PALM BEACH COUNTY, Fla. — The Palm Beach County Health Department is warning resisdents of a locally acquired case of the mosquito borne illness, Dengue Fever.

“we have been closely monitoring the county for the possibility of Dengue being reintroduced in our area since we have seen it in counties north and south of us,” said Health Director Alina Alonso, MD. “with today’s confirmation I am issuing a Mosquito Borne Illness Advisory.”

In 2009 locally acquired cases of Dengue were diagnosed in Key West and since then, others have been found in South Florida. this is the first locally acquired case in Palm Beach County although eight others have been reported this year and acquired out of the country.

Classic dengue fever is characterized by acute onset of high fever, 3-14 days after the bite of an infected mosquito. Patients develop high fevers, severe headache, muscle and bone aches, rash, severe pain behind the eyes and mild bleeding from the nose or gums. Acute symptoms, when present, usually last about 1 week, but weakness, malaise, and anorexia may persist for several weeks. Treatment emphasizes relief of symptoms, avoiding aspirin and other non steroidal anti-inflammatory medications and drinking plenty of fluids. Severe manifestations (e.g., dengue hemorrhagic fever and dengue shock syndrome) are rare but may be fatal.

Dengue is carried by the Aedes aegypti mosquito which is commonly known as the household mosquito but unlike others it is a day biter. The advisory encourages all to drain any standing water from around the home or business as these mosquitoes can leave their eggs in the smallest water reservoirs. all are also advised to cover their windows with screens in good condition, use air conditioning when possible and cover themselves with light weight long sleeve clothing and pants. Insect repellants containing DEET or picaridin are also effective in preventing the mosquito from biting.

Mosquito control has been notified and is stepping up its spraying efforts to reduce the Aedes mosquito population.

Persons experiencing symptoms should see their medical provider or if severe visit the nearest hospital or clinic.

What is dengue?

Dengue (pronounced den—gee) is a disease transmitted to humans by the bite of an infected mosquito. in the Western Hemisphere, the Aedes aegypti mosquito is the most important transmitter or vector of dengue viruses. it is estimated that there are over 100 million cases of dengue worldwide each year.

What is dengue hemorrhagic fever (DHF)?

DHF is a more severe form of dengue infection. it can be fatal if unrecognized and not properly treated in a timely manner. DHF is caused by infection with the same viruses that cause dengue fever. with good medical management, mortality due to DHF can be less than 1 percent.

How is dengue spread?

Dengue is transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus. The mosquito becomes infected with dengue virus when it bites a person who has dengue virus in their blood. The person can either have symptoms of dengue fever or DHF, or they may have no symptoms. after about one week, the mosquito can then transmit the virus while biting a healthy person. Dengue cannot be spread directly from person to person.

What are the symptoms of dengue?

The principal symptoms of dengue are high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash and mild bleeding (e.g., nose or gums bleed, easy bruising). Generally, younger children and those with their first dengue infection have a milder illness than older children and adults.

What is the treatment for dengue?

There is no specific medication for treatment of a dengue infection. Persons who think they have dengue should use analgesics (pain relievers) with acetaminophen and avoid those containing aspirin. They should also rest, drink plenty of fluids and consult a physician. If they feel worse (e.g., develop vomiting and severe abdominal pain) in the first 24 hours after the fever declines, they should go immediately to the hospital for evaluation.

Where can outbreaks of dengue occur?

Outbreaks of dengue occur primarily in areas where Ae. aegypti (sometimes also Ae. albopictus) mosquitoes live. this includes most tropical urban areas of the world. Dengue viruses may be introduced into areas by travelers who become infected while visiting other areas of the tropics where dengue commonly exists.

What can be done to reduce the risk of acquiring dengue?

There is no vaccine for preventing dengue. The best preventive measure for residents living in areas infested with Ae. aegypti is to eliminate the places where the mosquito lays her eggs, primarily artificial containers that hold water. Items that collect rainwater or to store water (for example, plastic containers, 55-gallon drums, buckets, or used automobile tires) should be covered or properly discarded. Pet and animal watering containers and vases with fresh flowers should be emptied and cleaned (to remove eggs) at least once a week. this will eliminate the mosquito eggs and larvae and reduce the number of mosquitoes present in these areas. Using air conditioning or window and door screens reduces the risk of mosquitoes coming indoors. Proper application of mosquito repellents containing 20-30 percent DEET as the active ingredient on exposed skin and clothing decreases the risk of being bitten by mosquitoes. The risk of dengue infection for international travelers appears to be small. there is increased risk if an epidemic is in progress or visitors are in housing without air conditioning or screened windows and doors.

Performing a Medical Symptoms Check (Medical History)

Side effects for commonly prescribed drugs:

Side effects that results from combined drugs:

• Antidepressants: this is often happening when you first start taking them, these symptoms include light-headedness, feeling a little ‘spaced out’, headaches, tummy symptoms and problems with sleeping. these side effects may end after 2 weeks at most.
• Aspirin-type medicines such as ibuprofen or diclofenac: these medicines can be a bit tough on your stomach; taking them with food helps.
• Blood pressure lowering medication: Tiredness and problems with erections in men may happen with some blood pressure medicines.
• Painkillers: Some codeine-containing drugs commonly cause problems with constipation, so you may need to ask you physician about using additional laxatives.

• Combined oral contraceptive pill and antibiotics: if you’re a woman taking the combined oral contraceptive pill, also starting to take certain antibiotics can make the pills less effective and put you at risk of becoming pregnant.
• Statins and macrolide antibiotics: If you take a cholesterol-lowering drug belonging to a group of drugs called statins, also taking a type of antibiotic of the macrolide group (such as erythromycin or clarithromycin) increases the risk of muscle aches.

These are some important hints that might be useful when preparing your own medical symptoms check. There are still some other topics that we can talk about in another article to complete the medical symptoms check list.

How about medications? Modern medicine is based mainly on drugs; doctors can’t deal with many diseases without drugs, which can be effective in relieving pain and its symptoms. But almost any medicine may have side effects. these side effects may be a direct result of the drug itself or due to interaction of different types of drugs resulting in more side effects.

There is something called ‘Contraindications’, where someone has certain health conditions, but needs to avoid taking new drugs while having certain health problems. You need to think about contraindications when you start taking a new drug and having new symptoms making you feel unwell. Another important issue about drugs is ‘Allergic reactions’. this includes feeling symptoms like rash, itching or difficulty breathing after taking new medicine. You can have an allergy to certain medicines just as some people are allergic to certain foods or insect bites. if you know or suspect that you suffer from an allergy, make sure that your doctor and other people close to you know about the condition.

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Indigestion – Dyspepsia

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
The term dyspepsia Act includes food-related suffering in the absence of any organic lesion (endoscopic and radiological examinations are normal). Dyspepsia is present at about 25-30% of the population, causing problems especially difficult diagnosis and selection of patients that require further investigation because of extensive investigation of all these patients is impossible. The etiology is unknown. Many factors are believed to be involved in the absence of scientific data. Among these are: food hygiene TROUBLE, alcohol, spices, heat (too hot or too cold foods), H. pylori, use of nonsteroidal anti-inflammatory aspirin. Among these factors are given credit only the last two, in their case is proven and their removal produces changes in some cases improvement of symptoms. Symptoms of dyspepsia may be: Type-ulcerous Reflux-type -Type dyspepsia or motility disorder associated with irritable bowel syndrome. Gastric cancer and all diseases can manifest as biliary dyspepsia, unfortunately does not help differentiate their symptoms. Because dyspepsia is more a symptom than a disease, treatment depends on the pathological condition. Excess stomach acid does not cause dyspepsia, antacids such use will not improve. Symptoms often disappear without treatment within a few hours. If they, in turn worsen medical consultation is needed. The best method of treatment is to avoid foods that trigger.
Causes of indigestion
Dyspepsia can be caused by pathologic conditions of the digestive tract, such as: Gastro-esophageal reflux disease Peptic-ulcer Gastric-cancer -Diseases of the pancreas or bile ducts. Often the underlying cause of dyspepsia is not known. This type is called functional dyspepsia and anatomic substrate junction is where the stomach makes small intestine. Dyspepsia can be related with abnormal motility, stomach muscles relax and contract, as the stomach receives food and propel them to ingurgitate intestine. A theory proposed by researchers is the concept of visceral hipersensitivitate, presumably normal stimuli are perceived as abnormal, such as painful as a normal colony contraction can be painful. It is unclear what causes this hipersensitivitate, but is increasingly circulated bacterial and viral infectious diseases of the digestive tract. Another cause of dyspepsia and the overpopulation is the colonic bacteria, this condition can be diagnosed by cmedicala test has expired hydrogen and treated with antibiotics. Non-digestive diseases were associated with dyspepsia include: -Diabetes, diabetic gastroparesis -Thyroid disease -Hyperparathyroidism And anxiety-depression -Renal diseases. Another important cause of dyspepsia are drugs. It seems that many of these are associated with dyspepsia, for example: NSAIDs-nonsteroidal anti-inflammatory drugs, aspirin, ibuprofen -Antibiotics -Estrogen contraceptive therapy post-menopause. During menstruation, women worsening digestive symptoms. These changes correspond to the maximum increase female hormones: estrogen and progesterone. It was demonstrated that leuprolide injection therapy, a drug that inhibits the release of estrogen and progesterone is effective in reducing symptoms of dyspepsia. Pregnancy and excessive air swallowing during eating also trigger symptoms.

SOME PEOPLE who are more "susceptible" do get the symptoms you describe. I treated youngsters in The Priory who has such severe adverse reactions like you did…. it DOES happen in some people.

No drug is EVER safe, especially illegal ones! some people have a reaction to relatively "safe" drugs / medication like aspirin…. its just shows that no drug is universally safe.

What exactly is your question?

You do not have dementia, you are probably perfectly healthy.

Are you asking why you had the reaction you had?

Firstly the marijuana could have been laced with another drug and that might account for part of your reaction. if you were drinking alcohol or if you take benzodiazepines, barbiturates, hypnotics, antihistamines, or certain other drugs (legally or illegally) that may have exacerbated the effects of marijuana.

Having said that you have the answer, "people have different reactions."

Smoking marijuana is often not like it is in a film and although most people feel relaxed and have other pleasant effects that certainly is not universal.

I remember when I tired marijuana I felt calm, I was laughing, and I became dangerously suggestible. if someone would have told me to run into traffic to get hit by a car there is a good chance I would have done it. I was lucky to be with friends who would not let any harm come to me. However they did screw with me and convinced they me I was in Buffalo, Canada (there is no such place) and then I was convinced I was in Buffalo, New York after walking one block.

It is was a very strange experience and not consistent with typical reactions to marijuana but that is what people risk- some will have a terrible or at least a very odd experience that may be closer to LSD intoxication or barbiturate intoxication.

But alcohol also creates a wide rage of reactions- some people become stimulated, active, social, and fun. some feel relaxed, sedated, and at ease with life. some become sad, agitated, and depressed. some people become angry, rageful, and even violent. A small majority actually become suicidal.

Alcohol has also been conclusively shown to be far more dangerous than marijuana. Alcohol is toxic and overuse can destroy the body more so than any other drug. Alcohol can lead to physical dependency which makes it much harder to stop and once that sets in people can't stop or they can potentially die (without treatment the mortality rate from withdrawal is up to 25%). Marijuana has never killed a person but alcohol has killed thousands and it can kill by drinking or by not drinking (in the physically dependent). The number of deaths caused by secondary complications of alcohol is staggering.

Alcohol, where it invented recently, would be a highly controlled substance. I can also tell you if I had to become addicted to a drug the last one I would pick is alcohol.

December 28, 2010 in Features Joe and Teresa Graedon the Spokesman-Review

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Q. I take aspirin for arthritis pain. It’s the only painkiller that works for me, but sometimes if I have a headache, the aspirin doesn’t seem to work.

a fellow worker suggested that I eat a chocolate candy bar when that happens. Though I was skeptical, I tried one. the combination worked, and it has ever since. What’s in chocolate that helps? It’s great that something so delicious is a painkiller!

A. many over-the-counter headache remedies contain caffeine along with aspirin and acetaminophen. This combination can be quite effective for migraines (Headache, March 2006).

Although chocolate does not have much caffeine, it does contain a similar compound called theobromine. Perhaps the theobromine is working together with aspirin to ease your headache pain.

we should note that some people with migraines report that chocolate triggers their headaches, so this delightful remedy may not work for everyone.

Q. Do you know of any home remedies for help in relieving symptoms of eczema? when humidity is low, my skin condition is aggravated something awful. it gets dry, itchy, red and ugly where it cracks and peels.

A. This time of year is exceptionally rough on skin conditions such as eczema or dry skin. there are many remedies that may work together to ease symptoms.

one reader had success by putting Pepto-Bismol on the itchy patches. Others report that old-fashioned Noxzema skin cream can ease symptoms. another moisturizer, CeraVe, also has supporters.

we have summarized these and many other options in our Guide to Skin Care and Treatment. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, no. SL-28, P.O. Box 52027, Durham, NC 27717-2027. it also can be downloaded for $2 from our website: peoplespharmacy.com.

Some readers also find oral supplements helpful. Old-fashioned additions such as cod-liver oil and brewer’s yeast have provided some people with good results; others use probiotics as well as fatty-acid supplements such as borage oil or hempseed oil. Oolong tea has been tested scientifically and found to be effective in treating eczema (Archives of Dermatology, January 2001).

Q. I frequently have heartburn when I eat spicy foods. Recently, a bartender offered a concoction of club soda and bitters. He mixed six drops of bitters with a shot glass of soda. it worked instantly to relieve my heartburn. I now keep bitters and soda at home, and it is effective every time.

A. Bitters have been used for hundreds of years to improve appetite or relieve indigestion. they contain an extract of herbs and barks. Bartenders use a few drops of bitters in certain mixed drinks such as Bloody Mary, Manhattan, mojito or Old-Fashioned.

Q. I want to let you know about something that stunned me. I have suffered from restless leg syndrome (RLS) for nearly 35 years. a friend casually mentioned that pie cherries had helped her leg pain and thought maybe they would help my RLS.

I was skeptical, since I have tried many treatments, including medications. I had been on Mirapex for years and recently had to increase the dose. nevertheless, RLS was troubling me day and night.

I started eating pie cherries (about two dozen with their juice) each day. I have not had RLS for two weeks since I began.

Q. Thanks for sharing your story. People also tell us that pie cherries may sometimes ease gout pain.

In their column, Joe and Teresa Graedon answer letters from readers. E-mail them via their Web site: PeoplesPharmacy.com.

MEADVILLE — Why didn’t a Titusville homicide suspect who died of an overdose of over-the-counter drugs get medical treatment right after telling authorities he had taken the pain medication? “I can’t answer that right now,” Det. Timothy Russell of Titusville Police Department said Tuesday. “I have to establish the timeline and put the pieces together on how it all happened.” Russell said it may take several weeks to finish a report on the death of Michael Paul Brooker, 35, of Phoenix, Ariz., who was charged by Titusville Police with killing Renee Gates, 23, of Titusville. Gates was Brooker’s  girlfriend. Gates died at 2:15 p.m. Sunday at UPMC Presbyterian Hospital in Pittsburgh from an acetaminophen overdose after apparently having taken the pills a few days before, an official at the Allegheny County Medical Examiner’s office said. different authorities have either not been available or have said they do not know how much painkiller Brooker took or when he did so. Crawford County District Attorney Francis Shultz said earlier this week Brooker had told police he had taken aspirin or Tylenol prior to turning himself in to police in Titusville.   Acetaminophen is the generic name for Tylenol, an over-the-counter pain medication. the Allegheny County Coroner’s Office ruled Brooker’s death a suicide since the acetaminophen level in Brooker’s body was so high it caused liver failure. the Allegheny County Medical Examiner in Pittsburgh says they are issuing the death certificate on Brooker, but that any autopsy on his body must be authorized by Crawford County authorities. Brooker was arraigned during the early morning hours of Dec. 22 on a Titusville Police charge of homicide for Gates’ death a few days earlier. He was taken to the Crawford County jail in Saegertown following arraignment, and was subsequently hospitalized. Police charged Brooker after he walked into the Titusville police station around 11:20 p.m. Dec. 21 and told officers he’d killed Gates. Brooker told the police on duty that Gates died almost three days earlier in a violent fight at her apartment and Brooker had left her body buried in the snow outside, near the apartment. During Brooker’s initial interview, Brooker told the officers on duty that he had ingested pills, Russell said. Questioned why medical treatment wasn’t sought for Brooker right away, Russell said he didn’t know, adding that his investigation wasn’t complete. “I want to get the facts straight on what was said to whom,” he said. “not that I can recall,” Russell said when asked if Brooker mentioned ingesting pills during a subsequent interview Russell himself had with Brooker. Brooker died Sunday after being transferred from Meadville Medical Center late Wednesday. Death records at Allegheny County Medical Examiner’s Office records show Brooker arrived at UPMC Presbyterian shortly after midnight Wednesday (early Thursday morning), about 24 hours after he turned himself in to Titusville police. there wasn’t a record of the exact time Brooker was admitted to UPMC, according to the Allegheny County Medical Examiner’s Office. Crawford County jail Warden Tim Lewis is on vacation this week and unavailable for comment. County jail officials said they couldn’t release information on when Brooker initially was taken to Meadville Medical Center for treatment. Contacted by the Tribune, Ted Watts, Crawford County’s attorney, said a release of when Brooker was taken to Meadville Medical Center would violate federal medical privacy laws since it indicated Brooker was being treated at a medical facility. a person shouldn’t take more than 4,000 milligrams of acetaminophen in a day, according to the website for U.S. National Library of Medicine, which is part of the U.S. National Institutes of Health. Regular strength Tylenol is 325 milligrams per pill, and extra strength is 500 milligrams per pill. Ingesting 7,000 milligrams or more can lead to a severe overdose, according to the website. Overdose symptoms may not occur until 12 hours or more after taking the drug, according to the website. Russell said he still is awaiting a forensics report from the Pennsylvania State Police crime lab. Russell said also he must continue to conduct interviews of persons living in the apartment complex on Rockwood Drive where Gates lived. Russell said he hoped to send a final report on the case to Crawford County District Attorney Francis Schultz within the next three weeks. Schultz confirmed Tuesday he was awaiting a final report on the case. Keith Gushard can be reached at 724-6370 or by e-mail at kgushard@meadvilletribune.com.

Brooker's death the third jail-related death since 2008

the death of Michael Paul Brooker, an inmate from the Crawford County jail, is one of two jail-related deaths this year and three since 2008. Corrections Officer Gary M. Chapin, 49, was assaulted by an inmate the night of Oct. 13 while Chapin was performing his duties as a corrections officer at the jail in Saegertown. Chapin died Nov. 15 after never regaining consciousness. His death was ruled a homicide by the Crawford County Coroner’s Office. Gregory G. Brown, 24, of Meadville, is accused by Pennsylvania State Police of assaulting Chapin. Brown is scheduled to have a preliminary hearing Jan. 24 on one count each of criminal homicide, aggravated assault and assault by prisoner. if convicted, Brown faces a maximum of life in prison and a $50,000 fine on the criminal homicide charge, while the aggravated assault charge carries a maximum penalty of 20 years in prison and a $25,000 fine, and the assault by prisoner charge carries a maximum penalty of 10 years in prison and a $25,000 fine. Crawford County Coroner Pat McHenry ruled Chapin’s death a homicide due to complications of blunt force trauma to the head. McHenry said the autopsy showed Chapin had been thrown to or pile-driven into the floor head-first. In another jail-related death incident, the family of Gregory W. Williams of Johnstown filed a federal lawsuit against the county in January of this year. Williams was an inmate at the jail who died there Jan. 31, 2008. the family claims his death was due to negligence by Crawford County prison, its officials and its health care provider. that case is still pending in U.S. District Court in Johnstown.

By Jessica Ward Jones, MD, MPH Associate News EditorReviewed by John M. Grohol, Psy.D. on June 24, 2010

“Take two aspirin and call me in the morning.”  For schizophrenia?  perhaps.  New research suggests that aspirin may be of benefit in reducing the symptoms of schizophrenia.

Schizophrenia is a serious psychological disorder characterized by impairments in thinking that can lead to delusions, difficulty in determining reality, and hallucinations.  Sufferers are at high risk for substance abuse and suicide.  up to 2.2 million Americans suffer from the disease. 

There is no single known cause for schizophrenia, but chemical and structural abnormalities of the brain as well as genetics appear to play a role.  Treatments include antipsychotics and psychosocial therapy.

Prior research noted an improvement of symptoms in schizophrenia when patients were taking anti-inflammatories such as celexicob, a cyclooxygenase-2 inhibitor.  these results suggest that inflammation may play a role in causing some of the symptoms of schizophrenia.

Dr. Laan Grobbee and his team of researchers in the Netherlands evaluated whether using a medication to treat inflammation might improve the symptoms of schizophrenia.  They used aspirin as an anti-inflammatory because cyclooxygenase-2 inhibitors are known to increase the risk of cardiovascular disease.

Grobbee conducted a randomized, double-blinded, placebo-controlled study with 80 patients who had had schizophrenia for fewer than five years.  Patients were randomly assigned to either 1000mg of aspirin or placebo, and treated for three months.

Patients who required antipsychotic medications (70 percent) continued to be treated with olanzapine, clozapine, or risperidone.  All patients were given a proton-pump inhibitor as a precaution to protect them from any possible stomach irritation due to the aspirin.

The Posititive and Negative Syndrome Scale (PANSS) was used to measure the change in symptoms at the beginning of the treatment and after three months.

After three months, the patients treated with aspirin showed a significant reduction in the PANSS (4.86 points) compared to the patients treated with placebo (1.57 points). 

Cognitive function was also assessed, and there did not appear to be any negative effects from the aspirin.

These results suggest that there may indeed be an inflammatory component of schizophrenia that could perhaps be responsive to anti-inflammatory agents such as aspirin.  Grobbee noted an even greater improvement in patients with altered immune function.

The authors suggest that aspirin may also theoretically work in treatment of schizophrenia through other mechanisms such as the N-methyl d-aspartate receptor, another active area of research.

Given recent research showing schizophrenics at increased risk for cardiovascular disease and other high-risk metabolic conditions such as defects in insulin function, aspirin may be of benefit in more than one way.

It is unclear if aspirin therapy would be effective in someone suffering from the disease for many years.  perhaps after a long period of untreated inflammation, aspirin would be of little effect.

Future research in this area could include larger trials to determine how many patients might be responsive to therapy, studies to determine what other (if any) anti-inflammatory agents might be of benefit, and research to determine whether therapy might be helpful in patients with a long term diagnosis.

Source: Journal of Clinical Psychiatry

I have a severe headache in the lower right hemisphere of my head and it's been lasting for around six hours so far. It's more of a pain like something is pushing against it or there's a stabbing pressure in that area. I don't have any other symptoms except when I cough it's hurts more and I'm a little bit dazed and uncomfortable.
When I lie down, the pain goes away but once i get up the pain comes back really badly.

could this be a blood clot?

Sounds like a migraine. Stay down, drink water, keep taking advil or aspirin or tylenol, whichever you prefer. If tomorrow it's the same, I'd see a doctor.