Study Shows Limits in Helping Children Deal With Conflict | Alcohol Abuse and U.S. Troops Back From War

 

The Journal of the American Medical Association, or JAMA, has published its yearly issue on violence and human rights.

One report is on a study of a mental health program for children affected by political violence in Central Sulawesi, Indonesia.

The study of the school-based intervention involved about five hundred children. The average age was ten. Some took part in a therapy program for five weeks. They met fifteen times with locally trained mental-health workers. The other children, a control group, received no therapy.

The researchers say the therapy appeared to moderately reduce signs of post-traumatic stress disorder. It also helped support feelings of hope. But it did not reduce signs of depression or abnormal fear.

A team from the Netherlands, at the nonprofit organization HealthNet TPO and Vrije University Medical Center, did the study.

In an audio commentary on the JAMA Web site, the journal's editor in chief, Cathy DeAngelis, expressed regret at the findings. In her words: "I guess violence to children has its toll no matter what you do."

Another study in the special issue looked at alcohol use among American troops back from war. At the beginning of the study, more than forty-eight thousand service members answered questions about their use of alcohol. Some went on to fight in Iraq and Afghanistan, and some were deployed in non-combat duties. Most were not deployed.

Later, the men and women answered questions again about their drinking.

New cases of heavy drinking were highest among younger service members and members of the Reserve and National Guard returning from the wars. These normally part-time forces have played an important part in Iraq and Afghanistan. But those who fought in the wars were sixty-three percent more likely to later abuse alcohol than non-deployed personnel.

Active-duty service members involved in combat were thirty-one percent more likely to begin binge drinking when they returned home. Drinking four to five drinks within about four hours is considered binge drinking.

The Naval Health Research Center in San Diego, California, did the study. The researchers note that high rates of alcohol misuse have been reported among service members returning from past conflicts. But there has been little information so far about the current wars. 

 

Brain Aneurysms: Rare but Usually Deadly If They Burst

 

We often hear the term brain aneurysm. Joe Biden had two of them twenty years ago. Doctors saved his life. Now the sixty-five year old senator from Delaware has just been named the vice presidential choice of Democrat Barack Obama. 

Ohio's first black congresswoman, however, was not so lucky. Fifty-eight year old Representative Stephanie Tubbs Jones died last week within hours after a brain aneurysm burst. Doctors said she may have had no warning, which would not be unusual.

A brain aneurysm is a weak or thin area along an artery wall in the brain. It can become so thin that it ruptures and bleeds. The most common form looks like a small, round berry hanging from the artery.

The Mayo Clinic in Minnesota says as many as fifteen million people in the United States, or five percent, have a berry aneurysm. Fewer than thirty thousand will ever suffer a rupture.

The National Institute of Neurological Disorders and Stroke estimates that forty percent of victims die within twenty-four hours. Another twenty-five percent die within six months.

People may live a long and healthy life and never know they have an aneurysm. But sometimes, if it gets big enough, it can cause pain or other problems that lead to its discovery.

In Joe Biden's case, his neck hurt for several weeks. Doctors thought he had a pinched nerve and a virus. But in February of nineteen eighty-eight, tests showed a leaking artery at the base of his brain. Doctors operated successfully, and again three months later for an aneurysm in another area.

Janet Sutherland is director of the Chicago chapter of the Brain Aneurysm Foundation, a support group. She describes what happened when she suffered a rupture in March of two thousand four.

It began with the worst headache ever. She called emergency services. Rescuers found her collapsed in her kitchen.

The operation was a success. But she was in a coma for three weeks. She woke up blind and unable to move. She had two surgeries to return her sight and another to correct a second aneurysm. She spent five months in the hospital and many months in physical therapy.

Today Janet Sutherland can walk again, and says she can see better than ever.

Experts say most brain aneurysms happen in people born with an abnormality in an artery wall. Other causes can include head injuries, high blood pressure, infections, tobacco use and use of stimulant drugs.

 

Understanding Down Syndrome

 

Deep inside each cell in our body is all the genetic information needed for life. Human genes are normally organized along forty-six chromosomes -- twenty-three from each parent.

But as a result of a mistake in cell division, some people have three copies of the twenty-first chromosome. There are supposed to be just two.

About one in every seven hundred babies has this extra copy. The name for this condition is Down syndrome. A British doctor named John Langdon Down first described it in the eighteen sixties.

Republican vice presidential candidate Sarah Palin has a son who was born in April with Down syndrome. The Alaska governor and her husband also have four other children who do not have it.

Many babies with Down syndrome have low muscle tone, so they need extra support when they are held. Their heads are smaller than average and they can have unusually shaped ears. Also, their eyes often angle upward.

People with Down syndrome often have other conditions. These include problems with their heart and with their breathing and hearing. But a lot of these conditions are treatable.

As a result, people with Down syndrome are living longer. In nineteen eighty-three, they lived an average of just twenty-five years. Today the average life expectancy is fifty-six.

But that longer life has led to a sad discovery. People with Down syndrome may have an increased risk for Alzheimer's disease at an early age.

The National Down Syndrome Society says an estimated twenty-five percent of those thirty-five and older show signs of Alzheimer's.

In the general population, this brain-wasting disease is usually not found until people are over the age of sixty-five. It slowly destroys memory, thinking and reasoning skills.

Down syndrome is the most common genetic cause of mental retardation. Most people with Down syndrome are mildly to moderately retarded. Many are able to attend regular classes with other students. Later, as adults, many hold jobs and lead independent lives.

An estimated three hundred fifty thousand people in the United States have Down syndrome. There are tests that can be done to look for it during pregnancy.

The risk of Down syndrome is higher for older mothers. The rate for those under thirty is one in one thousand births. In women age forty-four, like Sarah Palin, that number is one in thirty-five.

 

Teenagers and Pregnancy.

 

More than seven hundred thousand teenagers a year get pregnant in the United States. The teen pregnancy rate has fallen thirty-eight percent since the early nineteen nineties.

And the National Campaign to Prevent Teen and Unplanned Pregnancy says the teen birth rate has fallen by almost as much. Six out of ten pregnant teenagers in two thousand six gave birth. 

The nonprofit campaign says these changes have been driven by decreases in sexual activity and increases in contraceptive use.

But it points to recent findings that reductions in teen sex and increases in contraceptive use have leveled off. And the teen birth rate is rising for the first time in fifteen years.

Last week, many Americans talked about the news that the seventeen-year-old daughter of Sarah Palin is pregnant and will get married. Sarah Palin is the governor of Alaska and the Republican nominee for vice president. Campaign officials said the family released a statement because of claims on the Internet that the candidate's baby son was really her daughter's baby.

But there have been other reasons why teen pregnancy has been more of a subject of national discussion lately.

The movie "Juno" came out last December. A teenager gets pregnant and decides to have the baby and give it up for adoption. This comedy about a serious subject won an Academy Award.

And this past June, Jamie Lynn Spears gave birth. The TV star and sister of Britney Spears was sixteen when she got pregnant. Many parents of her young fans were not happy to have to discuss it.

Eight out of ten pregnancies in teenagers are unplanned, compared to half of all pregnancies nationally.

A two thousand one UNICEF report on teenage births in rich nations showed that the United States had the highest rate. But, as a New York Times columnist just noted, the United States did not have the highest rate of sexually active teens. A few others had higher rates. Denmark had the highest. Yet its teen birth and teen abortion rates were much lower than America's.

Part of the debate over what to do about teen pregnancy is how to deal with sex education. Some people argue for an expansion of "abstinence-only" programs. These center on the message that young people should not have sex until marriage. Other people argue that while this may be a good message to teach, it should not be the only one taught in schools.

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New Findings on Children and Mental Illness

 

People who are schizophrenic sometimes hear voices or see things that are not real. They might believe other people want to hurt them. They can become fearful and socially withdrawn.

Schizophrenia is explained on the National Institute of Mental Health Web site as a brain disorder that is severe and disabling. It is also chronic, meaning long term.

The disorder usually appears in males in their late teens or early twenties and in females in their twenties or thirties. Experts say it rarely appears in children, but when it does, it generally affects them more severely than adults.

Children with schizophrenia are often treated with "second-generation" antipsychotic drugs. But do these costly newer drugs work better than older ones that cost less? The National Institute of Mental Health recently paid for a study by four universities in the United States. The research teams found that the answer was no.

They studied one hundred nineteen people between the ages of eight and nineteen. The patients were observed over an eight-week period. Some received risperidone or olanzapine, two newer drugs. Others received a first-generation antipsychotic drug, molindone.

The researchers found that all of the patients experienced about the same improvement. But the risperidone and olanzapine caused serious weight gain.

In fact, the institute cancelled the olanzapine research because the patients who took it gained an average of almost six kilograms. The concern was that the weight gain could lead to diabetes.

The study appeared in the American Journal of Psychiatry.

Past studies have shown that children born to older fathers have a higher risk of schizophrenia as well as autism. Now, scientists are finding evidence of a similar link for bipolar disorder. This disorder is marked by periods of extremes in mood and behavior. It was formerly called manic depression.

A new study in Sweden involved more than thirteen thousand patients with bipolar disorder. Researchers compared them to similar people of the same age and sex who did not have the disorder.

The study found that fathers fifty-five and older were one and a third times more likely to have a bipolar child than fathers twenty to twenty-four. The scientists say the reason could be that older sperm is more likely to cause genetic abnormalities. The findings are in this month's Archives of General Psychiatry.

 

New Findings Add to Health Concerns About a Chemical in Plastics

 

Bisphenol A is a chemical widely used to make hard, polycarbonate plastic. Food storage containers, reusable water bottles and baby bottles are among the many different products that may contain BPA. BPA is also commonly used in protective coverings inside metal food and drink cans.

People can swallow small amounts of BPA as they eat or drink. An industry Web site says more than forty years of safety research shows that products made with bisphenol A are safe.

But others question the safety of BPA. Now, a large study has linked it to diabetes and heart disease in adults.

Researchers divided almost one thousand five hundred American adults into four groups based on BPA levels in their urine. All the levels were within the limits considered safe by the United States Food and Drug Administration. Yet the study found that the highest group was more than twice as likely as the lowest group to have heart disease or diabetes, or both.

The Food and Drug Administration and chemical industry officials said the study does not show that bisphenol A caused the diseases. The researcher who led the study, David Melzer at England's University of Exeter, agrees. He says the findings must be reproduced and that other studies are also needed.

But he also says that if BPA is a cause of these conditions, then just reducing contact with it might prevent some cases. The study appeared last week in the Journal of the American Medical Association.

Earlier this month, United States government scientists from the National Toxicology Program released a final report on BPA. They found that the chemical is of "some concern" for effects on development of the prostate gland and brain in fetuses, infants and children. They made the same finding for behavioral effects.

The scientists based their findings mostly on studies of laboratory animals. Even so, the program director said "the possibility that BPA may affect human development cannot be dismissed."

In April, Canada became the first country to propose a ban on plastic baby bottles that contain BPA. The government has said it will publish its final decision by October eighteenth.

Some plastic goods are now being marketed as BPA-free. But some people wonder whether any other chemicals that might take its place are any better.

New Money for Malaria

 

Governments, businesses and other groups have promised to add three billion dollars to the fight against malaria. The promises came last week at a meeting at the United Nations in New York.

The money will support a new Global Malaria Action Plan. The plan aims to stop the disease in Africa by two thousand fifteen. Malaria is not limited to Africa, but ninety percent of deaths happen south of the Sahara. British Prime Minister Gordon Brown said the plan will not only support bed nets, but research, cutting drug costs and expanding health care systems.

Governments and international groups spent a billion dollars on malaria programs last year. But the Roll Back Malaria Partnership says the world should spend more than five times that amount. It says doing so could save four million lives by two thousand fifteen. The partnership includes United Nations agencies, the World Bank and leading drug makers.

Earlier this month, the World Health Organization released its World Malaria Report for two thousand eight. The report presented sharply lower estimates of malaria cases than in the past. W.H.O. officials say the corrections were mostly the result of better methods of collecting information.

Until now, the agency has said there were as many as five hundred million infections every year, with a million deaths. The new report estimates the number of malaria cases in two thousand six at about two hundred fifty million. And it estimates the number of deaths at eight hundred eighty-one thousand. The great majority who die are young children.

The W.H.O. says the old numbers came from using malaria maps from the nineteen sixties. But changes have taken place, including the movement of people to cities, especially in Asia. The disease is less common in urban areas.

The report says malaria deaths have decreased in several countries, and a few African nations have reduced deaths by half. Yet the malaria drugs needed for what is known as artemisinin-based combination therapy reached only three percent of African children in need.

In the last two years, though, there have been greatly increased efforts to provide families with bed nets. These nets are treated with insecticides to kill the mosquitoes that spread malaria. Campaigns for indoor spraying of insecticides in homes have also increased in Africa and elsewhere.

 

Fat Cell Gene Linked to Colon Cancer

 

A new study has found that a fat cell gene may reduce the risk of colon cancer in some people. The study provides what scientists say is the first evidence of a genetic link between a fat cell gene and colon cancer. The research could lead to better tests for the disease as well as measures to help prevent it.

Current evidence suggests a relationship between obesity, insulin resistance and colon cancer risk. The scientists say what they have found now is an area of a gene that is connected with the cancer risk. They say this area is most likely not the cause of the disease, but they think it is where the connection comes from.

The gene is involved in the formation of a hormone called adiponectin. Some people have higher levels of this hormone in their blood, others have lower levels. Higher levels have been linked with lower rates of obesity and insulin resistance. And lower levels have been linked with higher rates.

The Journal of the American Medical Association published the new findings last week. Boris Pasche from the Comprehensive Cancer Center at the University of Alabama at Birmingham led the research.

Colon cancer is one of the leading causes of cancer deaths. Every year it kills almost six hundred eighty thousand people around the world. And doctors find more than one million new cases. The disease is highly treatable if discovered early.

The research involved two studies with a total of about one thousand five hundred people. The larger of the two studies involved New Yorkers of Ashkenazi Jewish ancestry. Colon cancer is more common in Jews of eastern European ancestry than in the general population. The other study involved people of different ethnicities from Chicago, Illinois.

Currently, in the United States, the general advice is for colonoscopy tests for colon cancer to begin at the age of fifty. A colonoscopy can find and remove growths before they become cancerous. But the test is invasive and can be uncomfortable.

A study last month in the New England Journal of Medicine expressed support for a test called a virtual colonoscopy. It uses X-ray and computer technology to search for growths, but cannot remove them. There are still some questions about the effectiveness of a virtual colonoscopy compared to a traditional one. But doctors hope it might appeal to people who would otherwise not be tested at all.

 

Hand Washing: So Important, It Gets a Day Of Its Own

 

Wednesday, October fifteenth, is the first Global Handwashing Day. Activities are planned in more than twenty countries to get millions of people in the developing world to wash their hands with soap.

For example, private donors will give one hundred fifty thousand bars of soap to schools in Ethiopia. The Education Ministry wants one million schoolchildren to wash their hands for Wednesday's event.

Experts say people around the world wash their hands but very few use soap at so-called critical moments. These include after using the toilet, after cleaning a baby and before touching food.

Global Handwashing Day is the idea of the Public-Private Partnership for Handwashing with Soap. Partners include the United Nations Children's Fund, American government agencies, the World Bank and soap makers Unilever and Procter and Gamble. The goal, they say, is to create a culture of hand washing with soap.

The organizers say all soaps are equally effective at removing disease-causing germs. They say the correct way to wash is to wet your hands with a small amount of water and cover them with soap. Rub it into all areas, including under the fingernails. Rub for at least twenty seconds.

Then, rinse well under running water. Finally, dry your hands with a clean cloth or wave them in the air.

The Partnership for Handwashing says soap is important because it increases the time that people spend washing. Soap also helps to break up the grease and dirt that hold most of the germs. And it usually leaves a pleasant smell, which increases the likelihood that people will wash again.

The partnership says washing with soap before eating and after using the toilet could save more lives than any vaccine or medicine. It could help reduce cases of diarrhea by almost half. And it could reduce deaths from pneumonia and other breathing infections by one-fourth.

Diarrhea is the second leading cause of child deaths, killing more than one and a half million children a year. Pneumonia is the leading cause, killing about two million children under five each year. Hand washing can also prevent the spread of other diseases.

When people get germs on their hands, they can infect themselves by touching their eyes, nose or mouth. Then they can infect others.

 

Colds, Flu and Folk Advice

 

Autumn and winter are cold and flu season -- when people are most likely to catch the viruses that cause influenza and the common cold.

Is the old advice true that dressing warmly will help prevent a cold? Or if you do get sick, should you follow the old saying, "Feed a cold and starve a fever"?

And what about that fever? Should you take medication to reduce your temperature, or is it better to let the body treat the infection itself?

Everyone seems to have an answer. But how much value is there in popular wisdom?

Doctor Alvin Nelson El Amin knows a lot about cold and flu season in California. He is medical director of the immunization program for the Los Angeles County Department of Public Health.

Doctor Nelson El Amin says research may be just starting to provide evidence for long-held beliefs. For example, scientists for years dismissed the idea that getting cold and wet might cause colds or flu.

But recent studies have shown that cold temperatures cause stress on the body. That stress can create conditions more inviting to viruses. So maybe it does make sense to wrap up warmly before going outside.

And what about the advice to feed a cold and starve a fever? Doctor Nelson El Amin says if you have a cold and are hungry, you should eat. But a fever, especially a high one, suggests a more serious problem. He says people are usually not hungry anyway when they have a high fever. Eating might even cause a person to vomit. But drinking plenty of liquids is important. A fever can easily dehydrate the body.

Finally, when should you treat a fever? Doctor Nelson El Amin says a fever should be treated if it stays at forty degrees centigrade or above for a day or more. A temperature that high can damage brain cells. The doctor also believes in treating a fever if it prevents a person from sleeping.

Aspirin, acetaminophen and ibuprofen can all be used to reduce pain and fever. But aspirin should not be given to children because it can cause a rare condition.

One belief that Doctor Nelson El Amin wanted to make clear is wrong is that influenza vaccine can cause the flu. It cannot. Sometimes people get the flu from another person soon after they get vaccinated, so they blame the vaccine, he says.

But, flu vaccines do not protect everyone who gets them. Still, even if a person does get sick, the vaccine can limit the effects of the virus.

 

Almost Half of All Deaths Are in People Under 60

 

A new study from the World Health Organization says fifty-nine million people died from all causes in two thousand four. Ten million of them were children.

The report says almost half of all the people who died were under the age of sixty. About twenty percent of them were under fourteen.

Colin Mathers was the lead author of the study. He is the W.H.O.'s coordinator for epidemiology and burden of disease. He says the research points to major differences around the world.

COLIN MATHERS: "Africa stands out. The burden of disease, premature mortality is twice as high as for other developing regions in the world. And a substantial component of that burden is because of the high levels of child mortality in Africa compared to other regions. Half of all deaths in Africa are children under fifteen to compare with high income countries where one percent of deaths are under fifteen -- a huge difference."

The number one cause of death around the world is heart disease, followed by strokes. Four of the ten leading causes of death worldwide are infectious diseases. These are pneumonia, infectious diarrhea, H.I.V./AIDS and tuberculosis. Other leading causes of death are lung disease, cancers of the windpipe and lungs, road accidents and low birth weight.

The research also shows that between the ages of fifteen and sixty, men have a much higher risk of death than women. The researchers say this is mainly because of injuries from violence, including war.

The study found that the Middle East produced fifty-five percent of the world's war dead in two thousand four. The Middle East has about eight percent of the world population.

Africa has the highest risk of death for men under sixty, followed by eastern Europe. The report says early deaths in Eastern Europe are mostly the result of injuries and heart and lung disease. But deaths from accidental alcohol poisoning are also common.

Worldwide, almost fifteen percent of deaths in women of reproductive age in two thousand four were related to pregnancy. More than five hundred thousand women died of preventable problems during pregnancy or childbirth.

Another finding in the report is a prediction that by two thousand thirty, tobacco will cause ten percent of all deaths worldwide.

 

Treating Anxiety Disorders in Children | Long-Term Risks of Teen Alcohol Use

 

Children's mental health was the subject of two recent studies. One involved treatment of anxiety disorders, the other examined long-term effects of alcohol use in teenagers.

The first study involved about five hundred children in the United States, ages seven to seventeen. They had moderate to severe disorders involving worries and fears.

For treatment, one group received Zoloft, an antidepressant drug. Another group received cognitive behavioral therapy, sometimes called the talking treatment. Therapists taught the children about anxiety and guided them through structured tasks to help them face their fears.

A third group received both the medicine and the therapy.

John Walkup at the Johns Hopkins Medical Institutions in Maryland was the lead author. He says the study clearly showed that combination treatment was the most effective. Eighty-one percent of the children treated with both medicine and cognitive behavioral therapy improved.

But Doctor Walkup says the medicine or therapy alone also showed good results. Sixty percent of the therapy-only group improved, as did fifty-five percent of the Zoloft-only group.

For comparison, a fourth group received a placebo. The children took sugar pills thinking it was medicine. Twenty-four percent of them also improved.

The National Institute of Mental Health paid for the study. The New England Journal of Medicine published it.

The alcohol study appeared in the journal Psychological Science. The lead researcher was Candice Odgers of the University of California, Irvine. She used records from a major health study of one thousand people born in New Zealand in the early nineteen seventies.

She found that people who experiment with alcohol before they are fifteen are more likely to become addicted to alcohol or other drugs. This was true even in teens with no family history of drug dependence. They are also more likely to have behavior problems, fail in school, commit crimes and get pregnant at a young age.

Just this week, a Rand Corporation study in the journal Pediatrics linked sexual content on television shows to teen pregnancy. Girls and boys who watch a lot of it were twice as likely as others to be involved in a pregnancy over the following three years.

 

Obama Team Reviews Bush's Order on Stem Cells

 

Bethesda, Maryland, near Washington, D.C., is home to the National Institutes of Health. N.I.H. calls itself "the Nation's Medical Research Agency." But it supports research worldwide with its budget of almost twenty-nine billion dollars.

Federal agencies will get new leaders when Barack Obama is president. But the head of N.I.H. resigned early. Elias Zerhouni left at the end of October after six and a half years as director.

For now, the acting director is Raynard Kington. Doctor Kington has been deputy director for the past five years. Directors are appointed by the president and confirmed by the Senate.

The National Institutes of Health had strong financial support during Doctor Zerhouni's first two years. But Congress did not increase the budget very much after that.

Albert Reece is dean of the University of Maryland medical school. He says that since two thousand four, N.I.H.'s budget has been reduced by more than thirteen percent after considering inflation.

Doctor Reece, writing in the Baltimore Sun, urged President-elect Obama to increase the funding. It would not only improve the nation's health, he says, but also help restart the economy. Medical centers funded by N.I.H., he said, support more than three million full-time jobs.

Right now, the Obama team is looking at executive orders signed by President Bush. Those that conflict with Mister Obama's positions could be canceled or amended. One area being looked at is stem cell research. Stem cells can grow into any kind of tissue in the body.

President Bush has restricted federal support for research on embryonic stem cells because of his beliefs about protecting life. Others say the embryos would be destroyed anyway because they are unused embryos from fertility clinics.

Mister Obama says the research may lead to improved treatments for Alzheimer's disease and other conditions. He says other treatments being studied are not substitutes for research on embryonic stem cells. He has called for expanded federal support.

Doctor Zerhouni told Congress last year that he thought the limits were interfering with research.

Political appointees have to resign when the administration changes in January. But Elias Zerhouni says he left before the election so the next president would have to start thinking early about N.I.H. He says he wants to work on writing projects and explore other professional opportunities.

 

Health: Keeping Ears Clean

 

Some people's ears produce wax like busy little bees. This can be a problem even though earwax appears to serve an important purpose.

Experts say it protects and cleans the ear. It traps dirt and other matter and keeps insects out. Doctors think it might also help protect against infections. And the waxy oil keeps ears from getting too dry.

So earwax is good. It even has a medical name: cerumen. And there are two kinds. Most people of European or African ancestry have the "wet" kind: thick and sticky. East Asians commonly have "dry" earwax.

But you can have too much of a good thing.

The glands in the ear canal that produce the wax make too much in some people. Earwax is normally expelled; it falls out of the ear or gets washed away. But extra wax can harden and form a blockage that interferes with sound waves and reduces hearing.

People can also cause a blockage when they try to clean out their ears -- but only push the wax deeper inside. Earwax removal is sometimes necessary. But you have to use a safe method or you could do a lot of damage.

Experts at N.I.H., the National Institutes of Health, suggest some ways to treat excessive earwax yourself. They say the wax can be softened with mineral oil, glycerin or ear drops. They say hydrogen peroxide or carbamide peroxide may also help.

Another way to remove wax is known as irrigation. With the head upright, take hold of the outer part of the ear. Gently pull upward to straighten the ear canal. Use a syringe device to gently direct water against the wall of the ear canal. Then turn the head to the side to let the water out.

The experts at N.I.H. say you may have to repeat this process a few times. Use water that is body temperature. If the water is cooler or warmer, it could make you feel dizzy. Never try irrigation if the eardrum is broken. It could lead to infection and other problems.

After the earwax is gone, gently dry the ear. But if irrigation fails, the best thing to do is to go to a health care provider for professional assistance.

You should never put a cotton swab or other object into the ear canal. But you can use a swab or cloth to clean the outer part of the ear. The experts agree with the old saying that you should never put anything smaller than your elbow in your ear.

 

Feeling No Pain: The World of Anesthesia

 

Anesthesia is used during operations and other medical procedures to block pain signals from traveling through the nervous system. The kind of anesthesia that patients receive depends on their condition and the kind of procedure they need.

Local anesthesia is used to make a small area of the body lose feeling. Usually, local anesthesia is for minor procedures, like fixing a tooth or closing a wound. The person remains fully awake.

Regional anesthesia is used to block pain in a large area of the body. For example, when a woman is giving birth, she might request an epidural anesthesia. It is injected into the fluid in the spine. It acts on the lower half of the body.

General anesthesia makes a person fall asleep. This is known as being "put under." The drugs are injected into the blood or breathed as gas. General anesthesia also blocks memory.

People are not supposed to remember an operation when they wake up. In rare cases, they do. The Mayo Clinic says patients may have a sense of their surroundings during about one-fifth of one percent of all operations. It says they generally do not feel pain, but may wish to talk to a mental health provider if the memories trouble them.

An anesthesiologist is a doctor specially trained to give anesthesia. During an operation, the anesthesiologist will observe the patient's heart rate, blood pressure and amount of oxygen in the blood. A breathing tube may be put into the person's windpipe. The tube is connected to a respirator machine.

There are, of course, risks to anesthesia. People can have different reactions to the drugs. Mistakes can happen. But medical experts say the safety of anesthesia has greatly improved.

The Mayo Clinic says not too long ago, one in ten thousand cases resulted in death. Now, it says, the number is one in two hundred fifty thousand.

The experts say everyone's experience with anesthesia is different. To reduce the risks, the Mayo Clinic says open communication is important among the patient and the doctors before an operation.

Patients can expect questions like: What is your current health? What medications do you take? Do you smoke or drink alcohol? Do you know if you have any allergies to foods or medicines? And what experiences have you had in the past with anesthesia?

 

نوشته شده در Mon 1 Dec 2008ساعت 11:2 PM توسط سیندرلا| |