Medical Journeys

Archive for the ‘Disease’ Category

The National Institutes of Health reports that many patients are unsatified with conventional Crohns disease treatments for a variety of reasons and more than half of these people seek alternatives.

Symptoms of the disease are uncomfortable to live with and can greatly affect the quality of a person’s life. As such, it is understandable that those who suffer from this condition would seek alternatives, especially when traditional therapies are often ineffective or cause unwanted side effects.

Recommended Crohns disease treatments depend primarily on the severity of symptoms.

The cause of the disease is unknown still, but recent Crohns disease information indicates that the disease may be caused by a bacterial infection. The most commonly accepted theory, however, is that Crohns is the result of a dysfunction of the immune system.

Milder symptoms are usually experienced during the onset of the condition and, in such cases, Crohns disease treatments may include an anti-diarrhea medication, aminosalicylates or corticosteroids. In the event these options fail, prescription medications that suppress the immune system may be prescribed by a physician.

Current Crohns disease information indicates that symptoms are caused by inflammation;however, it’s not an open and shut case because non-steroidal, anti-inflammatory drugs have been linked to flare-ups as well.

Corticosteroids are used with other Crohns disease treatments, such as dietary changes, to control and reduce inflammation. Corticosteroids, however, are not believed to be safe for prolonged use due to potentially serious side effects, such as increased blood pressure, osteoporosis and a heightened risk of infection.

Additionally, corticosteroids lose their effectiveness over time so they do not present a long term solution.

In some cases, Crohns disease treatments with medications that work by suppressing the immune system have been effective. However, the problem here is that using these drugs increases a patient’s risk of infection because of the compromised immune system. With a compromised immune system, the body will find it more difficult to combat infection effectively.

In addition, the use of such medications may increase the risk of cancer. This is because the immune system’s function is to help the body attack and destroy abnormal cells. Such abnormal cells, if left unchecked, could progress into cancerous ones. The latest Crohns disease information indicates that aminosalicylates alleviate symptoms for some Crohns sufferers; however, on the downside, they may reduce white blood cell counts. In short, aminosalicylates may also lower a person’s resistance to infections and other diseases by compromising the immune system.

Current convetional Crohns disease treatments, in summary, obviously have their fair share of drawbacks and downsides. Current Crohns disease information lists surgical removal of the affected areas of the intestines as the only cure. And, it should go without saying that many people view surgery as an extreme, last resort measure. A compilation of Crohns disease information published in August, 2006 concluded that conventional Crohns disease treatments were inappropriate 52% of the time.

A group of gastroenterologists, surgeons and general practitioners evaluated the treatment plans of their colleagues for appropriateness.

This is not told to alarm you, but it could be part of the reason why more and more people are choosing natural alternatives to alleviate Crohns.

Some of the most prominent of these natural alternatives are: aloe, slippery elm, and mangosteen. If you have not heard of any of these, what’s important to know is that there is evidence that these substances may effectively reduce inflammation and relieve pain.

However, none of them have been proven in clinical studies to relive Crohns symptoms, but there are many anecdotal cases of people claiming they helped greatly.

What we do know is that slippery elm and mangosteen have a long history of use as digestive aids. Indeed, the Mangosteen in particular is referred to as “Queen of Fruits” in its native land for its many healing properities and uses, which include relieving diarrhea, pain and inflammation. Scientifically speaking, the mangosteen has been shown to harbor anti-inflammtories, which explains why it is sought out as a natural pain reliever.

Current Crohns disease information indicates that reducing inflammation relieves abdominal pain and other symptoms. In the end, decisions about Crohns disease treatments are a personal choice. But whichever way you choose — conventional or natural — make sure you tell your doctor of your intentions.

Recent Crohns disease information indicates that patients sometimes do not inform their doctors about natural remedies they are using. Some doctors and researchers are concerned about this, because some botanicals and herbals have been known to interact with certain prescription medications.

One possible reason for patient non-disclosure may be that people are afraid of what their doctors will say about the use of a natural treatment, but increasingly, many doctors today are more open minded to natural alternatives.

Mike Leuthen is chief editor of [http://www.restore-your-health.com] Visit us on the web for more crohns disease information today.

Author: Mike Leuthen
Article Source: EzineArticles.com
Provided by: Guest blogger

We can hardly find a person who has not suffered from abdominal pain at least once in his life. Abdominal pain may be of different types, caused by a number of causes, which range from simple to life threatening conditions. Irrespective of the cause and the severity, it is troublesome for the sufferers and the caregivers, and hence forces them to go for a medical consultation.

Abdomen is the part of the body between the thorax and the pelvis, which is separated from the thorax by a diaphragm and from the true pelvis by an imaginary plane. Anteriorly the anterior abdominal wall supports it and posteriorly, the spine and back muscles. Skin, superficial fascia, deep fascia, muscles, layers of fascia (Fascia transversalis), extra peritoneal connective tissue and the outer layer of peritoneum form the anterior abdominal wall. The abdominal cavity extends upwards in to the concavity of diaphragm and downwards in to the pelvic cavity. Since there is overlapping by the ribs in the upper part and pelvic bones in the lower part, the exact size of the abdominal cavity is masked.

The abdomen contains digestive organs like stomach, small intestine, large intestine, liver, gall bladder, pancreas, and uro-genital organs like kidneys, ureters, bladder, fallopian tubes, ovaries and uterus. It also contains organs like spleen, adrenal glands, mesenteric lymph nodes, blood vessels and lymphatic vessels etc. Ligaments formed by peritoneal tissue attach these organs and keep them in position. The peritoneum is a large serous membrane lining the abdominal cavity and has got two layers. The outer layer is called parietal peritoneum and it covers the inner surface of the abdominal wall and the inner layer is called visceral peritoneum, which covers the organs and restricts their mobility. These two layers of peritoneum are connected by omentum and mesentery through which the organs get blood supply and nerve supply. The cavity formed by the two layers of peritoneum is a potential space, called peritoneal cavity, which is moistened by a serous fluid to avoid friction of abdominal contents.

Types of abdominal pain:

Depending upon the origin, there can be different types of abdominal pains.

1. Visceral pain (Splanchnic pain): This is caused by stimulation of visceral nerves by a noxious agent, which may be living organisms, toxins, mechanical stimuli like stretching, excessive muscular contraction or an ischaemia. Visceral pain is dull in nature and is poorly localized and felt in the midline.

2. Parietal pain: This is also called somatic pain. Here, some noxious agents stimulate the parietal peritoneum causing a sharp and localized pain. This type of pain is worse by movements.

3. Referred pain: Here the pain, though originating in other sites, is felt in the abdomen due to common nerve supply. Example: Conditions like pleurisy, pericarditis, torsion of testes etc. cause pain in abdominal region due to supply of nerves having the same root value (Spinal segments).

It has already been mentioned that abdominal pain is agonizing for the affected person and his family members irrespective of its cause and severity. Intensity of pain may not always indicate the seriousness of the condition because severe pain can be from mild conditions like indigestion and flatulency, where as mild pain may be present in life threatening conditions like perforation, cancer etc. Hence proper diagnosis and management is very essential.

Modes of presentation of abdominal pain:

1. Acute abdominal pain: Here, the pain is sudden with a rapid onset and short course, which may be due to severe or mild lesions. The term ‘acute abdomen’ is used in conditions wherein the patient complains of acute abdominal symptoms that suggest a disease, which definitely or possibly threatens life and may or may not demand urgent surgical interference. Acute pain may be colicky or non colicky in nature.

2. Chronic abdominal pain: Here the pain is long lasting and recurrent or characterized by long suffering. The complaints persist for a long time with fluctuations in the intensity of symptoms.

3. Sub acute abdominal pain: As the name indicates the duration of pain lies between acute and chronic conditions.

4. Acute exacerbation: In this state, a person having chronic symptoms comes with sudden onset of symptoms that simulate an acute condition. In such cases the patient or the bystanders give the history of chronic sufferings.

Causes of abdominal pain:

The etiology of abdominal pain can be discussed under the following headings.

A. Pain due to lesions in the abdomen: Example: Gastritis, Duodenitis, Appendicitis, Peritonitis, Pancreatitis, Intestinal obstruction, Renal colic, Cholecystitis, Gall stones with obstruction, Peptic ulcer, Intestinal perforation, Non ulcer dyspepsia, Food allergy, Hepatitis, Liver abscess, Mesenteric lymphadenitis, Inflammatory bowel diseases (Ulcerative colitis, Crohn’s disease), Dysentery, Cancer of the gastro intestinal tract (GIT), Abdominal TB, Abdominal migraine, Acute regional ileitis, etc.

B. Pain due to metabolic and general problems: Example: Poisoning, Renal failure, Diabetes, Thyroid problems, Hyper parathyroidism, Porphyria, Drugs, Lead colic, Black widow spider bite, Blood diseases, Malaria, Leukemia, Peri arteritis nodosa, Hereditary angioedema, Cystic fibrosis.

C. Pain due to lesions outside the abdomen (Referred pains & neuralgic pains): Here the pain is referred from other sites due to common innervations. Example: Pneumonia, Heart attack, Sub acute bacterial endocarditis, Torsion of testes etc. Pains as a result of some neurogenic lesions are also included in this category. Example: Herpes zoster, Spinal nerve root pains, Tabes dorsalis, TB spine, Abdominal epilepsy, etc.

D. Functional pain: Here, the pain comes without any lesions, mostly due to some psychological causes. Example: Panic disorder, School stress, Somatisation disorder, History of sexual abuse, Irritable bowel syndrome.

E. Pain due to lesions in the urinary tract: Both upper and lower urinary tract lesions cause abdominal pain. Example: Urinary tract infection, Cystitis, Pyelonephritis, Urinary retention, Renal colic, Ureteric colic.

F. Pain due to gynecological and obstetrical problems: Even though the gynecological organs are situated in the pelvis, most of the lesions present with pain in lower abdomen. Example: Menstrual colic, Ruptured ectopic gestation, Acute salpingitis, Endometriosis, Endometritis, Pelvic inflammatory disease, Torsion of polyp, Pelvic abscess, IUCD pain, Puerperal infection.

G. Causes in children: In children there are some common causes, which are worth mentioning. Example: Babies colic, Lactose intolerance, Milk allergy, Intussusception, Volvolus, Torsion of testes, Accidental swallowing, Streptococcal throat infection, Congenital megacolon, Overfeeding, Food allergy, Aerophagy.

H. Non specific abdominal pain: Here, no immediate cause is found even after history taking and investigations.
In about 35 to 40% of cases of abdominal pain, the cause may not be identified easily and hence treated symptomatically. But, if the pain persists along with the appearance of other signs and symptoms that indicate the underlying cause, it should be identified as early as possible to manage the case properly.

Provisional disease diagnosis:

Here the probable condition causing abdominal pain is diagnosed by considering the history, signs and symptoms along with other clinical findings.

Lab investigations:

This includes several diagnostic procedures that can help for the final disease diagnosis. The choice of investigation depends upon the signs and symptoms that indicate a probable condition. The suitable investigation helps to reach a final diagnosis.

Example: Routine blood, Routine urine, Blood biochemistry, Stool examination, X-ray Barium x-ray Ultrasonography, Endoscopy of GIT, CT scan, MRI scan, Gastric acid secretion studies, Laperoscopy, Mucosal biopsy, ECG, Excretory urography, ERCP, IVP, Exploratory laparotomy etc are some useful investigations.

Final disease diagnosis:

After doing necessary investigations, the disease or the condition causing abdominal pain is diagnosed by correlating with the clinical findings and the history of the patient. In case of a diagnostic dilemma, a team of doctors are involved in the diagnosis and management.

Author: Dr Muhammed Rafeeque BHMS
Article Source: EzineArticles.com
Provided by: Bumper guardian

One of the most widely recognized causes of premature death worldwide today is heart disease. Although this may sound very depressing, the reality is that the incidence of premature deaths caused by heart disease has significantly declined in recent years. Although progress has been made in the treatment of heart disease, additional effort needs to be made to prevent this illness as much as possible. Heart disease often takes a toll on the sufferer’s and his family’s lives. Treating heart disease can also be very complicated, requiring specialized human resources, equipment and medication. The costs of such treatments are also very high. In summary, prevention is better than the cure. Let’s now review the other factors.

Who Are At Risk?

People who have a family history of heart disease are probably the most at risk. So, bear in mind that if hereditary heart disease is prevalent in your family it would probably be a wise step to discuss this aspect with your doctor and to have regular annual appointments with him to check for potential problems. Be assured that if you do this, your chances of circumventing heart disease will be so much better.

Heart Disease Is A Leading Cause For Fatalities

Although more men are prone to heart disease than women, it is the most widely recognized cause of death in women. Strangely enough the observation that women live longer than men is also still true. Women therefore have to take certain measures to prevent the onset and development of heart disease.

Recognition Of The Problem Often Occurs Too Late

Doctors and specialists today, armed with improved technologies, are able to diagnose and treat heart disease more comprehensively than ever in the past. Unfortunately, by the time most people realize that they are suffering from heart disease, it would have escalated to an advanced stage that poses a treatment challenge for physicians. Often the onset of the illness only comes to light when the person has already been afflicted by a stroke or heart attack.

Of the many contributing factors of heart disease in people, smoking cigarettes is the most critical. Other factors such as elevated blood cholesterol levels as well as obesity, high blood pressure, sedentary lifestyles and diabetes heighten the incidence of heart disease. The person who does not deny these risk factors will have a better understanding and chance of survival should he or she be afflicted by some form of heart disease. Obviously it will mean making some necessary lifestyle changes.

Tremendous advances in medical technology have been made in many areas and also in terms of treatment protocols for sufferers of coronary heart disease. The development of drugs specifically designed to prevent heart attacks has increased and are readily available. Surgical techniques have advanced tremendously since the days of Dr. Chris Barnard and the first heart transplant. Both drug and surgery treatment protocols are designed for the elimination of heart problems and the restoration of proper heart function. The success of these developments is documented by the sharp decline of fatalities due to heart disease.

Steps Forward In Dealing With Heart Disease

Many new preventive measures have been developed to reduce the problems associated with heart disease. In addition to the advances in medical treatment for people suffering from heart disease, public awareness for these illnesses has increased dramatically. People are educating themselves with regards to the good benefits of a healthy lifestyle, staying away from smoking and drugs and working out to a cardiovascular exercise routine that is specifically designed to exercise the heart to make it stronger.

This statement by no means indicates that heart disease is not a serious threat, or that heart disease can be circumvented with minor treatment programs. Not at all! Heart disease is a serious health condition the danger of which can never be underplayed. But it is interesting and important to realize that heart disease is no longer the death threat that it was in years gone by.

Check Ups Can Prevent Heart Problems

Regular examinations by the doctor will not prevent heart disease from happening, but these examinations may have a significant impact on your heath if they are able to nip a heart problem in the bud before it becomes serious. This makes sense with regards to any illness. Detecting heart disease early in its developmental stages can motivate the patient to obtain treatment as a matter of urgency. When treatment is received promptly, the higher the chances are to successfully treat the heart disease before it turns out to be life threatening. Because this is so important regular – at least annual – checkups are necessary for those who might be at risk for heart disease.

Cindy Heller is a professional writer. Visit heart disease cure to learn how do you get heart disease and the relationship between sleep apnea and heart disease.

Author: Cindy Heller
Article Source: EzineArticles.com
Provided by: Gadget reviews

There is growing concern about the link between cosmetic sun bed use and the rising incidence of skin cancer in Scotland. This issue was highlighted at the Scotland Against Cancer conference last year at which a case was made for thorough regulation of sun bed operators. It was felt that tighter controls could have a positive impact on skin cancer prevention efforts.

Individuals and organisations with an interest in skin cancer prevention have continued to express concern about rising sun bed use and the effect this may have on levels of skin cancer which is the fastest rising cancer in Scotland, and a particular problem in the West of Scotland. The risk of skin cancer is related to lifetime exposure to ultraviolet light and intense exposure to such light is the most dangerous to the skin. For example, too much time spent in the sun on holidays abroad or excessive time spent in the sun on the occasional hot day in Scotland, constitutes this type of exposure.

Sun bed use also provides a form of intense exposure to ultraviolet light. Just one session a month will double the average individual’s annual dose of ultraviolet radiation. Sun bed use is on the rise in Scotland and there is now a significant body of evidence to suggest that the sunbed industry suffers from a lack of regulation. Cases of malpractice by operators have been documented in a survey by the Royal Environmental Health Institute of Scotland (REHIS). In particular there is evidence that children, who are especially sensitive to ultraviolet light, are now regularly using sunbeds. Just one day of burning as a child increases the risk of getting skin cancer as an adult.

Tanning in General

Tanning is your body’s natural protection against sunburn; it’s what your body is designed to do. Developing a tan is your body’s natural way of protecting against the dangers of sunburn and further exposure.

Whether you tan outdoors under the sun or indoors in a tanning facility, the tanning process is the same. This natural process takes place when your skin is exposed to ultraviolet light. Light is composed of energy waves that travel from the sun to the Earth. Each energy wave can be identified by its length in nanometres, (nm), which is one-billionth of a meter. Light can be broken into three general categories: infrared, visible and invisible. Ultraviolet light is in the invisible light spectrum. There are three kinds of ultraviolet light: UVA, UVB and UVC. Tanning itself takes place in the skin’s outermost layer, the epidermis. There are three major types of skin cells in your epidermis: basal cells, keratinocytes and melanocytes. All play different roles in the tanning process. Everyone has roughly the same number of melanocytes in their bodies–about 5 million. Your heredity determines how much pigment your melanocytes can produce. Melanocytes release extra melanosomes whenever ultraviolet light waves touch them. This produces a tan in your skin.

Skin Types

I. – Always burns; never tans, pale white skin; “Celtic”

II. – Burns easily; tans minimally; White skin

III. – Burns moderately; tans gradually to light brown average; Caucasian skin

IV. – Burns minimally, always tans well to moderately brown; Olive skin

V. – Rarely burns; tans profusely to dark; Brown skin

VI. – Never burns; deeply pigmented; Black skin

Effects of UV

There is a body of scientific research demonstrating that the production of the activated form of vitamin D is one of the most effective ways the body controls abnormal cell growth. Moderate exposure to sunlight is only way for the body to manufacture the vitamin D necessary for producing activated vitamin D.A 1997 report by the National Academy of Sciences Institute of Medicine recommends 200 IU/day of vitamin D for women aged 50 years or younger, 400 IU/day for those aged 51-70 and 600 IU/day for those older than 70. Moderate exposure to sunlight helps the body manufacture vitamin D and eating salmon or mackerel and drinking fortified milk or juices is a step in the right direction. The amount of vitamin D formed in a given period of exposure depends on the colour of your skin–that is, how rich your skin is in melanin. Melanin absorbs UV radiation. Therefore it diminishes the production of vitamin D. The darker a person’s skin, the longer he or she has to be in the sun or exposed to UVB radiation to form a significant amount of vitamin D.
Like melanin, sunscreen also absorbs UV radiation and therefore greatly diminishes the skin’s vitamin D production. For example, sunscreen with a PDF of 8 diminishes a person’s ability to produce vitamin D by 95%. In addition, winter sunlight in the northern latitudes does not have enough UVB radiation to produce vitamin D in the skin leading to diminished vitamin D levels in winter.
Moderate exposure is the most responsible way to maximize the potential benefits of sun or UV exposure while minimizing the potential risks associated with either too much or too little sunlight. Avoiding sunburns is critical to moderation. Experiencing painful sunburns before the age of 20–not lifetime exposure to the sun–is the factor associated with an increased risk of malignant melanoma, the most serious type of skin cancer.

History and Facts of Indoor Tanning

Europeans started tanning indoors with sunlamps that emitted ultraviolet (UV) light as a therapeutic exercise to harness the positive psychological and physiological effects of exposure to UV light. This practice became widespread in Europe, particularly in the sun-deprived northern countries by the 1970s–several years before the first indoor tanning facility was established in the UK. Although indoor tanning is considered a cosmetic exercise the roots are therapeutic and many people do in fact visit tanning facilities for that purpose.

The indoor tanning industry has grown substantially in 25 years. Today it is a strong part of the small business community. And each year about 10 percent of the public visits an indoor tanning facility. This business is estimated to be worth £3 billion worldwide.

The indoor tanning industry’s position is summed up in this declaration:

“Moderate tanning, for individuals who can develop a tan, is the smartest way to maximize the potential benefits of sun exposure while minimizing the potential risks associated with either too much or too little sunlight.”

The indoor tanning salon industry claims to be part of the solution in the ongoing battle against sunburn by teaching people how to identify a proper and practical life-long skin care regimen. No legislation covers indoor tanning just the following government guidance:

“Like the sun, sun-beds give out UV rays that can increase the risk of skin cancer. The more you use sunbeds, the greater the risk is likely to be and when the tan fades, the skin damage remains. If you’re under 16 you should never use a sunbed, as young skin is more delicate and prone to damage than older skin. Even if you are over 16 you should be very careful if you choose to use one. You should also really avoid sunbeds altogether if you:

a. – have fair or freckly skin

b. – burn easily

c. – have a lot of moles

d. – have a family history of skin cancer

e. – use medication that increases your sensitivity to UV.

If you do decide to use one, limit yourself to two sessions a week, over a period of 30 weeks, every year. But remember that if you don’t tan in the sun, you won’t tan any more easily on a sunbeds.”

Skin Cancer

Skin cancer has a 20- to 30-year latency period. The rates of skin cancer we are seeing today are most likely the result of bad habits from the 1960s, 1970s and 1980s that were based on ignorance and misinformation about sun tanning. In those days, many people still considered sunburns an inconvenient right of spring, a precursor to developing a summer tan. People believed that sunburns would “fade” into tans, and so tanners hit the beaches with baby oil and reflectors. Severe burns were commonplace. Today we know how reckless and uninformed that approach was. What’s more, the photobiology research community has determined that most skin cancers are related to a strong pattern of intermittent exposure to ultraviolet light in people who are genetically predisposed to skin cancer. These skin cancers are not simply the result of cumulative exposure. Once again, this suggests that heredity and a pattern of repeated sun burning are the primary factors associated with skin cancer.

Melanoma is a cancer of the pigment-producing cells (melanocytes). An increased risk of melanoma has been associated with people who have moles or repeated sunburn experiences as a child or young adult. Most melanomas occur on non-sun-exposed parts of the body. For example, melanoma is infrequently found on the face. Although melanoma accounts for only 5% of all newly diagnosed skin cancer cases each year, it is responsible for the majority of skin cancer deaths. Melanoma is the only form of skin cancer that is aggressive with any regularity.

Heredity, fair skin, an abnormally high number of moles on one’s body (above 40) and a history of repeated childhood sunburns have all been implicated as potential risk factors for this disease. As a nation high in Celtic heredity Scotland needs to consider these facts.

Scotland’s Skin Cancer Epidemic

Scotland may be experiencing a skin cancer epidemic with the incidence of skin cancer tripling in the last thirty years. There were over 7,000 cases of skin cancer diagnosed in 2001, up from 2,200 in 1975 and higher rates of melanoma incidence have been reported in Scotland than in the rest of the UK.

In the age group 20-39 years, malignant melanoma is the second most common cancer in the UK. This is an unusually young age distribution for an adult cancer and emphasises the importance of its prevention and early treatment to avert the potential loss of many years of life.
On average, about 20 years of life are lost for each melanoma death in the UK.

The NHS and a number of cancer charities have most clearly linked the steep rise in incidence to changing cultural perceptions of a tan as desirable and the steep rise in the number of people taking holidays in the sun.

Tanning grew significantly in popularity through the 1960s, 1970s and 1980s and as skin cancer may take 20 or more years to develop; the high rates of skin cancer can be expected to continue for many years to come.

Mortality from skin cancer, particularly melanoma, it’s most aggressive form, has not fallen despite major public health initiatives to raise awareness of sun protection and skin cancer. Attempts are being made by health promotion agencies to tackle this growing problem through encouraging people to change their behaviour on holiday and convincing Scots to take care on sunny days at home.

Another source of ultraviolet light is that derived from sunbed use and medical evidence on the risk of sunbeds to health is increasing. Sunbeds have been linked to a variety of negative health effects, including eye damage, photodermatosis, photosensitivity, premature skin ageing and skin cancer.

Ultraviolet rays from sunbeds have been classified as Group 2A carcinogens by the International Association for Research into Cancer (IARC) that is, “probably causing cancer in humans.” Recent analyses from studies in different countries over the last ten years have shown that the use of sunbeds increased the risk of cancer and the risk appears to be higher if use begins early in life.
Furthermore, in the UK a significant study from the British Medical Association found that sunbed users were 2.5 times more likely to develop skin cancer. The risks appear to be higher in the young.

A model has been developed to estimate human ultraviolet exposure to both sunlight and sunbeds, and this information was used to predict the contribution of sunbeds to melanoma mortality in the UK. The results of this study indicate that sunbeds cause 100 deaths from melanomas each year in the UK

The World Health Organisation (WHO) recommended in 2005 that no one under 18 should use a sunbed and that there is a need for guidelines or legislation to reduce the risks associated with sunbed use. WHO argues that growth in the use of sunbeds, combined with the desire and fashion to have a tan, are considered to be the prime reasons behind the fast growth in skin cancers in developed countries. The highest rates are found predominantly in those countries where people are fairest-skinned and where the sun tanning culture is strongest: Australia, New Zealand, North America and northern Europe. The people of Scotland are particularly fair-skinned and therefore at relatively high risk of developing skin cancer.

Risk Associated with Sunbeds Use

Despite common claims, radiation from sunbeds is no safer than exposure to the sun itself. The emission from many sunbeds is greater than that from the midday sun in the Mediterranean. The UVA portion of the emission spectrum can be 10-15 times higher than that of the midday sun.
A 1986 survey found that people believed that sunbeds cause less damage to skin than outdoor tanning. This is partly because of the marketing of sunbeds as a way of getting a ’safer’, ‘controlled’ tan. Positive health claims are still being used to market cosmetic sunbeds.

In 2005 the action of ultraviolet light on skin to synthesise Vitamin D in the body was used in an advertisement funded by The Sunbed Association to promote the use of sunbeds as healthy. When a consumer complained about the inference, the Advertising Standards Authority upheld the complaint, in recognition of the fact that health professionals do not recommend sunbeds as the main source of Vitamin D, because of the risk associated with skin damage and cancer.
This was also the conclusion of the recent American Academy of Dermatology conference in May 2005. This conference reviewed evidence and recommended that Vitamin D supplements are a safer, cheaper and better alternative to raise Vitamin D levels than ultraviolet light, especially for the frail elderly and possibly for dark-skinned people with low sun exposure. Because of the documented causal relationship between skin cancer and sunbeds, many international and UK health organizations have publicly recommended that sunbeds should not be used, or their use should be limited and regulated to protect public health.

Lack of Regulation

There exists no relevant legislation other than the general Health and Safety guidance, mentioned earlier, to control the use of sunbeds.

The HSE has issued guidelines and cosmetic sunbed premises and machines are subject to the requirements of health and safety legislation in Scotland. Control of exposure is governed by the general provisions of the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulation 1999.

To comply with this legislation, duty holders are required to assess the health and safety risks caused by their work activities which will include the risks to employees and customers from exposure to ultraviolet radiation and put in place measures to control these risks as far as is reasonably practicable.

Specific guidance has been issued by the HSE on Controlling the Risks from the Use of Ultraviolet Tanning Equipment and can be found at:

http://www.hse.gov.uk/pubns/indg209.pdf

Some businesses operate under a voluntary code of conduct agreed by the Sunbed Association. The Sunbed Association claims 20-25% of cosmetic sunbed premises are in membership. Consequently, with those numbers, voluntary arrangements can only have limited effect.

Although the Sunbed Association provides training schedules, there appears to be no requirement for training associated with the use of non-therapeutic UV radiation. The responsibility is on the provider to supply appropriate information that will allow potential clients to make an informed decision about whether or not sunbeds are suitable for their use. International legislation is diverse but it is significant that the need for regulation is recognized in France, Belgium, Sweden, Canada and the USA. European standards exist to regulate ultraviolet lamp emission strength and sunbed products.

The Case for Sunbed Salon Licensing

It is only within the last decade that public health authorities in Scotland have begun to highlight the health risks associated with sunbed use and in particular, the increased risk of developing skin cancer. In the past, many local authorities provided tanning facilities within their own leisure centres. The association of sunbeds with leisure facilities reinforced the perception that a tan is a sign of good health. Fortunately, over the last decade most sunbeds have been removed from local authority premises. In the main, this has been done because local authorities perceive this to be an action they can take to discourage the use of sunbeds for cosmetic tanning purposes, and to highlight the dangers associated with use.

In addition, the problem of skin cancer has often been viewed as a local community issue, with the subsequent onus on local authorities to take action. However, while the provision of sunbeds in local authority facilities has decreased, the number of commercial sunbed premises has increased.
Furthermore, there are growing concerns that some cosmetic sunbed premises are poorly run and offer little advice on the health risks associated with sunbed use.

A 2003 REHIS survey of 794 cosmetic sunbed premises in all 32 Scottish local authority areas identified a number of un-staffed and unsupervised premises and salons that were failing to check the age of customers or enquire about skin type or medical conditions which may deem sunbed use particularly ill advisable. In addition, the survey highlighted a number of salons that were failing to offer customers adequate eye protection.

Surveys in the UK and North America show that tanning salon operators typically show ignorance of sunbed risks and fail to enforce rules for using sunbeds.

The University of Dundee and Perth and Kinross Council in a joint study of privately operated premises in Tayside revealed the following major incidences of poor practice:

o 89% exercised no administrative control on the number of sessions/customer

o 81% failed to give adequate advice to customers

o 59% maintained no customer records

o 33% displayed no guidance to users

The recent change by many commercial operators to adopt more powerful UV lamps using shorter wavelengths has led to even greater concern amongst health professionals. An assessment by the Photobiology Unit at the University of Dundee Ninewells Hospital concluded that “all tanning units are potentially harmful and that the newer stand-up type has a much greater risk than has been generally appreciated.

Scottish Executive Proposal

Compel local authorities to issue licences regulating cosmetic sunbeds premises. Require providers of cosmetic tanning facilities, or equipment, to obtain a licence to operate from the local authority. The licensing conditions would be set so that local authorities could:

o Prevent the use of sunbeds by children

o Protect adults from over-exposure

o Ensure that sunbed users are supervised

o End the use of coin-operated machines

o Ensure that sunbed sessions are monitored and limited

o Provide health risk information in sunbed parlours

o Inspect premises

The proposal seeks to achieve a number of objectives. By providing health risk information it aims to ensure adults are equipped to make informed choices about the risks of sunbed use. The conditions of licensing would require staff to be on premises, which would help to prevent overexposure to ultraviolet light, especially by those who are more sensitive such as users with fair skins. Reduce the number of burns and accidents currently attributed to the misuse of unsupervised equipment and would drive up standards amongst operators. Premises not holding a licence would not be permitted to trade.

The lack of sunbed regulation in commercial premises and the damaging impact this can have, is best illustrated by example.

In the summer of 2004, two young boys aged 11 and 13 years old used unsupervised sunbeds in Stirling and were so badly burnt, they had to be admitted to hospital. Stirling Council environmental health officers were alerted to investigate the incident but because there was no legislation covering the regulation of sunbeds, action could not be taken against the salon for being un-staffed or for allowing young people under the age of 16 years to use a sunbed.

Impact of Licensing Scheme

It is anticipated that those businesses which could not meet a licensing requirement would be required to either invest in their businesses or be forced to cease trading. This would also eliminate the existence of coin-operated sunbed machines as well as the presence of un-staffed locations.
The cost of a licensing scheme must be balanced against the cost of reducing the harm caused by sunbeds. Although there would also be an administrative charge to operators of premises, in the long run the regulations would reduce the number of Scots – presently around 7,000 per year – who are being treated for skin cancer by the National Health Service.

Conclusion

Scotland needs to take action to tackle skin cancer and the public health message that sunbeds are potentially dangerous needs to be heard loud and clear. A system of licensing for sunbed salons could do for skin cancer what the health warning on packs of cigarettes has done for lung cancer.
It would introduce health controls in an otherwise very unregulated area, it would protect our young people and children from harm and it would raise public awareness of the dangers of skin cancer.

It is suggested that the voluntary regulation scheme is ineffective, and there may be a need for formal regulation in this area. Regulating sunbeds to ensure that children do not use them and to ensure that all users are aware of the risks associated with sunbed use, could be a major step forwards in the drive to control Scotland’s skin cancer epidemic.

Reference Material: (If you have a deeper interest)

1. Statistical Information Team Cancer Research UK (2006) ‘CancerStats, Malignant Melanoma-UK’Information available online at http://info.cancerresearchuk.org/cancerstats/

2. Spencer, J. & Amonette, R. Indoor tanning: risks, benefits, and future trends.

3. Solar and ultraviolet radiation. (IARCPress, Lyon, 1992)

4. Gallagher RP, Spinelli JJ, Lee TK. Tanning beds, sunlamps and risk of cutaneous malignant melanoma,Cancer Epidemiol Biomarkers Prev 2005;14:562

5. Young AR, Tanning devices – fast track to skin cancer? Pigment Cell Res 2004;17:2-9

6. Karagas MR, Stannard VA, Mott LA, et al. (2002) Use of tanning devices and risk of basal cell and squamous cell skin cancers. Journal of the National Cancer Institute 94:224-6.

7. Westerdahl J, Olsson H, Masback A et al. (1994) “Use of sunbeds or sunlamps and malignant melanoma in Southern Sweden”.American Journal of Eepidemiology 140:691-9.

8. Diffey, B. A quantitative estimate of melanoma mortality from ultraviolet A sunbed use in the U.K.Br J Dermatol 149, 578-81 (2003).

9. WHO fact sheet : Sunbeds, tanning and UV exposure, March 2005, at http://www.who.int/mediacentre/factsheets/fs287/en/

10. Gerber, B., Mathys, P. Moser, M., Bressoud, D. & Braun-Fahrlander, C. Ultraviolet emission spectra of sunbeds. Photochem Photobiol 76, 664-8 (2002).

11. Wester, U., Boldemann, C., Jansson, B. & Ullen, H. Population UV-dose and skin area–do sunbeds rival the sun? Health Phys 77, 436-40 (1999)

12. Autier, P. Perspectives in melanoma prevention: the case of sunbeds. Eur J Cancer 40, 2367-2376 (2004). Advertising Standards Authority- non-broadcast adjudication, 7September 2005, http://www.asa.org.uk

13. Lim HW, Sunlight, tanning booths and Vitamin D, J Am Acad Dermatol 2005;52;868-76

14. British Medical Association- http://www.bma.org.uk

15. REHIS calls for Executive Action on Sunbeds, poor standards putting Scots at risk,November 2003

16. Ross, R. & Phillips, B. Twenty questions for tanning facility operators: a survey of operator knowledge. Can J Public Health 85, 393-6 (1994)

17. Moseley, H., Davidson, M. & Ferguson, J. A hazard assessment of artificial tanning units. Photodermatol Photoimmunol Photomed 14, 79-87 (1998).

18. Culley, C. et al. Compliance with federal and state legislation by indoor tanning facilities in San Diego. J Am Acad Dermatol 44, 53-60 (2001).

19. Moseley, H, MDavidson and J Ferguson. (1999) “Sunbeds and the need to know” British Journal of Dermatology. 141: 573-609

20. Royal Environmental Health Institute survey, November 2003 [cited in note 2].

21. NHS Scotland – Survey of Sunbed Salons in Scotland. Information collated by Royal Environmental Health Institute of Scotland, 3 Manor Place, Edinburgh, EH3 7DH, November 2003.

Author: Colin Muir
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Alzheimer’s disease

Alzheimer’s disease was first observed by a German Psychiatrist in 1906 by Alois Alzheimer; hence the name. Emil Kraepelin helped in the discovery by linking the disease with a neuropath logical basis of psychiatric disorders. It was found to be a type of dementia and is now conceded to be a part of aging. It seems to be a common and natural symptom of the aging process.

By the 1980’s the disease became well-known and people all over the world started to be diagnosed with the disease. Prior to the 1970’s or 1980’s, people who had suffered from the disease were thought to have been crazy. They were considered a flaw on society and was shielded from others. They, much like others who had a mental illness, were never shown to the public like a family secret.

Now Alzheimer’s affects thousands of people a year. It isn’t hidden anymore, but those with the disease are being treated and given the attention that they deserve. In the medical world, Alzheimer’s has been diagnosed as part of senile dementia and is mostly affecting those over the age of 65. However, some people have been diagnosed with the disease as early as 30.

Symptoms of the disease, is mostly a notice in memory loss. As the disease progresses, a person’s short term and long term memory is affected to the point where they may not remember anyone within five minutes. The forgetfulness will affect the person in several other ways. A person will become easily confused and scared. As the disease progresses, the person’s behavior will change to the point where they may have outbursts of violence or cries.

The later stages of the disease will then affect the person’s mobility. They will have a hard time balancing themselves and their muscles will deteriorate. They may even become unable to feed themselves. Eventually they will pass on from the disease. Doctors have noted the disease to last seven to ten years if not interrupted by other natural cause deaths like heart attacks.

They have marked a couple people to live up to fifteen years with the disease. But, most people will reach their final stage of the disease within five years. There is no cure for the disease, but some doctors have come up with their own theories on how to delay the symptoms of the disease. Most doctors will recommend that as you age, that you try to stay active and have well-balanced meals. By staying healthy and active, a person is less likely to be affected early in their life.

As for the diagnose, many people will be given blood tests to out rule any alternative diagnoses or issues and then they are given other tests that last weeks or even months. These tests try to observe the pattern of memory and intellectual loss. Doctors, with the help of the family and friends, are able to diagnose a person 85% accurate, but to be 100% the patient and disease must wait for microscopic examination of the brain tissue, which is down by autopsy.

The author J. L. Jacobsen is a freelance writher, and writhe articles of difference stuff. Medical is one of the favourites. [http://www.online-medical.biz]

Author: Jarl Jacobsen
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