Archive for July, 2010

What the Heck is Fibermyalgia?

July 25th, 2010
Nathan Wei asked:




The cause of fibromyalgia (FM) is unknown but theories pointing toward abnormal hypothalamic pituitary axis function or dysfunction of neurotransmitter pathways in the brain are currently popular.

Several studies have demonstrated different abnormalities in central nervous system functioning. Abnormal sleep studies showing alpha intrusion during delta (stage 4) sleep and a reduction of rapid eye movement (REM) sleep have been seen. In addition, abnormal SPECT scans have suggested lower blood flow to the thalamus and caudate nucleus in the brains of fibromyalgia patients.

Approximately 2 percent of the population has fibromyalgia. About 80 percent of patients with fibromyalgia are women. While fibromyalgia may occur as a primary condition, it is also a secondary condition, occurring in as many as 30 percent of patients with systemic lupus erythematosus and rheumatoid arthritis.

Patients with fibromyalgia complain of generalized pain affecting both sides of the body and both the upper as well as lower part of the body.

Pain tends to be aggravated by weather changes as well as by stress.

While patients will complain of subjective joint swelling, objective swelling is absent.

Sleep disturbance occurs in almost all patients. Complaints of chronic fatigue and non restorative sleep (feeling as if they haven’t slept) are common. Sleep apnea may aggravate the situation.

Tender trigger points are noted in all patients. A patient with 11 of 18 tender trigger points fulfills a major diagnostic criterion for the diagnosis of fibromyalgia. These trigger point tender areas are stereotypic meaning the same areas are tender in all patients with the diagnosis of FM..

Other symptoms include migraine headache, decrease in short term memory, cognitive dysfunction, blurred or double vision, hypersensitivity to sound and smells, shortness of breath, chest pains, palpitations, irritable bowel, irritable bladder, painful menses, painful urination, multiple drug allergies, multiple sensitivities to chemicals.

Laboratory testing will not be diagnostic. However, laboratory testing will help to exclude other conditions such as polymyalgia rheumatica, hypothyroidism, rheumatoid arthritis, systemic lupus erythematosus, etc., that might masquerade as fibromyalgia. FM is a diagnosis of exclusion so it is imperative that other possible causes of aches and pains are ruled out.

Imaging tests may also be helpful in establishing the presence or absence of FM.

Treatment must be individualized. Most patients will respond to a combination of non impact aerobic exercise (swimming, stationary bike, elliptical trainer), cognitive behavioral therapy, and medication.

Medications that have been found to be helpful include tricyclic antidepressants in low doses, muscle relaxants such as cyclobenzaprine, also in low doses, and selective serotonin reuptake inhibitors (SSRIs).

Other medicines such as gabapentin and tramadol may also be helpful.

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Is Your Antidepressant and Reflux Disease Linked?

July 25th, 2010
Kathryn Whittaker asked:




There could be a link between antidepressant and reflux disease. Therefore, if you take antidepressants and are suffering from frequent acid reflux/GERD (gastroesophageal reflux disease), your antidepressant medication could be contributing to the symptoms you are experiencing.

Researchers have discovered that a link between antidepressant and acid reflux does in fact exist. Of course, there are different types of antidepressants and not all of them cause or exacerbate symptoms. The type of antidepressant that has been most commonly linked with GERD is known as Tricyclic antidepressants (TCAs). TCAs are a certain type of antidepressant designed to provide relief from symptoms related to depression such as sadness and irritability.

Tricyclic antidepressants work to restore and balance chemicals within the brain to help treat and prevent depression. However, though effective, these antidepressants also have a number of potential side effects including an increased risk of acid reflux. This link exists because the neurotransmitters the TCAs work on in the brain are the same as those found in the stomach.

Thus, both the brain and stomach are equally affected, which means when the TCAs slow down and relax the muscles in the brain, they also slow down and relax the muscles in the stomach. Hence, the lower esophageal sphincter (LES) becomes relaxed, allowing the contents within the stomach to be refluxed back into the esophagus. In addition, the slowing down of stomach muscles can also cause delayed stomach emptying allowing acid to remain longer, increasing the chance of reflux.

The most common symptom to watch for if you think your antidepressant medication may be affecting you is heartburn. Heartburn is characterized by a painful, burning sensation within the upper chest.

Though there are other antidepressant medications, tricyclic antidepressants are commonly prescribed to treat a variety of depression disorders. If you are on any of the TCAs that have been approved by the FDA (Food and Drug Administration) for depression and you suffer from GERD, or are noticing an increase in your acid reflux symptoms (I.E. frequent heartburn), you need to bring this to your doctor’s attention.

Tricyclic antidepressants include: Amitriptyline, Amoxapine, Desipramine, Doxepin, Imipramine, Nortriptyline, Protriptyline, and Trimipramine.

Your doctor may be able to suggest or approve another type of medication to treat depression to reduce the chance of reflux disease, however this attempt at switching medications may be unsuccessful. The reason is because there are diverse antidepressant drugs and everyone responds differently to medications. Thus, what works well for someone, may not be beneficial to another. Therefore, if TCAs are the only meds that work for you in terms of bringing depression under control, your only option is to try other methods to prevent or control acid reflux.

To help limit and prevent symptoms try the following:

Increase your intake of water Limit or stop consuming alcoholic beverages Stop smoking Eat frequent and smaller portions of food. Avoid foods that can trigger acid reflux or make it worse (i.e. spicy, fatty foods, chocolate, mint, caffeine, citrus fruits and juices) Refrain from lying down or exercising at least one hour after eating Sleep with your head elevated 4 inches to prevent reflux from occurring while sleeping. Manage your stress. Stress can exacerbate GERD symptoms, learn how to reduce your stress by finding ways to relax and release your tension.

Finally, be sure to talk to your doctor about your antidepressant and reflux disease concerns. He or she may be able to help you find a method of acid reflux treatment that works well for you.

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The Advantages and Disadvantages of Pre-Employment Drug-Screens

July 25th, 2010
Breckenridgeconservatories.co.uk asked:




Many organizations consider pre-employment drug screening as an effective strategy to save their workplace from unwanted conflicts due to the drug abusers. Pre-employment drug screening is a proactive measure companies take to maintain high productivity environment. It helps them to make the workplace safer, and their employees free from frequent sick leaves and to prevent drug abuse on the job.

The Advantages of Pre-Employment Drug Screens

Pre-employment drug testing has many advantages.

•    Pre-employment drug testing helps organizations to check drug-abuse habits of the job applicants. Thus, it helps them to avoid hiring people with habit of frequent drug abuse.

•    Pre-employment drug testing not only helps organizations to create a safer and drug-free workplace but also reduces or avoids their chances of handling any future conflicts due to the drug abused employees in their organization. These conflicts include workplace violence or accidents, health benefit utilization and costs, lowered productivity, high insurance premiums, and frequent health-related absences.

•    The pre-employment drug-screening program in an organization also has an ample potential to drive the drug abusers away from applying in it. This can be very helpful for small and medium businesses where drug abusers are more likely to apply, as they don’t need to invest much of their time and money on such applicants.

Drawbacks of pre-employment drug screens

Though pre-employment drug screening has many advantages, there are some issues associated with it.

•    The major drawback of drug screening is its sample collection process where job applicants are likely to feel violation of their privacy. This increases the hassle for organizations of handling the screening more sensitively.

•    Some drugs such as marijuana remain detectable for up to three weeks after their usage. Some other drugs such as cocaine might remain only for few hours after usage. Thus, making a hiring decision based on these results requires much caution as it may affect the career of a job applicant.

•    There are some possibilities of prescription-drugs affecting the drug-testing results. Organizations     discriminating a job applicant based on the prescription drug-abuse could be violating the Americans with Disabilities Act.

Some latest advances in medical testing have resulted in evolvement of certain drug-screening products, which are easy to monitor, adulteration proof, affordable, and provide instant and reliable results. These enable organizations to conduct pre-employment drug-screening effectively, with a decreased potential of drawbacks.



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