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THE EMOTIONAL EATER-THE MIND/BODY SPLIT: LOVE TO IT, LIVE TO EAT, EAT TO LIVE

Habit will no longer dictate what you eat, nor will eating be only an emotional response to an emotional situation; no longer will hunger be like an assailant coming out of the dark, giving you a quick rabbit punch in the neck. Your heart will say go and your head will say no—and you will begin to listen to your head. You will continue to love to eat and live to eat, but you will begin to eat to live. And as you realize and experience that nothing is leaving the planet, that it will all be here tomorrow and the next day and the day after that for you to enjoy, you get a feeling for later. You begin to think about later and tomorrow and feeling good. So in those moments of madness when all hell breaks loose and you are like a soul possessed and your heart is shouting feed me, feed me; when with wild abandon, without discrimination, you would like to shove it in with both hands, you simply won’t be able to. It no longer works; it doesn’t feel good.But you will still eat. The truth is you will always love to eat in those “moments of madness,” and that’s okay. But you will become aware of a brief moment of clarity in the midst of “being possessed,” a moment in which you have a choice. The choice does not have to be not to eat; just not to destroy yourself in the process. Food will work for you if you’ll only let it.When the need to eat is all-consuming, when your heart is shouting go and your head is shouting no, you will listen to them both. A synergy will develop between your head and your heart, and you will heal your mind/body split. Eating will work for you if you’ll only let it.And you will begin to choose to feel good because it feels a lot better than feeling bad. Eating and feeling good is what the Beverly Hills Diet is all about.What have you got to lose?*60\251\8*


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COSMETIC SURGERY FOR AGEING SKIN: LIP AUGMENTATION, RHINOPLASTYAND OTOPLASTY

Lip augmentationLip augmentation is particularly useful for ageing lips, as lips tend to become smaller and more sunken over time. The corners of the mouth also tend to droop. To create fuller lips, a filling agent such as fat, collagen or silicone is injected into the lips. Most filling agents are of only temporary benefit and the process needs to be repeated after several months. Silicone, the only permanent filler, has now been largely abandoned due to adverse publicity.
Rhinoplasty Because the nose is such a prominent facial feature, large or irregular noses can markedly detract from a person’s looks. Rhinoplasty is a complex procedure, requiring great expertise, but the results can be dramatic.There have been a number of improvements in the area of rhinoplasty. For example, better nasal tip definition can now be achieved by using cartilage grafts taken from inside the nose or ear. Cartilage grafts can also be used on other parts of the nose to improve the profile.The technique of ‘open rhinoplasty’ is increasingly being performed in more difficult cases. This enables a full view of the nose to be obtained, whereas previously all rhinoplasties were performed ‘blind’. Post-operative care has also improved, so that the dreaded nasal packs are now rarely needed. Many rhinoplasties can be done as day procedure operations, making them more affordable.Although rhinoplasties are often performed on teenagers for cosmetic correction of bumpy or long noses, it is not always appreciated that the nose becomes elongated with age and the effects of gravity. The nasal tip droops just as the skin does, so nasal correction in adult life can substantially improve one’s appearance.
Otoplasty This is a simple, effective technique to remedy ‘bat’ ears. Here the cartilage is released so that the ears can spring back into a more natural position. Otoplasty can generally be performed under local anesthetic and recovery is rapid.
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HIV: CAUSES OF CONSTITUTIONAL SYMPTOMS-TUBERCULOSIS

The causes of constitutional symptoms are diverse. Sometimes the cause is anxiety and depression. Sometimes the cause is the common aches and pains—colds, influenza, gastroenteritis, nervous stomach, headaches—that affect everyone.     Sometimes the cause is one of the opportunistic infections. When constitutional symptoms are accompanied by cough and shortness of breath, the cause is probably Pneumocystis pneumonia. When constitutional symptoms are accompanied by headache or other symptoms of central nervous system infection, the cause is probably toxoplasmic encephalitis or cryptococcal meningitis. When constitutional symptoms last for weeks or months, the cause is probably tuberculosis, Mycobacterium avium, cytomegalovirus, lymphoma, fungal infections, drugs, or HIV itself.     Tuberculosis-Tuberculosis (TB) is an infection of the lungs by a bacterium called Mycobacterium tuberculosis. Though the symptoms are usually those of lung infections—cough, bloody sputum, shortness of breath—occasionally the person with TB has only constitutional symptoms—fever, night sweats, and weight loss. In people with HIV infection, TB occurs more frequently and with greater severity; it can also spread to parts of the body other than the lungs.     TB can be active or inactive. If TB is active, the bacterium is multiplying and invading tissue; the person with active TB has symptoms. If TB is inactive, the bacterium is dormant and the person has no symptoms. Most of the people who have active TB have previously had inactive   TB for several years.     Anyone who has TB, active or inactive, is likely to have a positive skin test. People with HIV infection, for whom TB is more frequent and more serious, should routinely get skin tests. Because the skin test relies on an immune response, it is most reliable early in the course of HIV infection and less reliable later when the immune system has weakened. If the skin test is positive and the person has inactive TB, a drug called isoniazid or INH will prevent TB from becoming active. If the skin test is positive and the person has active TB, isoniazid combined with other drugs will control the disease.     TB, when active, can be transmitted to others. Anyone living with someone who has active TB should take the skin test.*138\191\2*


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CONQUERING CHILDREN’S CANCER

When I started reporting on cancer, children with acute lymphatic leukemia died within 18 months. Today, several drugs taken in combination have boosted the 5-year survival rate to 70 percent. Some cancer-stricken children are living long enough to bear children.
At Children’s Hospital and the Dana-Farber Cancer Institute in Boston, a special group of baby leukemia patients has not had a relapse in years. That’s a cancer cure, and for me it’s absolutely breathtaking.
Even for the relapsed patient, there’s hope. In a third of these cases, bone marrow transplants provide new, cancer-free blood. First, doctors treat the child with heavy doses of cancer-killing drugs. That treatment not only kills the cancer cells but also the patient’s blood-forming system. To provide a source of blood cells, doctors transplant healthy marrow from the bones of a donor, usually a relative. If the marrow “takes,” the leukemia is vanquished.
With cancer-killing drugs, the doctors have also achieved great successes in other types of leukemia, cancers of the lymph glands, and various types of rare tumors, all of which used to be incurable. Physicians now save up to 85 percent of these critically ill children.
Dr. David Nathan, who heads the cancer division at Children’s Hospital in Boston, remembers when, not too long ago, “all of my patients died”.
“Can you imagine,” he says, “what this new success means? If we lose a patient now, there is enormous roaring and rage.”
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CHILDREN AND ASTHMA: MILD SYMPTOMS

Following is a checklist of the signs of an impending attack or the worsening of mild symptoms in asthmatic children:
•Sleep disturbance: does your child wake up in the night coughing and wheezing?
•Does your child have a persistent cough?
•Is your child tired in the morning?
•Does wheezing or shortness of breath limit your child’s normal activities?
•Does your child have to use a bronchodilator frequently? According to Dr R., even the most vigilant parents can miss important signs in their asthmatic children:
The most caring parents often overlook the development of worsening symptoms, but parents of asthmatic children must make an effort never to take any symptoms for granted.
I’ll ask Jimmy’s parents how he is and they’ll tell me he’s fine, his asthma is okay. Then I’ll ask them specific questions and I’ll find out he’s been waking three nights a week with asthma, he’s fatigued in the morning and he’s short of breath after any exertion. Because Jimmy has been doing this on and off for years, his parents have become used to it and assume it’s a normal asthma pattern. They often tell me there is nothing new to report, yet the child is displaying quite disturbing symptoms. My specific questions often reveal poor management.
A common worry for parents with asthmatic children is that the child may be on too many drugs and that lasting side effects may occur. Most of the asthma drugs used today have little or no side effects. However, long-term doses of oral steroids can have side effects, so doctors do not prescribe them unless they feel steroids are essential in stabilizing symptoms. In many situations, the long-term side effects of severe, untreated asthma are more detrimental to a child’s health than those of the prescribed medication. If you are worried about your child’s medication, your doctor should be able to reassure you or suggest possible alternative medication.
It is normal for children with asthma to express frustration and resentment when their illness restricts their activities. Children can suffer anxiety when they are having an asthma attack, and some develop psychological problems associated with their asthma. Some asthmatic children become introverted and withdrawn, while others react to the disease by becoming irritable and demanding. A child with any sort of illness can be quite difficult to handle and can cause stress to develop in the rest of the family. Sometimes both parents and children need support and encouragement from their doctor and other health professionals. Unfortunately, some parents feel that if they need professional help in coping with the problems of a sick child, they are somehow admitting failure. Nothing could be further from the truth. By seeking professional advice, parents take positive action toward resolving problems that would probably get worse if they were allowed to continue.
Patricia found that her non-asthmatic daughter needed just as much special attention as did her two asthmatic sons:
I have two asthmatic children, aged four and six. I also have an elder child, aged 11. We have just been through a period where the two asthmatic children have been particularly bad. We have had the dashes to hospital, the daily sessions with the nebulizer and the constant interrupted nights. Both my husband and myself have been exhausted and stressed. While I thought I had managed a very hard time fairly well, I was terribly upset when I found our eldest child sobbing in bed one night. When I asked her what was the matter, she said that I had not told her that I loved her for weeks, that her father had not read her a story for ages and that she wished she had asthma. She was feeling very neglected and, I think, jealous of the attention the two sick children were getting. Later on, her teacher told me she had not tuned in earlier to her feelings, and we have taken time to explain how worried we have been about the younger two. We have involved her to a degree in our discussions about asthma and she now helps us when we administer medication to her brothers. We also make sure we give her some solo time. This can be difficult when you are tired, but it is obviously worth it. I think we have avoided what could have become quite a serious family problem.
Another parent, Charlotte, found the easiest way to get her son to accept his asthma was to introduce him to other asthmatic children:
My child hates using his puffer in public and suffers deeply when he has to pull out of his sporting activities because of wheezing. He has even fudged his peak flow meter readings so that I will let him go to soccer practice. He has developed a way of making the reading go up by jerking his head forward when he blows. We have had some very upsetting scenes when I have curtailed his activities because of his wheezing or one of his regular chest infections. He desperately wants to be like all the other kids, not having to do things like taking medicine before sport, or going on school camps with his portable nebulizer. His attitude has improved since he has matured and since we organized with the specialist, whom he likes, to have a talk to him about his asthma. We also sent him on one of the asthma holiday camps run by the Asthma Foundation. I think it was actually that experience which was the turning point. He realized there are lots of kids who get asthma and that he could be a lot worse. We still have the occasional scene, but he is generally coping well and is more positive about life.
A recent development in the care of asthmatic children is that more schools are becoming aware of the potential severity of the disease and are including asthma medications, such as Ventolin, in their first aid kits. The various Asthma Foundations have been very active in instructing teachers and other staff about how to deal with asthmatic children and what to do in an asthma emergency. As a further aid for teachers, the Asthma Foundations have produced a concise and informative pamphlet, What Every Teacher Should Know About Childhood Asthma.
In the past, many schools as well as individual teachers have been reluctant to become involved in the administration of any medication stronger than aspirin because of the potential legal implications if anything goes wrong. But it is now accepted that allowing a teacher to administer measured doses of a bronchodilator is not dangerous, even if the diagnosis of asthma turns out to be incorrect. Not all teachers have the willingness or the knowledge to become involved in any aspect of first aid, and this position should be respected by both parents and school administration. However, it is in the interests of everyone involved to ensure there are enough people on the school staff prepared to take control in the event of an asthmatic child needing attention.
Parents of asthmatic children should keep teachers up to date about their child’s asthma. All relevant details, such as medication dosages or changes in daily peak flow meter readings, should be recorded on the child’s record card. When a child is known to have asthma, be it chronic, intermittent or mild, the record card should be kept in a place that is readily accessible to all school staff members.
If your child’s school is reluctant to become involved in monitoring and treating asthma symptoms, don’t be afraid to push for changes in the school’s attitude. As Susannah, the mother of a 12-year-old asthmatic girl, reports, school staff’s awareness of asthma is vital to the proper care of asthmatic children:
My daughter is at a private school that until very recently refused to have any asthma medication in its infirmary. This same school had actually experienced an asthma death of a student a few years ago. Even though my asthmatic daughter is old enough and capable enough to carry her own medication, I felt very strongly about the school’s attitude. So did a number of other parents with asthmatic daughters, and eventually we persuaded the principal to invite a respiratory specialist to talk to the teaching staff. As a result, a number of teachers expressed interest in learning more about coping with an asthma emergency and now there is a bronchodilator in the sick bay.
This was all very positive, but there are still problems. Even after the specialist explained aspects of asthma to the staff, one of the sports mistresses forced my daughter to play sport even though my daughter was asthmatic at the time. This particular teacher even refused her permission to get her Ventolin from the classroom. This sort of incident really worries me. I think that asthma education within the community must improve. You would think one asthma death at the school would be enough to make the staff more aware!
This report is just one of numerous such stories from parents of asthmatic schoolchildren. However, the support and understanding for asthmatic children from schools and other teaching institutions has improved dramatically overall. Asthma is much more of a community issue than it was in the past and most schools are willing to participate in the management plan of their asthmatic students.
Current treatment for childhood asthma is safe and usually effective. Only a very small percentage of young asthmatics are unable to lead a normal, active life.
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SEIZURES AND EPILEPSY IN CHILDHOOD: UNDERSTANDING YOUR CHILD’S TESTS – “WHY DO AN EEG ANYWAY? AND WHY REPEAT IT?”

“I still don’t understand why one does an EEG,” you say. “You’ve said it doesn’t diagnose epilepsy. You’ve stated that it doesn’t rule out epilepsy. It sounds to me like it’s useless, one of those boondoggle tests doctors request in order to make more money.”
Despite all of its limitations, the EEG is useful for comparison if seizures continue, get worse, or change in character. An EEG might detect slowing, thereby possibly suggesting a need for concern, and for other types of testing, or focal spikes, a possible local source for the seizure. The EEG can be helpful in diagnosing some special forms of epilepsy. Therefore the EEG is, indeed, a useful test in the diagnosis and management of children with epilepsy, although, of course, only one part of that diagnosis and management.
“If that’s all they get out of the test, why would they want another one?” you might ask. Others might question, “Will the follow-up EEG really show that the epilepsy is getting better or worse?” The answer to both of these questions is that an EEG should be repeated only when it will provide useful information. It should not be repeated routinely, say, every three months, every six months, or even every year, since if your child’s seizures are controlled, you shouldn’t care if the EEG is normal or not, that is, until you want to consider stopping medication.
An EEG should be repeated only if:
• Seizures are continuing despite appropriate medication, or
• Seizures are changing in pattern or frequency, or
• Seizures that have been well controlled now recur, or
• If the child’s functioning is changing.
In any of these above circumstances, a change in the EEG could provide a clue to the reason for the change. A person who has had a few generalized tonic-clonic seizures, followed by successful control of seizures, might have only an initial EEG and no further EEG unless the physician considers stopping medication, and then a second EEG may provide important information about the possibility of further seizures. A child who has frequent seizures or focal seizures might by way of comparison require many EEGs to determine where the seizures are coming from. A third child with difficult-to-control seizures might also require many EEGs, or even continuous monitoring of the EEG for days, in order to capture the seizures as they occur and identify their origin in order to plan surgery. But continuous EEG monitoring, either with ambulatory (walking around) equipment or video monitoring, is a special test and should be used only in such special circumstances.
So the answer to the question “Why repeat the EEG?” is that it depends. But if your physician wants a repeat, don’t hesitate to ask why. He should be able and willing to tell you.
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KEY POINTS: CLASSIFICATION, DIAGNOSIS, AND SCREENING FOR DIABETES

In 1995, the classification of diabetes mellitus was changed, with the major categories being type 1 (immune-mediated or idiopathic) and type 2 diabetes mellitus.
Diagnostic criteria for gestational diabetes mellitus (GDM), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and diabetes mellitus were updated.
The major change was lowering the fasting plasma glucose from > 140 mg/dl to > 126 mg/dl for the diagnosis of diabetes mellitus. Pre-diabetes is defined by either IFG (110-125 mg/dl) or IGT. People with pre-diabetes are at a high risk for the development of diabetes and coronary heart disease.
Screening for the presence of diabetes is best done by measuring the glucose concentration in a specimen of venous plasma, taken after an overnight (> 8 hours) fast.
Fingerstick glucose testing is not accurate enough to use for screening.
Screening should be confined to members of high-risk groups
Two recent major studies have indicated that the onset of type diabetes in people with IGT may be delayed by intensive lifestyle changes (diet and exercise). One study showed that metformin therapy was effective. => These studies indicate that increased use of glucose tolerance testing in people at high risk for diabetes should be used in the future because therapy may decrease the risk of diabetes.
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LIFESTYLE FOR A HEALTHY PROSTATE: WAYS TO REDUCE STRESS

Do other people upset you, particularly when they don’t do things your way? Try cooperation instead of confrontation; it’s better than fighting and always being “right.” A little give and take on both sides will reduce the strain and make you both feel more comfortable.
A good cry can be a healthy way to bring relief to your anxiety, and it might even prevent a headache or other physical consequence. Take some deep breaths; that activity also releases tension.
You can’t always run away, but you can “dream the impossible dream.” A quiet country scene painted mentally, or on canvas, can take you out of the turmoil of a stressful situation. Change the scene by reading a good book or playing beautiful music to create a sense of peace and tranquility. Of considerable help to me is that each day I will take at least 20 minutes to create a scene in my mind of the ocean, which is my favorite spot to relax and to regenerate my enthusiasm for whatever project I am involved in.
It helps to talk to someone about your concerns and worries. Perhaps a friend, family member, teacher, or counselor can help you see your problem in a different light. If you feel your problem is serious, you might seek professional help from a psychologist, psychiatrist, or social worker. Knowing when to ask for help may avoid more serious problems later. No man is an island and can stand alone.
If a problem is beyond your control and cannot be changed at the moment, don’t fight the situation. Learn to accept things as they are—for now—until such time as you can change them. As expressed at Alcoholics Anonymous meetings, “God grant me the serenity to accept the things that I cannot change, the courage to change the things I can, and the wisdom to know the difference.”
Take care of yourself. Get enough rest and eat well. If you are irritable and tense from lack of sleep or if you are not eating correctly, you have less ability to deal with stressful situations. If stress repeatedly keeps you from sleeping, you should ask your doctor to help.
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PMS: NUTRITIONAL DEFICIENCIES

There is plenty of research to support a link between poor eating habits and PMS. The main problems are thought to be caused by shortages of:
• vitamins, particularly B-group vitamins
• minerals such as magnesium and zinc
• essential fatty adds
LACK of essential fatty acids. Essential fatty acids (EFAS) are not fats, like butter, nor adds like those you might have used in school chemistry
lessons. They are more like vitamins (in fad they were called vitamin F when they were first discovered), EFAS are vital for good health and, because our bodies cannot make them, we have to obtain them from our food.
EFAS belong to a group of polyunsaturated fatty adds (PUFAS for short), PUFAS have several roles’ in the body inducting:
• forming part of the membrane that surrounds every cell in the body 15
• providing energy
• maintaining body temperature
• insulating the nerves
In the case of PMS it’s thought that the effect on prostaglandin production is the root of the problem.
There are several types of prostaglandin (scientists believe there are many more that have not yet been discovered). They are involved in a range of processes from blood dotting, lowering blood pressure, causing the womb to contract, and protecting against stomach ulcers.
In the brain a shortage of prostaglandins is thought to lead to low levels of the body’s natural tranquillizers, the endorphins – hence the symptoms of anxiety reported by some women with PMS.
The most important source of EFAS in the diet are meats, dairy products, oily fish, seafoods such as shrimps and prawns, and green leafy vegetables.
The story is further complicated by the fact that there are two forms of linoleic add. One of them – the cis form – is more easily used by the body than the other – the trans form.
The natural state of most PUFAS is in the this form. But during heating or the process of Tiydrogenation’ (as, for example, in the manufacture of low fat’ spreads) the molecule may become changed into the trans form.
For the body, trying to use the trans form is rather like trying to put a left shoe on your right foot. It looks similar but the ‘fif is wrong.
In effect the trans forms are useless as the body cannot convert them and they prevent the body from using cis forms as they block the spaces in the cells where the chemical conversions take place. If s rather like the battle for space between adrenalin and progesterone.
Since some processed foods such as soft margarines and vegetable cooking oils (particularly those that contain hydrogenated oils) may contain up to 50 per cent trans-fatty adds there is real concern that EFA deficiency is widespread.
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THE KINDS OF SEIZURE: SIMPLE PARTIAL SEIZURES – WITH SECONDARY GENERALIZATION

All partial seizures may at times spread to affect the whole brain. While this usually results in a tonic-clonic seizure (see Generalized Seizures above), an atonic seizure in which a child suddenly collapses to the floor or is thrown down, or a tonic seizure in which the child suddenly stiffens and arches his back may result from this spread, depending on the direction of electrical spread.
The parent should carefully observe the onset of a seizure and its progression to enable the physician to take an accurate history in order to determine if there was focal onset, aura, or warning. As with focal or partial seizures, a focal onset of a generalized seizure implies a focal
problem or disturbance. Generalized seizures with focal onset require an especially careful medical evaluation, because if these seizures cannot be controlled with medication, and if the focus can be identified, there may be a possibility of a “cure” of the seizures by surgical removal of the area where the seizure begins.
Now with an understanding of the brain and how it works and with some understanding of its organization and anatomy, you should be better able to understand the many kinds of seizures and the different names physicians use when they describe your child’s seizure or seizures. This naming is important because it will help determine the treatment for your child.
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