Archive for May, 2009

20
May

Entering HIV Treatment

   Posted by: author1    in Diseases

Each HIV infected patient who is entering into care should have a full medical history, physical, lab evaluation and counseling. This is to confirm the presenence of HIV, get historical and laboratory data, discuss treatment of HIV with patient, and initiate care as suggested by HIV primary care guidelines. Baseline information then is used to define management goals and plans.

A new patient should have the following tests performed on them in their first visits

•  HIV antibody testing (if prior documentation not available) or if HIV RNA is undetectable (AI);
– CD4 + cell count
– HIV RNA (Viral Load);
•  Complete blood count, chemistry profile, transaminase levels, BUN and creatinine, urinalysis, screening test
for syphilis (e.g., RPR, VDRL, or treponema EIA), tuberculin skin test (TST) or interferon-γ release assay
IGRA (unless there is history of a prior TB or positive TST or IGRA), anti Toxoplasma gondii IgG,
hepatitis A, B, and C serologies, and Pap smear in women;
– Fasting blood glucose and serum lipids if the person is considered to be at risk for heart disease and for
baseline evaluation before the start of ARV therapy and
• For patients who have pretreatment HIV RNA >1,000 copies/mL, genotypic resistance testing when the
regardless of whether or not a patient is going to begin therapy immediately they need to enter into care. For patients who
have HIV RNA levels of 500–1,000 copies/mL, resistance testing also may be considered, even though
amplification may not always be successful (BII). If therapy is deferred, repeat testing at the time of
antiretroviral initiation should be considered (CIII).

Patients living with HIV infection must often cope with multiple social, psychiatric, and medical issues that are best
addressed through a multidisciplinary approach to the disease. The evaluation also must include assessment of
substance abuse, economic factors (e.g., unstable housing), social support, mental illness, comorbidities, high-risk behaviors, and other factors that are known to impair the ability to adhere to treatment and to promote education about HIV Once evaluated, these factors should be managed accordingly.
Lastly,  risk behaviors and effective strategies to prevent HIV transmission. to others should be
provided at all a patient’s clinical visits.

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13
May

Common Food Allergies – Itching For Relief

   Posted by: Dr. Tonia Mitchell ND    in Allergies

Besides stress (one of my favorite topics) the other broad category that affects the health of my patients the most is allergies.  There are different types of allergic reactions.  This article will focus on the symptoms of common food allergies and how you can find out if you have them.

Let’s start with the type of food allergy you are likely to be most familiar with:

  • The immediate type reaction.  This type of food reaction can be very severe and occurs because the immune system is overreacting to a substance that it perceives as being a hostile foreign invader, but that is usually safe for most people. Certain immune receptors (IgE antibodies) bind with certain foreign proteins in foods (allergens) and cause certain immune cells (mast cells) to release histamine.  This powerful messenger causes inflammation and other detrimental effects such as a narrowing of the windpipe.  This type of allergic response can be related to eczema, hay fever and, most seriously, asthma as well as anaphylaxis which can lead to shock and death.  People who are aware of these type of food allergies often will carry an epi-pen or an inhaler.  But if you eat a food and your lips or tongue feels tingly, or you have trouble breathing, you are likely allergic to it.  It is best to stay away from that food.  The most common food allergies in this group in decreasing order of frequency include:
  1. egg
  2. fish
  3. shellfish
  4. nuts
  5. peanuts

Immediate type allergies can be tested by a skin prick test or a blood test.

The next type of allergy is less familiar, although incredibly common, to most people and it is called:

  • The delayed type sensitivity. These common food allergies can take up to 72 hours to actually present themselves as symptoms.  This makes it hard to know what food is causing what reaction.  The most common food allergies of this type are (in decreasing order of frequency):
  1. milk
  2. chocolate
  3. wheat
  4. citrus
  5. food colorings

Delayed allergies are mediated by another chemical in the immune system called IgG antibodies.  The IgG antibodies form complexes with allergens and these complexes are deposited into tissues anywhere in the body which can cause a wide array of symptoms.

Digestive symptoms can include: gas, bloating, diarrhea, constipation, cramping, ulcers and heartburn.

Mental / emotional symptoms can include:
anxiety, depression, hyperactivity, insomnia, confusion, inability to concentrate or decreased memory.

Skin symptoms can include: acne, eczema, hives, itching or rashes.

Other symptoms can include: bed wetting, chronic bladder infections, yeast infections, chronic or recurrent colds and flus, headaches, migraines, hayfever, asthma, fatigue, joint pain, painful periods or infertility.

As you can see these allergies can cause a number of effects in the body – things many people live with on a daily basis. The good news?  You don’t have to live in discomfort!!  Methods of testing include various elimination and challenge diets, blood tests and stool tests.  If you suspect you might have one of these common food allergies talk to your Naturopathic Doctor or licensed health care professional about discovering your allergies.

Naturopathic medicine is a safe, effective and natural approach to you and your family’s health.  Naturopathic doctors can and will empower you to live a healthy lifestyle while treating and preventing disease.  Find more information on the services I offer at Arbour Wellness Centre at Nanaimo Naturopathic Doctor.

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12
May

The Many Effects of Cigarette Smoking

   Posted by: author1    in Quit Smoking

Dangers Of Smoking Video

Many people today are vaguely aware of the many dangers of smoking, from lung cancer to bronchitis.  However, the real truth is that there are many, many parts of one’s body, many members of one’s family, and many aspects of one’s life that are hit hard by the effects of cigarette smoking.

Consider these areas of the body that are damaged by smoking.  Your skin is usually touched by premature aging and wrinkles, as one of the common effects of smoking is poor blood circulation and a loss of oxygen, both of which are needed for healthy skin.  A smoker’s mouth usually has discolored and stained teeth and plaque, and teeth can actually become loose as the gums dry up and become brittle.

Cancers of the lips, mouth, throat and larynx are common effects of smoking, as are constant sore throats, a reduced sense of taste, and breath that smells of smoke.  That poor blood circulation means cold hands and especially cold fingertips, which are usually stained of tar.

Lung cancer is not the only effect of cigarette smoking that hits the respiratory system.  Most smokers are more prone to bronchitis, a constant shortness of breath and persistent cough with sputum, and are more likely to get colds, flu, pneumonia, and asthma.  Smoking also complicates tuberculosis and virtually any other respiratory condition one can get.

The effects of cigarette smoking also reach out to those around you as well.  Those who are exposed to second-hand smoke inhale about 15% the amount of nicotine as those who are active smokers, so for every ten cigarettes you have around your children, they may as well have smoked one a half cigarettes themselves.

Even pets have been found to suffer from increased health problems due to their owners smoking!  Many have respiratory diseases and cancers, all a part of the effects of cigarette smoking.

As for the rest of the body, the effects of smoking are many, including blood diseases, decreased circulation to the feet and toes, and difficulty recovering from wounds.  Really, when you think about it, there is not one place on the human body that does not suffer, and suffer greatly, from smoking’s effects.  Really, is there any reason why it’s not time to quit smoking for good?

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