What is an "Allergic Salute"?

Allergic Salute

QUESTION: During a recent examination of my 11 year old daughter for a
persistent runny nose, the doctor mumbled something about an "allergic
salute". I didn't want to reveal my ignorance, and thought I probably hadn't
understood, so I didn't ask him what he meant. However, I am still fearful
that I might have missed something important. Can you please shed some light
on this term?


ANSWER: If you had been watching your daughter at the moment the doctor made
his observation, you would have probably noticed that she had rubbed her nose
with a particular gesture. With fingers pointed up and the palm facing
outward, the back of the hand is rubbed along the side of the nose from the
nostril upward.

This motion is seen commonly in youngsters who suffer from
allergies that irritate the tissues that line the nose, and who suffer from
runny nose or rhinitis. I am sure you have seen your daughter repeat this
gesture many, many times and can see how appropriate the term "allergic
salute" really is. Actually it is quite effective, as not only does it wipe
away the disturbing mucus flowing from the nose, but also tilts the tip of the
nose upward, aiding your child to breathe. There is another sign of
persistent allergic rhinitis that you may also observe. It is a horizontal
crinkle near the lower end of the nose, called a transversal nasal crease,
that develops as a result of frequent "saluting" and is one of the signs that
many alert clinicians use in making a diagnosis of this condition. While all
of this is interesting to understand, it does not represent anything truly
serious that should cause you additional worry or anxiety about your child's
problem.

What is "Ptomaine Poisoning"?

What is "Ptomaine Poisoning"?

QUESTION: We recently attended a "high class" affair, a benefit for a
charity, and catered by a very reputable firm. However, only hours after the
dinner was over, several people were taken to the hospital with food
poisoning, but neither my husband nor I fell ill. I know the problem as
"tomain poisoning" but can find nothing in my home medical book by that name.
Can you provide the explanations I am seeking?

ANSWER: Though I can't give you all the information requested in your four
page letter, I can help clear up a few points for you. To start, it is
spelled "Ptomaine;" but even then you won't find any information, for
ptomaines are the result of protein decomposition and are perfectly harmless.
Look for your information under "staphylococcal food intoxication" (or "food
poisoning, staphylococcal") and you will find all your answers. When certain
foods, such as salads using mayonnaise, creamy food dressing, or cream filled
pastries, are prepared well ahead of time and then improperly refrigerated,
staph bugs can reproduce rapidly and produce toxins, which in turn cause all
the symptoms you listed, vomiting, "dry heaves" and diarrhea. There is no way
to detect the tainted food, as it looks and smells normal. Since all the food
may not have been prepared at once, or improperly refrigerated, not all the
guests at the banquet became ill. Be happy that you were among the lucky
ones.

What Makes a Person's Skin Turn Yellow?

QUESTION: Please settle an argument I'm having with a friend about what makes
a person's skin turn yellow. She says it means liver disease. I say it means
jaundice. Who's right?


ANSWER: Actually, both of you are correct. "Jaundice" merely means that the
skin is tinted yellow. The color comes from certain pigments contained in the
bile, and it's a sure sign something has gone wrong.

Most frequently it is a
disease affecting the liver, but can also be caused by problems in the
"biliary tree" (the tubes leading to and from the gall bladder).
There are some clues doctors use to tell the conditions apart. For one,
an individual with obstructive jaundice, caused by a blockage in the biliary
tree, usually notes the changed color of the skin before being aware of
feeling under the weather. In fact, jaundice patients often discover their
condition accidentally, when a friend or family member comments on the change
in their complexion. In contrast, patients suffering from hepatocellular
diseases (a fancy name for liver disease)--the most common variety is viral
hepatitis--usually complain early on of such concerns as weight loss, fever,
or a sensation of itching.
When a doctor suspects an obstruction in the biliary tree, a series of
noninvasive radiologic tests to discover the location of the blockage is
usually recommended. Ultrasonography can show dilated bile ducts; CT scans
are useful in providing more detailed data. For true liver disease, there are
a wide variety of blood and chemical tests to help determine the exact
diagnosis, and it sometimes take quite an effort before the exact cause of the
jaundice can be determined.

What is Potter's Syndrome or Disease?

Potter's Syndrome

QUESTION: Can you explain Potter's Syndrome or Disease? Our baby was born
with no kidneys and lived only 9 hours and that's what they said he had. We
really don't understand how this happened as I had a perfect pregnancy up
until two weeks before due date.

ANSWER: Dr. E.L. Potter first described this syndrome in 1946, and it is
recognized as a congenital malformation.
It is also called
facial-renal-dysplasia as there are several additional anatomical structures
that make up the face that also fail to develop fully.

Sometimes the lungs as
well as hands and feet are affected. There are no chromosomal abnormalities
found in this disease, so it is doubtful that it is inherited.

There are no
ways known to treat Potter's Syndrome, no precautions to avoid this tragic
occurrence. You did nothing wrong, so there must be no guilt, and as your own
physician has probably already counseled you, there is little chance of this
happening again. As to the "whys", I have no answers to offer you, for in
cases like yours I find that I, too, do not understand.

Whats a Diuretic?

What's a Diuretic?

QUESTION: I have been taking a medication for many years, called a diuretic.
I know it is a water pill, but that's all. Recently you write that we should
ask questions about our medications, so I am asking you: what's a diuretic?

ANSWER: I think I suggested you ask your doctor about medications, but if you
are asking me, I am happy to be your doctor, at least for now. Simply put, a
diuretic is a medication the increases the production of urine. Our kidneys
are in charge of that function and manufacture urine in a two step process.
The first step is to "filter" the blood through the clump of capillaries and
tubules that form a structure called a "glomerulus".

This produces a liquid
that passes through the tubules of the kidney to reach the main tube that
passes to the bladder (ureter). As the liquid passes through the tubules, new
chemicals are excreted into the liquid, while some precious chemicals and
water itself is reabsorbed back into the body. The final fluid that passes
down the collecting ducts is called urine. The structure that includes a
glomerulus, the tubules and the duct is termed a "nephron" and is the basic
anatomical and physiological structure that kidneys are made of. Now if you
have that all clear, I can describe just how diuretics work. They may either
increase the rate at which the glomerulus works, producing more basic fluid,
or they may decrease the reabsorption that takes place in the tubules. Either
action results in the production of more urine. Different chemicals that are
used as diuretics act on different parts of the nephron system, and so
physicians choose carefully, prescribing the one that is best for their
patient's condition. Diuretics may be used to prevent or eliminate swelling
(edema), control hypertension, and treat heart failure. The next question to
ask your doctor is "What am I taking this medicine for?" Sorry, I can't
answer that one for you.

Preventing Nosebleeds During Cold Weather

Preventing Nosebleeds

QUESTION: With the cold weather, an ever recurring problem has returned. My
eight year old son gets frequent nosebleeds which scare me to death. I guess
it's the sight of all that blood. What can be done to prevent them, and how
should they be handled when they do occur?

ANSWER: Many people experience the same emotions whenever blood appears, but
a little knowledge can go a long way here in helping you to prevent these
frequent episodes. I have nothing but good news for you, since most
nosebleeds are without serious consequences, particularly in children. There
are two types: Anterior, where the bleeding is in the front part of the nose,
and usually appears in one nostril or the other; and Posterior, where the
origin of the bleeding is deep in the nose. In the case of a posterior bleed
the blood runs through the back of the mouth and down the throat. Posterior
nosebleeds may be quite serious, usually occur in older people, and require a
physician's attention. In children, however, the bleed is of the anterior
type, are most common in the winter because the air is cold and extremely dry,
and so removes the natural moisture of the nasal membranes so that they crust
and crack. By using a bit of cream or ointment (such as Vaseline or A and D
ointment) inside the nose before exposure to the elements you provide another
coating to the sensitive inner lining and prevent the nose bleed. To treat
one that has begun simply pinch all the soft parts of the nose together, then
press backwards to compress the pinched parts of the nose against the bones of
the face. You must hold this for a minimum of five minutes to be effective,
and should keep your son sitting in an erect position. An ice pack against
the nose and cheeks may also help. If this doesn't work then it's off to the
doctor, who can stop the flow by cauterizing the bleeding vessel.

Use of Phytosterol to fight Cholesterol

Phytosterol

Phytosterols also known as plant sterols are a group of steroid alcohols naturally occuring in plants. It is a solid, unsaturated fat found in the fatty tissues of plant or basically plant cholesterol. One such phytosterol complex made up of beta-sitosterol, campesterol, stigmaseterol and brassicasterol is isolated from vegetable oil and marketed as a dietary supplement and to reduce cholesterol.

The human body needs cholesterol for various metabolic processes and for the formation of cell membranes. It produces cholesterol in the liver. Certain foods also have cholesterol which is imbibed by the body. This excess cholesterol is deposited on the arterial walls by the low density lipoproteins (LDL) leading to atherosclerosis. Phytosterols help by reducing the production and absorption of bad cholesterol.

Mechanism of phytosterol action

Phytosterols act as control agents to regulate cholesterol levels. Certain cells in the body metabolize and use the cholesterol for bodily functions. Dietary cholesterol combines with bile salts so that it can be absorbed by the intestine. There it is reassembled into lipoproteins which transport it to the liver. Phytosterols act directly on the digestive system and block the absorption of cholesterol by as much as 40%. The reduced amount of cholesterol reaching the liver increases the clearing of existing LDL particles leaving less LDL circulating in the blood stream. People with a largely vegetarian plant based diet therefore have low cholesterol levels.


Besides decreasing cholesterol absorption, phytosterols also have other mechanisms to protect the health of the heart. The Food and Drug Administration has stated that a diet of 0.8g of phytosterols per day can reduce the risk of cardiovascular disease and bring down cholesterol levels by 10 to 15%. Besides this, the beta-sitosterol reduces symptoms of an enlarged prostrate and brings down joint inflammations.

Foods containing phytosterols

Phytosterols are found largely in rice bran, corn, flax seed and wheat germ. Nuts, legumes, oranges, bananas, beetroot and brussel sprouts also have good concentrations of phytosterols. If the cholesterol level is in the normal range, regular diet containing these foods is sufficient to keep the cholesterol under check. They have been included in many breakfast cereals, oils and butter substitutes to provide additional intake for high cholesterol patients.

The Upside

• Phytosterols do not interfere with the high density lipoprotein (HDL) or good cholesterol levels.

• They do not produce any of the statin side effects like muscle or joint pain.

• They do not harm the liver or kidney.

The Downside

• Phytosterol taken in recommeded doses takes a long time to show considerable results.

• People with obesity or overweight problems must be careful to take a low-fat diet enriched with phytosterols.

• It cannot be used for people with high cholesterol readings. It must be combined with other ingredients or with statins to get a syngeric effect.

Phytosterols ARE an important breakthrough in the human struggle against cholesterol control. Taken in the right dose alongwith a disciplined life-style, proper diet and regular exercise, phytosterol can be all you need to lower and maintain your cholesterol.

What is the Difference Between Fibrositis and Fibromyalgia?

Fibrositis

QUESTION: My condition, fibrositis, still seems confusing to me and very
difficult to deal with. Perhaps you can offer some new insight. What is the
difference between it and fibromyalgia? Are there any treatments that give
relief? Please give me all the help you can.

ANSWER: A confusing disease indeed, even its name can cause confusion.
Fibrositis and fibromyalgia are the same disease (also know as Myofascial Pain
Syndrome). The term fibromyalgia (meaning muscle pain) is now preferred, for
there is no inflammatory process ("itis") seen in this syndrome. It is
classified as a rheumatic disorder that can cause pain, tenderness and
stiffness in muscles and tendons at specific "trigger points" that are
distributed over the back of the neck and shoulders, the sides of the breast
bone and the bony points of the elbows and hips. In addition there are a
whole flock of nonrheumatic symptoms to complicate the patient's life; poor
sleep, anxiety, fatigue and even irritable bowel symptoms.
While this confusing syndrome makes accurate studies hard to find, it is estimated that
as many as 10 million Americans may suffer from the condition. It is most
common in women and occurs between the ages of 35 and 60. Since there is no
cure, I can list the types of treatment that may offer you some relief, over
and above the use of analgesics such as aspirin or NSAIDs such as ibuprofen.
They include both ice packs and heat treatments, relaxation techniques, stress
management, biofeedback and stretching exercises. Low doses of tricyclic
drugs at bedtime may help sleep problems and reduce pain. A tender point may
be injected locally with a 1% lidocaine solution in combination with a 40 mg
hydrocortisone acetate suspension. Your prognosis may be favorable utilizing
a comprehensive, supportive program along with your physician's advice.

What is Globulin?

Globulin

QUESTION: What is globulin that doctors give to prevent infection?

ANSWER: Globulins are proteins found in the blood stream that contain the
antibodies the immune system uses to fight disease. Immune globulins are not
a recent discovery. They have been studied since the early 1900's, and have
been used to prevent the spread of polio, measles, and hepatitis A. Those
immune globulins were simply a by-product of blood donation, since they are
taken from the plasma of several human donors, concentrated and purified and
contain any antibodies to diseases those donors were exposed to. Specific
immune globulins with high antibody concentrations to certain diseases, such
as rabies, hepatitis B, tetanus, and others, are also widely used. For some
diseases, diphtheria for one, the immune globulins used come from animal
serum.

Immune globulins were great breakthroughs in fighting diseases, but they
have some drawbacks. They had to be injected into a muscle, which is painful
and which limits the amount that can be administered, making multiple
injections sometimes necessary.
An intravenous (IV) form of immune globulin has been created that has
several advantages over the intramuscular kind. It can be given more
frequently and in higher amounts, but has the drawbacks of higher cost, the
need for an IV hookup, and a greater risk of side effects.
The chief use for IV immune globulin is in helping people who have
antibody deficiencies and it is also used in treating autoimmune disorders.
Antibody deficiencies are usually inherited deficiencies of the immune system,
but some immune deficiencies are secondary to other diseases. People with
these immune problems are open to almost any infection and immune globulin
gives them the protections they lack.
The most famous immune deficiency is AIDS (it's called acquired immune
deficiency syndrome because it comes from a virus infection and is not
inherited). Immune globulin gives some protection to children with AIDS,
those who contracted it from their mothers during birth, but it does not
appear to help adult AIDS sufferers.
In autoimmune diseases, where the body is attacking itself, IV immune
globulin appears to inhibit some of the body's antibodies. It has been used
to treat a blood condition called thrombocytopenia and has also been tested
with other autoimmune diseases such as myasthenia gravis and systemic lupus
erythematosus.