World of Health

A healthy and balanced diet is important for the development of the unborn child. This includes an appropriate balance of carbohydrates, fats and proteins. Vegetarians should pay special attention to a balanced diet.  In addition, there are some special needs during pregnancy:
Folic acid

Folic acid (also known as vitamin B9), especially in early pregnancy is needed to prevent a neural tube defect. The risk of severe deformity can be minimized by taking folic acid as a dietary supplement.

Folic acid is found in whole grains, green leafy vegetables, spinach, broccoli, carrots, asparagus, brussels sprouts, tomatoes, egg yolks, nuts and liver.  It should be dispensed with on the liver during pregnancy because the high concentration of vitamin A could be toxic and there is the possibility of transmission of harmful substances stored in the liver. In several countries, including the United States there is artificially added folic acid flour and bakery products. For related discussion see article folic acid.
Calcium, iron and vitamin D
Calcium and iron to a high degree is required for the rapidly growing foetus. Calcium is present in particularly high concentrations of cheese and other dairy products.  Iron is found in meat, legumes and whole grain bread.  Although liver contains a lot of iron, the vitamin A content is so high that it can cause harm to the child.

With the threat of iron deficiency anaemia and iron supplements may also be taken.  Fatty fish meat (such as salmon) is a source of vitamin D. Lisa Bodnar and colleagues found deficits in a study in 80% of African American and almost half of white American women, even though 9 out of 10 of a total of 400 pregnant women needed vitamin supplementation.

Fluoride
Fluoride is considered not just as important to the hardening of tooth enamel, but also for bone growth. Foods with abundant fluoride content are saltwater fish, black tea and mineral water (those with a fluoride content higher than 1.5 mg per litre) provide fluoride.

In many regions the daily “needs” are a designated amount of about 1 milligram of fluoride not covered by the diet. In the trade therefore, fluoridated salt and fluoridated toothpaste is available. In some countries drinking water with fluoride added, should lead to better teeth.
Omega-3 fatty acids
Omega-3 fatty acids can not be formed by the body itself.  The omega-3 fatty acids are hormone-like substances that have an influence on the duration of the pregnancy, while another omega-3 fatty acid, docosahexaenoic acid, is used for the construction and function of the brain and eye (e.g. formation of Neuronal - membranes).

Saltwater fish such as salmon, anchovies, sardines, mackerel and tuna provide both long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid.  Predatory fish like tuna or swordfish however, often have relatively high mercury content, so they are not suitable for pregnant women. Raw fish should be avoided.

In the placenta sits a protein that ensures the supply for the growing child in particular of docosahexaenoic acid – at the expense of the mother. It provides the mother with omega-3 fatty acids particularly well, the pregnancy is slightly longer (up 1.6-2.6 days), and there is less chance of postpartum depression.

The child develops the functions of the eye and brain better (e.g. 4 points higher intelligence quotient at 4-year olds). Therefore, out of the major professional societies that have been developed, there are new recommendations for pregnant women. During pregnancy you should take at least 200 DHA / day, although it was pointed out that 2.7 g / day of omega-3 fatty acids in scientific trials did not have significant side effects.  Early pregnancy should have recognized deficiencies in the diet.

Iodine
Iodine deficiency during pregnancy can be the cause of goiter in the unborn, but also be the cause of poor growth, a disorder of brain development or miscarriages and stillbirths. Regular milk and dairy products to eat and to use only iodized salt. Often, an additional revenue of Iodine tablets are required.

Diabetics who do the routine monitoring of glucose can detect increases in blood glucose, without symptoms of hyperglycemia.  For these patients it is recommended, whenever possible, to search for the level of glucose in the blood. This can be done preferably on the following occasions, fasting and before meals (breakfast and dinner); fasting and two hours after food; up to two hours after meals Postprandial glucose is measured within two hours after food. The interpretation of their results must be made by the doctor.

In patients with diabetes, insufficient medical treatment for food and daily activities often occurs.  Other causes may be: Diabetes mellitus and primary or secondary to other pathologies such as colds or infections in general; Abuse habits; Lack of exercise and

metabolic syndrome.

Symptoms include Polyuria (excess urine) excessive hunger, weight loss accompanied by tiredness, dry skin, headaches which may progress to nausea and vomiting, drowsiness, difficulty breathing and breath acetone (sweet taste).

Chronic complications of hyperglycemia are related to microangiopathy characterized by impairment of capillary blood vessels, nephropathy and retinopathy. Macroangiopathy is characterized by the involvement of the arteries and circulatory deficiency in the brain, heart and limbs. Retinopathy  is characterized by changes in vision such as perception of floats, coloured rings or halos, poor daytime vision, pressure or pain on the eyes, or hypersensitivity to light.

Nephropathy - Characterized by persistent albuminuria (albumin excretion levels above 300 mg / dl) in the absence of other renal disorders. Neuropathy is the sensation of numbness, impotence, digestive disorders, urinary and / or circulatory, skin dryness, ulcerative lesions on the feet and legs, among others.

High levels of glucose in the blood can lead to long term, irreversible changes in nerves and in large and small blood vessels.  Diabetes can also reduce the body’s ability to resist infection, and increase the propensity to eye problems, kidney disease, high blood pressure, heart attacks, strokes, brain damage and amputation of upper and lower limbs.

If there are identified elevated levels of blood glucose, you should see a doctor or a health service for diagnosis and treatment. Adequate control of diabetes can help prevent and avoid the problems, together with healthy changes in lifestyle of the patient as: a raised level of information, leading to better management of the problem;

selecting a nutritionally balanced eating plan rich in complex carbohydrates;

decreased intake of fats in the diet;

careful choice of meal times;

low impact physical exercises like walking, swimming and cycling;

visit health professionals regularly and following their recommendations.

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Psoriatic arthritis is the inflammatory condition of the joints associated with psoriasis. For the diagnosis of psoriatic arthritis, it is a necessary prerequisite to be seronegative (i.e. that patients do not have rheumatoid factor or other auto-antibodies) and that no data is suggestive of rheumatoid arthritis.

The prevalence of psoriasis is approximately 1 to 3%. Of this population, between 5 to 10% suffer arthritis.). It is unclear why there is an association between arthritis and psoriasis. However, we know the importance played by cytokines, particularly the tumor necrosis factor.

Based on the manifestations of the disease, the following patterns are considered:
Asymmetric oligoarticular forms up to 50% of cases. It mainly affects proximal and distal joints (fingers). It is considered that a maximum of 5 affected joints are needed for a diagnostic criterion. Usually have a preference for the lower extremities; Similar to seronegative rheumatoid arthritis (no rheumatoid factor) with a more benign prognosis and more durable remissions. It is a symmetrical polyarthritis, with possible involvement of the spine;
Distal form: almost path gnomonic (exclusive) of psoriasis, but very rare. Almost always associated with psoriasis of the nails; Peripherally, with or without sacroiliitis spondylitis; Sacroiliitis or ankylosing spondylitis: with or without peripheral joint disease.

The diagnosis is mainly clinical, because analytics are non specific and alter only in severe cases. Synovial fluid analysis, although it is inflammatory, is also non specific.
Radiology is normal, at least until the process is well advanced, which is when signs like the following occur:

There may be a characteristic sign, called a ‘pencil in cup’ in the distal interphalangeal joints (distal narrowing and widening proximal); Bony ankylosis, especially in the fingers; Juxtaarticular Osteoporosis is less obvious than in rheumatoid arthritis. The condition of the spine is more common than in other pathologies, but differs in that it is asymmetric.

And sometimes syndesmophytes appear, but it also differs from other types of arthritis and usually involves only 2 or 3 vertebrae, beginning at the cervical region where it is not progressive.

The treatment of skin lesions is the same as any psoriasis. For joint symptoms are recommended. General measures such as physiotherapy and postural YEAR, which aims to: Encourage the extensor muscles of the back; Maintain the functionality of the large joints, most important for everyday life; Sleep on hard mattress with thin or no pillow can be helpful.

The so-called disease-modifying drugs (DMARDs) such as methotrexate and salazoprina are indicated in ankylosing spondylitis, especially if peripheral. It could be tested with retinoids and cyclosporin A, and anti-TNF biologic therapy (abciximab). Biological therapy involves the use of inhibitors of tumor necrosis factor (TNF).

TNF is a cytokine involved in the natural inflammatory and normal immune responses. It has been shown that the first fully human monoclonal antibody produced by recombinant DNA technology enables the reduction of signs and symptoms of active arthritis in patients with psoriatic arthritis, whether given as monotherapy or in combination with ARME agents.

Adalimumab binds specifically to TNF (tumor necrosis factor alpha) but not to lymphotoxin (TNF-beta) and neutralizes the biological function of this by blocking its interaction with the p55 and p75 for TNF in the cell surface.

Migraines can be one of the worst irritating illnesses; not only can they strike at anytime but they can also put you out of action for hours or even days. However what if there is a way to help you to make 2011 a migraine free year? Well by making modifications to your diet this can actually be a reality…

Doctors know very little about migraine causes except that they run in families, and may be triggered by many conditions ranging from nervous excitement, disturbed sleep patterns, stress and reactions to certain foods, such as cheese or chocolate. These headaches often come with nausea, vomiting, sensitivity to sound and light, and, perhaps most strangely of all, distorted sensory perception, especially vision. If you add together the range of different symptoms and so many different potential triggers, it is no surprise that researchers are perplexed about the science behind these headaches, or that sufferers seem to find treatments so hit-and-miss.

However research has found that in many people migraines are triggered by reactions to foods. Clinical studies shown that management of the diet can reduce the severity and, or, frequency of headaches or even stop them. However the problem is trying to figure out which foods are causing you problems. Luckily a simple finger prick test can do just that by identifying the trigger foods responsible for food intolerances. The test measures food-specific IgG antibodies and helps identify different food types in which an individual may be sensitive to.

The simple to use test is able to give you an accurate reading of exactly what foods your body is reacting against so that you know what to avoid. The test in question is the foodSCAN 113 from YorkTest and is the only test of its kind that is recommended by the charity Allergy UK. Supported by hard evidence the test was used in a study conducted York University and YorkTest on 514 migraine and headache sufferers and showed that showed that 81% benefitted in terms of the frequency and severity of their attacks if they removed the foods from their diet that showed a positive reaction. Some of the most common food intolerances people experience has been shown to be yeast, dairy, and wheat intolerance – everyday food types that you may have intolerance to but have never known!

Further studies using the same test have also found other food intolerance symptoms including bloating, irritable bowel syndrome, and nausea among others, which highlights the important role that your diet plays in your own wellbeing. So by indentifying food that your body has a reaction to you could make 2011 your healthiest year yet!

Dozens of badly needed procedures are being delayed or denied to thousands of patients across the country, as Primary Care Trusts (PCT) attempt to reduce or reign in spending between now and the start of their new fiscal year in April.

People will suffer in otherwise unnecessary pain as the NHS trusts attempt to pull themselves from financial ruin by ruining the health of those for whom they are assigned to care.  Stating a need to have funds in order to deal with the UK ageing crisis, PCTs are looking for ways to cut about £20 billion by 2014.  The only way to attain this is to delay or cancel procedures for those in need.

Many of the decisions about cuts were made during meetings held within the past two months, which means that the full impact of cost-saving measures are yet to be felt, however, we have some examples to consider, like NHS Eastern and Coastal Kent, where waiting time for all non-urgent operations, which can include things like cataract surgery, and knee and hip surgery, will be extended from three weeks to a full four months.

Warwickshire is suspending all shoulder, hip, and knee surgeries until April, while Warrington has delayed all IVF procedures until July.

Patients in Wiltshire must wait four months for routine surgeries, even as GPs are asked to delay referrals for non-urgent operations for at least two months.

It is worried that the elderly will suffer most in the course of this crisis and those who need the care the most will be turned away or delayed for protracted periods of time.  Already, people are complaining to the Patients Association that surgeries have been cancelled without explanation or rescheduling.

For years, it has been a complaint that NHS managers were overpaid, now it has come to a crunch and it is the patients who get squeezed instead of the bureaucrats, complains one insider.

Women with epilepsy who take carbamazepine during pregnancy may be at greater risk of having a baby with spina bifida, according to recent studies.  The research is not conclusive at this point, but the medical profession has been put on guard against prescribing the drug for pregnant women.

Carbamazepine is used to control seizures associated with epilepsy, and this control is very important during pregnancy.  This drug, also known as Tegretol, is one of the most effective, and physicians must weigh the dangers of an epileptic seizure during pregnancy against the possibility of spina bifida in a newborn infant.

Spina bifida presents a life-long health problem to its victims; it is a condition in which the spinal cord remains in place, but the vertebrae are malformed to one degree or another, leading to partial or complete paralysis in severe cases.  The latest study showed that babies born of women taking carbamazepine while pregnant were 2.6 times more likely to be stricken with the disease.

An even riskier seizure-controlling drug is valproic acid, known as Depakene.  In another study by the same group of researchers, they found that the use of valproic acid during pregnancy posed a six times greater risk of the women having babies with spina bifida.  The risk of other birth defects such as hypospadias was seven times greater with valproic acid.

The lead researcher in the study at the University of Groningen in the Netherlands said that the studies could help physicians and patients in deciding what treatment would be best, as it is a decision to be made on an individual basis.  He noted that although a definite connection has been established between carbamazepine and spina bifida, the overall ratio of incidence is only 3%, a comparatively small risk.