Wednesday, November 19, 2008
Saturday, November 15, 2008
Toxoplasmosis awareness, causes and prevention
What is toxoplasmosis?
Toxoplasmosis (toxo) is an infection caused by a single-celled parasite called Toxoplasma gondii .The infection is most commonly acquired from contact with cats and their feces or with raw or undercooked meat.The U.S. Centers for Disease Control and Prevention (CDC) estimates that more than 60 million people in the United States may carry the Toxoplasma parasite, but very few have symptoms because a healthy immune system usually keeps the parasite from causing illness.
What factors increase the risk of acquiring toxo?The following situations potentially expose a person to the toxoplasma parasite and increase the risk of acquiring toxoplasmosis:
touching your hands to your mouth after gardening, cleaning a cat's litter box, or anything that came into contact with cat feces
eating raw or partly cooked meat, especially pork, lamb, or venison
touching your hands to your mouth after contact with raw or undercooked meat
organ transplantation or transfusion (this is rare)
If a woman is pregnant when she is infected with toxo, the infection can be transmitted from her to the baby with sometimes catastrophic consequences.
What are the usual symptoms of toxoplasmosis?
Although people infected with toxoplasmosis are often unaware of having this disease, typical symptoms of toxo are flue like symptoms including swollen lymph nodes and muscle aches and pains that last from a few days to several weeks. If your immune system is normal, you cannot get the infection again.
Why do some people develop severe problems from toxo?
Few people with toxo develop symptoms because the immune system usually keeps the parasite from causing illness. However, anyone with a compromised immune system is at risk for serious problems from toxo. These individuals include those undergoing chemotherapy, people with HIV/AIDS or other immune disorders, and recent organ-transplant recipients.
In these people, an infection that occurred anytime during life can reactivate and cause the severe symptoms of toxoplasmosis such as damage to the eye, brain, or other organs.
Ocular toxoplasmosis, which damages the eyes, can lead to reduced vision, blurred vision, pain (often with bright light), redness of the eye, and sometimes tearing, according to the CDC.
Can toxoplasmosis develop into a more serious illness in babies?
Yes, the immune system in infants is not fully mature until after birth.
The babies of women who were exposed to toxo within a few months of becoming pregnant or during pregnancy are at an increased risk for developing a severe case of toxo. According to the NIH (U.S. National Institutes of Health), pregnant women who newly contract the toxoplasmosis parasite have a 40% chance of transmitting it to their unborn child. Women who were first exposed to toxo more than six months before becoming pregnant are not likely to pass the infection to their children.
Most infants have no symptoms at birth, but a small percentage may be born with eye or brain damage. Unfortunately, the signs and symptoms of the disease often appear a few months after birth.
A baby developing severe case of toxo
What is meant by a baby developing "a more severe case of toxo"?
Children born with toxoplasmosis can be afflicted with mental retardation, convulsions, spasticity, cerebral palsy, deafness, and severely impaired vision. The infant's head may be abnormally small (microcephaly) or abnormally large due to increased pressure on the brain (hydrocephalus).
How is toxo diagnosed in the lab?
There are many different kinds of blood tests for toxoplasmosis. The results can determine if the patient has had toxo and whether the infection is recent ("acute") or not.
How can toxoplasmosis be prevented?
Since toxo usually causes mild to no symptoms, and a healthy immune system prevents any remaining parasites in the body from causing further symptoms, most people don't need to worry about getting this disease.
However, if you have a weakened immune system or are pregnant, there are several steps you should take to prevent exposure to toxoplasmosis.
If you have a weakened immune system, get a blood test for toxoplasmosis. If your test is positive, your doctor can tell you if and when you need to take medicine to prevent the infection from reactivating.
If you are planning on becoming pregnant, you may consider being tested for toxo. If the test is positive, there is no need to worry about passing the infection to your baby (since you should have immunity against the parasite).
If you are already pregnant, you should discuss your risk of toxoplasmosis with your doctor who may order a blood sample for testing.
Wear gloves when you garden or do anything outdoors that involves handling soil since cats often use gardens and sandboxes as litter boxes. Wash your hands well with soap and warm water after outdoor activities, especially before you eat or prepare food.
Have someone else handle raw meat for you. If this is not possible, wear clean latex gloves and thoroughly wash with soap and hot water any cutting boards, sinks, knives, and other utensils that might have touched the raw meat. Wash your hands well with soap and warm water afterward.
Cook all meat thoroughly, especially pork or veal.
What is meant by a baby developing "a more severe case of toxo"?
Children born with toxoplasmosis can be afflicted with mental retardation, convulsions, spasticity, cerebral palsy, deafness, and severely impaired vision. The infant's head may be abnormally small (microcephaly) or abnormally large due to increased pressure on the brain (hydrocephalus).
How is toxo diagnosed in the lab?
There are many different kinds of blood tests for toxoplasmosis. The results can determine if the patient has had toxo and whether the infection is recent ("acute") or not.
How can toxoplasmosis be prevented?
Since toxo usually causes mild to no symptoms, and a healthy immune system prevents any remaining parasites in the body from causing further symptoms, most people don't need to worry about getting this disease.
However, if you have a weakened immune system or are pregnant, there are several steps you should take to prevent exposure to toxoplasmosis.
If you have a weakened immune system, get a blood test for toxoplasmosis. If your test is positive, your doctor can tell you if and when you need to take medicine to prevent the infection from reactivating.
If you are planning on becoming pregnant, you may consider being tested for toxo. If the test is positive, there is no need to worry about passing the infection to your baby (since you should have immunity against the parasite).
If you are already pregnant, you should discuss your risk of toxoplasmosis with your doctor who may order a blood sample for testing.
Wear gloves when you garden or do anything outdoors that involves handling soil since cats often use gardens and sandboxes as litter boxes. Wash your hands well with soap and warm water after outdoor activities, especially before you eat or prepare food.
Have someone else handle raw meat for you. If this is not possible, wear clean latex gloves and thoroughly wash with soap and hot water any cutting boards, sinks, knives, and other utensils that might have touched the raw meat. Wash your hands well with soap and warm water afterward.
Cook all meat thoroughly, especially pork or veal.
Transmission cycle of toxoplasmosis from cats to the others
Am I able to keep my cat?
Yes, but if you have a weakened immune system or are pregnant, there are some steps to take to avoid being exposed to toxo according to the Cornell College of Veterinary Medicine.
Most importantly, you can help prevent your cats from getting infected with toxo. Feed them dry or canned cat food and keep them indoors. Cats can become infected by eating or being fed raw or undercooked meat that is infected with the parasite, or by eating infected prey such as birds or rodents. Any cat that is allowed access to outdoors should be kept off beds, pillows, or other furniture that you also use. Don't bring a new cat into your house that might have been an outdoor cat or might have been fed raw meat. Avoid handling stray cats and kittens. Have your cat tested for the parasite. Your vet can answer any other questions you may have regarding your cat and the risk for toxoplasmosis.
Have someone who is healthy and not pregnant change your cat's litter box. If this is not possible, wear gloves and clean the litter box daily (the parasite found in cat feces needs a few days after being passed to become infectious). Wash your hands well with soap and warm water afterward.
Yes, but if you have a weakened immune system or are pregnant, there are some steps to take to avoid being exposed to toxo according to the Cornell College of Veterinary Medicine.
Most importantly, you can help prevent your cats from getting infected with toxo. Feed them dry or canned cat food and keep them indoors. Cats can become infected by eating or being fed raw or undercooked meat that is infected with the parasite, or by eating infected prey such as birds or rodents. Any cat that is allowed access to outdoors should be kept off beds, pillows, or other furniture that you also use. Don't bring a new cat into your house that might have been an outdoor cat or might have been fed raw meat. Avoid handling stray cats and kittens. Have your cat tested for the parasite. Your vet can answer any other questions you may have regarding your cat and the risk for toxoplasmosis.
Have someone who is healthy and not pregnant change your cat's litter box. If this is not possible, wear gloves and clean the litter box daily (the parasite found in cat feces needs a few days after being passed to become infectious). Wash your hands well with soap and warm water afterward.
Once infected with toxo, is my cat always able to spread the infection to me?
No, cats can only spread toxo in their feces for a few weeks after they are first infected with the parasite. Like humans, cats rarely have symptoms when first infected, so most people don't know if their cat has been exposed to toxo. In fact, most infected cats appear healthy. There are no good tests available to determine if your cat is passing toxo in its feces.
What is the treatment for toxoplasmosis?
Once the diagnosis of toxoplasmosis is confirmed, you and your doctor should discuss whether treatment is necessary. In an otherwise healthy person who is not pregnant, treatment is not needed. Symptoms will usually go away within a few weeks. For pregnant women or people who have weakened immune systems, drugs are available to treat the parasite that causes toxoplasmosis.
Toxoplasmosis At A Glance
· Toxoplasmosis (toxo) is a disease caused by a parasite.
· Toxo is acquired from contact with cats and their feces.
· Toxo is also acquired from eating or touching raw or partly cooked meat.
· Symptoms can range from none to very severe.
· A woman who contracts toxo right before or during pregnancy can transmit it to her baby with catastrophic consequences.
· People with immune deficiencies are at high risk for developing severe signs and symptoms of toxo.
Featured:
Toxoplasmosis (toxo) is a parasitic infection that causes flulike symptoms, swollen lymph nodes, and muscle aches and pains that may last from a few days to several weeks. Pregnant women who contract toxo have a 40% chance of passing the infection to their babies. Babies born with toxo may be afflicted with mental retardation, cerebral palsy, deafness, and severely impaired vision.
Medication for Toxoplasmosis
GENERIC NAME: PYRIMETHAMINE - ORAL (pir-ih-METH-uh-meen)
BRAND NAME(S): Daraprim
USES: This medication is used in the treatment and prevention of prevention of malaria or the treatment of Toxoplasmosis (a parasitic infection). Pyrimethamine is often taken in combination with other antimalaria medication.
HOW TO USE: Take this medication by mouth with food or meals as directed. For preventing malaria, this is usually taken once a week. For treatment of a malarial attack, this is taken once a day for 2 days, then given once a week. In the treatment of toxoplasmosis, this may be given once or twice a day for up to 5 weeks. Take this medication for the full time prescribed. Stopping therapy too soon may result in ineffective treatment.
SIDE EFFECTS: Nausea, stomach upset or loss of appetite may occur especially the first several days as your body adjusts to the medication. Other effects reported include headache, lightheadedness, dry mouth, diarrhea, trouble sleeping. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop a sore throat, unusual bruising, pale skin, swelling of the tongue, depression, irregular heartbeat. Use caution driving or operating machinery if this medication makes you lightheaded. This medication may cause blood disorders. It is important that lab tests be done periodically while taking this medication to monitor for this. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.
A is for animals, Z is for zoonoses.
They come from giant Gambian rats and fuzzy bunnies. They come from puppies and pythons. Whether the animal is friend or food or foe, it can carry dangerous diseases.
There are at least 39 important diseases people catch directly from animals. There are at least 48 important diseases people get from the bite of bugs that bit an infected animal. And there are at least 42 important diseases that people get by ingesting or handling food or water contaminated with animal feces.
Some are as old as memory: rabies, bubonic plague, food poisoning. Others have only recently emerged: monkeypox, West Nile encephalitis, Legionnaires' disease. And some, such as highly lethal bird flu, we fear even though they haven't -- yet -- spread in humans.
People have lived with animals for eons. There's a reason for that. They don't just make us feel better. They actually contribute to our health. People who keep pets tend to have lower cholesterol levels and lower blood pressure. They tend to get more exercise and to feel less lonely.
On the other hand, pets and other animals can get sick. And some of these illnesses can be quite dangerous. This article offers an overview of these diseases -- and how to avoid them.
Why Animal-Borne Diseases Matter
Diseases passed to humans from animals are called zoonoses. What makes one of these diseases important? Two things, "If you ask Americans in general what is the most important zoonosis, most would say rabies," "It is something they fear, it is in the news. But in terms of risk, there are only zero to two human cases a year in the U.S. It's one of those zoonoses that are important because of their seriousness, but not their frequency: rabies, tularemia, plague, monkeypox, listeria, anthrax. These are diseases that are very serious if one gets them but which are relatively uncommon."
On the flip side, are animal-borne diseases that are important because they are fairly common even if not often fatal. Cat-scratch fever, for example, infects as many as 20,000 Americans a year. And an estimated 4%-20% of U.S. kids get roundworm from dogs and cats.
ToxoplasmosisCats allowed to roam outdoors often pick up a parasite known as Toxoplasma gondii. Most of the time, the cat will fight off the infection before it becomes contagious. However, sometimes cats shed egg-like forms of the parasite in their feces. That's why pregnant women, small children, people with damaged immune systems, and people on cancer chemotherapy should avoid cleaning cat litter boxes.
Usually, a person who gets toxoplasmosis gets very few symptoms. But when a person does get the disease, it causes a flu-like illness and/or muscle aches and pains lasting for a month or even longer. "A very sizeable proportion of humans -- 30%-40% -- have been infected with toxoplasmosis, usually by eating undercooked meat," Glickman says. "Most people never had a symptom or had very mild disease. But in people [with weakened immune systems] it can be fatal. And the worst infections may be in pregnant women. The organism can go to the fetus and, if the baby doesn't die, cause lifetime illness."
Diseases from Cats and Dogs
By far they're our best friends. And that means cats and dogs are common sources of disease.
Cats often carry a germ called Bartonella henselae. Some 40% of cats are infected at least once in their lives -- usually when they're kittens -- but they don't look sick. Humans get infected only when they are bitten or scratched by an infected animal -- cat-scratch fever
Other bacterial infections humans can get from cats and dogs include:
Plague. Rodents carry the plague bacteria. Very rarely, cats get fleas from infected rodents and pass the disease to humans.
Q fever.
People are much more likely to get Q fever from barnyard animals than from cats. But it does happen. Half of infected people get symptoms that include fever, headache, chest or stomach pain, diarrhea, and/or vomiting. It can also cause temporary swelling of the heart -- a dangerous event for people who already have heart disease.
Campylobacter infection. Found in animal feces, this germ causes gastrointestinal symptoms. It's usually not dangerous, but can cause severe illness in people with weakened immune systems.
Leptospira infection.
Humans get infected via contact with water, food, or soil containing urine from infected animals. Left untreated, leptospirosis can be quite serious. It can lead to liver failure, trouble breathing, kidney damage, brain and spinal cord infection, and, rarely, death. Symptoms vary widely but can include high fever, severe headache, chills, muscle aches, and vomiting. There may also be yellow skin and eyes, red eyes, abdominal pain, diarrhea, or a rash.
Salmonella
infection. People get this often-severe gastrointestinal infection via contact with animal feces. It can cause severe kidney damage to young children.
Both cats and dogs sometimes get parasites that infect humans. One of the most common is roundworm. Left untreated, nearly all puppies and kittens pick up this parasite. Its egg-like form -- the oocyst -- can survive for years in soil.
When humans ingest oocysts, tiny worms hatch in the gut and move through the body. Symptoms include fever, coughing, asthma, and/or pneumonia. Once in a while, the tiny worms enter the eye and scar the retina. This results in permanent partial vision loss. "Some 750 to 1,500 kids go blind each year with roundworm infection [of the eyes] passed from dogs through feces to children.
Other parasites of cats and dogs:
Tapeworm. A person gets infected by swallowing an infected flea -- a relatively rare event, but it happens.
Hookworm. Hookworms are common in tropical and subtropical areas. They infest soil contaminated by animal feces. Humans get infected by direct contact, usually by walking on contaminated soil. Heavy infections can be serious.
Cryptosporidiosis.
This parasite cause mild to severe intestinal symptoms like diarrhea. It's not usually a dangerous infection, except to people with weakened immune systems.
Ringworm
isn't a parasite, but a fungal infection that forms a ring-shaped rash on the skin or a bald patch on the scalp. People can get it from direct contact with an infected animal.
Cats and dogs get viruses, too. Rabies is the most dangerous one. Be sure to keep up with your pet's rabies vaccination.
To protect yourself from diseases carried by house pets:
· Wash your hands with soap and running water after touching feces.
· Take your pet to the vet on a regular basis and keep up with all vaccinations recommended for your area.
· Avoid rough play with cats.
· If your cat or dog bites you, wash the area with soap and water right away.
· Wash your hands after handling your pet -- especially before eating or preparing food.
· People with weakened immune systems should take special precautions. These include never letting pets lick them on the face or on an open cut or wound, never touching animal feces, and never handling an animal that has diarrhea.
· Don't let your pet drink from toilet bowls or eat feces.
Other Pets, Other DiseasesWe humans have other friends besides cats and dogs. And with these other friends come other diseases:
Birds. Pet birds, including parrots and parakeets, can spread psittacosis. It's a relatively rare disease, with about 50 U.S. cases each year. Symptoms include fever, chills, headache, muscle aches, and a dry cough. There's often pneumonia, which can be quite serious and even fatal. Untreated infections can lead to serious heart, liver, and nerve problems.
Reptiles and amphibians. Snakes, turtles, lizards, frogs, toads, and salamanders -- like other animals -- can carry Salmonella bacteria. Wash your hands after handling them. Keep them in their habitat; don't let them wander your room. Keep reptiles and their equipment away from the kitchen. Don't clean reptile cages in sinks or tubs used by people. Don't kiss your reptile -- it won't like it, anyway. And keep reptiles and amphibians away from children younger than 1 and people with weakened immune systems.
Exotic animals. Yes, some people make pets of animals like African pygmy hedgehogs. These tiny, antisocial animals that roll up into spiky balls were a fad not too long ago. And they came with salmonella. More recently, pet Gambian giant rats brought monkeypox into the U.S. Similar to smallpox -- but fortunately milder and not as contagious -- monkeypox lurks in small mammals in the African rainforest.
Wild Animals
Wild animals should stay that way. Enjoy them from a distance. Even so, they're a rich source of human disease. Here are a few:
Raccoon roundworm.
This is the best reason not to feed wild racc
oons. The feces of an infected raccoon carry millions of roundworm eggs. These eggs become infectious in two to four weeks and can survive for years in the environment. They are very difficult to kill -- the CDC recommends cleaning contaminated decks or porches with boiling water or a propane flame gun (with proper caution, of course).Symptoms depend on where the roundworms travel in the body. They can include nausea, fatigue, enlarged liver, and symptoms of brain infection (poor coordination, inattention to one's surroundings, loss of muscle control, coma, and/or blindness). Some infections have been fatal. Diagnosis is difficult. If you are having symptoms after contact with raccoons, be sure to tell your doctor. There is no specific cure, but early treatment can limit the extent of disease.
Giardia infection. This microscopic parasite is the hiker's bane. It's one of the main reasons why you should always purify water taken from a stream, no matter how far from civilization you're camping. An infected animal sheds Giardia in its feces. It can survive for a long time in water and in soil.
Symptoms include, loose or watery diarrhea, stomach cramps, and stomach upset. People with Giardia infection are contagious and easily spread the parasite to others. Fortunately, there are excellent curative treatments.Hantavirus.
This deadly virus is carried by some strains of mice, especially deer mice. People get the infection by breathing dust contaminated with mouse droppings. If you need to clean an area that's been infested with mice, DON'T sweep it up in a big cloud of dust. Instead, put on latex gloves, wet the area with detergent or diluted bleach, wipe with damp towels, and then mop. Burn all contaminated materials. And be sure the mice are gone -- call an exterminator.
Lymphocytic choriomeningitis (LCM).
This is a virus spread by the common house mouse. The virus can infect the linings of the brain and spinal cord. It's a serious disease, although many people get only mild infections. Mice shed the virus in their urine, saliva, and feces. People get infected by eating contaminated food or by inhaling aerosolized mouse urine or feces. LCM has two phases. The first lasts about a week and begins with fever, loss of appetite, head and muscle aches, nausea, and/or vomiting. There may be other symptoms as well. The second phase happens just as the first one gets better. It may begin with symptoms of meningitis: fever, headache, and stiff neck. It may also begin with symptoms of encephalitis: sleepiness, confusion, and movement problems. There's no cure, but most people recover completely with supportive treatment. However, some people are left with permanent nerve or brain damage. About 1% of people with LCM die.
Lymphocytic choriomeningitis (LCM).
This is a virus spread by the common house mouse. The virus can infect the linings of the brain and spinal cord. It's a serious disease, although many people get only mild infections. Mice shed the virus in their urine, saliva, and feces. People get infected by eating contaminated food or by inhaling aerosolized mouse urine or feces. LCM has two phases. The first lasts about a week and begins with fever, loss of appetite, head and muscle aches, nausea, and/or vomiting. There may be other symptoms as well. The second phase happens just as the first one gets better. It may begin with symptoms of meningitis: fever, headache, and stiff neck. It may also begin with symptoms of encephalitis: sleepiness, confusion, and movement problems. There's no cure, but most people recover completely with supportive treatment. However, some people are left with permanent nerve or brain damage. About 1% of people with LCM die.
Tularemia (rabbit fever). People usually get tularemia from direct contact with rabbits. A person can also get it via the bite of an infected tick or deerfly, by eating contaminated food, by drinking contaminated water, or by breathing in F. tularensis, the bacteria that causes rabbit fever. It's very infectious: Fewer than 10 microscopic germs can cause a lethal infection. This is why tularemia was studied during World War II as a germ warfare agent. The kind of disease one gets depends on how one is infected. The inhaled form is most severe, with a 30%-60% fatality rate in untreated cases. It causes pneumonia with sudden fever, chills, muscle and joint aches, dry cough, and progressive weakness. In severe cases there is bloody spit with difficulty breathing.
Equine Encephalitis and West Nile Viruses
The equine encephalitis and West Nile viruses are transmitted from wild birds to humans -- and to horses -- by mosquitoes. It can cause a very dangerous infection of the brain and spinal cord. So can equine encephalitis, which has long been firmly rooted in the U.S. In fact, eastern equine encephalitis is considered a much more serious disease. About 30% of people who get it die, and another 30% have lasting nerve damage.
Most years there are very few cases of equine encephalitis. But some years are much worse than others -- and there's no way to predict in advance when there will be an outbreak.
Ebola Virus
It's hard to think of a more horrible disease than Ebola hemorrhagic fever. Ebola virus is spread by contact with the blood or body fluids of an infected person. Does it come from animals? Probably. Monkeys and great apes get it -- and people can get it from them when they butcher them for food. But monkeys die of Ebola, so they can't be the ultimate host. Most researchers think there's an animal out there harboring the virus. They just haven't found it yet.
SARSThat SARS emerged in China's Guangdong province seems sure. What's not sure is where it came from. SARS is a coronavirus, but it's not like any other member of the coronavirus family. Some researchers think it may have come from an endangered animal known as a masked palm civet -- like most exotic animals, a culinary delicacy in parts of China. Others find the evidence weak. Whether SARS evolved in animals or humans remains a matter of debate.
Influenza, bird flu viruses
One disease that's definitely evolving in animals is influenza. And one place it's evolving is none other than Guangdong, China, where animals are kept in close proximity to one another. Flu viruses tend to arise in ducks and geese. They spread to chickens and to pigs. Pigs can also get infected with human flu viruses, so they make a good mixing pot for new flu. When an animal or a person is infected with two different flu viruses, the viruses like to swap parts. Voilà! A new virus emerges.
Infectious disease specialists don't wonder whether there will be a new worldwide flu epidemic. They only wonder when it will happen. There have been two recent close calls.
In 1997, lethal bird flu arose in the poultry markets of Hong Kong. People got infected and died, but the slaughter of millions of chickens stopped the virus before it learned how to spread from person to person. In 2001 and 2002, similarly bird flu viruses evolved in Hong Kong chickens. Fortunately, they didn't spread to humans.
What Puts Us At Risk?Animals can pass parasites on to humans. Children should not kiss or be kissed or licked by pets. This is a very easy pathway for parasites to enter the human body. Keep infants and toddlers away from pets that have not been wormed.
Hands should be washed after each and every contact with a pet, otherwise one is putting self at serious risk.
Animals that are strictly indoor animals and that do not come into contact with the outdoors are a much lesser risk, but still a risk. Animals that come and go from the outdoors into the home pose a serious risk, especially to children. Cats and dogs for example clean their anus with their tongues. If they lick you, they are transferring parasites to your skin. If they lick your face, it does not take long for the parasite to find its way into your mouth and your intestine.
Toxoplasmosis and is usually acquired from cats. A small scratch from a cat or dog can also transmit the parasite. Cats use a cat box. They are moving around feces and urine that has been prior deposited in the cat box. This dirt that has parasites.
Cat boxes should be scooped daily and thoroughly bleached and washed on a weekly basis.
Make sure you use gloves; put two pair on when doing this. Use HOT water with the bleach. If you do this is in a bathtub, make sure you bleach and disinfect the bathtub afterwards to kill any bacteria or parasites. Its' best to clean the box outside. Mechanical cat boxes are a breeding ground for bacteria and parasites because you cannot easily disinfect them.
Dogs are no different because they also lick their anus. If you have a pet that is stretching its' behind on your carpet, you better get that pet to a vet to get wormed. You should also steam clean, at least three times a year, your carpet. Parasites can be transmitted to carpets from shoes and animals. Never walk barefoot on carpet, especially near doors. Cats should definitely be kept away from new born and infants less than three year olds. A parent that gets that sweet little kitty for their one year old is playing Russian roulette with their child's life. Parasites can exist on the fur as well. Indoor animals should be bathed regularly just like animals, twice a month, at least! And if it is an outdoor animal that comes indoors, do not let the animal lay on furniture, you are only inviting health problems.
You may think this is taking things to an extreme, but believe me, these deadly little parasites are on those dear loving pets of ours. If you own a cat, keep in strictly indoors, never let it go outdoors. If you practice these recommendations, you will find you will have less health problems. Do not under any circumstance; give your pet raw meat of any kind. You are providing the means for a parasite infection in the pet which can easily be transmitted to humans, especially children. Do not let your children play in areas where animals have defecated without spraying the area with bleach.
Animal feces should be picked up using a shovel daily and gloves should always be worn and hands washed thoroughly after any yard work. Wear a air filter mask while you do this if they area is dusty. The dust you breathe in will contain parasites. By the way, any garden work, always wear gloves. There are over 100 different parasites in soil that can be transmitted from the soil. Never work in soil if you have a cut on your hands. The little critters will get into your bloodstream via the cut. Do not flush cat box liter down the toilet. The parasites can cling to the bowl and crawl up to the seat. Once on the seat, they find their way into you. If you see rice like particles coming out in animal feces, they have worms or parasites.
Fleas are carriers of tapeworms. Recently a woman in New Jersey had severe lower colon pains and severe bloating. This went on for several months. She had two dogs in her house that she let outside every day. Several months after trying to cope with the colon pains, she then developed rashes and itching. Nine months later, they found through exploratory surgery, a large 3 and 1/2 foot tape worm inside her and several smaller ones. Upon investigation at her house, fleas were found in the carpet. Do not walk barefoot around animals unless they are strictly an indoor animal.
Tuesday, November 11, 2008
Alzheimer's disease New Look
Former President Ronald Reagan died Saturday June 5, 2004, at his home in Los Angeles. He was 93. He suffered from Alzheimer's disease since at least late 1994.
What is dementia?
Dementia is a syndrome characterized by:
· impairment in memory,
· impairment in another area of thinking such as the ability to organize thoughts and reason, the ability to use language, or the ability to see accurately the visual world (not because of eye disease), and these impairments are severe enough to cause a decline in the patient's usual level of functioning.
Although some kinds of memory loss are normal parts of aging, the changes due to aging are not severe enough to interfere with the level of function. Many different diseases can cause dementia but Alzheimer's disease is by far the most common cause for dementia in the United States and in most countries in the world.
What is Alzheimer's disease?
Alzheimer's disease (AD) is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, and perception. Many scientists believe that Alzheimer's disease results from an increase in the production or accumulation of a specific protein (beta-amyloid protein) in the brain that leads to nerve cell death.
The likelihood of having Alzheimer's disease increases substantially after the age of 70 and may affect around 50% of persons over the age of 85. Nonetheless, Alzheimer's disease is not a normal part of aging and is not something that inevitably happens in later life. For example, many people live to over 100 years of age and never develop Alzheimer's disease.
Who develops Alzheimer's disease?
The main risk factor for Alzheimer's disease is increased age. As a population ages, the frequency of Alzheimer's disease continues to increase. Ten percent of people over 65 years of age and 50% of those over 85 years of age have Alzheimer's disease. Unless new treatments are developed to decrease the likelihood of developing Alzheimer's disease, the number of individuals with Alzheimer's disease in the United States is expected to be 14 million by the year 2050.
There are also genetic risk factors for Alzheimer's disease. Most patients develop Alzheimer's disease after age 70. However, 2%-5% of patients develop the disease in the fourth or fifth decade of life (40s or 50s). At least half of these early onset patients have inherited gene mutations associated with their Alzheimer's disease. Moreover, the children of a patient with early onset Alzheimer's disease who has one of these gene mutations has a 50% risk of developing Alzheimer's disease.
There is also a genetic risk for late onset cases. A relatively common form of a gene located on chromosome 19 is associated with late onset Alzheimer's disease. In the majority of Alzheimer's disease cases, however, no specific genetic risks have yet been identified.
Other risk factors for Alzheimer's disease include high blood pressure (hypertension), coronary arteries disease, diabetes, and possibly elevated blood cholesterol.
Individuals who have completed less than eight years of education also have an increased risk for Alzheimer's disease. These factors increase the risk of Alzheimer's disease, but by no means do they mean that Alzheimer's disease is inevitable in persons with these factors.
All patients with Down syndrome will develop the brain changes of Alzheimer's disease by 40 years of age. This fact was also a clue to the "amyloid hypothesis of Alzheimer's disease"
What are the symptoms of Alzheimer's disease?
The onset of Alzheimer's disease is usually gradual, and it is slowly progressive. Memory problems that family members initially dismiss as "a normal part of aging" are in retrospect noted by the family to be the first stages of Alzheimer's disease. When memory and other problems with thinking start to consistently affect the usual level of functioning; families begin to suspect that something more than "normal aging" is going on.
Problems of memory, particularly for recent events (short-term memory) are common early in the course of Alzheimer's disease. For example, the individual may, on repeated occasions, forget to turn off an iron or fail to recall which of the morning's medicines were taken. Mild personality changes, such as less spontaneity, apathy, and a tendency to withdraw from social interactions, may occur early in the illness.
As the disease progresses, problems in abstract thinking and in other intellectual functions develop. The person may begin to have trouble with figures when working on bills, with understanding what is being read, or with organizing the day's work. Further disturbances in behavior and appearance may also be seen at this point, such as agitation, irritability, quarrelsomeness, and a diminishing ability to dress appropriately.
Later in the course of the disorder, affected individuals may become confused or disoriented about what month or year it is, be unable to describe accurately where they live, or be unable to name a place being visited. Eventually, patients may wander, be unable to engage in conversation, erratic in mood, uncooperative, and lose bladder and bowel control. In late stages of the disease, persons may become totally incapable of caring for themselves. Death can then follow, perhaps from pneumonia or some other problem that occurs in severely deteriorated states of health. Those who develop the disorder later in life more often die from other illnesses (such as heart disease) rather than as a consequence of Alzheimer's disease.
Ten warning signs of Alzheimer's disease
The Alzheimer's Association has developed the following list of warning signs that include common symptoms of Alzheimer's disease. Individuals who exhibit several of these symptoms should see a physician for a complete evaluation.
1. Memory loss
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation to time and place
5. Poor or decreased judgment
6. Problems with abstract thinking
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10 Loss of initiative
It is normal for certain kinds of memory, such as the ability to remember lists of words, to decline with normal aging. In fact, normal individuals 50 years of age will recall only about 60% as many items on some kinds of memory tests as individuals 20 years of age. Furthermore, everyone forgets, and every 20 year old is well aware of multiple times he or she couldn't think of an answer on a test that he or she once knew. Almost no 20 year old worries when he/she forgets something, that he/she has the 'early stages of Alzheimer's disease,' whereas an individual 50 or 60 years of age with a few memory lapses may worry that they have the 'early stages of Alzheimer's disease.'
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http://www.youtube.com/watch?v=Z6lA1P2tF0o
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Mild cognitive impairment
The criteria for dementia are conservative meaning that a patient must have had considerable decline in the ability to think before a diagnosis of dementia is appropriate. The progression of Alzheimer's disease is so insidious and slow that patients go through a period of decline where their memory is clearly worse than its baseline, yet they still do not meet criteria for dementia. This transitional syndrome is called Mild Cognitive Impairment (MCI).
Individuals affected with MCI have cognitive impairment that is demonstrated on formal neuropsychological testing but are still able to function well. Formal neuropsychological testing usually means that the patient is administered a battery of standardized tests of memory and thinking. Some of these tests are something like the IQ tests we may have taken in school. When these tests were developed they were administered to hundreds or thousands of people so that statistics are available to say how a person's score compares to a sample of healthy persons of the same age. If a person scores in the top 50%, it means that he or she did better than at least 50% of other normal people who took the test. Persons with lower scores - often in the bottom 7% - are considered to have MCI.
There are several forms of MCI. Perhaps the most common is associated with impairment in memory but not in the ability to plan and reason. Persons with this type called "amnestic MCI" (amnestic comes from "amnesia" and means no memory) have a high risk of developing Alzheimer's disease over the next few years. Persons with preserved memory but impaired reasoning or impaired judgment (call non-amnestic MCI) have a lower risk of developing Alzheimer's disease.
As treatments are developed that decrease the risk of developing Alzheimer's disease or slow its rate of progression (as of June 2007, no such medication has been approved by the FDA), recognition of amnestic MCI will be increasingly important. It is hoped that medications will be developed that will slow the rate of progression of MCI to Alzheimer's disease or completely prevent the development of Alzheimer's disease.
What are causes of Alzheimer's disease?
The cause(s) of Alzheimer's disease is (are) not known. The "amyloid cascade hypothesis" is the most widely discussed and researched hypothesis about the cause of Alzheimer's disease. The strongest data supporting the amyloid cascade hypothesis comes from the study of early-onset inherited (genetic) Alzheimer's disease. Mutations associated with Alzheimer's disease have been found in about half of the patients with early-onset disease. In all of these patients, the mutation leads to excess production in the brain of a specific form of a small protein fragment called ABeta (Aβ).
Many scientists believe that in the majority of sporadic (for example, non-inherited) cases of Alzheimer's disease (these make up the vast majority of all cases of Alzheimer's disease) there is too little removal of this Aβ protein rather than too much production. In any case, much of the research in finding ways to prevent or slow down Alzheimer's disease has focused on ways to decrease the amount of Aβ in the brain.
What are risk factors for Alzheimer's disease?
The biggest risk factor for Alzheimer's disease is increased age. The likelihood of developing Alzheimer's disease doubles every 5.5 years from 65 to 85 years of age. Whereas only 1%-2% of individuals 70 years of age have Alzheimer's disease, in some studies around 40% of individuals 85 years of age have Alzheimer's disease. Nonetheless, at least half of people who live past the 95 years of age do not have Alzheimer's disease.
Common forms of certain genes increase the risk of developing Alzheimer's disease, but do not invariably cause Alzheimer's disease. This means that in majority of patients with Alzheimer's disease, no genetic risk factor has yet been found. When medical treatments that prevent or decrease the risk of developing Alzheimer's disease become available, genetic testing may be recommended for adult children of patients with Alzheimer's disease so that they may be treated.
Many, but not all, studies have found that women have a higher risk for Alzheimer's disease than men. It is certainly true that women live longer than men, but age alone does not seem to explain the increased frequency in women. The apparent increased frequency of Alzheimer's disease in women has led to considerable research about the role of estrogen in Alzheimer's disease. Recent studies suggest that estrogen should not be prescribed to post-menopausal women for the purpose of decreasing the risk of Alzheimer's disease. Nonetheless, the role of estrogen in Alzheimer's disease remains an area of research focus.
Some studies have found that Alzheimer's disease occurs more often among people who suffered significant traumatic head injuries earlier in life, particularly among those with the apoE 4 gene.
In addition, many, but not all studies, have demonstrated that persons with limited formal education - usually less than eight years - are at increased risk for Alzheimer's disease. It is not known whether this reflects a decreased "cognitive reserve" or other factors associated with a lower educational level.
How is the diagnosis of Alzheimer's disease made?
As of June 2007, there is no specific "blood test" or imaging test that is used for the diagnosis of Alzheimer's disease. Alzheimer's disease is diagnosed when:
1) a person has sufficient cognitive decline to meet criteria for dementia;
2) the clinical course is consistent with that of Alzheimer's disease;
3) no other brain diseases or other processes are better explanations for the dementia.
What other conditions should be screened for?
There are many conditions that can cause dementia, to include the following:
Neurological disorders: Parkinson’s disease, cerebrovascular disease and strokes, brain tumors,blood clots, and multiple sclerosis, can sometimes be associated with dementia although many patients with these conditions are cognitively normal.
Infectious diseases: Some brain infections such as chronic syphilis, chronic HIV, or chronic fungal meningitis can cause dementia.
Side effects of medications: Many medicines can cause cognitive impairment, especially in elderly patients. Perhaps the most frequent offenders are drugs used to control bladder urgency and incontinence.
Psychiatric medications: such as anti-depressants and anti-anxiety medications and "neurological medications" such as anti-seizure medications can also be associated with cognitive impairment.
If a physician evaluates a person with cognitive impairment who is on one of these medications, the medication is often gently tapered and/or discontinued to determine whether it might be the cause of the cognitive impairment. If it is clear that the cognitive impairment preceded the use of these medications, such tapering may not be necessary. On the other hand, "psychiatric," "neurological," and "incontinence" medications are often appropriately prescribed to patients with Alzheimer's disease. Such patients need to be followed carefully to determine whether these medications cause any worsening of cognition.
Psychiatric disorders: In older persons, some forms of depression can cause problems with memory and concentration that initially may be indistinguishable from the early symptoms of Alzheimer's disease. Sometimes, these conditions, referred to as pseudodementia, can be reversed. Studies have shown that persons with depression and coexistent cognitive (thinking, memory) impairment are highly likely to have an underlying dementia when followed for several years.
Substance Abuse: Abuse of legal and/or illegal drugs and alcohol abuse is often associated with cognitive impairment.
Metabolic Disorders: Thyroid dysfunction, some steroid disorders, and nutritional deficiencies such as vitamin B12 deficiency or thiamine deficiency are sometimes associated with cognitive impairment.
Trauma: Significant head injuries with brain contusions may cause dementia. Blood clots around the outside of the brain (subdural hematomas) may also be associated with dementia.
Toxic Factors: Long term consequences of acute carbon monoxide poisoning can lead to an encephalopathy with dementia. In some rare cases, heavy metal poisoning can be associated with dementia.
Tumors: Many primary and metastatic brain tumors can cause dementia. However, many patients with brain tumors have no or little cognitive impairment associated with the tumor.
The Importance of Comprehensive Clinical Evaluation
Because many other disorders can be confused with Alzheimer's disease, a comprehensive clinical evaluation is essential in arriving at a correct diagnosis. Such an assessment should include at least three major components; 1) a thorough general medical workup, 2) a neurological examination including testing of memory and other functions of thinking , and 3) a psychiatric evaluation to assess mood, anxiety, and clarity of thought.
Such an evaluation takes time - usually at least an hour. In the United States healthcare system, neurologists, psychiatrists, or geriatricians, or frequently become involved. Nonetheless, any physician may be able to perform a thorough evaluation.
The American Academy of Neurology has published guidelines that include imaging of the brain in the initial evaluation of patients with dementia. These studies are either a noncontrast CT scan or an MRI scan. Other imaging procedures that look at the function of the brain (functional neuro-imaging), such as SPCT,PET and fMRI, may be helpful in specific cases, but generally are not needed. However, in many healthcare systems outside of the United States, brain imaging as not a standard part of the assessment for possible Alzheimer's disease.
Despite many attempts, identification of a blood test to diagnose Alzheimer's disease has remained elusive. As of June 2007, such testing is neither widely available nor recommended.
What is the prognosis for a person with Alzheimer's disease?
Alzheimer's disease is invariably progressive. Different studies have stated that Alzheimer's disease progresses over two to 25 years with most patients in the eight to 15 year range. Nonetheless, defining when Alzheimer's disease starts, particularly in retrospect, can be very difficult. Patients usually don't die directly from Alzheimer's disease. They die because they have difficulty swallowing or walking and these changes make overwhelming infections, such as pneumonia, much more likely.
Most persons with Alzheimer's disease can remain at home as long as some assistance is provided by others as the disease progresses. Moreover, throughout much of the course of the illness, individuals maintain the capacity for giving and receiving love, sharing warm interpersonal relationships, and participating in a variety of meaningful activities with family and friends.
A person with Alzheimer's disease may no longer be able to do math but still may be able to read a magazine with pleasure. Playing the piano might become too stressful in the face of increasing mistakes, but singing along with others may still be satisfying. The chessboard may have to be put away, but playing tennis may still be enjoyable. Thus, despite the many exasperating moments in the lives of patients with Alzheimer's disease and their families, many opportunities remain for positive interactions. Challenge, frustration, closeness, anger, warmth, sadness, and satisfaction may all be experienced by those who work to help the person with Alzheimer's disease.
The reaction of a patient with Alzheimer's disease to the illness and his or her capacity to cope with it also vary, and may depend on such factors as lifelong personality patterns and the nature and severity of stress in the immediate environment. Depression, severe uneasiness, paranoia, or delusions may accompany or result from the disease, but these conditions can often be improved by appropriate treatments. Although there is no cure for Alzheimer's disease, treatments are available to alleviate many of the symptoms that cause suffering.
What treatment and management options are available for Alzheimer's disease?The management of Alzheimer's disease consists of medication based and non-medication based treatments. Two different classes of pharmaceuticals are approved by the FDA for treating Alzheimer's disease: cholinesterase inhibitors and partial glutamate antagonists. Neither class of drugs has been proven to slow the rate of progression of Alzheimer's disease. Nonetheless, many clinical trials suggest that these medications are superior to placebos (sugar pills) in relieving some symptoms.
Cholinesterase inhibitors
In patients with Alzheimer's disease there is a relative lack of a brain chemical neurotransmitter called acetylcholine. (Neurotransmitters are chemical messengers produced by nerves that the nerves use to communicate with each other in order to carry out their functions.) Substantial research has demonstrated that acetylcholine is important in the ability to form new memories. The cholinesterase inhibitors (ChEIs) block the breakdown of acetylcholine. As a result, more acetylcholine is available in the brain, and it may become easier to form new memories.
Four ChEIs have been approved by the FDA, but only donepezil hydrochloride (Aricept), rivastigmine (Exelon), and galatamine (Razadyne - previously called Reminyl) are used by most physicians because the fourth drug, tacrine (Cognex) has more undesirable side effects than the other three.
Most experts in Alzheimer's disease do not believe there is an important difference in the effectiveness of these three drugs. Several studies suggest that the progression of symptoms of patients on these drugs seems to plateau for six to 12 months, but inevitably progression then begins again.
Of the three widely used AchEs, rivastigmine and galantamine are only approved by the FDA for mild to moderate Alzheimer's disease, whereas donepezil is approved for mild, moderate, and severe Alzheimer's disease. It is not known whether rivastigmine and galantamine are also effective in severe Alzheimer's disease, although there does not appear to be any good reason why they shouldn't.
The principal side effects of ChEIs involve the gastrointestinal system and include nausea, vomiting, cramping, and diarrhea. Usually these side effects can be controlled with change in size or timing of the dose or administering the medications with a small amount of food. Between 75% and 90% of patients will tolerate therapeutic doses of ChEIs.
Partial glutamate antagonists
Glutamate is the major excitatory neurotransmitter in the brain. One theory suggests that too much glutamate may be bad for the brain and cause deterioration of nerve cells. Memantine (Namenda) works by partially decreasing the effect of glutamate to activate nerve cells. It has not been proven that memantine slows down the rate of progression of Alzheimer's disease. Studies have demonstrated that some patients on memantine can care for themselves better than patients on sugar pills (placebos). Memantine is approved for treatment of moderate and severe dementia, and studies did not show it was helpful in mild dementia. It is also possible to treat patients with both AchEs and memantine without loss of effectiveness of either medication or an increase in side effects.
Non-medication based treatments
Non-medication based treatments include maximizing patients' opportunities for social interaction and participating in activities such as walking, singing, dancing that they can still enjoy. Cognitive rehabilitation, (whereby a patient practices on a computer program for training memory), may or may not be of benefit. Further studies of this method are needed.
Treatment of psychiatric symptomsSymptoms of Alzheimer's disease include agitation, depression, hallucinations, anxiety, and sleep disorders. Standard psychiatric drugs are widely used to treat these symptoms although none of these drugs have been specifically approved by the FDA for treating these symptoms in patients with Alzheimer's disease. If these behaviors are infrequent or mild, they often do not require treatment with medication. Non-pharmacologic measures can be very useful.
Nevertheless, frequently these symptoms are so severe that it becomes impossible for caregivers to take care of the patient, and treatment with medication to control these symptoms becomes necessary. Agitation is common, particularly in middle and later stages of Alzheimer's disease. Many different classes of agents have been tried to treat agitation including:
antipsychotics,
Mood-stabilizing anticonvulsants,
. Trazodone (Desyrel)
. Anxiolytics
. Beta–blockers.
Studies are conflicting about the usefulness of these different drug classes. It was thought that newer, atypical antipsychotic agents such as clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa, Zydis), quetiapine (Seroquel), and ziprasidone (Geodon) might have advantages over the older antipsychotic agents because of their fewer and less severe side effects and the patients' ability to tolerate them. However, more recent studies have not demonstrated superiority of the newer antipsychotics. Some research shows that these newer antipsychotics may be associated with increased risk of stroke or sudden death than the older antipsychotics, but many physicians believe this question is still not resolved.
Apathy and difficulty concentrating occur in most Alzheimer's disease patients and should not be treated with antidepressant medications. However, many Alzheimer's disease patients have other symptoms of depression including sustained feelings of unhappiness and/or inability to enjoy their usual activities. Such patients may benefit from a trial of antidepressant medication. Most physicians will try selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), citalopram (Celexa), or fluoxetine (Prozac), as first-line agents for treating depression in Alzheimer's disease.
Anxiety is another symptom in Alzheimer's disease that occasionally requires treatment. Benzodiazepines such as diazepam (Valium) or lorazepam (Ativan) may be associated with increased confusion and memory impairment. Non-benzodiazepine anxiolytics, such as buspirone (Buspar) or SSRIs, are probably preferable.
Difficulty sleeping (insomnia) occurs in many patients with Alzheimer's disease at some point in the course of their disease. Many Alzheimer's disease specialists prefer the use of sedating atypical antidepressants such as trazodone (Desyrel). However, other specialists may recommend other classes of medications. Sleep improvement measures, such as sunlight, adequate treatment of pain, and limiting nighttime fluids to prevent the need for urination, should also be implemented.
Potential and future therapies for Alzheimer's disease
A variety of clinical research trials are underway with agents that try either to decrease the amount of Aβ1-42 produced or increase the amount of Aβ1-42 removed. It is hoped that such therapies may slow down the rate of progression of Alzheimer's disease. As of June 2007, it is not known how well such therapies may work.
Caring for the caregiver and Alzheimer's disease resources
Caring for the caregiver is an essential element of managing the patient with
Alzheimer's disease. Caregiving is a distressing experience. On the other hand, caregiver education delays nursing home placement of Alzheimer's disease patients. The 3Rs - Repeat, Reassure, and Redirect - can help caregivers reduce troublesome behaviors and limit the use of medications. The short-term educational programs are well liked by family caregivers and can lead to a modest increase in disease knowledge and greater confidence among caregivers.
Alzheimer's Disease At A Glance
Alzheimer's disease is a brain disease of unknown cause that leads to dementia.
Most patients with Alzheimer's disease are over 65 years of age.
One of Hollywood's most iconic stars, Charlton Heston, has died at age 84. His death was not unexpected. Heston had been suffering from the ravages of advanced Alzheimer's Disease since 2002There are 10 classic warning signs of Alzheimer's disease:
· memory loss,
· difficulty performing familiar tasks,
· problems with language,
· disorientation to time and place,
· poor or decreased judgment,
· problems with abstract thinking,
· misplacing things,
· changes in mood or behavior,
· changes in personality,
· loss of initiative.
Patients with symptoms of dementia should be thoroughly evaluated before they become inappropriately or negligently labeled Alzheimer's disease. Although there is no cure for Alzheimer's disease, treatments are available to alleviate many of the symptoms that cause suffering.
The management of Alzheimer's disease consists of medication based and non-medication based treatments organized to care for the patient and family.
Treatments aimed at changing the underlying course of the disease (delaying or reversing the progression) have so far been largely unsuccessful. Medicines that restore the defect, or malfunctioning, in the chemical messengers of the nerve cells have been shown to improve symptoms.
Herbal products can help maintain the life of Alzheimer’s patients
· Huperzine, an anticholinesterase alkaloid, is divided into two chemical species, huperzine A and huperzine B, which have similar effects but differing activity levels (huperzine A being about 10 times as strong as huperzine B).
· Macleaya cordata
· Coptis chinenses
· Securinega suffruticosa
· Pinus pinaster ssp
· Ginkgo biloba 120 to 240 mg a day
· Rosemary
· Lecithi
· angelica or dong-quai·
· American Ginseng
Supplements.
· Vitamin E 2,000 IU
· Acetyl-L-carnitine 1,500 mg a day
· Phenylalanine
· S-Adenosylmethionine (SAMe)
· Tyrosine Vitamin C (Ascorbic Acid)
· Vitamin A (Retinol)
· Vitamin B1 (Thiamine)
· Vitamin B12 (Cobalamin)
· Vitamin B9 (Folic Acid)
Sites of interest:
http://www.xcell-center.com/
http://www.stammzellendokumentation.de/engl.html
· memory loss,
· difficulty performing familiar tasks,
· problems with language,
· disorientation to time and place,
· poor or decreased judgment,
· problems with abstract thinking,
· misplacing things,
· changes in mood or behavior,
· changes in personality,
· loss of initiative.
Patients with symptoms of dementia should be thoroughly evaluated before they become inappropriately or negligently labeled Alzheimer's disease. Although there is no cure for Alzheimer's disease, treatments are available to alleviate many of the symptoms that cause suffering.
The management of Alzheimer's disease consists of medication based and non-medication based treatments organized to care for the patient and family.
Treatments aimed at changing the underlying course of the disease (delaying or reversing the progression) have so far been largely unsuccessful. Medicines that restore the defect, or malfunctioning, in the chemical messengers of the nerve cells have been shown to improve symptoms.
Herbal products can help maintain the life of Alzheimer’s patients
· Huperzine, an anticholinesterase alkaloid, is divided into two chemical species, huperzine A and huperzine B, which have similar effects but differing activity levels (huperzine A being about 10 times as strong as huperzine B).
· Macleaya cordata
· Coptis chinenses
· Securinega suffruticosa
· Pinus pinaster ssp
· Ginkgo biloba 120 to 240 mg a day
· Rosemary
· Lecithi
· angelica or dong-quai·
· American Ginseng
Supplements.
· Vitamin E 2,000 IU
· Acetyl-L-carnitine 1,500 mg a day
· Phenylalanine
· S-Adenosylmethionine (SAMe)
· Tyrosine Vitamin C (Ascorbic Acid)
· Vitamin A (Retinol)
· Vitamin B1 (Thiamine)
· Vitamin B12 (Cobalamin)
· Vitamin B9 (Folic Acid)
Sites of interest:
http://www.xcell-center.com/
http://www.stammzellendokumentation.de/engl.html
Thursday, November 6, 2008
Parkinson's disease, full spectrum information
What Is Parkinson's Dieaese?
Two well know celebrity, suffering from Parkinson’s diseaseParkinson's disease is named after the English physician Dr. James Parkinson, who described it in 1817. However there is a much earlier description of Parkinson's disease among the writings of Leonardo da Vinci, in the Royal collection at Windsor Castle in England.Parkinson's disease (PD) is a slowly progressive condition resulting from a deficiency in the brain of a chemical called dopamineDopamine is one of many chemical messengers (called neurotransmitters) in the brain that allow nerve cells to communicate with each other. Without it, messages from the brain to the muscles are disrupted.
Over a period of time symptoms appear that include:
.Tremor (shaking) when the body and limbs are at rest
.Slowness and difficulty beginning a voluntary movement, such as standing up from a chair or turning around, and difficulty with fine precise movements such as doing up buttons. (called bradykinesia).
.Muscle stiffness, also called rigidity, and Difficulty with maintaining balance (called postural instability)
The amount of dopamine in the brain is reduced in Parkinson's disease because some of the nerve cells that produce it are destroyed.The small group of nerve cells affected in Parkinson's disease nerve cells lies deep in the brain, in a region called the substantia nigra or (black substance), a part of the brain involved in initiating movement. It is situated near the center of the brain and contains a clump of dark cells that manufacture dopamine
Facts About Parkinson's Disease·
The incidence of Parkinson's disease is increasing at a rate that is faster than the population is aging.· Parkinson's disease affects an estimated 1 in 1,000 people over age 55.· Parkinson's disease affects about 1 in 100 people age 65 and older.· Some 20 percent of people with Parkinson's disease may be diagnosed under the age of 50.· About 8 percent to 10 percent of people with Parkinson's disease may be diagnosed under the age of 40.
Well-known people who have had or have Parkinson's disease include Pope John Paul II, Francisco Franco, Muhammad Ali, Yasir Arafat, Janet Reno, Sir Michael Redgrave, Adolf Hitler, Vincent Price, Morris Udall, Margaret Bourke White, Pierre Elliot Trudeau, and Michael J. Fox.·
There has been excellent progress with research into the treatment of Parkinson's disease. This includes stem cell technology in which very basic cells are grown in the laboratory, and can be easily cultivated into large populations. Researchers have succeeded in turning these stem cells, in the laboratory, into dopamine producing nerve cells, like those cells in the substantia nigra of the brain that produce dopamine.· Human trials have already begun and been published using retinal epithelial cells, and human trials using stem cells for the treatment of Parkinson's disease should begin in the foreseeable future.What Causes Parkinson's Disease ?Deep inside the brain, in an area of the brain called the basal ganglia, are nerve cells that normally control a person's voluntary movement and coordinate changes in person’s posture.
Basal ganglia and substantia nigra
When the brain sets in motion an action that results in lifting an arm, for instance, the basal ganglia signals and transmits messages to the other parts of the brain.Those messages are forwarded as electrical impulses along and between nerve pathways by the chemical messenger called dopamine, which is made in the area of the brain called the substantia nigra. The message passes on to the basal ganglia and down the spinal cord to the muscles used to lift the arm.The basal ganglia are normally rich with this chemical called dopamine which has been delivered from a nearby area in the brain called the substantia nigra where the dopamine is manufactured.· In people with Parkinson's, the nerve cells in the substantia nigra (where the dopamine is made) die, and the surviving cells do not produce enough dopamine.·
The symptoms of Parkinson's will begin when 80 percent of dopamine production from this area of the brain is lost. We do not know why some previously normal nerve cells die causing dopamine levels to fall.
· Parkinson's is known to occur in some families, (10 percent to 15 percent of Parkinson's disease may be inherited) and several genes, have been identified in the last decade that appear to be associated with Parkinson's and undoubtedly more will be discovered as research continues. However, not all familial Parkinson's disease is inherited and in these cases it may occur as a result of a shared environment and a common susceptibility.
· When Parkinson's disease is inherited, it tends to occur in people under fifty years of age. However, this does not mean that everyone who develops Parkinson's under the age of fifty has inherited the disease.
· The majority of people with have what is called sporadic disease, which means it occurs in the absence of a family history with no known cause.· Researchers feel that there may be more than one
cause of disease.
· There is renewed interest in the possibility that a virus might be one cause of Parkinson's. Parkinson's was a complication of the influenza pandemic that occurred after World War 1. This virus disappeared in the early 1930s, before it could be identified. Animal studies support this, and two studies in humans showed that Parkinson's is much more common in people who work and live in close contact with others.
· The most recent study involved confirmed earlier findings that teachers and members of the medical profession carry twice the risk. The last study found no increase in Parkinson's in welders.
· A recent study described three statistically significant clusters of people who worked together and who developed Parkinson’s within a similar time frame. One involved 4 members of a TV cast and crew (4 subjects out of 120) one a group of professors (4 subjects out of 30) and one a group of people in the office of a garment factory (3 out of 7). The authors do not speculate on the cause but each group worked in an environment with artificial ventilation.
· There are still some scientists who think that "free radicals" may contribute to the damage to the nerve cells. These are toxic substances made in the body as a result of normal chemical reactions. Some people with Parkinson’s have increased levels of iron in the brain, which is part of the oxidation process. The implication of these findings is unclear.
· Aluminum toxicity. Aluminum is one of the most abundant minerals found on earth,and one of the most toxic to humans. Aluminum damages nervous systems in both infants and adults. It is implicated in anemia, osteomalacia, glucose intolerance, memory deficits, and Alzheimer's, Lou Gehrig's (amyotrophic lateral sclerosis), and Parkinson's diseases. Scientists do not yet understand whether aluminum is a primary cause of Alzheimer's or is accumulated in the brain as a result of a malfunction caused by the disease. They do know, however, that aluminum wreaks havoc on human nervous systems and should be avoided.
· In some cases, the cause is known. Parkinsonism can be a consequence of some medications (used to treat psychiatric illness or control nausea). A small group of people developed Parkinsonism as a result of a known toxin called MPTP, found in an illegal synthetic opiate-derivative street drug and sold in California in the early 1980s.
What Are The Signs And Symptoms Of Parkinson's Disease?
Parkinson's disease has classic signs and symptoms, but they do not all appear at the same time or to the same degree. Some people are more troubled by one than another. The condition can vary significantly between individuals, for example how the disease progresses, and how well someone responds to the drugs, etc. Therefore, people with PD should never compare themselves with others who have PD.
Parkinson captivity on wheelchair
These Are The Four Major Signs Of PD:
Tremor.
In about 70 percent of people with PD, this is the earliest symptom to appear. It is a tremor that occurs in a limb when it is at rest. The tremor starts in one arm or leg on one side of the body and can progress to include the other side of the body. It usually remains more pronounced on one side of the body. Although socially distressing, the tremor does not usually interfere with activities of daily life, and it tends to disappear with voluntary movement (picking up a cup, for example). Often, medications do not completely control tremor. Fatigue, emotional stress, and worrying about the tremor can make it worse in the short term.
Rigidity.
This describes increased tone or stiffness in the muscles when they are at rest. Joints may sometimes feel locked. The lack of mobility often causes muscle fatigue and ache. Rigidity usually responds well to treatment.Slowness of movement. This condition is called bradykinesia. Fine movements become clumsy, for example, doing up buttons. Typically, it is often hard to begin a movement, for example, getting up from a chair, or there may be an abrupt stopping of ongoing movement such as when turning corners or going through doorways. This symptom is the most disabling, but it responds well to treatment.
Impaired balance.
Normally, reflexes allow us to make rapid adjustments to changes in the body's center of gravity when standing or walking. These reflexes become impaired in people with PD who may eventually be at risk for falls. Medication may help, but rehabilitation therapy is most valuable.Symptoms:There are also a number of symptoms associated with PD. Not all people will experience them to the same degree.
They include:
A changed facial expression.Because the facial muscles that normally create expression don't move as well, people with PD sometimes appear to look uninterested or sad when they are not. This is known as hypomimia.A soft voice.This is known as hypophonia. People with PD may have difficulty being heard, particularly on the phone.
In addition, the rhythm of the voice can be affected, and words may be spoken in a monotone.Small, cramped handwriting.Writing may be normal size for the first few words and then will trail off and get smaller. This is known as micrographia.Pain.Painful stiffness, for example affecting the shoulder or calves, is a common early feature of PD. Painful cramps can also affect some people, sometimes as a result of too much medication and sometimes too little. The physician will want to know when the cramps occur in relationship to the timing of the drugs.
Successful treatment of PD symptoms can lead to improved mobility, but can sometimes aggravate existing arthritis.Fatigue.Everyday tasks take longer to complete when one has PD. It is hard to do two things at once. Sleep may also be disturbed. When combined, these problems often contribute to the tiredness experienced by many. It also takes a while for people with PD to learn to pace themselves to avoid reaching the end of a day without feeling exhausted. Some people experience a noticable benefit in their symptoms after a good nap or a sleep.Depression.Research indicates that up to 50 percent of patients with PD can experience a period of depression during their illness.
Depression in PD is caused by disturbed brain chemistry, and it can be triggered or made worse by stressful situations in life. Depression may occur at any time during the illness. But if depression is present when the person is first diagnosed with PD, it sometimes gets better on its own when PD symptoms start to improve with treatment.Depression may, however, need some treatment itself. The most important first step is for the person with PD to be able to admit to being depressed and seek appropriate help. Today's antidepressants are safe and well tolerated, and most can be taken very successfully with antiparkinson drug therapy. There may be mild side effects early in treatment (dry mouth, dizziness, drowsiness), but these usually disappear with time.
Full benefit from treatment for depression can take from four to six weeks. Patience, determination, and family support are needed while the right dose level is achieved.Constipation.PD and the drugs used for its treatment contribute to constipation. Severe constipation can lead to a medical emergency. If constipation continues to be a problem, it is important to seek medical help.
Intellectually, people with PD usually remain normal. But because speech and everyday tasks take longer to execute, it may appear that they lack comprehension or understanding - when actually they know exactly what they want to do but are unable to process their thoughts or actions in a timely manner. Some 30 percent of patients with PD, however, do develop dementia - the loss of cognitive and intellectual functions without impairment of perception or consciousness. Dementia can also lead to disorientation, a flattened mood, impaired memory, judgment, and intellect.
Medications Used to Treat Parkinson's Disease
Nice To Know:
A few important comments before describing the medications for Parkinson's DiseaseDrug therapy for Parkinson's disease, and the choice of drugs used for the treatment of Parkinson's disease, should be a joint decision between the person with Parkinson's disease and the physician, based on the severity of symptoms and their impact on quality of life.
· It is emphasized that treatment for Parkinson's disease should always be individually tailored for each person.
· Never compare your treatment schedules with those of other people with Parkinson's Disease. You are all different.
· Properly selected medications with the correctly tailored dose form the mainstay of treatment of Parkinson's Disease.Drugs currently used to treat Parkinson's Disease make movement easier and can prolong function for many years.
Medications aim to replace or mimic the missing chemical dopamine, in the brain.The following are the medications used in the treatment of Parkinson's Disease. Each will be considered below.
1- Levodopa with carbidopa:
SinemetTMSinemet CRTM Levodopa, with benserazide,:
2- ProlopaTM in Canada and MadoparTM in Europe
3- COMT inhibitors:entacapone (ComtanTM), TasmarTM)
Dopamine agonists:
pramipexole,MirapexTM), ropinerole ( RequipTM), bromocriptine( ParlodelTM), pergolide ( PermaxTM)
Other medications:amantadine (SymmetrelTM), benztropine (CogentinTM), trihexyphenydil (ArtaneTM), deprenyl (EldeprylTM) Levodopa
Sinemet CR
How It Works Levodopa (L-dopa for short) has been used successfully in the treatment for Parkinson’s Disease for over 30 years. It remains the most effective treatment for Parkinson’s Disease.L-dopa is a natural chemical found in animals and plants. When L-dopa is formulated for drug use, the generic name levodopa is used.In patients with Parkinson’s Disease the cells in the brain that produce dopamine die (for more details see what causes Parkinson’s Disease LINK).
Levodopa works by being taken up by the surviving dopamine-producing cells in the brain, and is converted by these cells into dopamine. Levodopa PreparationsLevodopa is combined with carbidopa, (Sinemet CRTM, SinemetTM and is the main treatment for Parkinson’s Disease. (Another preparation, levodopa in combination with benserazide, is available in Canada, Europe and other parts of the world.)
Combining carbidopa or benserazide with levodopa has several benefits:
Carbidopa or benzerazide prevent levodopa from being converted to dopamine outside the brain.They allow more levodopa to enter the brain where it is needed.They help to reduce or prevent the side effects of dizziness and nausea.The combination is usually started with low, but increasing doses, until the best effect is achieved.
Carbidopa or benzerazide prevent levodopa from being converted to dopamine outside the brain.They allow more levodopa to enter the brain where it is needed.They help to reduce or prevent the side effects of dizziness and nausea.The combination is usually started with low, but increasing doses, until the best effect is achieved.
Levodopa never loses its effectiveness, although with increasing disability the dose required to control symptoms is also enough to precipitate unwanted side effects.
Nice To Know:
Levodopa is considered the "gold standard" of Parkinson’s Disease therapy, and it is more effective when combined with carbidopa or benserazide. But despite that success, some of the levodopa in a given dose is converted to dopamine outside the brain, where it is not needed, rather than in the brain where it is needed, due to the action of an enzyme, in the body called COMT.
There are now drugs that block the COMT enzyme. They are called COMT inhibitors because they inhibit the action of this enzyme. This makes each dose last longer.
Need To Know:
Levodopa/carbidopa preparations· Levodopa/carbidopa tablets are referred to by two numbers. The large number is the amount of levodopa, in milligrams, in each tablet. The small number is the amount of carbidopa in each tablet, also measured in milligrams.
Levodopa/carbidopa is available as:
Sinemet CRTM (controlled-release drug)· 200/50 peach oval scored· 100/25 pink oval
Sinemet CRTM is a controlled-release tablet of levodopa/carbidopa.
Sinemet CRTM (controlled-release drug)· 200/50 peach oval scored· 100/25 pink oval
Sinemet CRTM is a controlled-release tablet of levodopa/carbidopa.
Tablets should not be chewed or crushed.
· The 200/50 can be split, but not the 100/25.· The total daily dose of Sinemet CRTM may be significantly higher than standard SinemetTM, due to absorption differences.
· For some patients, a "booster" dose of immediate-release SinemetTMmay be required in the morning or late afternoon.
· Sinemet CRTMappears to cause less dizziness and nausea than immediate release SinemetTM.
Immediate Release (Standard) SinemetTM
· 100/25 yellow oval scored
· 100/10 pale blue oval scored
· 250/25 darker blue oval scored
· The blue immediate release tablets are increasingly less often used by neurologists Physicians may use either the SinemetTM or Sinemet CRTM preparation for their patients as soon as therapy is needed. The slow, steady release of the drug into the brain by the controlled-release Sinemet CRTM preparation may be better for remaining dopamine cells than the abrupt delivery of the SinemetTM (similar to a soaker hose versus a fire hydrant).
The immediate-release and controlled-release SinemetT Mpreparations are best started slowly, increasing by small amounts until the required dosage is reached.A starting dose may be one-half of a tablet once a day increasing to three to four times a day.
This dose can be increased every four to seven days as tolerated.
Both medications can sometimes cause nausea and dizziness when they are started.At high doses, they may cause involuntary movements (dyskinesias) and confusion. All side effects are dose-dependent (disappear when the drug is reduced or stopped).
Physicians are somewhat divided as to whether anitparkinson drugs should be taken on an empty stomach or with food. Taking the tablet with food will reduce the likelihood of side effects. Sinemet CRTM should always be taken with food for proper absorbtion.
Side Effects of Levodopa:
Levodopa preparations are not without side effects. The most common include nausea, vomiting, low blood pressure, involuntary movements, and, at higher doses in the elderly and frail, confusion.Nausea and vomiting can be a problem as the drug is being introduced. This is because the dose of carbidopa is not large enough to control these side effects.
Ironically, the nausea and vomiting often get better as the levodopa/carbidopa dose is increased.
The controlled-release preparation, Sinemet CRTM, is absorbed more slowly and far less likely to cause early side effects. Taking the drug with a light meal or snack can also help these side effects.Involuntary movements (dyskinesias) writhing, jerking, or free flowing movements and nodding can occur. The rate at which dopamine "turns over" in a person's brain cells may determine whether or not they will develop dyskinesia,. Dyskinesia can only be controlled effectively by lowering the dose of levodopa or, in some severe cases, surgery.
Other drug side effects include: "Wearing-off effect." This happens when Parkinson's symptoms begin to recur before the next scheduled dose of drug, due to progression of the disease. When this happens, it is easy to think that the drug is making your symptoms worse - for a while after you take the next dose, your symptoms can continue to worsen until the next dose 'kicks in'. This happens because the drug takes a while to be absorbed and reach your brain.These can be improved by the addition of a COMT inhibitor, or a dopamine agonist "On-off attacks."
These are unpredictable fluctuations in response to drug therapy that may last up to several hours. They are thought to be due to a combination of levodopa dosage and progression of symptoms. The dopamine storage cells may lose their capacity to retain the dopamine delivered by the medication.
These can usually be improved with lower, more frequent doses of the drug, the use of a controlled release drug or with the addition of a dopamine agonist.
COMT Inhibitors medications. COMT inhibitors are a new class of drug that allows even more levodopa to enter the brain, by blocking an enzyme in the body called COMT. COMT stands for Catechol-O-Methyltransferase. This enzyme is responsible for most of the levodopa in a given dose being converted to dopamine outside the brain (where it is not needed).Entacapone, (ComtanTM) is able to inhibit one of the COMT enzymes responsible for the breakdown of dopamine in the body, resulting in greater and more sustained blood levels of dopamine when given together with carbidopa/levodopa.
Entacapone is administered together with each dose of carbidopa/levodopa. It prolongs the duration of levodopa, benefit, is easy to use, and provides quick results. There is a possibility that a person will experience the side effects of too much levodopa, which can then be controlled by reducing the levodopa or entacapone dose or spacing out the dosing regimen. The primary indication for the use of entacapone is for the treatment of the wearing-off effect.(Tasmar TM), is another COMT inhibitor that has proved to be very useful as an add-on medication for the treatment of Parkinson's Disease, but had the serious side effect of fatal liver damage in a few individuals.
Currently there are four dopamine agonists available:
1. Pramipexole (Mirapex TM)
2. Ropinirole, (RequipTM)
3. Bromocriptine (ParlodelTM)
4. Pergolide (PermaxTM)·
Pramipexole dihydrochloride and Ropinirole Hydrochloride are non-ergot dopamine agonists.
· Bromocriptine and pergolide are ergot-derived dopamine agonists. Ergot is a fungus that grows on grasses, and rye in particular. It produces alkaloids that are used in a wide range of drugs.
· Pramipexole (Mirapex ®) TM or Ropinirole TM(Requip®) may be used as a "first line" treatment, that is, as the main treatment, particularly for people with young onset (under 50) Parkinson's Disease.
· Dopamine agonists are now frequently added to levodopa early in treatment, before levodopa side effects first occur, to extend the duration of benefit between each dose.These drugs may also be used to replace some levodopa if its side effects have become unmanageable. When given together with levodopa, symptom control between doses lasts longer, and wearing-off reactions, on-off effects , and dyskinesias can be reduced.Side effects: Dopamine agonists can cause stomach upset, nausea and vomiting, and dizziness from lowered blood pressure when first started and, at high doses, confusion or hallucinations.
These side effects are dose-dependent and reversible.The best results are achieved when the agonist is started in a low dose, increasing by half a tablet until the required dose is reached. These drugs should be taken with food to minimize side effects and can be taken at the same time as other antiparkinson drugs.Pergolide has recently been associated with cardiac valve disease in patients taking the drug for a long time.
If you are on this drug discuss whether you should switch to another with your physician.
Bromocriptine and pergolide can both cause fibrotic changes in the lungs after prolonged use but these symptoms are reversible if the drug is stopped. They also can cause a condition in the lower legs that makes them red, hot, and painful (erythromelalgia).At the time ropinerole and pramipexole were first marketed there were reports of patients falling asleep while driving when taking one of these drugs. Some countries banned people taking the drugs from driving. Two major published studies have since shown that in certain people any drug used to treat Parkinson's disease can produced daytime sleepiness and so everyone should be aware of this possibility whatever treatment they are on.
The antibiotic CIPRO ®TM should be used with caution by patients taking ropinerol.
Other medications that are useful in treating Parkinson’s Disease include the following:
1- Amantadine (Symmetrel TM) is available as a 100 mg soft red gelatin capsule or a syrup. This drug can be used as early treatment for rigidity,. For many years, the action of amantadine was not understood. It has recently been shown to be a glutamate antagonist and to be effective at reducing dyskinesias. This is now its major role in the treatment of Parkinson’s Disease
Side effects: Amantadine can cause lightheadedness and confusion and a red "spider's web" mottling on the legs (lividoreticularis). It should be used with caution in the elderly and those with urinary problems. It should not be stopped abruptly after prolonged use. Anticholinergic drugs (such as benztropine CogentinorTMtrihexyphenidyl Artane TM) or antihistamines, used in the treatment of allergy symptoms (such as diphenhydramine) may be used alone in the early stages of treatment, if tremor, is the major problem. These medications are more useful in treating tremor than the slowness and stiffness.
Side effects: In older, frail individuals, side effects that include confusion, blurred vision, and urinary retention often limit the usefulness of these drugs.
Selegiline, (EldeprylTM) The use of this drug has declined in the last five years. This drug has a modest action. It works by slowing the breakdown of dopamine in the brain by inhibiting one of the enzymes responsible for the breakdown of dopamine (called monoamine oxidase B). It comes in 5 mg tablets and the daily dose must not exceed 10 mg. If used as initial treatment, selegiline may delay use of levodopa by about a year but should be stopped when more treatment is needed. There are reports suggesting that it should not be used in conjunction with levodopa. It can have a mild antidepressant effect.
Side effects: The major side effect is insomnia (because it converts to amphetamine in the brain), and lack of sleep is extremely detrimental to a person with Parkinson’s Disease. Even though selegiline has few side effects, it has the potential to enhance side effects associated with levodopa if they are taken together.Many of the drugs described above are now available in generic forms.
PARKINSON'S DISEASE:
What do you do if you have to go into hospital?
Anyone with Parkinson’s Disease needing to go into hospital or have surgery is encouraged to be well informed about how to ensure good management of your Parkinson’s Disease while in hospital.While it is easier to plan in advance for pre-scheduled admissions to hospital for elective surgery' (for e.g. hip replacement, heart, prostate or bladder surgery, emergency hospital admissions pose greater challenges (for e.g. hip surgery after a fall/fracture, pneumonia, infection, bowel impaction or stroke).
Be aware that trips to emergency rooms for the management of increased dyskinesia or prolonged off periods are best avoided. These episodes will eventually resolve spontaneously and it is better to stay at home in a calm, safe environment.
WHEN CONSIDERING SURGERYDay. surgery is generally no problem for a Parkinson’s Disease patient. However, some procedures, such as cataract surgery or some dental procedures, where you would normally be awake, may pose a problem if your tremor or dyskinesia create too much movement. You should bring this to the attention of the surgeon before the date of the procedure is set. It is important to ensure that you know how your GP, surgeon and neurologist (if you see one) will coordinate the care of your Parkinson’s Disease, with your procedure.
Deep brain Stimulation Pacemaker For The BrainPlease watch the following web sites:
http://www.youtube.com/watch?v=QuN5E4ebKz8&NR=1http://www.youtube.com/watch?v=IOHtUzW02cghttp://www.youtube.com/watch?v=a-8LW5GAlbc&feature=relatedhttp://www.youtube.com/watch?v=B6sqV7bEPo0&feature=relatedhttp://www.youtube.com/watch?v=YgIJJ7s23OIhttp://www.youtube.com/watch?v=QuN5E4ebKz8&NR=1 http://www.youtube.com/watch?v=WW-SWAnphFU&NR=1
Gene therapy for Parkinson’s
Gene therapy for Parkinson’sAn experimental treatment for Parkinson’s disease seemed to improve symptoms — dramatically so, for one 59-year-old man — without causing side effects in an early study of a dozen patients.The gene therapy treatment involved slipping billions of copies of a gene into the brain to calm overactive brain circuitry.More than half a million Americans have Parkinson’s. They endure symptoms that include tremors, rigidity in their limbs, slowness of movement and impaired balance and coordination.Eventually they can become severely disabled.
Active Tremor Control Therapy. (Deep brain stimulation)
The Active Tremor Control Therapy is a wire that is placed within the brain of an individual who is suffering from Parkinson's disease. This device is connected to a pacemaker-like generator, which will create an electrical pulse within the individual's brain. The generator is implanted within an area close to the collarbone and, when a tremor is coming on, all the individual must do is wave a handheld magnet directly over the pulse generator. Once the individual does this, the generator releases an electrical shock in the area of the brain that causes the tremors. This electrical shock actually blocks the tremors from surfacing. after this device is implanted within the body of someone with Parkinson's, the symptoms practically disappear. Individuals are able to eat and drink without being disrupted with uncontrollable tremors.
No side effects from treatment The Lancet paper reports that over a year, patients showed no side effects from the procedure. What’s more, they showed improvements in an overall assessment of symptoms like tremors, stiffness and walking problems.
The improvements were evident at a checkup three months after the procedure and persisted to the end of the study, one year after the surgery, researchers reported. By that time, the overall amount of improvement from before surgery was about 24 percent when measured at times that patients were off their normal medication, and 27 percent at times when they were on medication.
The improvements were evident at a checkup three months after the procedure and persisted to the end of the study, one year after the surgery, researchers reported. By that time, the overall amount of improvement from before surgery was about 24 percent when measured at times that patients were off their normal medication, and 27 percent at times when they were on medication.
If surgery is recommended, discuss with the surgeon:
· Benefits & risks of the procedure
· Tests & procedures involved
· Expected outcomes and odds of success
· Potential complications· Length of hospital stay
· Alternatives to surgery.
Is there a more conservative approach?
. Alternatives to general anaesthesia
· Alternatives to admission· Then you can make an informed choice
.Pre-operative MedicationFor surgery requiring a general anesthetic, your anti-Parkinson medication may be stopped the night before surgery. Alternatively you may be allowed to take an early morning dose of Sinemet with the least amount of water. Ask if it is possible to be first on a morning surgery list to avoid long periods without medication.
Parkinson’s Disease medication timing in hospital.
Ask your doctor to send your drug regimen and schedule with your hospital admitting orders before hospital admission. Also, bring your medications with you in the original bottles. Bring several copies of your list of daily Parkinson’s Disease medications and schedule to hospital. If, for example, you take your medication three times daily, write the times take. Otherwise it mat be interpreted as taken every 8 hours.
If you are on an experimental Parkinson’s Disease drug bring your own supply and a letter about the study.Discuss with your doctor the possibility of getting authorization to administer your own medication if you have frequent doses or as needed doses.Contraindicated drugs & side effectsSupply a list of all allergies to the hospitalFor pain control, Morphine tends to be better tolerated for those with Parkinson’s Disease versus Demerol. Demerol, pre-medication and drugs used for anesthesia can cause severe confusion, which may take a few days to a few weeks to resolve even in people who are not normally confused.For post operative nausea ask not to be given dopamine antagonist drugs such as Reglan or Maxeran (metoclopramide) or Compazine or Stemetil (prochlorperazine) for nausea.
Gravol is a useful drug choice and can be given both by mouth, suppository and injection.
(Domperidone only prevents the nausea associated with antiparkinson drugs).If you become confused post-operatively it could be drug or anaesthesia induced or the result of dehydration, constipation or an infection.
Avoid all conventional anti-psychotic drugs such as haloperidol, respiridone, and olanzapine. Quietapine (Seroquel) is the only safe antipsychotic drug for Parkinson’s patients.For bladder or prostate problems, anti-cholinergic drugs often help relieve muscle spasms after surgery, but these can cause confusion, constipation and retention of urine.Re-starting anti-Parkinson medication after surgeryIn most cases you can restart your anti-Parkinson drugs as soon as you are fully awake, and able to sit up and swallow.Anti-Parkinson drugs cannot be given during surgery.
After some surgical procedures (for e.g. abdominal surgery) you will not be able to take anything by mouth.If this is the case you should ask about having a nasogastric tube inserted before surgery even if the surgeon does not usually insert one for your procedure. You must be able to restart your anti-Parkinson drugs as soon as possible post-operatively to ensure optimal mobility. Post-surgery, crushed regular levodopa can be given with water through tube. Other tablets and the contents of capsules can be administered via nasogastric tube. However, Sinemet alone is preferred for the first few days to minimize the risk of psychosis and nausea.
After some surgical procedures (for e.g. abdominal surgery) you will not be able to take anything by mouth.If this is the case you should ask about having a nasogastric tube inserted before surgery even if the surgeon does not usually insert one for your procedure. You must be able to restart your anti-Parkinson drugs as soon as possible post-operatively to ensure optimal mobility. Post-surgery, crushed regular levodopa can be given with water through tube. Other tablets and the contents of capsules can be administered via nasogastric tube. However, Sinemet alone is preferred for the first few days to minimize the risk of psychosis and nausea.
THE IMPACT OF HOSPITAL STAYS AND PROCEDURES ON PARKINSON’S DISEASE
Parkinson’s Disease is already creating stress, so your body may be less able to cope with additional problems and adapt to the hospital environment.Stress reduces energy for healing and will make all Parkinson’s Disease symptoms worse.
Parkinson’s Disease is already creating stress, so your body may be less able to cope with additional problems and adapt to the hospital environment.Stress reduces energy for healing and will make all Parkinson’s Disease symptoms worse.
Use the stress management skills that work for you, such as breathing exercises, relaxing music on a walkman, and optimismDifferent diet, inadequate fluid and lack of mobility can lead to constipation, which can be severe. Bring a bowel management protocol with youDo not be surprised if you aren't always clear about what is going on. Different staff on different shifts and medical jargon can all create uncertainty.
Ask questions and seek clarification.Medication complications can disrupt mobility and mental status, and delay recovery.
Family caregivers need both a support system and a key hospital contact person.
Communicating your needsStaff may not have much Parkinson’s Disease experience, so discuss these issues with the nurse:
· On/off fluctuations are not intentional
· The importance of taking Parkinson’s medications on time. Most hospitals allow nurses a window of time in which they can deliver medications. Delayed drug delivery can disrupt your Parkinson’s Disease and delay your recovery.
· Physical and mental slowness associated Parkinson’s Disease
· Speech problems may affect intercom use
· Hand dexterity may affect eating/hygiene
· Bed turns, transfers and walking assistance may be required
· Hospital stays increase the risk of falling and fractures for those with Parkinson’s Disease.Restoring
Mobility and Rehabilitation during hospital recoveryPatients with Parkinson’s Disease need to restore their mobility as quickly as possible to avoid complications such as pneumonia, deep vein clots, urinary tract infections, and increased rigidity.Physiotherapy should be ordered by your doctor following surgery for chest therapy to ease ribcage rigidity and risk of lung complications as well as body mobility exercises.
There are inpatient and outpatient geriatric programs commonly used by patients needing assessment and rehabilitation services.Discharge planning, If necessary:Ensure that you and your family understand the medical team's follow up plans.Discuss the following with appropriate staff members ,home nursing care, rehabilitation therapy and caregiver respite needs, concerns arising about the need for ongoing facility care, The hospital social worker can provide links to the community health department.Living With Parkinson's DiseasePeople with mild Parkinson's disease who take medication often regain a relatively ordinary activity level.
Michael J Fox hug
ConstipationIt is important to embark on a program of prevention rather than crisis management.
Fava Beans fresh and dray full of LevodopaBeans and Parkinson's disease
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General Advice, Continue regular daily activities.
This is important to help maintain mobility. In the early stages of PD, such normal movement should be maintained to the fullest extent possible. Do all you can to remain mobile and active.Lead as normal a life as possible; don't restrict activities you're able to do.A regular exercise program that involves some stretching and weight bearing (short of becoming exhausted) is beneficial because, as motor function becomes more impaired, an exercise program or physical therapy may help maintain or reestablish physical conditioning.
Walking is excellent, and a 30-minute walk each day can be a realistic goal. Start with a 10-minute walk and build it up in 5-minute increments over the course of several days, according to your tolerance. You should walk when you feel your best and not put it off while you complete household chores, etc. In inclement weather, walk around the house with the radio or CD player on.It is never too early to seek the advice of rehabilitation specialists for help determining a realistic exercise level, or if you have difficulty with activities of daily living (getting in and out of the tub).
It also is helpful if you have problems with balance and safety, difficulties with speech, or for fatigue and stress management. The physical therapist, occupational therapist, and speech language pathologist can each help you maintain function and independence.If balance is a problem, adaptive training and use of quad-canes or straight canes, and other mechanical aids, can help maintain independence.Because constipation can result from the PD, or from drugs used to treat the illness , or from inactivity, you should consume adequate food and a high-fiber diet.
Dietary supplements such as psyllium or stool softeners can help regulate bowel movements as well.
Need To Know:
ConstipationIt is important to embark on a program of prevention rather than crisis management.
Increase daily fluid intake, especially in hot weather. Families and caregivers may need to reinforce this. At least six cups of liquid should be drunk daily.Older people may not be able to tolerate large amounts of raw fruit and vegetables, but can usually manage dried fruits, hot prune juice, canned fruits, and soft cooked vegetables, all of which may help to relieve constipation.
Introducing bran or high-fiber cereal into the diet is important, but they should bestarted slowly and in small amounts.Large amounts can cause stomach cramps and excess gas, particularly in people who cannot exercise. Bran should therefore be taken with caution and be accompanied by an increase in fluid intake.Regular exercise is also important.Stool softeners, bulk laxatives, and bowel stimulants are the main categories of laxatives available over-the-counter. Any of these may be used if a simple change in diet is not effective.Good NutritionGood nutrition will help you maintain your best level of health if you have PD.
A professional dietitian/nutritionist is your best source of reliable nutrition information.There is no specific diet for people with PD. Recommended daily allowances of the various food groups can be obtained from a dietitian or from your local health unit.Sometimes your symptoms can interfere with your eating well. If you are experiencing problems with appetite, chewing or swallowing, weight loss, or constipation, a consultation with a registered dietitian/nutritionist could be very helpful.
For people with difficulty chewing and swallowing:
Smaller frequent meals may be easier to manage than three full-sized meals a day.Food should be hotter or colder than the inside temperature of the mouth.Avoid crumbly fibrous food if swallowing is difficult.Eat in a quiet and relaxed atmosphere in a high backed chair.Sucking on ice for a few minutes before eating may make swallowing easier (it may also help speech). Iced sodas also promote swallowing. The icy bubbles on the back of the throat help to trigger the swallowing reflex. Sour or acid food may be easier to swallow.Put a few ice cubes in a blender with a small amount water or juice and blend until the ice is in small fragments. Have some of this chipped ice available throughout the dayAdd some liquid to food in your mouth to assist swallowing.
Managing Stress:
Try to avoid unnecessary stress in your life:
Leading a healthy life, eating regularly, sleeping regularly, and exercising will help keep you fit both mentally and physically.Many people continue to work although this can be a problem for those who face the public every day, particularly for those who need to speak in a large space (classroom) or are required to supervise in some situations.
The executive with a personal secretary to provide protection from the public will find it easier than a schoolteacher.All symptoms of PD get worse under stress. Therefore, talk to your physician and your employer about managing stress and/or early retirement or reduced working hours if necessary (and possible).
Since most people need to continue working for financial reasons, talk to your doctor about regulating your treatment so that it works best while you are on the job - particularly if you work shifts or work either very short or long days. This information will help the doctor to plan the best dosing schedule.
Traveling
Having PD does not mean you need to stay at home. Many people with PD travel frequently, and long distances, very successfully. You just need to plan a journey more carefully.Rest the day before and after you travel, particularly if time changes are involved.Take advantage of any service offered at airports, railroad stations, cruise ship terminals, etc. that allow you to board or exit in advance.Don't walk miles at airports if there is a moving walkway, motorized cart, or wheelchair service.
Save your energy.If you are traveling by car, stop frequently for some exercise, and don't travel as many miles in a day as you once did. Don't travel for long periods in very hot weather.Always keep all your medication in their original bottles in your hand baggage. Checked-in baggage may be lost or delayed. Customs officials are suspicious of odd containers containing several unnamed pills.Making the Most Of Your TeamYou need your partner, family and friends on your side. You may have to educate them yourself. Your family may find the adjustment to your diagnosis as difficult as you do.It is a good idea to seek some professional help if you or anyone else cannot come to terms with the diagnosis.
Inability to accept it can generate anxiety that can work against your symptoms and cause friction within the family.A variety of professionals may comprise your care team:Your primary care physician will continue to look after your general health and will liaise with your neurologist if you have one. Continue your annual check-ups, and don't assume that every problem with your health is related to PD.If you attend a specialty PD clinic, there may be a nurse available to provide education and counseling, as well as provide information about how best to manage the disease.
Depending on the clinic, the nurse may be your most frequent contact for advice.If you are depressed or are having difficulty adjusting to your diagnosis and have a high level of anxiety, you might benefit from the help of a psychiatrist.
Depression, anxiety, and other disorders may occur in some, but not all, people with PD. They can be disturbances in feelings, thoughts, behaviors, and intellectual functions such as memory. Psychiatrists use several methods of treatment that include verbal therapies (psychotherapy), marital and family counseling, and the use of medications.A physical therapist can help you with your posture, walking, and balance (to prevent falls), as well as with safe completion of daily activities (getting in and out of bed).
Many people exercise alone, but community-based programs are better because they offer social support and a good reason to get out of the house on a regular basis.An occupational therapist can offer advice and instruction on adapted equipment, safety promotion at work and at home, conserving energy, problem-solving, and improving mobility. Some offer help with stress management, as well.
A consultation with an occupational therapist in your home can be valuable if it needs some adaptation to provide easy access for someone with limited mobility.A speech-language pathologist can design a program to improve communication - possibly with ways other than speech. If you have a problem with swallowing, either a speech-language pathologist or an occupational therapist may help.A nutritionist can help you plan a healthy diet, considering your need to either maintain or reduce your weight. A nutritionist can also offer advice about meal preparation, taking your PD symptoms into account. A nutritionist can be your best source of information about food values.A social worker might help you solve social, emotional and economic concerns.
Primary care personal
Nice To Know:
You might benefit from a consultation with a physical therapist even if you are newly diagnosed. This is important if you plan to begin an exercise program or want to know whether you can continue your current sports and exercise. Walking and swimming are excellent activities for people with PD. However, in the months before diagnosis, you may have noticed some difficulty with exercise or sports, and you might have felt more tired than you once did. These problems often improve when you start medication and can return to your former level of activity. (For instance, one avid golfer only succeeded in scoring a hole-in-one after taking SinemetTM; and thereafter, his golfing friends wanted to take it too!)
What Does The Future Hold For Parkinson's Disease patients?
Parkinson's Research And Those With The Disease?
Great progress has already been made in three distinct realms of PD:· Increasing knowledge about the causes of PD, including the identification of four genes for PD as well as some clues to environmental causes. (PD is twice as common in people who work closely with other members of the public.)·
Great progress has already been made in three distinct realms of PD:· Increasing knowledge about the causes of PD, including the identification of four genes for PD as well as some clues to environmental causes. (PD is twice as common in people who work closely with other members of the public.)·
Improved disease management that minimizes side effects and maximizes benefit from the available drugs·
. Ability to improve function using new surgical treatments
· Advances in imaging procedures have already advanced our knowledge about PD, by allowing researchers to visualize chemical changes as they occur in the brains of living people, where in the past researchers had to rely on postmortem autopsy tissue.·
.By charting the rate of cell loss over time with repeated scans in the same individuals, researchers may be able to determine the rate of progression. From this, using mathematical models, they might be able to determine when PD actually began in an individual. Researchers are now, and have been for many years, involved in new clinical trials, technologies, surgical procedures , and drug treatments.
Today's progress may mean tomorrow's prevention or cure, as PD research continues to focus on areas such as:
· functions and anatomy of the motor system and its regulation of movement and relationship to the brain·
.PD's possible connection to environmental factors such as viruses and toxins·
.Genetic factors to determine whether defective genes play a role and whether certain people are genetically susceptible to developing PD·
.An adhesive patch that continually supply levodopa to prevent fluctuating response.
· implanting capsules containing dopamine-producing cells into the brain
· development of drugs to delay, prevent, or reverse the disease - some of which are controlled-release formulas.·
Much research is underway studying various techniques to replace the cells that have been destroyed.
Research using fetal tissue is fraught with problems including government resistance. Thus alternative and better sources for dopamine-producing cells are being studied. Studies using retinal epithelial cells are already being carried out in humans and early results have been published.
Of even greater significance is stem cell technology, using basic cells which can reproduce in the laboratory, and can be easily cultivated into large populations. The trick is turning these stem cells into dopamine-producing nerve cells, like those cells in the substantia nigra of the brain that produce dopamine. This has recently been achieved in laboratory experiments. Human trials should begin within the next couple of years.
Are There Any Clinical Trials To Participate In?
There are clinical trials taking place all the time and scientists/researchers are always eager for participants. However many studies have restrictions about how far away subjects can live from the center conducting the trial.
Frequently Asked Questions.
Here are some frequently asked questions related to Parkinson's disease.
Q: Should I stop my Parkinson's disease medications before general surgery or an operation?
A: Some neurologists recommend that medications be stopped 12 hours prior to general anesthesia for surgery. If you are on a complicated drug regimen, ask your surgeon prior to surgery to contact the physician responsible for your Parkinson's disease therapy so that your drugs can be given appropriately.
Q: Can I drink alcohol if I am being treated for PD?
A: A modest intake of alcohol is not a problem for people with Parkinson's disease. However, medications should not be taken with alcohol, and you should avoid alcohol altogether while you are building up the dose of a new drug.
Q: Are there any vitamins or minerals that cure Parkinson's disease?
A: Vitamins and minerals certainly contribute to a healthy lifestyle and supplement food intake. However, none have been found to halt the disease process or cure PD.
Q: I have read that I should avoid protein and dairy products in particular?
A: This is untrue for the majority of patients with PD. We all need adequate amounts of all the food groups to maintain health. A protein redistribution diet can be useful in a very, very small number of patients who have fluctuations in response to their standard SinemetTM. This diet should be developed with the cooperation of your dietician and neurologist. If it is not effective in one week, it should be abandoned. It is true that any extra-large meal can cause a delay in gastric emptying and this may make anyone feel sluggish and tired. Most people with PD do better eating more frequent smaller meals with high-energy, easily digestible snacks in-between.
A: This is untrue for the majority of patients with PD. We all need adequate amounts of all the food groups to maintain health. A protein redistribution diet can be useful in a very, very small number of patients who have fluctuations in response to their standard SinemetTM. This diet should be developed with the cooperation of your dietician and neurologist. If it is not effective in one week, it should be abandoned. It is true that any extra-large meal can cause a delay in gastric emptying and this may make anyone feel sluggish and tired. Most people with PD do better eating more frequent smaller meals with high-energy, easily digestible snacks in-between.
Q: Do I have to stop my PD meds when I'm taking drugs for another illness?
A: Do not stop taking your Parkinson's disease drugs if you have to take medications for another medical problem. You can take antibiotics, painkillers, etc. Bear in mind that if you do get a common viral infection such as a cold or flu, for example, or if you develop another illness that makes you feel unwell, your PD symptoms may be worse for a while because of the extra stress on your body as a result of the added illness. If you are taking ropinerole, and are prescribed CiproTM it is possible that your ropinerole dose may have to be adjusted while you are taking the antibotic as CiproTM can affect absorption.
Putting It All Together
1. Here is a summary of the important facts and information related to Parkinson's disease.
2. Parkinson’s disease (PD) is a slowly progressive condition resulting from a deficiency in the brain of a chemical called dopamine. This deficiency interrupts messages from the brain to the muscles.
3. Parkinson’s disease produces shaking of the body and limbs, slowness and difficulty beginning a voluntary movement, muscle stiffness and difficulty with maintaining balance.
4. The exact cause of Parkinson’s disease is unknown. The condition is known to occur in some families, but not all PD is inherited.
5. The four major signs of PD are tremor, rigidity, slowness of movement, and impaired balance. Some people also will experience a changed facial expression, a soft voice, cramped handwriting, pain, fatigue, depression, and constipation.
6. Parkinson’s disease may be treated with medication or surgery.
7. Medication for PD aims to replace or mimic the missing chemical dopamine in the brain.
8. Surgery for PD aims to destroy small portions of brain tissue or disable nerve cells.
9. Eating nutritious foods, getting enough exercise, managing stress, and remaining active are keys to living with Parkinson’s disease.
10. Great progress has been made in understanding and treating Parkinson’s disease, and research continues to uncover new clues about this condition.
FOOD, Herbal, Supplement for Parkinson’s
Herbal:
· Huperzine
· Rosemary
· Lecithi
· angelica or dong-quai·
Supplement:
Carnitine (L-Carnitine)
Phenylalanine
S-Adenosylmethionine (SAMe)
Tyrosine Vitamin C (Ascorbic Acid)
Vitamin A (Retinol)
Vitamin B1 (Thiamine)
Vitamin B12 (Cobalamin)
Vitamin B9 (Folic Acid)
Vitamin E
Fava Beans, Levodopa, and Parkinson's DiseaseBy Kathrynne Holden, MS, RDMs.
Phenylalanine
S-Adenosylmethionine (SAMe)
Tyrosine Vitamin C (Ascorbic Acid)
Vitamin A (Retinol)
Vitamin B1 (Thiamine)
Vitamin B12 (Cobalamin)
Vitamin B9 (Folic Acid)
Vitamin E
Fava Beans, Levodopa, and Parkinson's DiseaseBy Kathrynne Holden, MS, RDMs.
Holden is a registered dietitian specializing in Parkinson's disease. She has published research,
books, articles, and manuals on nutrition and PD, including "Eat well, stay well with PD." For more information you may call (USA) 877-565-2665, or 970-224-5066; or visit her website: http://www.nutritionucanlivewith.com/
Fava Beans fresh and dray full of LevodopaBeans and Parkinson's disease
In the past few years, I've been increasingly asked for information about fava beans as a source of levodopa. It's clear that many people are trying fava beans without fully understanding their properties. This article is designed to answer questions that have arisen about fava and Parkinson's disease (PD).
I hope this may clear up some of the confusion about the bean, and encourage people to discuss its use with their doctors and dietitians.This bean is a legume called "fava" (fah-vuh), faba, broad bean, and horse bean. Its botanical name is "Vicia faba." There are many species of faba; however, the "faba major"is the bean of concern here. It grows in a long pod, like a giant green bean, with large, flat seeds inside. It has been eaten for thousands of years throughout the world, especially in the Mediterranean region.
How are fava beans related to PD?
Fava beans contain levodopa, the same chemical in Sinemet, Madopar, Dopar, Larodopa, and other levodopa-containing medicines used to treat PD. In fact, the entire fava plant, including leaves, stems, pods, and immature beans, contains levodopa.
The amount of levodopa can vary greatly, depending on the species of fava, the area where it's grown, soil conditions, rainfall, and other factors. It appears that the young pod and the immature (green) beans inside the pod contain the greatest amount of levodopa, and the mature, or dried bean, the least. Three ounces (about 84 grams or cup) of fresh green fava beans, or three ounces of canned green fava beans, drained, may contain about 50-100 mg of levodopa. If using the young pod as well as the beans, the amount of levodopa may be greater than that in the fresh beans alone.
What effect do fava beans have on PD?
Some small studies have shown that the levodopa in fava beans can help control the symptoms of PD, just as medications containing levodopa do. In fact, a few people report that the effects from fava last longer than the effects from medications. Some researchers believe fava beans may contain other substances besides levodopa that could be helpful.However, although some people report good effects, others find no antiparkinson effect from fava beans at all; and still others report adverse effects, such as nausea and dyskinesia. Much more research needs to be done to determine how effective fava beans may be.
Are there any problems associated with eating fava beans?
Yes, there a number of concerns to be aware of:Variable levodopa amounts. Because fava plants have varying amounts of levodopa, it's possible to get either too much or too little levodopa. Too little levodopa will not relieve PD symptoms; and too much levodopa can cause overmedication effects, such as dyskinesia - particularly if other PD medications are being used at the same time. Also, the levodopa can cause nausea in some people.
Yes, there a number of concerns to be aware of:Variable levodopa amounts. Because fava plants have varying amounts of levodopa, it's possible to get either too much or too little levodopa. Too little levodopa will not relieve PD symptoms; and too much levodopa can cause overmedication effects, such as dyskinesia - particularly if other PD medications are being used at the same time. Also, the levodopa can cause nausea in some people.
Allergies.
Raw fava beans can produce an allergic reaction in some people but not all, including discomfort, and occasionally, coma. Cooking may prevent allergic reactions.Monoamine oxidase inhibitor (MAOI) use.
Another consideration is the use of fava for people who take MAOIs. These include: isocarboxazid (Marplan); phenelzine (Nardil); tranylcypromine (Parnate); and selegiline (deprenyl, Carbex, Eldepryl).MAOIs taken in combination with pressor agents (foods high in dopamine, tyramine and phenylethylamine), can bring about a dangerous, and sometimes fatal, increase in blood pressure. Levodopa in medications or in fava can convert to dopamine in the bloodstream. It should be noted that selegiline is a different type of MAOI (MAOI-type B), and in the amount normally used by people with PD (10 mg daily), it is not thought to pose a risk when used with dopamine. However, people using any MAOI should discuss foods containing pressor agents with their physicians and dietitians.
Favism (G6PD deficiency).
Favism .. is an inherited disease in which a person lacks an enzyme called glucose-6-phosphate dehydrogenase (G6PD). When these people eat fava beans, they develop a condition called hemolytic anemia. This anemia causes red blood cells to break apart and block blood vessels. When such blockage occurs in the kidneys, it can result in kidney failure and even death. Although favism is usually detected in childhood, adults can be affected as well.G6PD deficiency is rare, occurring mostly among people of Mediterranean, African, and Southeast Asian descent, but others can be affected as well. Your physician can perform a blood test for G6PD to determine whether you are at risk. If you find you have inherited G6PD deficiency, your dietitian can help you locate other foods that may be of concern, and can help you plan safe and healthful menus. For more information on favism.
Favism .. is an inherited disease in which a person lacks an enzyme called glucose-6-phosphate dehydrogenase (G6PD). When these people eat fava beans, they develop a condition called hemolytic anemia. This anemia causes red blood cells to break apart and block blood vessels. When such blockage occurs in the kidneys, it can result in kidney failure and even death. Although favism is usually detected in childhood, adults can be affected as well.G6PD deficiency is rare, occurring mostly among people of Mediterranean, African, and Southeast Asian descent, but others can be affected as well. Your physician can perform a blood test for G6PD to determine whether you are at risk. If you find you have inherited G6PD deficiency, your dietitian can help you locate other foods that may be of concern, and can help you plan safe and healthful menus. For more information on favism.
Should you eat fava beans if you have Parkinson's disease?
Many people with PD can benefit from use of fava beans. If you'd like to try them, discuss it with your physician first. Besides MAOI use and risk for favism, your doctor may want to adjust the amount and/or timing of your PD medications.If your doctor agrees that you should try using fava beans, he or she will probably ask you to start out with a very small amount at first, to see what effect, if any, fava has for you.
An ounce (about 28 grams, or two tablespoons of beans) a day is probably right for most people to begin with. After a week you should notice whether there is any effect, and if not, your doctor may suggest that you increase the amount. If the fava beans reduce PD symptoms, your doctor may want to adjust your other PD medications.
How often should I eat fava beans?
There is too little information available to give an exact answer; also, each person with PD is different, and has different medication needs. Some people report a half cup (4 ounces, 112 grams) of fava a day, or even every other day, gives good results. Begin with a small amount, increasing gradually under your doctor's supervision, until you find the combination of fava and/or PD medications that's right for you.Even if fava beans help, you shouldn't eat too much. If you fill up on fava, you'll be too full for other foods, and will miss out on the benefits they offer. A dietitian can help you plan menus that include fava beans and will best meet your personal needs.
Where can I get fava beans?
Fresh pods and/or green fava beans are available in season at specialty produce markets and some specialty foods shops. They may also be found at Middle Eastern markets, some supermarkets, and farmers' markets. Grocery stores may be willing to special order the fresh pods or beans in season, frozen pods/beans, or canned green fava beans, such as produced by Krinos or Cortas. Be sure to specify "green fava beans," not dried or mature beans.
Nutrient information for fava beans.
Besides levodopa, fava beans are rich in valuable nutrients. Fava pods with beans are a good source of iron, magnesium, potassium, zinc, copper, selenium, and many vitamins. The beans alone are also good - 3 ounces (98 grams) of cooked fresh beans contain 56 calories, 20 grams carbohydrates, 5 grams protein, 2 grams fiber, and substantial amounts of iron, magnesium, and vitamin C.
How do I prepare fava beans?
The pods, including beans, are best eaten when very young, before a "string" forms along the side. They can be steamed or boiled until tender. Add some olive oil or butter, lemon juice, salt and pepper, and serve as a vegetable side dish, like snow peas.
Please watch the following sites
http://www.youtube.com/watch?v=8-EtPKrGY94
http://www.youtube.com/watch?v=hrfAj-HUjzU&NR=1
To use the fresh green fava beans, shell the beans from the pods, like green peas. Then boil or steam them till tender - usually two to 10 minutes, depending on size and age. Add butter, salt and pepper, or your own favorite seasoning, and serve as a side dish. You can also add the cooked beans to salads. If the beans seem too chewy, cook for 8-10 minutes, then cool and slip off the outer skins; cook a few more minutes if needed. Some people like to eat the skins, others find them too tough.
In conclusion, fava beans are an excellent food, as well as a possible way to help fight the effects of PD. Discuss use of fava with your doctor and registered dietitian. Here's to your good health!
http://www.youtube.com/watch?v=hrfAj-HUjzU&NR=1
To use the fresh green fava beans, shell the beans from the pods, like green peas. Then boil or steam them till tender - usually two to 10 minutes, depending on size and age. Add butter, salt and pepper, or your own favorite seasoning, and serve as a side dish. You can also add the cooked beans to salads. If the beans seem too chewy, cook for 8-10 minutes, then cool and slip off the outer skins; cook a few more minutes if needed. Some people like to eat the skins, others find them too tough.
In conclusion, fava beans are an excellent food, as well as a possible way to help fight the effects of PD. Discuss use of fava with your doctor and registered dietitian. Here's to your good health!
Cooked and Canned fava beans ready to eat with whole wheat bread
Sources for fava beans: (Be sure to ask for green, or immature, fava beans, either the beans themselves or the entire pod. The pods may be fresh or frozen; the beans may be fresh, frozen, or canned.
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