Many stressed out young people suffer from hyperventilation which can feel like a heart attack but isn’t.

The picture above is of haemoglobin the chemical which carries oxygen from the lungs to the cells of your body that are then used to produce energy (ATP) and sustain life. in the return trip, the waste product carbon dioxide (CO2) is carried from the cells to the lungs for disposal. Hyperventilation is “an increase in the rate and depth of breathing that exceeds the body’s need to remove the waste product CO2″ (Marieb & Hoehn, Human Anatomy and Physiology, 5th ed.) Hyperventilation can be described as breathing too fast or overbreathing. Click button to listen to Hyperventilation and rightclick to download

FAMILY MATTERS: Hope and help for hyperventilaters, Understanding the triggers and overcoming the psychological and physiological symptoms brought on byanxiety by Dr Kraisit Naruekhatpichai

Most of us know and may experience some familiar symptoms caused by stress, such as stomach ache, headache and insomnia. Some people, however, still don’t know that stress can also affect the respiratory system and lead to respiratory disorder. This symptom is called Hyperventilation Syndrome (HVS). Hyperventilation Syndrome involves breathing too deeply and rapidly followed by a tingling sensation in the hands and feet. unlike asthma, a recent study concluded that HVS is most likely a psychologically-based disease. People who are around HVS sufferers need to understand that for patients with this condition it is a consequence of behavioural breathlessness rather than a direct physical sickness. although HVS doesn’t result in actual physical obstruction that prevents proper breathing, patients suffering from this condition still feel that it interferes with how they get on with their daily lives This syndrome (the reason it is called a syndrome is because when HVS occurs it involves a series of symptoms) usually affects young women aged 15-30, especially when they feel uncontrollably frustrated and extremely angry, in which the underlying psycho-mechanism triggers the sufferer to breathe rapidly and deeply. after prolonged, rapid and deep breathing, the lungs release so much carbon dioxide and takes in so much oxygen that eventually it gets to the point where the exchange rate of CO2 and O2 exceeds the metabolic requirements of the body, which can result in haemodynamics and chemical imbalance. also, calcium in the blood will take in more protein and cause low calcium in the blood; low blood calcium can lead to symptoms such as numbness or tingling in the fingers, toes or around the lips. although HVS sounds as though it vitally impacts people’s lives, it is reported to be quite common. Most patients and even their loved ones often think of HVS as a life-threatening occurrence, like lung disease, or that it increases the risk of cardiovascular disease, and thus need emergency care, which is not always the case. Some families spend loads of money and waste so much time trying to get an unnecessary diagnosis. The first occurrence of an episode of hyperventilation is typically the most severe because it gets easier for the syndrome to reoccur thereafter. after a patient has experienced several panic attacks, sometimes just one deep breath could bring on shortness of breath, along with all the other symptoms mentioned above. such patients will feel they need to visit the hospital often, and will usually be diagnosed as having nothing seriously wrong with them. Or worse, they don’t receive a proper explanation on their condition from the doctor. Some patients may become overly concerned about their health, and unfortunately their family members might misunderstand their actions as attention-seeking behaviour. If, however, sufferers strongly feel that their condition does greatly have an impact on their daily lives and the people around them, they should come forward and speak to a psychologist about the best suitable treatment. first aid tips and suggestions for HVS patients are as follows: 1. Do not panic. All the symptoms are largely not at all harmful. try to stay calm and in control of your breathing and try to breathe a bit more slowly. 2. If this does not work, use a paper bag and breath into it slowly. Make sure the paper bag covers your mouth and nose completely – that way, it will bring back the balance of carbon dioxide and calcium in the blood. it will also help get rid of the tingling sensation and numbness in the fingers, toes and area around the lips. 3. have a full understanding of the condition. when it happens, make sure that people around you know that this is not an act or an attempt at seeking attention. Family and friends should be supportive to patients but at the same time must make sure they are not getting more and more out of control with their anxieties or spoiled. 4. be mentally stronger. try to confront the problems of the condition with smart solutions and try to relax. also, regular exercise can help reduce the chance of hyperventilating as it lowers tension and stress levels. 5. If all else fails, seeing a psychologist might be the best solution. and get the right prescription drug if necessary Dr Krisit Narukatpichai is CEO and a psychologist at Manarom Hospital. (Source: Bangkok Post, FAMILYMATTERS, Hope and help for hyperventilaters, Understanding the triggers and overcoming the psychological and physiological symptoms brought on by anxiety, 1/06/2011, Dr Kraisit Naruekhatpichai, link) Health Vocabulary respiratory – relating to the process of breathing air in and out ???????????????? respiratory disorder – a disease in the lungs (or affecting the process of breathing air in and out) (See Wikipedia)lungs – the organs in your chest that fill with air when you breathe ??? carbon dioxide – CO2, the chemical waste product created by the body’s cells and sent by the blood to the lungs for breathing out (expiration) into the air thus disposing them (See Wikipedia) haemoglobin – the protein composed that “gives red blood cells their characteristic color; function primarily to transport oxygen from the lungs to the body tissues” also carries 10% of the carbon dioxide from the cells to the lungs as waste disposal (See Wikipedia) hyperventilation - an increase in the rate and depth of breathing that exceeds the body’s need to remove the waste product CO2, breathing too  fast or overbreathing, to the person suffering from hyperventilation it seems like they are not getting enough oxygen, but actually fast breathing reduces the carbon dioxide (CO2) concentration of the blood to below its normal level because one is expiring more CO2 than is being produced in the body, thereby raising the blood’s pH value (making it more alkaline), initiating constriction of the blood vessels which supply the brain and preventing the transport of oxygen and other molecules necessary for the function of the nervous system, can result from a psychological state such as a panic attack or from a physiological condition such as metabolic acidosis, can cause symptoms such as numbness or tingling in the hands, feet and lips, lightheadedness, dizziness, headache, chest pain, slurred speech, nervous laughter, and sometimes fainting (See Wikipedia) Hyperventilation Syndrome (HVS) – “a respiratory disorder, psychologically or physiologically based, involving breathing too deeply or too rapidly (hyperventilation). HVS may present with chest pain and a tingling sensation in the fingertips and around the mouth (paresthesia) and may accompany a panic attack. People with HVS may feel that they cannot get enough air. in reality, they have about the same oxygenation in the arterial blood (normal values are about 98% for hemoglobin saturation) and too little carbon dioxide in their blood and other tissues. While oxygen is abundant in the bloodstream, HVS reduces effective delivery of that oxygen to vital organs due to low-CO2-induced vasoconstriction and the suppressed Bohr effect. The hyperventilation is self-promulgating as rapid breathing causes carbon dioxide levels to fall below healthy levels, and respiratory alkalosis (high blood pH) develops. This makes the symptoms worse, which causes the person to try breathing even faster, which further exacerbates the problem” (See Wikipedia) panic – a sudden strong feeling of fear and confusion, which makes you act without thinking carefully ???????????? (See glossary) panic attack – a sudden and short period of intense fear, usually begin abruptly and reaching a peak within 10 minutes and then decreasing over the next several hours; many who experience a panic attack fear they are having a heart attack or a nervous breakdown, symptoms include “increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating (which increases grip and aids heat loss). because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH (respiratory alkalosis or hypocapnia), which in turn can lead to many other symptoms, such as tingling or numbness, dizziness, burning and lightheadedness. Moreover, the release of adrenaline during a panic attack causes vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness. a panic attack can cause blood sugar to be drawn away from the brain and towards the major muscles. it is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood” (See Wikipedia) release – to allow a substance to flow out from somewhere ????? metabolism (noun) – the chemical processes in the body that use food to make energy (ATP)and build new cells (See Wikipedia) metabolic (adjective)   anxiety – a feeling of nervousness or worry stress – a feeling of worry and tension from difficulties in life; when you worry and think too much about problems insomnia – not being able to sleep  syndrome – “the association of several clinically recognizable features, signs (observed by a physician), symptoms (reported by the patient), phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others” (See Wikipedia) condition – same as “medical condition” medical condition – a broader tterm than disease and can include injuries to the body (See Wikipedia) X brought on by Y – disease or medical condition X caused by conditions or event Y X triggers Y (verb) – conditions or event X causes disease or medical condition Y trigger (noun) -a cause of a disease or medical condition psychology (noun) – the scientific study of the human mind and the reasons for human behaviour psychologist (noun) – a person who works in the area of psychology (practices psychology) mental –  ??????????????, ???????????????? mental disorder – a condition that has a negative effect on a person’s beahviour or emotions during daily life (See Wikipedia and Google Definitions)psychological (adjective) psychologically (adverb)   psychologically-based disease – same as “mental disorder”mental sickness – same as “mental disorder” physiology (noun) – the study of how bodies function (See Wikipedia)physiological (adjective)  physical sickness – involving the body (not just the mind)  symptom – a sign that someone has an illness ????? series of symptoms – one symptom happening, then another symptom, and another, and so on … diagnosis – when a doctor makes a judgement about what disease a patient has tingling – a strange feeling under the skin (like stinging) ?????????????????????????????? sensation – feeling a tingling feeling – having a strange stinging-like feeling under your skin numb (adjective) – having no feeling in part of your body numbness (noun)  asthma – a long-term condition in which the lungs become inflammed and breathing difficult ????????? (See Wikipedia) physical obstruction – an object that prevents another object from passing through a passageway (example: a piece of food in the throat became a “physical obstruction” that prevented breathing) suffering – having physical or mental pain or problems ?????????????? underlying – underneath, supporting, forming a foundation or basis for something prolonged – continuing for a long time ???????????? rapid – happening quickly ???????????? life-threatening – it might kill you risk – the possibility that something dangerous or unpleasant might happen ?????????? cardiovascular – related to the heart and blood vessels the heart and blood vessels (veins, arteries) in the body and the way that they operate to support life, “an organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases and help stabilize body temperature and pH to maintain homeostasis” (See Wikipedia) cardiovascular disease – a disease that affects the heart or blood vessels (See Wikipedia) emergency – an unexpected situation involving danger in which immediate action is necessary ??????????? emergency care – (See Wikipedia on emergency medical services and emergency medicine) occurrence – something that happens ?????????, ????????????????????, ??????????????? episode – a short period in which someone suffers from an illness badly  severe – very serious and worrying ????????? ?????????????? severe episode – suffering from an illness very badly patient – someone who is receiving medical treatment ??????, ????? treatment – the process of providing medical care ???????? aid – help; assistance ????????????? First Aid – medical help given to a sick or injured person before full medical treatment from a doctor is available (See Wikipedia) calm – peaceful and quiet; without anxiety ??????,???????????, ??? stay calm – continue being quiet and peaceful (without worrying) tension – the feeling of being so nervous or worried that you can’t relax ????????????? prescription – medicine that a doctor prescribes to cure an illness General Vocabulary X concluded that Y – after studying the situation, explanation Y was given X a consequence of Y – X happened because Y happened actual – real; existing in fact ???? reason – an explanation ??????  frustrated – want something but cannot get it, feeling annoyed and impatient because you are prevented from achieving something ???????,???????????, ??????????eventually – at the end of a period of time or at the end of a process ???????? X sounds as though Y – X seems to have the meaning Y, if X then Y it seems vital – very important impact – effect vitally impacts people’s lives – has a big effect on life (big change in life) quite common – happens often, seen oftentypically – usually; normally ???????????????? concerned – worried about something ??????????? attention-seeking – when people do things to make other people pay attention to them (look at them, spend time with them) pay attention to – watch, listen or take notice of someone or something impact – an effect or influence ??????? come forward – doing or saying something (after not doing or saying anything, perhaps because you are shy or think your problem is not important) suitable – right for a situation or person ??????? supportive – helping spoiled – when a child is given every they want (so that they always expect this, which ruins their personality eventually) confront – try to deal with and solve a difficult problem ??????????????????????????? chance – possibility

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Lung cancer is a major killer of men and ladies throughout the country. oxygen pollutants, secondhand smoke, cigarette smoking especially, in addition to other causative factors contribute to the disease.

Most folks believe how the lung cancer is generally usual one of many cigarette smokers as well as it is really true how the great the greater portion of cases are or have been smokers. but there are non-smokers do get lung cancer and smokers who don’t get it.

Signs of lung cancer are generally not apparent in the early stages. nevertheless it is really more effective to uncover lung cancer as possible.

The most usual early symptom of lung cancer is haemoptysis (coughing up blood). Consider this early symptom a warning indication of the cancer, which may pretty properly be curable.

If you obtain that you simply are coughing up blood, you’ll should immediately get in touch with your doctor , in particular in the event you’re 40 many years of age, or older, having a long-term smoking habit.

Some of the main signs include:

* Hacking, prolonged cough* Coughing up blood * Shortness of oxygen * Wheezing * Chest ache * missing hunger * missing weight * Recurring bronchitis or pneumonia

The earlier mentioned signs or symptoms also being the signs or symptoms of many other lung problems, so it is really always advisable to figure out a physician to ascertain the cause

Secondary signs of simple cellular lung cancer include:

* Weakness * Difficulty swallowing * improvements in nails* Hoarse or raspy voice * sizeable fever * inflammation of facial features

It’s true that most signs or symptoms of lung cancer do not show by themselves till the disease is in its sophisticated stages.

However, from the perfect time to time people demonstrate signs early in the disease’s development. it is really essential how the in the beginning notice of signs or symptoms or concern sends you straight to the doctor.

The sooner treatment is begun, the better. A cure is possible if caught early enough and, if not, then a more effective level of quality of life and more of it.

When lung cancer spreads to other elements of the body, organs and bones, known to as ‘metastasizing’, signs and signs or symptoms include:

* Aching and sharp bone ache * improvements in the human brain that demonstrate by themselves through weakness, numbness, dizziness, and seizure * Jaundice (whites of eyes, nails, and skin yellow)* Masses near the skin’s surface* Headaches* Numbness and the decrease of feeling in your extremities

All of these signs and signs or symptoms of lung cancer may pretty properly be caused by other health problems. the only way to know for confident is to search for guidance from your doctor as quickly as possible.

i am in 10th class right now. in my 8th class i cut my hand with a blade and i do not know that the blade was new or not. is there any chances of tetanus to me????

The spore or germ that causes this infection doesn't only grow or stay on something that is rusty. the reason a lot of people say that a rusty nail will give you tetanus if you step on it or cut yourself with it is because that is what they have always been told that happens. the tetanus spore live on rust or any object that has oxygen or the lack of so rust is a great example. If you had tetanus from that item you cut yourself on you would have shown signs within 48 to 72 hours so no worries I would say….

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February 8, 2011 in Blood Disorder

The medical term used for blocked blood vessels due to thrombus or blood clot in the arms or legs is Deep Vein Thrombosis. This condition is often accompanied by thrombophlebitis which occurs due to the inflammation of veins. Deep vein thrombosis symptoms may include increased blood clotting tendency, decreased blood flow, damage to the walls of the blood vessel. the following article explains more on deep vein thrombosis symptoms.

Symptoms of Deep Vein ThrombosisA person suffering from this condition may observe the following symptoms.

• Unfortunately, many people suffering from deep vein thrombosis may not experience any kind of symptoms as such in the initial stages. This usually happens as the blood tries its best to pass through the clot present in the blood vessel.
• Swelling in the legs is the most prominent symptom of deep vein thrombosis. This can be sometimes accompanied by discoloration and pain. Your leg may turn bluish and this is a clear indication that the blood vessels are not receiving enough oxygen. This condition is known as cyanosis and this usually occurs in the calf area.
• Pain can also be felt in and around the area and it can be due to poor supply of blood and oxygen to the legs. Pain can be observed while walking or even in standing position.
• Phlegmasia alba dolens is another common symptom of this condition which is also referred as milk leg or white leg. This symptom can be indicated easily as the leg may turn pale. This condition can also rely completely on superficial veins for drainage. This can further lead to paleness, edema and pain in the leg.
• This condition can cause severe pain and severe edema leading to cyanosis in the lower extremity of the legs. This can progress further to gangrene if not treated in the earlier stages.
• The other symptoms of this condition is Paget-von Schroetter disease which occurs due to the presence of blood clot in arms. This condition usually affects the subclavian and axillary veins. It can be observed in young adults and swelling, redness, pain and warmth are a few symptoms of this condition.

If you observe any of the above mentioned deep vein thrombosis symptoms, make sure that you consult a doctor immediately. This condition can turn fatal and may lead to several other health complications.

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I'm writing a movie script and a character in the movie has lung cancer, before she dies so the symptoms seem real what are some examples of symptoms right before death? Would the person shake because of shock or being desperate to call for help?

Thanks

Hola revolutionary – Part of what you write may be true. If the cancer has spread to invade through the wall of an artery and adjacent air passage (such as the trachea or bronchus), the cancer could have eaten away a hole in the artery wall and the final appearance could be a sudden spurt or large flow of blood coming from the trachea into the mouth and out the lips and nose. before then, the cancer could have greatly reduced breathing of vital air (oxygen) and the patient become quite pale with grayish color skin changes. The only times I have seen shaking of the body connected is when the lung cancer has spread to a certain area of the brain, but then sudden blood vomiting does not happen at the same moment. good luck with your script.

All people are different
Some would be very quiet and weak and have their eyes shut and look white and say nothing
Others may try to talk and shake and be afraid

go to: en.wikipedia.org/wiki/Lung_cancer

-If you change the type of cancer you can show more attractive scenes in movie

Yes that's pretty much right.

check cancerssociety.org/ for detail info

This article deals with the secondary lung cancer symptoms and its different types and stages.

The lungs

The lungs are a pair of organs in the chest that are in charge of breathing. When one breathes in, the air passes from the nose through the trachea and into one of the two bronchi (airways) which enter into the lungs. the airways are divided into two smaller tubes and tiny sacs that are present at the end. the oxygen is taken from the air that is passed into the bloodstream. the pleura protect the lungs which is a protective lining that consists of two membranes.

The cancer

The cancer may start in the lung or it can spread there from a primary location elsewhere in the body. If a cancer spreads to the lungs from other part of the body then it is called secondary or metastatic lung cancer.

Some of the cancer cells may break away from the primary location and travels through the bloodstream or the lymphatic system to other parts of the body. however, any type of cancer can spread to the lungs and the most common types to cancer are the large bowel, breast, bladder, testicle, stomach, esophagus, and kidney.

Secondary Lung Cancer Symptoms

• Sputum-coughing up blood-stained phlegm
• A cough that does not clear up
• Pain in the chest.
• Breathlessness

Many of these symptoms have similarities with primary lung cancer. They commonly occur due to other health conditions such as a chest infection. A doctor may guess a secondary lung cancer if there has been a previous diagnosis of cancer and one has some of these symptoms.

Diagnosis

A number of tests may be performed to diagnose the secondary lung cancer which includes:

Chest x-ray: This may be taken to detect the size and position of the tumors.

CT (computerized tomography) scan: it is a series of x-rays that creates a three-dimensional image of the inside of the body. the patient is given a drink or injection of a dye which permits particular areas to be seen more clearly on the computer screen. the patient will be asked not to eat or drink for at least four hours before the scan.

MRI (magnetic resonance imaging) scan: This test uses magnet instead of x-rays to make a detailed picture of areas of the body. Some patients are given an injection of dye into a vein in the arm that helps the scanner to show up the images more clearly.

PET scan: This uses low-dose radioactive sugar to assess the activity of cells in different parts of the body. A radioactive substance is injected into the vein and a scanning is done after a couple of hours of time.

Biopsy: Sometimes the doctors may recommend carrying out a biopsy. A needle is inserted thorough the mouth or nose to remove a small piece of tissue. the sample is then examined under a microscope.

The cancer may also cause fluid to gather in the space between the pleura. This is called as a pleural effusion. If this happens, it is possible to remove some of the fluid and examine it for cancer cells.

When the cancer cells are studied, the doctors can tell that whether it is a secondary lung cancer or not. for example, if a stomach cancer has spread to the lungs, the cancerous cells would appear similar to the stomach cells rather than the lung cells.

The treatment

Chemotherapy, hormonal therapy, surgery, and radiation therapy are the four treatment options available for the secondary lung cancer. it is depend upon the patient’s health, the type of the primary cancer. Sometimes a combination of the treatments is used to cure the disorder.

The secondary lung cancer is curable if it is diagnosed early. A doctor’s advice has to be taken if any of the secondary cancer symptoms persist.

Inflammation in the body?s tissues spell trouble, especially if it goes on for a long time.

A SNIPER?S bullet that tears through the chest, and a massive heart attack, have two things in common ? searing pain and the possibility of death. If that is overly dramatic, let us review today what is slowly cooking us to death.

The three assassins that are stealthily killing us day by day are sugar, oxygen, and inflammation, like a sweet on fire! Arguably, this column is not meant for serious scientists, but I am very passionate about science, as the insight of our insides opens the gate to so many possibilities in the prevention of chronic ailments.

The path of preventive medicine has always fascinated me as we are gatekeepers, ushering a person on a journey that may change destiny. A practitioner is also a map maker drawing up directions, but alas, the directions are often too confusing, difficult to follow, and worse, downright misleading. It had never occurred to me that a simple mind made complex (by too many textbooks) can regain wisdom from simplicity, and that was when my lenses changed from microscopic to wide angled, as the deceptive trio was unmasked.

Hot stuff: High glycaemic foods are pro-inflammatory in nature.

The mere mention of the word stress conjures up less than friendly images of the tyranny within. Our body is continuously bombarded by three types of stresses, namely glycaemic stress, oxidative stress, and inflammatory stress. These three assassins work in concert to corrode the pillars supporting true health.

Glycaemic (sugar) stress is the chronic effects of feeding the body with too much sugar. in its simplest form, glucose is paramount for energy production, without which there would be no life. yet it is a highly toxic molecule when in excess. The reason for this dilemma is obvious ? we eat too much!

?But I don?t take sugar? is a common defence. Bear in mind that all carhohydrates turn to sugar, albeit at different rates. It is no secret that our favourite foods are generally high glycaemic, shooting up our blood sugar rapidly, and crashing down rapidly like a roller coaster, with the unused sugar turning into fat around the belly.

A protruding waistline is an incubator for many diseases. The Metabolic Syndrome harbours the sinister ambitions of diabetes, hypertension, heart disease, stroke and obesity.

Oxidative stress (free radical burden) is the pressure on our bodies caused by excessive errant oxygen molecules known as free radicals, which literally steal our health and youth by the seconds. The demands of modern society, bludgeoning influx of toxic foods, environmental poisoning, compounded by unhealthy lifestyle habits, add up the load of free radicals, thereby inducing a significant oxidative stress. this state is not ameliorated by the imbalanced nutrition stemming from poor food choices.

Acute inflammation

Some fertile areas of the body that do not get too much sun are like a damp, tropical rainforest, perfect for mushrooming fungi of all sorts. A yeast infection at the underarm can be an incessant nuisance, resulting in uncontrollable scratching due to itchy skin inflammation.

Among the foliage, bacteria finds the abode an ideal breeding ground and causes trouble when it invades the skin. A boil in the armpit is more than just a painful embarrassment.

The marvellous story of the body?s ministry of defence goes something like this. under the skin are stationed sentries (macrophages), which are roused by the intrusion of a foreign invader. they quickly send out SOS signals (cytokines) that open up the blood vessels and mobilise an army of specialised white blood soldier cells (neutrophils) that creep along the engorged arteries.

Fluid and cells pour onto the site of infection, the latter gobbling up the bacteria like hungry wolves or delivering knockout punches to everything in their path. in the indiscriminate search and destroy mission, the white blood cells spray round after round of ammunition that annihilate not only the intruders but innocent bystanders as well.

The collateral tissue damage leads to painful pus formation, which either ?ripens? and discharges to the exterior or is ultimately released by the doctor?s knife.

Fortunately, once the threat is neutralised, the inflammation mode is turned off and the cinders finally extinguish, leading to resolution.

The preceding sequence of events was first described by Aulus Cornelius Celsus, a Roman medical writer from the 1st century AD, who described the stages of dolor (pain), calor (heat), rubor (redness) and tumour (swelling).

Next time, when a ?bag? of pus appears, refrain from complaints and be appreciative that our protectors have done a good job. Imagine the devastating peril should the inflammation spread beyond the boundaries (septicaemia) to infect the entire host.

Not all acute inflammation are infective in nature. Bronchitis, asthma and sinusitis invoke a different form of inflammation. an offending trigger sets off a cascade of immune reactions that congest and clog the airways.

Acute inflammation can also be brought on by injury, errors in metabolism (e.g. gout), auto-immune diseases (e.g. rheumatoid arthritis, lupus, etc, when the immune system turns on the host), and so on.

Chronic inflammation ? the secret killer

Both glycaemic and oxidative stress have been dealt with in detail in past articles. The final link to chronic degenerative diseases is chronic inflammation.

Unlike the distress of acute inflammation, this is a much more sinister situation as there are no immediate symptoms. A state of inflammation that does not switch off is deemed chronic. Potent inflammatory mediators are released and the cycle is self propagating in a vicious manner.

We issue our own licence to eat rather indiscriminately. As our palate is the master of our stomach, gustatory pleasure is of prime importance, and needless to say, our high glycaemic favourites are pro-inflammatory in nature. The expanded waistline, a.k.a. visceral fat, is like a rumbling volcano spewing hot stuff (inflammatory mediators) that can trigger inflammation.

When the human cells are attacked by free radicals or external threats, be it poisoning, injury, or damage, a master switch (nuclear factor kappa beta) within the cells is thrown, like an alarm system, which then instructs the cells?s DNA to send signals to manufacture pro-inflammatory proteins, which in turn propagate more inflammation.

As the bell is constantly ringing, inflammation becomes chronic and prolonged as the body is fooled into believing that the threat is persistent.

When immune cells are erroneously turned on, they revolt by attacking the host, resulting in a bizarre potpourri of conditions, collectively known as auto-immune diseases. Rheumatoid arthritis and lupus commonly cause painful joint inflammation, but the process can affect multiple organs.

Multiple sclerosis, with consequent paralysis, occurs when nerves are inflamed. Psoriasis is a disfiguring inflammatory skin disorder. Even Alzheimer?s disease has underlying inflammation.

It seems almost every chronic condition is stamped by inflammation. Certainly the body?s discharge pipes, namely the intestines, are not spared. Crohn?s and ulcerative colitis are notorious troublemakers.

The heart is on fire

About a decade ago, there were scientific rumblings that heart disease is associated with inflammation. this was first proposed by a German pathologist, Dr Rudolph Virchow, in the mid 1800s, and as usual, his theory was sidelined into the archives.

Today, the concept is re-emerging from the closet. being conquered by naivety and a subscriber of scepticism for a greater part of life, my eyebrows raised to my scalp line when I first heard that heart disease was due to inflammation. I thought it was just a plumbing problem, now they tell me that the heart is on fire!

For years, it was taught that having high cholesterol equates to heart disease, and yet 50% of heart attacks have normal cholesterol counts, which begs for the search of some other underlying mechanism.

In an article printed in a respected peer-reviewed journal, the Archives Of Internal Medicine (April 11, 2005), a meta-analysis (review) of 100 clinical trials involving 250,000 individuals found that a group of cholesterol busters lowered death due to heart attack by 23%, as compared to omega 3 fish oil, which outperformed drugs by a whopping 32%. this led the researchers to infer that fish oil offered cardioprotection through an alternative mechanism, likely an anti-inflammatory pathway, as fish oils do not affect cholesterol levels.

It is curious to note that the same cholesterol drugs are feverishly being studied at this very moment to determine if they have anti-inflammatory properties apart from lowering cholesterol. The one with this additional feature would beat the pack.

As the fire of inflammation burns within the artery walls, as in the case of progressive heart disease, an inflammatory substance called C-reactive protein is released and its presence has been used to gauge the extent of inflammation within the blood vessels. this test can be easily requested in a routine blood analysis.

I have never been excited in my entire professional career until now (ironically, just as I am contemplating early retirement) when finally the pieces of the jigsaw puzzle come together to become a complete picture. many modern day diseases are man-made and are preventable. The roots are now bared and need our outmost attention.

We have spent too much time and money treating the foliage. Nurturing the roots pays long-term dividends, and if we do not start now, then when?

Dr C.S. Foo is a medical practitioner. for more information, e-mail .my.

SOURCE: Speakfromtheheart.com

  Dec 16, 2010 05:00 ET

MISSION, KS–(Marketwire – December 16, 2010) –  (Family Features) as a cardiac nurse, Carol was devoted to helping patients suffering from heart disease. But when she began to experience a subtle pain in her jaw as she walked from her car to the hospital where she worked, she brushed it aside. she knew it was angina, a symptom of a heart problem, but she ignored her symptoms because she didn’t want to face a diagnosis.

Chronic angina affects more than 10 million Americans and is the most common symptom of coronary heart disease (CHD). Angina occurs as a result of reduced blood flow to the heart and can be brought on by exercise, extreme temperatures, mental or emotional stress or walking in cold weather, uphill, or after eating. When the heart doesn’t get as much oxygen as it needs, it cannot work properly, ultimately leading to the pain and discomfort of angina.

“It started for me as jaw pain, but soon I was experiencing pronounced pain when walking up hills,” recalls Carol, who is from Redwood City, Calif. “I kind of knew what it was, but didn’t want to believe it. as a nurse accustomed to caring for heart patients, being officially diagnosed was the first time I felt mortal.”

As with confronting any health condition, the first step in managing angina is acknowledging the symptoms. People experience angina differently. during an angina episode, most people feel uncomfortable pressure or pain in their chest. others may feel indigestion, exhaustion or shortness of breath.

Even after she was diagnosed, Carol still lived in fear. she kept her fears to herself and quietly structured her life around her angina. she avoided activities which might provoke an attack – anything from changing the bed linens to walking briskly across a parking lot.

“Patients need to speak with their healthcare professionals about their symptoms and keep an ongoing dialogue even after a diagnosis,” says Kathy Berra, MSN, ANP, FAAN, FPCNA, a board member of the Preventive Cardiovascular Nurses Association. “There are a number of treatment options available to help relieve and control angina to minimize its impact on daily life and patients should be aware of all of their options.”

As a nurse, Carol understood the importance of communicating with her cardiologist, but she didn’t want to admit how much her angina controlled her life. It was only when her symptoms worsened that she realized she needed to tell her doctor. the key to regaining control, she says, was learning to recognize the pattern of her specific angina symptoms and alerting her doctor when that pattern changed.

“Communication is a two-way street. to develop a proper treatment plan, your healthcare professional first has to know what specific symptoms you’re experiencing, how often you have them, and are they getting worse,” Berra explains. ”The sooner you start having meaningful conversations with your provider, the sooner you can start living your life again.”

A new online resource from Gilead Sciences, SpeakFromTheHeart.com, includes tools to help patients have a more productive conversation with their cardiologist with a goal of leading to better management of chronic angina.

“Having angina doesn’t mean you have to limit your life,” Carol advises. “With the proper treatment you can control angina, instead of angina controlling you.”

Photo courtesy of Getty Images

December 15, 2010, 9:24 pm

* Thalassaemia is a genetically transmitted disease

* It affects the haemoglobin component of red blood cells and leads to early destruction of the affected cells.

* there is a wide spectrum of presentations depending on the type of involvement of the genes

* Severely affected children need regular blood transfusions.

* Iron overloading is a major problem that leads to life-threatening complications

* Newer modalities of treatment hold a lot of promise.

* the disease can be prevented by detecting carriers of the genes involved.

The red blood cells in the normal human being perform the important function of transporting and providing oxygen to the tissues of the body. for this important function to be performed the normal haemoglobin plays a crucial role and the normal amount of haemoglobin in the blood is scrupulously regulated in the human body. the normal red cells have a finite life span of around 120 days and there is a dynamic process of old red cells being destroyed in the body followed by replenishment of the destroyed red cells by new cells formed in the bone marrow. there is a very specific chemical structure of normal human haemoglobin and any alteration of this structure makes the cells more susceptible for destruction and in such instances they are destroyed well before their normal life span of 120 days.

Thalassaemias are inherited genetic disorders that involve decreased and defective production of haemoglobin which is the molecule found inside all red blood cells which play a part in the transportation of oxygen throughout the body. Normal human hemoglobin contains two different kinds of protein chains named alpha and beta chains. there are two types of thalassaemia, alpha-thalassaemia and beta-thalassaemia. Their names describe which part of the hemoglobin molecule is affected, namely the alpha or the beta chain. any deficiency in these chains causes abnormalities in the formation, size and shape of the red blood cells. This process makes these cells to be more susceptible to destruction by the normal regulatory processes of the body. As a result, people with thalassaemia often have a reduced number of red cells in the bloodstream which leads to anaemia which can affect the transportation of oxygen to body tissues. In addition, thalassemia can cause the red cells to be smaller than normal or drop the haemoglobin content in them to below-normal levels. Depending on the type of thalassaemia and the degree to which they are affected, children with this disease may exhibit an array of the illness ranging from very mild inconsequential disease to a very severe life-threatening format. In other words, some only have mild anaemia with little or no effects while others require frequent serious medical treatment.

Thalassaemia is always inherited and passed on from parents to children through their genes. A child usually does not develop severe symptoms unless both parents carry a thalassaemia gene. these parents, who are reasonably normal to all intents and purposes, are known as "carriers" of the disease. if only one parent passes a gene for thalassaemia on to the child, then the child is said to have the thalassaemia trait. such a thalassemia trait will not develop into the full-blown disease and no medical treatment is usually necessary. many families have thalassaemia carriers, but the trait often goes undiagnosed because it produces none or very few symptoms. Frequently, thalassaemia is not diagnosed in a family until a baby is born with a severe form of the disease. at one time it was believed that the disease affected only people of Italian or Greek descent, but it is now known that many people with thalassaemia also come from or are descended from Africa, Malaysia, China and many parts of South East Asia. Because of a recent pattern of migration from Southeast Asia, there has been an increase in the past decade of thalassaemia in Europe and the USA.

Children with alpha-thalassaemia trait do not have thalassaemia disease. People normally have four genes for alpha globin, two inherited from each parent. if one or two of these four genes are affected, the child is said to have alpha-thalassemia trait. A specific blood test called a hemoglobin electrophoresis is used to screen for alpha-thalassaemia trait and can be done in infancy. often, results of the haemoglobin electrophoresis test are normal in people who have alpha-thalassaemia trait and a diagnosis of alpha-thalassaemia is made only after other conditions are ruled out and after the parents are screened. the disease can be harder to detect in older children and adults. those who have the alpha-thalassaemia trait usually have no significant health problems except mild anaemia which can cause slight fatigue. Alpha-thalassaemia trait is often mistaken for iron deficiency anaemia because the red cells appear small when viewed under a microscope. Other cases can cause more severe anaemia where three genes are affected. People with this form of alpha-thalassaemia may require occasional blood transfusions during times of physical stress, like fevers or other illnesses or when the anaemia is severe enough to cause symptoms such as fatigue. the most severe form of the disorder is called alpha-thalassaemia major. This type is extremely rare and women carrying fetuses with this form of thalassaemia have a high incidence of miscarriage because the fetuses cannot survive.

Beta-thalassaemia, the most common form of the disorder seen, is grouped into three categories such as beta-thalassemia minor (trait), intermedia, and major. A person who carries a beta-thalassemia gene has a 25 per cent or 1 in 4 chance of having a child with the disease if his or her partner also carries the trait. Beta-thalassaemia minor often goes undiagnosed because children with the condition have no real symptoms other than mild anaemia and small red blood cells. It is often suspected on routine blood tests such as a complete blood count and can be confirmed with a haemoglobin electrophoresis. No treatment is usually needed. As with alpha-thalassaemia trait, the anaemia associated with this condition may be misdiagnosed as an iron deficiency. Children with beta-thalassaemia intermedia have varying effects from the disease. Mild anaemia might be their only symptom or some might require regular blood transfusions. the most common complaint is fatigue or shortness of breath. Some of them also experience heart palpitations which is also due to the anaemia and mild jaundice which is caused by the destruction of abnormal red blood cells that result from the disease. the liver and spleen may be enlarged, which can feel uncomfortable for a child. Severe anaemia can also affect growth. another symptom of beta-thalassaemia intermedia can be bone abnormalities. Because the bone marrow is working overtime to make more red cells to counteract the anaemia, these children can experience enlargement of their cheekbones, foreheads, and other bones. Gallstones are a frequent complication because of abnormalities in bile production that involve the liver and the gallbladder. Some of them with beta thalassaemia intermedia may require a blood transfusion only occasionally. They will always have anaemia, but may not need transfusions except during illnesses, medical complications or later on during pregnancy. Other children with this form of the disease require regular blood transfusions. In them, low or falling haemoglobin levels greatly reduce the blood’s ability to carry oxygen to the body, resulting in extreme fatigue, poor growth, and facial abnormalities. Regular transfusions can help alleviate these problems. Beta-thalassaemia intermedia is often diagnosed in the first year of life. Doctors may be prompted to test for it when a child has chronic anaemia or a family history of the condition. As long as it is diagnosed while the child is still doing well and has not experienced any serious complications, it can be successfully treated and managed.

Beta-thalassaemia major, also called Cooley’s anemia, is a severe condition in which regular blood transfusions are necessary for the child to survive. although multiple lifelong transfusions save lives, they also cause a serious side effect. That is the overloading of iron in the bodies of thalassaemia patients. Over time, people with thalassaemia accumulate deposits of iron, especially in the liver, heart, and endocrine hormone-producing glands. the excessive iron deposits eventually can affect the normal functioning of these organs and in many cases, premature deaths are due to complications arising as a result of malfunctioning of these organs.

To minimize iron deposits, children need to undergo chelation or iron-removing therapy. This can be done by taking daily medication by mouth or by subcutaneous or intravenous administration. Daily chelation therapy when given regularly has been proven to prevent liver and heart damage from iron overload, allow for normal growth and sexual development and increase the life span. Iron concentrations are monitored every few months. Sometimes liver biopsies are needed to get a more accurate picture of the bodyiron load. Children on regular transfusions are monitored closely for iron levels and complications of iron overload even when they are on the chelation medications. Other risks associated with chronic blood transfusions for thalassemia major include blood-borne diseases like hepatitis B and C. Blood banks screen for such infections, in addition to rarer infections such as HIV. In addition, those who have many transfusions can develop allergic reactions that can prevent further transfusions and cause serious illnesses.

For children and teens with thalassemia, adolescence can be a difficult time, particularly because of the amount of time required for transfusions and chelation therapy. Over the last few decades, some severely affected children in other countries have successfully undergone bone marrow transplants to treat thalassaemia major. It is however considered only in cases of very severely disabling thalassaemia disease. there is considerable risk to bone marrow transplants as the procedure involves the destruction of all of the blood-forming cells in the bone marrow and repopulating the marrow space with donor cells that must match perfectly with the tissues of the patient. the closest match is usually from a sibling. the procedure is usually undertaken in children younger than 16 years of age who have no existing evidence of liver scarring or serious liver disease. Results have been encouraging so far, with disease-free survival in many patients. Blood-forming stem cells taken from umbilical cord blood have also been successfully transplanted and research using this technique is expected to increase in the future. currently bone marrow transplantation treatment and stem cell transplant techniques are the only known "cure" for the disease.

In the Sri Lankan scenario, thalassaemia, especially the severe forms of the disease cause many problems for the health service and the families of affected children. there are areas in the country such as the North Central province, Central province, Uva province and the Southern province where there are considerable numbers of affected children. the prevalence of the disease is increased in communities where there is inter-marriage, marriage between close relatives and consanguinity. This is simply because of the fact that the chance of two carriers marrying is that much increased in these situations. With time, many carriers are produced in the community and they may not even be related. In such a scenario, even unrelated marriages could produce siblings with the severe form of the disease.

The National Health Service of Sri Lanka spends a very large amount of money for regular medical treatment, follow-up, blood transfusions and iron chelation therapy for these children. Some of these patients are from very poor communities in very remote areas of the country. the necessity for regular travelling for medical treatment and follow-up leads to many problems for these families most of whom have major social and economic problems. They go through untold suffering in their quest to keep these unfortunate children alive and relatively healthy. the resources of the hospitals in these areas are also taxed to the maximum in trying to cope with the problem which has become a never-ending type of predicament.

The authorities have now established a National Thalassaemia Centre in Kurunegala and also provided the North Colombo Teaching Hospital at Ragama with several facilities for ultra-modern testing for these diseases. the ultimate aim is to detect carriers and prevent marriages between them. This will be a very potent arm in preventing the severe form of the disease and in that context thalassaemia, at least the severe form of it, is one of the eminently preventable diseases. In addition, continuing research into the disease has produced several potent chelating agents that can prevent the long term consequences of iron overload for those requiring regular multiple blood transfusions. In time to come even bone marrow and stem cell transplantation may become real possibilities in the country.

As frightening as thalassaemias can be, the future outlook is somewhat encouraging. In the past few decades, new techniques and advanced forms of therapies have greatly improved the quality of life and life expectancy for children who have these diseases. Modern methods of screening for carrier states hold a golden promise and a window of great opportunities for prevention of the more severely affected cases in the future. one hopes that, even in our country, we would be able to make life that much better for these unfortunate affected families and await the light at the end of the tunnel as a result of effective prevention of the disease in the future.

The writer would appreciate feedback from the readers. Please e-mail him at