thyroxine) briefly saw research as
an anti cholesterol agent but was pulled due to cardiac side-effects.
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Ligament
Fibrous tissue that connects bones (or two different parts of a single bone). They
are sometimes called "articular ligaments", "fibrous ligaments", or "true ligaments".
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Liothyronine
Liothyronine sodium, also known as T3 is a thyroid hormone drug used to treat
hypothyroidism. It is a major component of the medication Cytomel.
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Lupus
Systemic lupus erythematosus is a chronic, inflammatory autoimmune disorder. It may
affect the skin, joints, kidneys, and other organs.
Normally, the immune system controls the body's defenses against infection. In SLE and
other autoimmune diseases, these defenses are turned against the body and rogue immune
cells attack tissues.
Antibodies may be produced that can react against the body's blood cells, organs,
and tissues. These lead immune cells to attack the affected systems, producing a
chronic (long-term) disease.
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Lyme Disease
Lyme disease, which is also known as Lyme borreliosis, is an infection transmitted by
the bite of deer ticks carrying the spirochete (spiral-shaped bacterium)
Borrelia burgdorferi.
The disease was named for Lyme, Connecticut, the town where it was first diagnosed in
1975 after a puzzling outbreak of juvenile arthritis. The organism that causes the
disease was identified in 1982 and named for its discoverer, Willy Burgdorfer.
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Malaise
Malaise is a feeling of general discomfort or uneasiness, an "out of sorts" feeling,
often the first indication of an infection or other disease.
Malaise has been referred to as "the creeping crud" (especially in reference to the
malaise caused by communicable diseases such as influenza and the common cold). This
usage may have originated in folk medicine, but it is adopted from the French word
meaning "discomfort", "feeling faint", "feeling sick".
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Methocarbamol
Methocarbamol is a
central muscle relaxant for skeletal muscles, used to treat spasms.
Robaxin® is a trade name
for methocarbamol. It is structurally related to
guaifenesin.
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Migraines
Migraine headaches are caused by constrictions of your blood vessels and arteries, and
are also known as vascular headaches. Due to stress, fatigue, or illness, the blood
vessels in your head and neck begin to constrict and then dilate, causing severe
pain, nausea, dizziness, and eye pain.
A migraine headache can also move around your head, shifting from side to side. The
common migraine is usually preceded by episodes of anxiety, depression, and fatigue. The
less common type of migraine is the "classic" migraine, and is always immediately
preceded by visual symptoms including double vision, blurry vision, flashing dots, bright
lights, or distorted vision. These visual symptoms are often called the migraine aura.
Sufferers of the "classic" migraine may experience these symptoms for 15 to 60
minutes immediately before a migraine. Migraine symptoms typically last about 4 hours,
though they can plague you for as long as a week. Migraines can develop also into
chronic headaches.
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Mitochondrial
In cell biology, a mitochondrion (plural mitochondria) is a membrane-enclosed
organelle, found in most eukaryotic cells. Mitochondria are sometimes described as
"cellular power plants," because they convert NADH and NADPH into energy in the form
of ATP via the process of oxidative phosphorylation.
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Mitogen
A mitogen is a chemical, usually some form of a protein, that encourages a cell to
commence cell division, triggering mitosis. Mitogens trigger signal transduction
pathways in which mitogen-activated protein kinase is involved, leading to mitosis.
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Mitral Valve Prolapse
Mitral valve prolapse is a heart valve condition marked by the displacement of an
abnormally thickened mitral valve leaflet into the left atrium during systole.
In its non classic form, MVP carries a low risk of complications. In severe cases of
classic MVP, complications include mitral regurgitation, infective endocarditis, and,
in rare circumstances, cardiac arrest usually resulting in sudden death.
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Micro vascular Disease
Micro vascular disease is a disease of any small blood vessels in the body. This
sometimes occurs when a person has had diabetes for a long time. The walls of the
vessels become abnormally thick but weak, and therefore they bleed, leak protein,
and slow the flow of blood through the body. Then some cells, for example in the
retina (diabetic retinopathy) or kidney (diabetic nephropathy), may not get enough
blood and may be damaged. Nerves are also damaged and may lead to loss of function
(diabetic neuropathy).
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Monamine Oxidase Inhibitors
Of all the antidepressant drugs, monamine oxidase inhibitors are used less often than
any others due to the serious risk of interactions they pose. They are still
regarded, however, as extremely useful for atypical cases of depression that do not
respond to other, milder forms of treatment. They are also effective in helping
cigarette smokers to kick their habit.
These drugs protect monoamine neurotransmitters from breaking down. They work on levels
of serotonin, melatonin, adrenaline, noradrenaline, phenylethylamine, and dopamine.
In addition to interacting with other prescription medications, monamine oxidase
inhibitors cause high blood pressure and can damage the liver.
MAOI's Include:
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Mononucleosis
A disease seen most commonly in adolescents and young adults, characterized by fever,
sore throat, muscle soreness, and fatigue. White patches on the tonsils or in the back
of the throat may also be seen, (resembling strep throat).
Mononucleosis (Mono) is usually caused by the Epstein-Barr virus (EBV), which infects B
cells (B-lymphocytes), producing a reactive lymphocytosis and atypical T
cells (T-lymphocytes) known as Downey bodies.
The virus is typically transmitted from asymptomatic individuals through blood or
saliva (hence "the kissing disease"), or by sharing a drink, or sharing eating utensils.
The disease is far less contagious than is commonly thought.
There are two main types of mononuclear leukocytes: monocytes and lymphocytes. They
normally account for about 35% of all white blood cells. With infectious mononucleosis,
this can rise to 50-70%. Also, the total white blood count may increase to 10000-20000
per cubic millimeter.
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Muscle
Muscle is the tissue of the body which primarily functions as a source of power. There
are three types of muscle in the body. The muscle responsible for moving extremities
and external areas of the body is called the "skeletal muscle." Heart muscle is
called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called
"smooth muscle."
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Muscle Relaxers
Muscle Relaxers are not really a class of drugs, but rather a group of different drugs
that each has an overall sedative effect on the body. These drugs do not act directly
on the muscles, rather they act centrally (in the brain) and are more of a total
body relaxant.
Typically, Muscle Relaxants are prescribed early in a course of back pain, on a
short-term basis, to relieve low back pain associated with muscle spasms. There are
several types of muscle relaxant medications that are commonly used to treat low back
pain.
Muscle Relaxers are also used for relief of spasticity in neuromuscular diseases, such
as multiple sclerosis,
as well as for spinal cord injury, stroke and
musculoskeletal
conditions. They may also be used for pain relief in minor strain injuries and
control of the muscle symptoms of tetanus.
Muscle Relaxants are divided into only two groups,
Benzodiazepines
and Methocarbamol.
The centrally acting group, benzodiazepines, appears to act on the central nervous
system, and contains 10 drugs which are chemically different.
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Musculoskeletal Disorders
Musculoskeletal disorders (MSD's) can affect the body's muscles, joints, tendons,
ligaments and nerves. Most-work related MSD's develop over time and are caused either
by the work itself or by the employees' working environment. They can also result
from fractures sustained in an accident. Typically, MSD's affect the back, neck,
shoulders and upper limbs; less often they affect the lower limbs.
Health problems range from discomfort, minor aches and pains, to more serious
medical conditions requiring time off work and even medical treatment. In more
chronic cases, treatment and recovery are often unsatisfactory, the result could
be permanent disability and loss of employment.
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Multiple Sclerosis
Multiple sclerosis is an inflammatory disease of the central nervous system. The
disease results in injury to the myelin sheath (the fatty matter that covers the axons
of the nerve cells), the oligodendrocytes (the cells that produce myelin) and, to a
lesser extent, the axons and nerve cells themselves.
The symptoms of multiple sclerosis vary, depending in part on the location of plaques
(areas of thick scar tissue) within the central nervous system. Common symptoms
include weakness and fatigue, sensory disturbances in the limbs, bladder or
bowel dysfunction, problems with sexual function, and ataxia (loss of coordination).
Although the disease may not be cured or prevented at this time, treatments are
available to reduce severity and delay progression.
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Myalgic Encephalopathy
The acronym ME/CFS refers to Myalgic Encephalomyelitis and Chronic Fatigue
Syndrome, according to the Canadian Case Definition.
The patient community has felt
That the term chronic fatigue syndrome trivializes the seriousness of this illness, as
the illness is typified by many severe symptoms in addition to fatigue, and fatigue
is generally regarded as a common symptom experienced by many otherwise healthy
individuals in the general population.
The term Myalgic Encephalomyelitis had been
used prior To the use of the term chronic fatigue syndrome (Acheson, 1959). Some
individuals Have preferred to use the term Myalgic Encephalopathy rather than
Myalgic Encephalomyelitis, as the former term does not suggest brain inflammation.
Myalgic Encephalopathy means "nervous system inflammation involving muscle pain", and
is characterized by prolonged fatigue associated with a wide range of accompanying
symptoms.
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Mycoplasma Fermentans
Mycoplasma fermentans is considered to be a commensal in the human mucosal tissues and
has often been found in saliva and oropharyngeal of 45% of healthy adults. Also,
M. fermentans organisms have been isolated from the human urogenital tract and are
suspected of invading host tissues from a site of mucosal colonization.
Although mycoplasma's are recognized primarily as extra cellular parasites or pathogens
of mucosal surfaces, recent evidence suggests that certain species may invade the
host cells.
The molecular and cellular bases for the invasion of M. fermentans from mucosal cells
to the bloodstream and its colonization of blood remain unknown.
Also, it remains unclear whether M. fermentans infection of white blood cells is
transient, intermittent or persistent. It is not clear how these stages influence
any disease progression. The invasion of host blood cells by M. fermentans is due
to inhibition of phagocytosis by a variety of mechanisms, including antiphagocytic
proteins such as protease's, phospholipases and by oxygen radicals produced by
mycoplasma's.
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Narcolepsy
Narcolepsy is a chronic central nervous system (CNS) disorder of unknown etiology that is
characterized by excessive daytime sleepiness (EDS), hypnogogic hallucinations, cataplexy, sleep paralysis, and disrupted nocturnal sleep. Mistakenly considered a rare disorder, it
is now estimated that one in every one to two thousand Americans may be afflicted with
this disease, a prevalence approximating that of multiple sclerosis.
The symptoms of this disorder adversely impact the psychological and social functioning of those afflicted, and is especially debilitating because the disease onset occurs most
often in the second and third decade of life, a time of increasing responsibility at
school and work. The diagnosis and treatment are often delayed because the complaint of
fatigue and sleepiness is often not taken seriously. It is often attributed to events
surrounding the psychosocial milieu of the individual, even though the complaint of
excessive daytime sleepiness always has an organic, nonfunctional explanation when an
organized clinical evaluation is attempted. Both the primary care physician and the
specialist play a pivotal role in screening and making appropriate referrals for
narcolepsy and other disorders of excessive sleepiness. A high index of suspicion will
lead to earlier diagnosis and treatment of this disabling disorder.
Recognizing Symptoms of Narcolepsy
Excessive Daytime Sleepiness (EDS): EDS is common with estimates in the general
population ranging from one to five percent. Sleepiness has a circadian tendency with
peaks of sleepiness in midafternoon and early morning. In normals, if the sleep need is
satisfied, the tendency to doze during periods of idleness or boring situations is
greatly reduced. Sleepiness indicates a sleep disorder when it persists and cannot be
resolved by increasing amounts of sleep. Patients with the complaint of fatigue and
sleepiness should be asked about their bedtime, wake up time, and napping behavior to
determine if sleep deprivation is the cause. Patients will often explain their sleepiness
using social or occupational demands to explain or justify this symptom. The astute
clinician will ignore these trivial explanations and come to his own conclusion regarding
the patient's sleep wake behavior.
Cataplexy: Cataplexy results when the atonia of REM sleep intrudes into
wakefulness. It occurs in about two thirds of patients with narcolepsy and the severity
of the symptom is quite variable. The symptom is very important because it is pathognomic
for narcolepsy. Cataplectic attacks are triggered by emotion such as laughter,
excitement, and anger. Attacks of cataplexy may be partial or complete. Limited attacks
affect the face or neck muscles and are characterized by drooping eyelids, sagging jaw,
or an inclined head. Speech may be slurred or stuttering. More complete episodes may
result in a buckling of the knees and a fall. During a cataplectic episode the
narcoleptic is fully aware of their surroundings but cannot move. The duration of the
episode, whether partial or complete, may vary from a few seconds to thirty minutes.
Cataplexy may occur only a few times in a lifetime with very strong emotion or may be
totally disabling with multiple attacks in a given day. Cataplexy may not occur for the
first time until months to years after the onset of EDS.
Sleep Paralysis: Approximately sixty percent of individuals with narcolepsy report
the experience of sleep paralysis. The frequency of episodes varies from a few lifetime
events to daily episodes. The episodes are frequently accompanied by vivid dreams. Sleep
paralysis may be hypnopompic or hypnogogic. During an episode the patients find
themselves unable to move their extremities or to speak, respiratory distress is rare as
phrenic nerve function is preserved.
Hypnogogic Hallucinations: Vivid dreams described as hallucinations occur at the
onset of nocturnal sleep, but may also occur during daytime naps or inadvertent sleep
episodes. Approximately seventy percent of narcoleptics experience these hallucinations,
which occasionally occur in association with sleep paralysis.
Fragmented Night Sleep: Although patients with narcolepsy fall asleep quite easily, they paradoxically often experience insomnia. At least sixty percent of patients with
narcolepsy report severe disruption of nocturnal sleep. Many of the patients will present
with an insomnia complaint and delay the diagnosis of narcolepsy if it is not considered
in the differential diagnosis.
Other Manifestations: Approximately fifty percent of narcoleptic patients
experience automatic behavior with retrograde amnesia. 8 Automatic behavior occurs when
sleep has partially overtaken the brain, but the body continues to perform familiar tasks
without conscious awareness of doing them. These episodes are sometimes confused with
partial complex seizures. Periodic leg movements during nocturnal sleep occur with a
higher incidence in narcoleptics than in the general population.
Treatment
In narcolepsy the goal of treatment is to provide symptom control and specifically to
relieve the most troubling symptoms, EDS and cataplexy. EDS is primarily treated with
stimulants or wake promoting agents. The commonly prescribed stimulant agents include
amphetamine, methylphenidate, and pemoline. These are CNS stimulants that increase
alertness and assist the patient to remain awake. These agents are associated with some
undesirable side effects, which include insomnia, hypertension, palpitations and
irritability. Tolerance to long-term stimulant therapy may occur necessitating an
increase in dosage to achieve the same control. Methylphenidate is the most widely used
stimulant. The dose required for effective treatment varies widely from patient to
patient. The usual range of methylphenidate dosage is 30-60 mg per day in the adult.
Reports of severe liver toxicity due to pemoline have limited its usefulness. Modafinil
is a novel wake promoting agent recently approved by the Food and Drug Administration
(FDA) for the treatment of narcolepsy. 15 It has been shown to reduce daytime sleepiness
with few side effects. Because of its improved safety profile and Schedule IV labeling,
many experienced clinicians utilize the drug modafinil as the drug of first choice in the
treatment of EDS of narcolepsy.
Stimulants and modafinil are not effective in the treatment of symptoms associated with
abnormal REM sleep, hypnogogic hallucinations, sleep paralysis and cataplexy. These
symptoms respond to tricyclic antidepressants that include imipramine, protriptyline,
clomipramine and selective seratonin re-uptake inhibitors (fluoxetine, sertraline and
fluvoxamine). These agents appear to act by suppressing REM sleep. Although the doses
generally used to treat cataplexy are lower than those required to treat depression, side
effects, particularly with the tricyclic group, are common. These include dry mouth,
constipation, tachycardia, urinary retention and impotence.
Sodium oxybate or gammahydroxybutyrate (GHB) is an endogenous compound found in many
tissues of the body that appears to be very effective for the treatment of cataplexy. 16
This compound is currently being considered for approval by the FDA. Data from clinical
trials suggests that this drug consolidates sleep and increases slow wave sleep time,
resulting in suppression of the auxiliary symptoms of narcolepsy and improving daytime
sleepiness. Sodium oxybate is given at bedtime and repeated four hours later. It has been
shown to be well tolerated and it is believed by this clinician to be the most effective
agent for the treatment of cataplexy.
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Sources:
-
Guilleminault C. Narcolepsy Syndrome. In: Kryger MH, Roth T, Dement WC, eds. Principles
and practices of Sleep medicine. 2nd ed. Philadelphia: WB Saunders 1994 549-561.
- Aldrich MS. Diagnostic Aspects of Narcolepsy. Neurology 1998; 50 (Suppl 1):52-57.
- Goswami M. The Influence of Clinical Symptoms on Quality of Life Inpatients with
Narcolepsy. Neurology 1998; 50 (Suppl 1):531-536.
- Mignot E. Genetic and Familial Aspects of Narcolepsy. Neurology 1998; 50 Mahowald MW,
What is Causing Excessive Daytime Sleepiness? Postgrad. Med. (Suppl 1):516-522.
- Lin L, Franco J, Li R, et al. The Sleep Disorder Canine Narcolepsy is Caused By a
Mutation in the Hypocretin (orexin) Receptor 2 Gene. Call 1999; 98:365-376.
- Mahowald MW. What is Causing Excessive Daytime Sleepiness? Postgrad.Med 2000;
107:108-123.
- Basetti C, Aldrich MS. Narcolepsy. Neuro Clin 1996; 14:545-571.
- Chaudhary BA, Husain I. Narcolepsy. J. Family Practice 1993: 36:207-213.
- ASDA Standards of Practice Committee. Practice Parameters For the Use of Stimulants
in the Treatment of Narcolepsy. Sleep 1994; 17:348-351.
- US Modafinil in narcolepsy multicenter study group. Randomized trial of Modafinil For
the Treatment of Pathological Somnolence in Narcolepsy. Annals of Neurology 1998;
43:88-96.
- Scharf MB, Lai AA, Branigan B, et al. Pharmacokinetics of Gammahydroxybutyrate (GHB)
in Narcoleptic Patients. Sleep 1993; 21:507-574.
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Naturopathy
Naturopathic medicine (also known as naturopathy) is a school of medical philosophy
and practice that seeks to improve health and treat disease chiefly by assisting the
body's innate capacity to recover from illness and injury.
Naturopathic practice may include a broad array of different modalities, including
manual therapy, hydrotherapy, herbalism, acupuncture, counseling, environmental
medicine, aroma therapy, nutritional counseling, homeopathy, and so on.
Practitioners tend to emphasis a holistic approach to patient care. Naturopathy has
its origins in the United States, but is today practiced in many countries around the
world in one form or another, where it is subject to different standards of regulation
and levels of acceptance.
Naturopathic practitioners prefer not to use invasive surgery, or most synthetic
drugs, preferring "natural" remedies, (i.e. relatively unprocessed or whole
medications), such as herbs and foods.
Licensed physicians from accredited schools are trained to use diagnostic tests such
as imaging and blood tests before deciding upon the full course of treatment.
Naturopathic Practitioners also employ the use of prescription medications and
surgery when necessary and refer out to other medical practitioners.
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Neoplasia
Neoplasia is abnormal, disorganized growth in a tissue or organ, usually forming a
distinct mass. Such a growth is called a neoplasm, also known as a tumor.
It is important to note that the term "neoplasm" is not synonymous with cancer,
since neoplasms can be either benign or malignant. Leiomyoma (fibroids of the uterus)
and melanocytic nevi (moles) are the most common types of neoplasms - both are benign.
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Neuroendocrine
Neuroendocrine cells are a specialized group of nerve cells (neurons) that produce
hormones. These hormones may be amines, neuropeptide's, or specialized amino acids.
They package the hormones in vesicles and send these packages via long processes (axons)
to blood vessels.
When stimulated (by hormones from the blood stream or other neurons) the neuroendocrine
cells secrete the hormones into the blood stream. The hormones then travel to their
target cells and may stimulate, inhibit or maintain function of these cells. The target
cells may feed back information to these neurons that regulates further secretion.
Specialized groups of neuroendocrine cells can be found at the base of the third ventricle
in the brain (in a region called the hypothalamus). This area controls most
anterior pituitary cells and thereby regulates functions in the entire body, like
responses to stress, cold, sleep, and the reproductive system.
The neurons send processes to a region connecting to the pituitary stalk and the
hormones (called releasing or inhibiting hormones) are released into the blood stream.
They are carried by portal vessels to the pituitary cells where they may stimulate,
inhibit, or maintain the function of a particular cell type.
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Neurochemicals
A neurochemical is an organic molecule that participates in neural activity.
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Neurological
A branch of medicine dealing with disorders of the nervous system. Physicians
specializing in the field of neurology are called neurologists and are trained to
diagnose, treat, and manage patients with neurological disorders.
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Neurotransmitters
Neurotransmitters are chemicals that allow the movement of information from one
neuron across the gap between it and the adjacent neuron.
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Norepinephrine
One of two catecholamine
hormones (epinephrine is the other) secreted by the adrenal glands, as well as at
nerve endings, as a neurotransmitter. It resembles adrenaline chemically and in its
actions on the body, which mimic sympathetic nervous system stimulation. It constricts
most blood vessels and is given for certain types of shock. Norepinephrine is formed
from tyrosine and converted to epinephrine. It was discovered by Ulf von
Euler-Chelpin (1905-83) in the mid-1940s.
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NSAID's
Non-steroidal anti-inflammatory drugs, NSAID's, are drugs with analgesic antipyretic
and anti-inflammatory effects - they reduce pain, fever and inflammation. The
term "non-steroidal" is used to distinguish these drugs from steroid, which (among a
broad range of other effects) have a similar eicosanoid-depressing, anti-inflammatory
action. The most prominent members of this group of drugs are:
Acetaminophen has
little anti-inflammatory activity, and is strictly speaking not an NSAID.
Part of the popularity of NSAID's is that, unlike opiods, they do not produce sedation
or respiratory depression and have a very low addiction rate. NSAID's, however, are
not without their own problems. The two main adverse drug reactions associated with
NSAID's relate to gastrointestinal (GI) effects and renal effects of the agents.
RISKS:
-
If you are taking a COX-2 inhibitor such as:
Celebrex® or
celecoxib you should
not use a traditional NSAID (prescription or over-the-counter).
-
GI Problems: Nausea/Vomiting,
Dyspepsia, stomach ulceration/bleeding, Diarrhea
-
Risk of ulceration increases with duration of therapy, and with higher doses.
-
NSAID's are also associated with a relatively high incidence of renal adverse drug
reactions.
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