Archive for March, 2011

DISORDERS THAT CAN BE CONFUSED WITH OR MIMIC RHEUMATOID ARTHRITIS

Monday, March 28th, 2011
What are some of the other diseases that can mimic RA?
Any disease that causes the joints to become red and hot can be mistaken for RA. Some of these conditions include Lyme disease, bacterial blood infection in the joint, infection with parvovirus, German measles, sometimes AIDS, hepatitis B, rarely crystal formation in the joints as occurs with gout, and palindromic joint disease.
What is palindromic rheumatism?
Palindromic rheumatism is arthritis that occurs in cycles. The disease goes away completely between attacks. An episode can last a few hours or a few days. The disease is usually treated with a disease-modifying drug like sulfasalazine or gold. Other anti-inflammatory agents may be used as well.
Will my RA go into remission?
It certainly can go into remission over time after the diagnosis is made. Doctors look for specific criteria to determine if a patient’s RA is in remission. At least five of the following criteria must be present before the doctor can say that the disease is in remission.
1.  The duration of morning stiffness must be less than 15 minutes.
2.  Absence of fatigue.
3.  Absence of joint pain.
4.  Absence of joint tenderness upon movement.
5.  Absence of swelling in joints and tendons.
6.  Sedimentation rate must be less than 30 in women and less than 20 in men.
How do I get into remission?
This can happen by itself or as a result of therapy.
*17/141/5*

DISORDERS THAT CAN BE CONFUSED WITH OR MIMIC RHEUMATOID ARTHRITISWhat are some of the other diseases that can mimic RA?Any disease that causes the joints to become red and hot can be mistaken for RA. Some of these conditions include Lyme disease, bacterial blood infection in the joint, infection with parvovirus, German measles, sometimes AIDS, hepatitis B, rarely crystal formation in the joints as occurs with gout, and palindromic joint disease.
What is palindromic rheumatism?Palindromic rheumatism is arthritis that occurs in cycles. The disease goes away completely between attacks. An episode can last a few hours or a few days. The disease is usually treated with a disease-modifying drug like sulfasalazine or gold. Other anti-inflammatory agents may be used as well.
Will my RA go into remission?It certainly can go into remission over time after the diagnosis is made. Doctors look for specific criteria to determine if a patient’s RA is in remission. At least five of the following criteria must be present before the doctor can say that the disease is in remission.1.  The duration of morning stiffness must be less than 15 minutes.2.  Absence of fatigue.3.  Absence of joint pain.4.  Absence of joint tenderness upon movement.5.  Absence of swelling in joints and tendons.6.  Sedimentation rate must be less than 30 in women and less than 20 in men.
How do I get into remission?This can happen by itself or as a result of therapy.*17/141/5*

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PATTERNS IN SCHIZOPHRENIA: CHANGES IN BEHAVIOR

Monday, March 21st, 2011
Withdrawing, remaining quietly in one place for long periods, being agitated and immobility are all common behavioral ‘disorders’ of this illness.
When I am walking along the street it comes on me. I start to think deeply and I start to go into a sort of trance. I think so deeply that I almost get out of this world. Then you get frightened that you are going to get into a jam and lose yourself.
The state of indifference reigning until now was abruptly replaced by inner and outer agitation. At first I felt obliged to get up and walk; it was impossible to stay in bed. Singing a requiem without pause, I marched three steps” forward and three steps back, an automatism that wearied me exceedingly and which I wished someone would help me break. I could not do it alone, for I felt forced to make, these steps and if I stopped from exhaustion, even for a moment, I felt guilty again.
… I was to lean on the back of my head and on my feet in bed, and twist my neck by throwing my body with a jerk from side to side. I fancy that I never attempted this with sincerity, because I feared to break my neck.
In the second instance, I would say, ‘You poor person. You really need someone to enter with you into that lonely world, so I am going to do that and I promise to stay there with you until the terrible witch-like spell upon you breaks. I love marching and singing. Now, let us get up and march together, one, two, three, one, two, three, and let us sing together … by the way, what is the meaning of this requiem and for whom was it sung? How interesting. One, two, three, do not forget the steps. Let’s keep going, for if we stop too early we are guilty of not really fulfilling a part of your myth. Only when it is completed can we both be free. I really understand you, you know, because I too often feel driven to do things, even though I hate doing them.’
In this case, there is no choice about breaking the spell alone. The man cannot break this spell, so it would be unwise to advise it. As far as we can see, there is no pattern for that, so it will not work. The man needs relationship with an outer person and asks for that.
In the other case, however, the pattern is a bit different. The patient says that he tried to resist the spell. Therefore I would say, ‘Wow, you are lucky, you have a really powerful taskmaster inside. I am glad you did not break your neck and follow him, that shows that you are stronger than he is and have more feeling than he does. But I wonder, what can we do with that force? How could you apply that discipline in your life? Have you finished high school? Are you afraid to finish college? Can you hold down a job?’
*81\227\8*

PATTERNS IN SCHIZOPHRENIA: CHANGES IN BEHAVIORWithdrawing, remaining quietly in one place for long periods, being agitated and immobility are all common behavioral ‘disorders’ of this illness.When I am walking along the street it comes on me. I start to think deeply and I start to go into a sort of trance. I think so deeply that I almost get out of this world. Then you get frightened that you are going to get into a jam and lose yourself.The state of indifference reigning until now was abruptly replaced by inner and outer agitation. At first I felt obliged to get up and walk; it was impossible to stay in bed. Singing a requiem without pause, I marched three steps” forward and three steps back, an automatism that wearied me exceedingly and which I wished someone would help me break. I could not do it alone, for I felt forced to make, these steps and if I stopped from exhaustion, even for a moment, I felt guilty again…. I was to lean on the back of my head and on my feet in bed, and twist my neck by throwing my body with a jerk from side to side. I fancy that I never attempted this with sincerity, because I feared to break my neck.In the second instance, I would say, ‘You poor person. You really need someone to enter with you into that lonely world, so I am going to do that and I promise to stay there with you until the terrible witch-like spell upon you breaks. I love marching and singing. Now, let us get up and march together, one, two, three, one, two, three, and let us sing together … by the way, what is the meaning of this requiem and for whom was it sung? How interesting. One, two, three, do not forget the steps. Let’s keep going, for if we stop too early we are guilty of not really fulfilling a part of your myth. Only when it is completed can we both be free. I really understand you, you know, because I too often feel driven to do things, even though I hate doing them.’In this case, there is no choice about breaking the spell alone. The man cannot break this spell, so it would be unwise to advise it. As far as we can see, there is no pattern for that, so it will not work. The man needs relationship with an outer person and asks for that.In the other case, however, the pattern is a bit different. The patient says that he tried to resist the spell. Therefore I would say, ‘Wow, you are lucky, you have a really powerful taskmaster inside. I am glad you did not break your neck and follow him, that shows that you are stronger than he is and have more feeling than he does. But I wonder, what can we do with that force? How could you apply that discipline in your life? Have you finished high school? Are you afraid to finish college? Can you hold down a job?’*81\227\8*

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LEARNING ABOUT INFECTIONS: INFECTIOUS HEPATITIS

Monday, March 14th, 2011
Infectious hepatitis is an infectious disease caused by a virus. Formerly the condition was simply called jaundice; now we know that catarrhal jaundice is produced by an inflammation of the liver resulting from an attack by the virus which is specific for that disease. Epidemiologists believe that the virus gets into the human being by two possible routes: 1) by inhaling a droplet from the throat coughed into the air by people who are infected, and 2) by consuming contaminated food or water.
A similar condition called homologous serum jaundice follows the injection of blood or serum from certain donors who harbor a virus that attacks the liver. This type of jaundice has a longer incubation period than infectious hepatitis – namely, from 50 to 140 days after the transfusion, compared to 25 or 46 days after receiving the virus.
Since the use of one syringe and a different needle for each person in a series of mass injections has been shown to be involved sometimes in causing homologous serum jaundice, doctors urge the only sure way to prevent this is to provide a heat-sterilized needle and a separate syringe for each person. Usually infectious jaundice causes gastrointestinal trouble, including nausea and loss of appetite, occasionally with fever, before the jaundice which is characteristic of this condition first appears. Symptoms include some upper abdominal pain on the right side and a loss of appetite associated with nausea. Vomiting and diarrhea occur in about one-fifth of the cases. Occasionally the liver is found to be enlarged and tender.
The jaundice and the symptoms gradually subside in from one to three weeks. When the jaundice has cleared completely and the patient is becoming convalescent, relapses may occur and the jaundice will reappear. Rest in bed is one of the most important treatments. Most of the patients get well and do not have any after-effects; about 90 per cent recover without any damage. The number of people who die is exceedingly small, perhaps one in every 500 people who are infected with this virus. In one or two per cent of the infected chronic liver damage occurs, and these people can be troubled thereafter with hardening and scarring of the liver.
Certain factors seem to predispose people who have infectious hepatitis to having a serious case instead of a mild one. Probably the most important factor is a low state of nutrition. The high mortality observed in outbreaks among the native people in such areas as India where famine has been prevalent is not seen in healthy European countries, where mortality rates are much less. In undernourished communities, the mortality rate may be fifteen times that among well-nourished people. Severe injuries or burns associated with infectious hepatitis make the condition much worse, and pregnancy is reported to increase the risk of serious and permanent damage to the liver. Since malnutrition, injuries, burns and pregnancy all are related to disturbance of the protein metabolism, the massive damage to the liver that occurs when people have diets deficient in protein seems to bear a definite relationship to the severity of infectious hepatitis.
Although various methods of treatment have been tested, no specific chemical substance has been found which is effective against the virus of infectious hepatitis. Rest in bed for as long as the illness persists is one of the most important forms of treatment. When the bile has disappeared from the urine of the patient, he is allowed to leave his bed in order to attend to his toilet. Otherwise he must have complete rest in bed until the enlargement of the liver and the tenderness has disappeared. After infectious hepatitis, return to work must be gradual since the condition leaves patients seriously exhausted.
Protein is necessary to maintain the integrity and function of the liver. The diet in infectious hepatitis should be rich in protein and carbohydrate but poor in fat. The fats must not, however, be so severely restricted that the food will become unpalatable and the patient will lose his appetite and quit eating. The diets recommended are 150 grams of protein, 350 grams of carbohydrate and 50 grams of fat which provide about 2,500 calories. This is more than ample for a person confined to bed. Since the appetite is weak, the meals are to be small and given at frequent intervals. People who are severely undernourished and who sustain infectious hepatitis may have extra amounts of certain basic amino acids, methionine, cystine or choline, which deficiencies seem to enhance the virulence of the virus. British investigators suggest that water-soluble vitamins, particularly ascorbic acid, must be provided in adequate amounts to these patients, and also the vitamins of the В complex.
Therefore, in addition to rest and careful supervision of diet, the treatment of infectious hepatitis is applied to control of unpleasant symptoms like constipation, the use of sedatives to insure rest and sleep and other methods of treatment to control nausea and vomiting. If much water is lost by vomiting and diarrhea, the provision of extra fluid is important.
*17/318/5*

LEARNING ABOUT INFECTIONS: INFECTIOUS HEPATITISInfectious hepatitis is an infectious disease caused by a virus. Formerly the condition was simply called jaundice; now we know that catarrhal jaundice is produced by an inflammation of the liver resulting from an attack by the virus which is specific for that disease. Epidemiologists believe that the virus gets into the human being by two possible routes: 1) by inhaling a droplet from the throat coughed into the air by people who are infected, and 2) by consuming contaminated food or water.A similar condition called homologous serum jaundice follows the injection of blood or serum from certain donors who harbor a virus that attacks the liver. This type of jaundice has a longer incubation period than infectious hepatitis – namely, from 50 to 140 days after the transfusion, compared to 25 or 46 days after receiving the virus.Since the use of one syringe and a different needle for each person in a series of mass injections has been shown to be involved sometimes in causing homologous serum jaundice, doctors urge the only sure way to prevent this is to provide a heat-sterilized needle and a separate syringe for each person. Usually infectious jaundice causes gastrointestinal trouble, including nausea and loss of appetite, occasionally with fever, before the jaundice which is characteristic of this condition first appears. Symptoms include some upper abdominal pain on the right side and a loss of appetite associated with nausea. Vomiting and diarrhea occur in about one-fifth of the cases. Occasionally the liver is found to be enlarged and tender.The jaundice and the symptoms gradually subside in from one to three weeks. When the jaundice has cleared completely and the patient is becoming convalescent, relapses may occur and the jaundice will reappear. Rest in bed is one of the most important treatments. Most of the patients get well and do not have any after-effects; about 90 per cent recover without any damage. The number of people who die is exceedingly small, perhaps one in every 500 people who are infected with this virus. In one or two per cent of the infected chronic liver damage occurs, and these people can be troubled thereafter with hardening and scarring of the liver.Certain factors seem to predispose people who have infectious hepatitis to having a serious case instead of a mild one. Probably the most important factor is a low state of nutrition. The high mortality observed in outbreaks among the native people in such areas as India where famine has been prevalent is not seen in healthy European countries, where mortality rates are much less. In undernourished communities, the mortality rate may be fifteen times that among well-nourished people. Severe injuries or burns associated with infectious hepatitis make the condition much worse, and pregnancy is reported to increase the risk of serious and permanent damage to the liver. Since malnutrition, injuries, burns and pregnancy all are related to disturbance of the protein metabolism, the massive damage to the liver that occurs when people have diets deficient in protein seems to bear a definite relationship to the severity of infectious hepatitis.Although various methods of treatment have been tested, no specific chemical substance has been found which is effective against the virus of infectious hepatitis. Rest in bed for as long as the illness persists is one of the most important forms of treatment. When the bile has disappeared from the urine of the patient, he is allowed to leave his bed in order to attend to his toilet. Otherwise he must have complete rest in bed until the enlargement of the liver and the tenderness has disappeared. After infectious hepatitis, return to work must be gradual since the condition leaves patients seriously exhausted.Protein is necessary to maintain the integrity and function of the liver. The diet in infectious hepatitis should be rich in protein and carbohydrate but poor in fat. The fats must not, however, be so severely restricted that the food will become unpalatable and the patient will lose his appetite and quit eating. The diets recommended are 150 grams of protein, 350 grams of carbohydrate and 50 grams of fat which provide about 2,500 calories. This is more than ample for a person confined to bed. Since the appetite is weak, the meals are to be small and given at frequent intervals. People who are severely undernourished and who sustain infectious hepatitis may have extra amounts of certain basic amino acids, methionine, cystine or choline, which deficiencies seem to enhance the virulence of the virus. British investigators suggest that water-soluble vitamins, particularly ascorbic acid, must be provided in adequate amounts to these patients, and also the vitamins of the В complex.Therefore, in addition to rest and careful supervision of diet, the treatment of infectious hepatitis is applied to control of unpleasant symptoms like constipation, the use of sedatives to insure rest and sleep and other methods of treatment to control nausea and vomiting. If much water is lost by vomiting and diarrhea, the provision of extra fluid is important.*17/318/5*

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