Sunday, July 8, 2012

What Is Polio? What Causes Polio?

Polio, or poliomyelitis, is a highly contagious viral infection that can lead to paralysis, breathing problems, or even death. The term poliomyelitis is from the Greek poliós meaning "grey", myelós referencing the spinal cord, and -itis meaning inflammation.

Polio can be classified as either symptomatic or asymptomatic. About 95% of all cases display no symptoms (asymptomatic polio), and between 4% and 8% of cases display symptoms (symptomatic polio). Symptomatic polio can be broken down further into a mild form called nonparalytic or abortive polio and a severe form called paralytic polio (occurring in 0.1% to 2% of cases).

Paralytic polio also may be classified as:
  • Spinal polio - attacks motor neurons in the spinal cord and causes paralysis in arms and legs and breathing problems

  • Bulbar polio - affects neurons responsible for sight, vision, taste, swallowing, and breathing

  • Bulbospinal polio - both spinal and bulbar polio
Many people with nonparalytic polio are able to make a full recovery, while those with paralytic polio generally end up with permanent paralysis.

Who gets polio?

Like many other infectious diseases, polio victims tend to be some of the most vulnerable members of the population. This includes the very young, pregnant women, and those with immune systems that are substantially weakened by other medical conditions. Anyone who has not been immunized against polio is especially susceptible to contracting the infection.

Additional risk factors for polio include traveling to places where polio is endemic or widespread, living with someone infected with polio, working in a laboratory where live poliovirus is kept, and having your tonsils removed.

What causes polio?

Polio is caused by the poliovirus, a highly contagious virus specific to humans. The virus usually enters the environment in the feces of someone who is infected. In areas with poor sanitation, the virus easily spreads through the fecal-oral route, via contaminated water or food. In addition, direct contact with a person infected with the virus can cause polio.

What are the symptoms of polio?

Polio, in its most debilitating forms, displays symptoms such as paralysis and death. However, most people with polio don't actually display any symptoms or become noticeably sick. When symptoms do appear, there are differences depending on the type of polio.

Nonparalytic polio (abortive poliomyelitis) leads to flu-like symptoms that last for a few days or weeks, such as fever, sore throat, headache, vomiting, fatigue, back and neck pain, arm and leg stiffness, muscle tenderness, muscle spasms, and meningitis.

Paralytic polio will often begin with symptoms similar to nonparalytic polio, but will progress to more serious symptoms such as a loss of muscle reflexes, severe muscle pain and spasms, and loose or floppy limbs that is often worse on one side of the body.

How is polio diagnosed?

Polio is often recognized because of symptoms such as neck and back stiffness, abnormal reflexes, and trouble with swallowing and breathing. A physician who suspects polio will perform laboratory tests that check for poliovirus using throat secretions, stool samples, or cerebrospinal fluid.

How is polio treated?

There is no cure for polio once a person becomes infected. Therefore, treatments are focused on increasing comfort, managing symptoms, and preventing complications. This may include providing bed rest, antibiotics for additional infections, pain killers, ventilators to help breathing, physiotherapy and moderate exercise, and a proper diet.

One treatment for lung paralysis due to polio was to place the patient into an iron lung - a device that would push and pull chest muscles to make them work. However, more modern portable ventilators and jacket-type ventilators are now employed.

How can polio be prevented?

Although polio essentially has been eradicated in the US since 1979 and in the Western Hemisphere since 1991, children and adults in Afghanistan, India, Nigeria, and Pakistan are still contending with the disease. There are two vaccines available to fight polio - inactivated poliovirus (IPV) and oral polio vaccine (OPV).

IPV, which consists of a series of injections beginning two months after birth and continuing until a child is 4 to 6 years old, is provided to most children in the United States. The vaccine is created from inactive poliovirus, but it is very safe and effective and cannot cause polio. OPV is created from a weakened or attenuated form of poliovirus, and it is the vaccine of choice in many countries because of its low cost, ease of administration, and ability to provide excellent immunity in the intestine. OPV, however, has been known to revert to a dangerous form of poliovirus that is able to paralyze its victim.

Polio vaccinations or boosters are highly recommended in anyone who is not vaccinated or is unsure if she is vaccinated.
Continue to Read more ...

What Is COPD? What Is Emphysema?

Chronic obstructive pulmonary disease (COPD) is a chronic disease that makes it hard for the patient to breathe. It is a progressive disease - meaning, it gets worse with time. A patient with COPD coughs a lot; the coughing brings up a large amount of mucus (some patients might not cough a lot, see paragraph about this further down). The patient will most likely wheeze, be short of breath, experience tightness of the chest, as well as other symptoms.

The majority of people who suffer from COPD are either current regular smokers or people who used to smoke regularly. Air pollution, chemical fumes, and/or dust may also contribute to the development of COPD. However, smoking is by far the largest factor.

Understanding COPD and Emphysema

To understand COPD it is necessary to know how the lungs work. When you breathe in, the air goes down your windpipe into tubes in your lungs - these tubes are called bronchial tubes or airways. The airways look like upside down trees or broccoli, with several branches. At the end of the branches are tiny air sacs called alveoli.

The airways and alveoli are flexible (elastic). When you breathe in they fill up with air like a balloon, when you breath out they deflate.

The airways and alveoli of a person with COPD do not get as much air as those of a person who does not have COPD. This could be due to one or more of the following reasons (In the USA and many other countries COPD includes emphysema and chronic obstructive bronchitis):
  • The airways and alveoli become less elastic
  • The walls between many of the alveoli are destroyed
  • The walls of the airways swell up (they become inflamed)
  • The airways become clogged up with excess mucus
  • The walls between many alveoli are damaged when a patient has emphysema. This causes them to lose their shape and become floppy. As the walls become totally destroyed, the patient ends up with a few large alveoli instead of many small ones
  • In chronic obstructive bronchitis, the patient's airway lining is permanently irritated and inflamed. The lining consequently thickens. Thick mucus builds up in the airways, making it harder for the patient to breathe.
  • The majority of COPD patients suffer from both chronic obstructive bronchitis and emphysema. In such cases the term COPD is more accurate.

How common is COPD?

COPD is the fourth major cause of death in the USA. Over 12 million Americans have been diagnosed with COPD. Health experts believe there could be another 12 million American who suffer from COPD but have not been diagnosed.

COPD develops gradually over a long period - it gets worse with time. Eventually, the patient finds it very hard and/or impossible to do routine activities. A person with severe COPD may not even be able to walk or cook.

COPD is nearly always diagnosed when the patient is middle-aged or elderly.

There is no cure for COPD. Once the damage to the airways and lungs has occurred, there is currently no way to reverse it. Measures can be taken to slow down the progression of the disease.

What causes COPD?

Approximately 80% to 90% of patients have COPD because of smoking. COPD can also be caused by air pollution, having repeated lung infections as a child, second-hand smoke (passive smoking), and a rare genetic disorder called Alpha-1 antitrypsin deficiency.

What are the Symptoms of COPD?

  • shortness of breath
  • coughing up a lot of phlegm (mucus)*
  • a general feeling of tiredness
  • frequent chest infections (flu, colds, etc)
*Some COPD patients don't cough much and don't bring up much mucus

Some patients with COPD never cough very much and when in hospital can barely produce enough sputum to cover half a teaspoon. Coughing up sputum and coughing in general appears to be less prevalent in those with Emphysema and of course, very common in patients with Chronic Bronchitis, both of which come under the COPD umbrella. If you don't cough or bring up mucus it does not necessarily mean you don't have COPD.

It is common for people to confuse the onset of COPD with the normal symptoms of getting older, such as tiredness and shortness of breath. It is important to get yourself diagnosed if you experience any of these symptoms.

How do I prevent COPD?

Do not smoke. If you smoke, give up. It is never too late to give up smoking.

If I already have COPD is it too late to give up smoking?

It is never too late to give up smoking. Quitting smoking will slow down the progression of COPD.

How is COPD treated?

  • the patient stops smoking
  • the patient has medications, including pills, inhalers (puffers) and supplemental oxygen
  • the patient joins a pulmonary rehabilitation class - a specialized exercise program

What is COPD? - video

A video explaining about COPD, together with diagrams. Video by Illumistream.

View Here

How long does a COPD patient live?

A patient who is diagnosed with COPD can live for a long time after diagnosis - this may depend on many things, including:
  • the patient's age
  • how severe the lung damage is
  • whether the smoking is stopped or cut down
  • what type of medical care and treatment the patient receives
  • what other health problems the patient might have
Continue to Read more ...

What Are Cataracts? What Causes Cataracts?

Cataracts are cloudy areas in the lens inside the eye - which is normally clear. Cataracts can develop in one or both eyes. If they develop in both eyes, one will be more severely affected than the other. A normally clear lens allows light to pass through to the back of the eye, so that the patient can see well-defined images. If a part of the lens becomes opaque light does not pass through easily and the patient's vision becomes blurry - like looking through cloudy water or a fogged-up window. The more opaque (cloudier) the lens becomes, the worse the person's vision will be.

According to Medilexicon's medical dictionary, cataract is "Complete or partial opacity of the ocular lens.".

There are two types of cataracts:

  • Age related cataracts - they appear later in life; the most common form.

  • Congenital cataracts (childhood cataracts) - these may be present when the baby is born, or shortly after birth. Cataracts may also be diagnosed in older babies and children - these are sometimes referred to as developmental, infantile or juvenile cataracts. Researchers from the University Zurich were the first to identify the chromosomal location and exact molecular defect in the coding region of the gene responsible for a childhood cataract.
The rest of this article focuses just on age-related cataracts.

A patient with cataracts will eventually find it hard to read, or drive a car - especially during the night. Even seeing people's facial expressions becomes difficult. Cataracts are not usually painful. The patient's long-distance vision is more severely affected at first.

As cataracts develop very slowly most people do not know they have them at first. However, the clouding progresses and vision will gradually get worse. Stronger lighting and eyeglasses can help improve vision. Nevertheless, eventually the vision impairment affects the patient's ability to carry out everyday tasks. At this point the individual will need surgery. Fortunately, cataract surgery is usually a very effective and safe procedure.

Cataracts cause more vision problems globally than any other eye condition or disease - especially in developing countries, where they are much more common among poor people, according to a study carried out in Kenya, The Philippines, and Bangladesh.

Some studies indicate that cataracts are more common among elderly people further down the socioeconomic ladder in the USA - prevalence of cataracts causing significant visual problems appears high among older U.S. Hispanics who also often encounter barriers to access to care (in the USA "Hispanics" refers to Americans of Latin American origin, not people who originate from Spain).

Both men and women are affected equally.

According to the National Health Service (NHS), UK, approximately one third of people aged 65 or over have cataracts in one or both eyes.

Factors that may increase the risk of developing cataracts

We are all at risk of developing cataracts because we will all get old one day - the greatest risk factor is age. In the USA approximately 50% of people aged 65 or more have some degree of lens clouding. 70% of Americans aged 75 or more have their vision significantly impaired by cataracts.

Researchers at the Wilmer Eye Institute at The Johns Hopkins Medical Institutions, Baltimore predicted that the number of people in the USA affected by cataracts is estimated to rise to 30.1 million people in the next 20 years, an increase of 50 percent, because people will live longer.

The following factors may increase a person's chances of developing cataracts:
  • Age

  • Close relatives who have/had cataracts (family history)

  • Diabetes

  • Ionizing radiation exposure - airline pilots have an increased risk of nuclear cataracts compared with non-pilots, and that risk is associated with cumulative exposure to cosmic radiation, scientists from the University of Iceland reported.

    The five-year incidence of nuclear cataract was 40% lower for statin users after adjusting for several factors, compared to non-statin users, another study found.

  • Long-term exposure to bright sunlight

  • Long-term use of corticosteroids - many people with asthma rely on inhaled, and sometimes oral, steroids, as do people with chronic obstructive pulmonary disease. A study conducted by the Centre for Vision Research, University of Sydney, Australia, revealed that cataract risk is higher for patients taking these medications.

  • Previous eye inflammation

  • Previous eye injury

  • Exposure to lead - lifetime lead exposure may increase the risk of developing cataracts, scientists from the National Institute of Environmental Health Sciences, USA revealed.

  • Crystallins loss of function - A specific type of protein (crystallins) begins to lose function as the eye ages. As the protein loses function, small peptides, made of 10 to 15 amino acids, start forming and accelerate cataract formation in the eye, a study revealed.

What are the symptoms of age-related cataracts?

Symptoms usually creep up many years after onset - usually when the person is elderly. Progressively, more of the lens becomes cloudy. People with mild cataracts will not notice they have it for a long time.

Cataracts often affect both eyes, but rarely equally.

People with cataracts may have the following symptoms:
  • Blurry, cloudy, or misty vision.

  • Some describe it as similar to looking through frosted glass.

  • Vision may be affected by small spots or dots.

  • The patient sees small patches which blur parts of his/her field of vision.

  • Vision gets worse when lights are dim.

  • Vision is sometimes worse when light is very bright (glare).

  • Some people with cataracts also comment that colors appear less clear and faded.

  • Reading becomes very difficult, and eventually impossible.

  • Glasses need to be changed more frequently.

  • Eventually wearing glasses becomes less effective.

  • In some rare cases patients can see a halo around bright objects, such as car headlights or street lights.

  • Double vision in one eye (rare).
As the person's vision deteriorates, and the glare of oncoming headlights and street lights gets worse, driving becomes awkward and potentially very dangerous - research carried out by optometrists and psychologists in Australia shows that motorists suffering from cataracts are less able to spot potentially dangerous hazards on the roads. Drivers with cataracts eventually start suffering from eyestrain and find themselves blinking more frequently in an attempt to clear their vision.

Cataracts do not usually cause any change in the appearance of the eye. Any discomforts, such as irritation, aching, itching or redness are most likely caused by some other eye disorder.

Cataracts are not hazardous to the sufferer's health, or the health of the eye. If the cataract becomes hypermature (completely white), the sufferer may experience inflammation, headache and some pain. Hypermature cataracts need to be removed if there is inflammation or pain.

How are cataracts diagnosed?

Anybody who experiences vision problems should see a GP (general practitioner, primary care physician), an ophthalmologist, or an optometrist. The GP will most likely refer the patient to an ophthalmologist, or an optometrist.
  • Ophthalmologist - a doctor who specializes in the medical and surgical care of the eye.

  • Optometrist - a person practicing eye care, but does not perform surgery.
The eye specialist will carry out a number of tests. These may include:
  • Visual acuity test - this tests how clearly the individual can see an object. It tests the person's sharpness of vision. The patient reads letters from across a room. The two eyes are tested separately (one is covered). By using a chart with progressively smaller letters, the specialist can determine how acute the patient's vision is. The chart is called a Snellen Eye Chart.

    Sometimes the chart has to be read twice - once with, and once without bright lights. This will give an indication of glare sensitivity.

  • Slit-lamp examination - this is a microscope which allows the specialist to see the structures at the front of the eye. An intense line of sight (a slit) is used to illuminate the cornea, iris, lens, as well as the space between the iris and the cornea. The slit makes it possible for the specialist to see these structures in small sections, making it easier to spot any problems.

  • Retinal examination - eye drops are administered which dilate the pupils, providing a bigger window to the back of the eyes. The specialist examines the lens for signs of cataract with either an ophthalmoscope or a slit lamp. If signs of cataract are found, the specialist can also determine how dense the clouding is. Most specialists will check for glaucoma at the same time, and perhaps some other eye conditions/diseases.

    The pupils will remain dilated for a few hours after the examination before the eye drops gradually lose their effect. During this time the patient may find it harder to focus on close objects. It is advisable to wear sunglasses, especially if it is a bright day. Driving is not advisable until the pupils are back to their normal size.

  • Measuring a protein related to cataract formation - A device based on a laser light technique called dynamic light scattering can safely eye test for measuring a protein related to cataract formation, according to researchers at the National Eye Institute, USA.
Although an eye test may help confirm a cataract diagnosis, it may not always reflect the patient's quality of life. Some patients who do badly in a test seem to have no problem with daily function, while others who may do well insist that their eyesight is poor and does interfere with ordinary activities.

Treatment for cataracts

If the patient is found to be only mildly affected surgical treatment may not be needed. During its early stages, stronger glasses and brighter lights may help improve vision. The following simple approaches may assist people who are not ready yet to have surgery:
  • Make sure your glasses are the most accurate prescription possible.
  • Use a magnifying glass for reading.
  • Get brighter lamps for your house. Halogen lights may help a lot.
  • Wear sunglasses to reduce glare on sunny days.
  • Try to refrain from driving at night.

However, these are only temporary measures - the cataracts will continue developing and gradually impair eyesight more.

Patients who take alpha-blockers or are considering taking alpha-blockers should be aware that the drugs may increase the difficulty of cataract surgery. While Flomax (an alpha-blocker) is largely prescribed to men to treat prostate enlargement, some women also take the drug to treat urinary retention problems. Other alpha-blockers are used to treat hypertension. The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery issued an advisory telling patients and GPs to inform their surgeon if they are taking alpha-blockers, or took them in the past. Once informed, the ophthalmologist can anticipate certain problems and employ different surgical techniques that help to achieve excellent outcomes.

When the cataracts are severe the only effective treatment is surgery. The specialist will recommend surgery if the patient:
  • Is having trouble looking after himself/herself.
  • Is having difficulties looking after someone else.
  • Cannot drive, or finds driving difficult.
  • Has problems leaving the house.
  • Finds it hard to see or recognize people's faces.
  • Has problems doing his/her job.
  • Cannot read properly.
  • Can no longer watch television properly.
The cloudy lens is removed from the eye and an artificial clear plastic one is put in its place - an intraocular implant (intraocular lens). In most developed countries, and a growing number of developing countries, cataract operations are performed as keyhole surgery. The patient will be given a local anesthetic. He/she will not usually have to spend the night in hospital. The operation is commonly known as phacoemulsification or phaco extracapsular extraction. Laser surgery is not used for cataract procedures. (There are more details about the operation further down this page)

Pre-operative assessment (assessment before surgery)

The specialist will assess the patient's eyes and general health. During the pre-operative assessment the eye will be measured so that the replacement artificial lens can be prepared.

The day of the operation - before it begins

Eye drops that dilate (widen) the pupils will be administered just before the procedure. Sometimes the eye drops will also have anesthetic in them, or the doctor may inject the tissue around the eye for a local anesthetic. As soon as the anesthetic starts working the area will be numbed and the patient will feel nothing. During the operation he/she will be aware of a bright light, but will not be able to see what is happening.

Various types of replacement lenses may be used:
  • Monofocal lens - this is a fixed-strength lens which is set for one level of vision - usually distance vision.

  • Multifocal lens - this type of lens may have two or more different strengths; near and distance vision.

  • Accommodating lens - this type of lens is the most similar to the natural human lens. It allows the eye to focus on near and distant objects.
The operation

The eye surgeon makes a tiny cut in the cornea at the front. He/she then inserts a minute probe through the cut. The probe uses ultrasound and breaks up the cloudy lens into very small pieces which are sucked out.

The artificial lens is then inserted through the cut. The lens sits in the lens capsule to keep it in place - the lens capsule is like a little pocket. When it is first inserted the lens is folded - it unfolds when in position.

The whole procedure should not take more than about 30 minutes. Most patients will wear an eye pad for protection for a short while.

Other procedures
  • Manual extracapsular extraction - the lens is removed in one piece. No ultrasound is used to break it up. The surgeon will make a slightly larger cut in the eye.

  • Intracapsular extraction - the lens capsule as well as the lens is removed. The artificial lens is sewn into the eye. This type of procedure is much less common.
After the operation

Most patients will experience vision improvement virtually immediately. It may take a while for the eye to settle down completely. The cut in the eye may occasionally need a stitch - in most cases, however, it is so small that it heals by itself.

Patients should avoid vigorous activities for a while. Most individuals find they can go about their daily activities as soon as they get home. An appointment will be made to test the patient's vision. Most patients will need different glasses after their operation. The new glasses can only be determined after his/her vision has settled down - this can take several weeks.

There is no other way to cure cataracts. Medications, dietary supplements, exercise or optical devices are not effective. As mentioned earlier, during the early stages there are some things the patient can do to help see things better - but they are only temporary.

Prevention of cataracts

To prevent suffering the complications of cataracts it is advisable to have regular eye exams, especially as you get older. The following steps are advisable to lower your risk of developing cataracts - some of them have convincing circumstantial evidence of their worth, while others (smoking, diet) are proven measures:
  • Give up smoking - several studies have indicated that a higher percentage of smokers develop cataracts, compared to non-smokers. There are also indications that smokers are likely to experience cataract symptoms earlier. Smoking also increases the risk of other eye disease/conditions.

  • Nutrition - eat plenty of fruits and vegetables, whole grains, unrefined carbohydrates, good quality fats (avocado, olive oil, omega oils), and either plant sourced proteins or lean animal sourced proteins.

    The findings by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, USA suggest that vitamins and polyunsaturated fatty acids - two categories of nutrients believed to have health benefits - may both affect cataract development, although not necessarily in beneficial ways.

    Women who consume plenty of dark leafy vegetables which are rich in lutein and zeaxanthin, as well as sufficient vitamin E from supplements/foods seem to have better protection against developing cataracts, scientists from the Brigham & Women's Hospital and Harvard Medical School, Boston found.

  • Sunlight - wear sunglasses that block ultraviolet B rays (UV radiation). Many people are not aware of the damage UV radiation can cause to the eyes - a study found that only 49% of Americans said UV protection was the most important factor when purchasing sunglasses.

  • Sleep - make sure you get at least 7 hours of good quality, continuous sleep every night.

  • Obesity - obesity significantly raises the risk of developing diabetes type 2, which in turn is an important cataract risk factor. Keeping your weight within the recommended limits will help prevent your risk from increasing.

  • Diabetes - be careful to have your diabetes under control; follow your treatment plan assiduously.

  • Exercise - Researchers from the U.S. Department of Energy's Lawrence Berkeley National Laboratory reported that running reduces the risk of both cataracts and age-related macular degeneration.


  • Blindness - If the cataracts are left untreated, they may lead to blindness.

  • Higher mortality rates - people aged 49 and older with cataract and those aged 49 to 74 years with age-related macular degeneration appear to have higher mortality rates over an 11-year period than those without such visual impairments, according to a study carried out by researchers at the University of Sydney, Australia.
Continue to Read more ...

What Is Exercise? The Benefits Of Exercise

When we talk about exercise, we nearly always refer to physical exercise. Exercise is the physical exertion of the body - making the body do a physical activity which results in a healthy or healthier level of physical fitness and both physical and mental health. In other words, exercise aims to maintain or enhance our physical fitness and general health. People exercise for many different reasons. Some of them are included below:
  • Strengthening muscles
  • Optimizing the cardiovascular system
  • Practicing specific athletic skills
  • Controlling bodyweight
  • For fun
  • To win
  • To socialize
  • To get away from it all
People don't exercise for various reasons. A study found that stress levels and cultural considerations affect how much and for what reasons college students exercise.

There are three broad Intensities of exercise:

  • Light exercise

    The exerciser is able to talk while exercising. Going for a walk is an example of light exercise.

  • Moderate exercise

    The exerciser feels slightly out of breath during the session. Examples could be walking briskly, cycling moderately, or walking up a hill.

  • Vigorous exercise

    The exerciser is panting during the activity. The exerciser feels his/her body is being pushed much nearer its limit, compared to the other two intensities. This could include running, cycling fast, and heavy weight training.

Exercise can be divided into three broad categories, aerobic, anaerobic, and agility training:

Aerobic exercise

Aerobic exercise has the aim of improving the body's consumption of oxygen. The word aerobic means with oxygen. Aerobic refers to our body's use of oxygen in its metabolic process (energy-generating process). Most aerobic exercises are done at moderate levels of intensity for longer periods, compared to other categories of exercise. An aerobic exercise session involves warming up, exercising for at least 20 minutes, and then cooling down. Aerobic exercise involves mainly the large muscle groups.

A physical therapist, Col Pauline Potts, and an exercise physiologist, Kenneth Cooper M.D., both in the US Air Force, were the first to use the term aerobic exercise during the 1960s. Dr. Cooper wanted to find out why some very strong people were poor at long-distance running, swimming and cycling. He researched people's performance in terms of their ability to use oxygen with the use of a bicycle ergometer. In 1968 Dr. Cooper published his book Aerobics. The book included scientific programs using aerobic exercises, such as swimming, running, cycling and walking. The book became a bestseller. All present aerobic programs use Cooper's data as a baseline.

Aerobic exercise is generally performed at a moderate level of intensity over a long period. Running for 20 minutes is an aerobic exercise, while sprinting 200 meters is not. Playing badminton for 30 minutes is an aerobic activity if the movements of the players are fairly continuous. Golf, on the other hand, is not seen as aerobic because the heart rate has not been raised at a sustained level for long enough.

Aerobic exercise is considered to have the following benefits:
  • Strengthens the muscles that are involved in respiration - exercises that facilitate the flow of air in and out of the lungs.

  • Strengthens and enlarges the heart muscle. This improves aerobic conditioning - pumping of blood and the heart rate (lowers the pulse of a person when he/she is resting).

  • Tones muscles throughout most of the body.

  • Reduces blood pressure.

  • Improves circulation.

  • Raises the number of red blood cells, which in turn facilitates transportation of oxygen.

  • The sleep quality of insomnia patients can improve with moderate exercise, a study found.

  • Improves mental health.

  • A study found that exercise reduces migraine suffering.

  • Reduces the risk of heart disease and cardiovascular problems.

  • Helps improve survival rates of patients with cardiovascular diseases significantly, as this study found.

  • Stimulates bone growth (high impact aerobic exercise), reduces risk of osteoporosis.

  • Increases stamina or endurance. Aerobic activity increases the body's ability to store energy molecules such as fats and carbohydrates within the muscle.

  • Increases blood flow through muscles.

  • Improves muscles' ability to use fats during exercise, thus preserving the intramuscular glycogen.
What is Anaerobic exercise?

The aim of anaerobic exercise is to build power, strength and muscle. The muscles are exercised at high intensity for short durations. A short duration usually means no more than about two minutes.

Anaerobic means without air. Anaerobic exercises improve our muscle strength and our ability to move with quick bursts of speed. When thinking of anaerobic exercise, think of short and fast or short and intensive. Anaerobic exercises include:
  • Weight lifting
  • Sprinting
  • Intensive and fast skipping (with a rope)
  • Interval training
  • Isometrics
  • Any rapid burst of hard exercise
Oxygen is not used for energy during anaerobic exercise. During this type of exercise a by-product - lactic acid - is produced. Lactic acid contributes to muscle fatigue and must be used up during recovery before that muscle can be subjected to another anaerobic session. During the recovery period oxygen is used to give the muscle a "refill" - to replenish the muscle's energy that was used up during the intensive exercise.

Overall, anaerobic exercise uses up fewer calories than aerobic exercise. The cardiovascular benefits of aerobic exercises are greater than the cardiovascular benefits of anaerobic exercises. However, anaerobic exercise is better at building strength and muscle mass, while still benefitting the heart and lungs. As you build more muscle you will burn more fat, even at rest. Muscles burn more calories per unit volume than any other tissue in the body. A muscly person burns more calories than a non-muscly person, even if while he/she is resting. This study found that resistance training may aid in weight loss.

How Does Anaerobic Exercise Work?

When a short, intensive burst of activity occurs there is a temporary shortage of oxygen being delivered to the working muscles at first. The production of anaerobic energy creates a by-product; lactic acid. As mentioned above, lactic acid causes muscle fatigue, which is the reason the session cannot last long. However, after regular training the person's body becomes better equipped to handle lactic acid. After several practice sessions the body becomes better at getting rid of lactic acid - it also learns how to produce less of it. The body also produces buffers that postpone the onset of fatigue during an anaerobic session. Anaerobic exercises offer the following benefits:
  • The exerciser gets stronger
  • The exerciser experiences growth in muscle mass
  • Strengthens bones
  • Strengthens and protects the joints
  • Helps control bodyweight
  • The exerciser can withstand a greater buildup of lactic acid and other waste substances, and can eliminate them more rapidly
What is agility training?

Agility training aims to improve a person's ability to speed up and slow down, change directions while maintaining balance and control. In tennis, for example, agility training helps the player maintain control over his/her court positioning through good recovery after each shot. A crucial skill in tennis is to be able to position yourself in the court so that you can hit the ball to maximum effect. Agility does not only help the tennis player get to the ball more effectively and set up for a better shot, it also gives him/her better balance in order to hit the ball.

Agility training is practiced extensively by people who practice certain sports where positioning, coordination, balance and the ability to suddenly change posture and speeds are essential.

Agility and coordination are two key attributes for a successful soccer (UK/Ireland: football) player. Such compound movements as dribbling, turning, passing and intercepting require a wide assortment of balance, coordination and other skills, such as the ability to accelerate and decelerate quickly. A good soccer player also needs excellent special awareness and accurate timing. Soccer players often practice improving their ability to change the direction of the body abruptly, or shift stance without losing balance.

Agility includes speed, strength, balance and coordination. The following sports are known to require agility (there are many more than on this list):
  • Tennis
  • Soccer
  • Rugby
  • American football
  • Squash
  • Hockey
  • Badminton
  • Volleyball
  • Basket ball
  • Martial arts
  • Boxing
  • Wrestling

Yoga and Pilates

Some exercises include a combination of stretching, muscle strengthening, balance, etc. A good example is Yoga.

Many experts say stretching is an exercise in itself. Yoga exercises, or movements, improve your balance, flexibility, posture and circulation. Yoga originated in India a long time ago, and is aimed at unifying the mind, body and spirit. Modern yoga - the type of yoga practiced by most people in western countries - uses a combination of meditation, posture, and breathing exercises. Yoga can be tailored to meet the needs of individuals, such as those with arthritis, asthma, or certain body pains. Pilates is similar to Yoga, but it focuses more on the core abdominal and back muscles.

Some facts about exercise and lack of exercise

Most of us know how beneficial exercise is for our health. It is surprising, however, how little many of us know about the dangers of being unfit. In Western Europe, North America, Japan, Australasia, and much of the rest of the world, the number of overweight/obese people is growing alarmingly fast.
  • The UK has a population of 61 million. 24 million of them are overweight/obese today. Experts say it will not be long before 25% of the UK's population is obese (not overweight, just obese). The USA has already reached that figure - in Tennessee and Alabama over 30% of adults are obese today.

  • 9,000 premature deaths each year in the UK are because of obesity. Obesity significantly reduces the lifespan of a person.

  • Physically active people have a much lower risk of developing heart disease, stroke, type 2 diabetes, and many types of cancer.

  • 30% of heart disease deaths in the UK happen to people under 75 years of age.

  • Vigorous exercise can help elderly people avoid disability, a study found.

  • Women who do not exercise regularly have more complications during and after pregnancy. This article explains why women should be encouraged to exercise during pregnancy.

  • Exercise improves your mood.

  • Physical activity after the menopause reduces breast cancer risk, a study revealed.

  • Regular exercise improves your sex life.

  • A study found that exercise makes you eat less by suppressing appetite hormones.

  • Exercise improves your confidence.

  • A study explains how exercise can reduce cigarette cravings for people who are trying to quit smoking.

  • Exercise helps you live longer (mainly for the many reasons listed above).

  • Even some cancer patients can benefit from exercise. A study explains how exercise can help non-small cell lung cancer patients.

Finding the time to exercise

Many people who do not exercise say they do not have the time. However, it is possible to increase the amount of time you are physically active, even if you are extremely busy. For example:
  • See how many trips you take by car and decide which ones could be replaced by walking or cycling. This does not have to be a black or white measure. It could include parking your car half a mile from your destination and walking the rest of the way. Traffic experts throughout most of the world say that the majority of car trips are very short ones.

  • If you are using public transport try getting off at an earlier stop and walking the rest of the way.

  • A study found that interactive video games - such those played on the Nintendo Wii - may raise heart rate and provide exercise intensity levels high enough to meet federal physical activity guidelines.

  • When you are in a building and want to go upstairs, try walking it, rather than taking the elevator or escalators. This does not have to be a black or white measure - you can do half and half.

  • There are several gentle exercises you can do while watching TV. Especially when the adverts are on.

  • If you do not have time to exercise but have time to watch TV, think about how much of that TV time could be replaced by some physical activity. Most people say they do not have time to exercise, but we are all watching more TV than ever before. Even short bursts of 30 second exercises are good for improving metabolism, a study found.

  • Migraine - there are many safe exercises for migraine sufferers.

  • If you do housework, see if you can do it a bit more vigorously and turn it into an exercise session.

Tips on adding exercise to your routine

Experts say that for a physically inactive person to become active, and remain active for the long-term, the activity needs to be convenient and enjoyable. The activity needs to be something you can easily fit into your routine for several days each week. Even if you end up adding just 30 minutes of physical activity to your day, that is fine. Some of the examples below are the easiest to fit into a daily routine:
  • Go for a brisk 30-minute walk five times each week. Ideally, it should be done in one session. If you can't, two 15-minute sessions would also be good.

  • Walk you dog more often. If you do not have a dog but know a nearby friend who has one, offer to walk it for him/her.

  • Find out whether there are any swimming pools nearby. Try to add some swimming to your weekly routine. This does not have to be every day.

  • During your lunch break at work go for a walk.

  • Join some exercise classes.

  • Join a martial arts club. Beginner's sessions can be gentle and fun.

  • Beginners must remember that the secret is "little and often". A little bit every day is great - one big session once a week is not. Make sure your progress is gradual. Make sure you drink plenty of water during and after you exercise. Check with your doctor if you are not sure about your health.

  • Experts say an exercise program should include both aerobic and anaerobic activities. This is true. However, if you are currently inactive, anything is better than nothing.

Some advice when you start an exercise program

When people start an exercise program they may experience various emotions, from elation to anxiety about not being able to keep it up. Remember the following tips which may help you achieve long-term success:
  • Remember why you started

    People start exercising for many reasons: weight loss, health, vanity, the doctor told them to, and to recover from an illness. Keep remembering why you started as this will help keep you motivated.

  • Do everything at your own pace

    Humans tend to be competitive animals. This is great for the winner, and those who come second or third. However, being competitive in the wrong way can kill motivation. If you have to compete, compete with your past self. Compare your performance today with your performance in two weeks' time. Check your weight, heart rate, blood pressure - then take it again in about three weeks and see the difference.

  • You have to like it

    For long-term success the activity has to be something you enjoy. There are so many activities to choose from. Perhaps there is an activity you really enjoyed when you were a child.

  • Join a club with a friend

    If you join a fitness club with a friend, or exercise with a friend you may enjoy the sessions more. Some people prefer not to have the stress of someone else around. This depends on you.

  • Experts can be very useful

    A study found that exercise and behavioral intervention improves fitness and lowers systolic blood pressure.

  • Variation

    Every few weeks change your exercise program. This is important for your motivation and also for best results. The body improves faster if you change your program now and again. This does not mean you have to change walking/running to something else. It could mean changing your speed and distance, and pacing yourself in a different way, perhaps altering your route.

  • Be realistic about your goals

    Some people are motivated by goals, others find them stressful. If you need goals make sure they are realistic - and work towards them.

  • The longer you keep it up the longer you will continue to do it

    After a few weeks your exercise routine starts to become a habit. Even if you find it a bit of a chore at first, remember that after a few weeks it will really become a habit.
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What Is MRI? How Does MRI Work?

MRI is short for Magnetic Resonance Imaging. It is a procedure used in hospitals to scan patients and determine the severity of certain injuries. An MRI machine uses a magnetic field and radio waves to create detailed images of the body. Common reasons people go in to get an M.R.I. are for a sprained ankle or back pain.

What should I do to prepare for an MRI?

There is little to no preparation needed before getting an MRI. When you first arrive at the hospital, the doctors will ask you to change into a gown. You will also be asked to remove all accessories such as jewelry, credit cards, and any metallic objects. The reason for this is because MRIs involve magnets, which may interact with objects in your possession. This in turn may lead to bad results and/or poor image quality.

What does an MRI machine look like?

Most MRI machines look like a long tube, with a large magnet present in the circular area. When beginning the process of taking an MRI, the patient is laid down on a table. Then depending on where the MRI needs to be taken, the technician slides a coil to the specific area being imaged. The coil is the part of the machine that receives the MR signal.

A man having a medical examination via MRI scan

Is an MRI going to hurt?

You can breathe a sigh of relief. It is not going to hurt one bit. The exam itself is a painless procedure that is noninvasive, meaning that the body is not tampered with in any way. Since humans are not able to feel any type of radio waves, patients will not feel a thing. A loud tapping noise will be experienced, however, as the magnets are turned on and off throughout the exam. No need to worry, though. If you think the noise will bother you, just ask the technician for a pair of earplugs to drown out the noise.

How long does the MRI test last?

The exam itself takes about 30 - 45 minutes. However, this may vary depending on the number of body parts being examined.

So how does MRI work?

A strong magnetic field is created by passing an electric current through the wire loops. While this is happening, other coils in the magnet send and receive radio waves. This triggers protons in the body to align themselves. Once aligned, radio waves are absorbed by the protons, which stimulate spinning. Energy is released after "exciting" the molecules, which in turn emits energy signals that are picked up by the coil. This information is then sent to a computer which processes all the signals and generates it into an image. The final product is a 3-D image representation of the area being examined.

Unlike CT scanning or general x-ray studies, no ionizing radiation is involved with an MRI.
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What Is Fungus? What Are Fungi?

Fungi (Singular: fungus) are classified within their own kingdom - The Kingdom Fungi, while some are in The Kingdom Protista. A fungus is neither a plant nor an animal. It is similar to a plant, but it has no chlorophyll and cannot make its own food like a plant can through photosynthesis. They get their food by absorbing nutrients from their surroundings.

Kingdom Fungi includes mushrooms, rusts, smuts, puffballs, truffles, morels, molds, and yeasts, and thousands of other organisms and microorganisms. They range from microscopic single-celled organisms, such as yeast, to gigantic multicellular organisms.

Many fungi play a crucial role in decomposition (breaking things down) and returning nutrients to the soil. They are also used in medicine, an example is the antibiotic penicillin, as well as in industry and food preparation.

For a long time fungi were classified as plants, mainly because of their similar lifestyles - both are seen to grow in soil and are sessile (permanently attached; not moving). Plant and fungal cells both have a cell wall, while cells from the animal kingdom don't. Fungi are thought to have diverged from the plant and animal kingdoms about one billion years ago.

What is Mycology?

Mycology is the study of fungi - it is a branch of biology. A mycologist studies fungi's genes, biochemical properties, their use to us as a source of food, their hallucinogenic, poisonous and pathogenic (ability to cause disease) properties. It was not until the 16th century, when the microscope was developed, that mycology became a well established science.

What is the difference between a mushroom and a toadstool?

Most reputable scientific reference sources indicate that there is no scientific difference. People tend to refer to toadstools as the toxic (poisonous) ones and mushrooms as the edible ones. However, many mushrooms are poisonous too. A number of non-scientefic dictionaries state that a toadstool is an inedible mushroom. So, the safest answer is "There is no scientific difference, but people refer to toadstools as the inedible or toxic ones." The word toadstool is commonly used in children's stories to indicate a poisonous or colorful mushroom.

Where do fungi exist?

Fungi exist in various habitats, including deep down in the ocean, lakes, rocks, deserts, very salty environments, and areas of extremely high or low temperatures. Some can prevail even after being exposed to intense UV and cosmic radiation as one would encounter during space travel. During the 13 years the Mir space station was in orbit, a great deal of equipment was continuously being damaged by mutated fungi that had been breeding in the space station. At first technicians were puzzled and thought the problems must have been due to faulty workmanship. The majority of fungi live on land.

Fungi and bacteria are the main decomposers of organic matter in virtually all ecosystems on Earth.

Taxonomists have classified approximately 70,000 types of fungi. Experts say there are many more - possibly 1.5 million. Fungi used to be classified according to their shape, structure, biological and biochemical characteristics. Advances in DNA sequencing have helped extend the classification of different species of fungi. Taxonomy is the classification of organisms.

How do fungi feed?

Although fungi are similar to plants in many ways, they do not have chlorophyll, the green pigment that enables plants to make their own food with the aid of sunlight (photosynthesis). Fungi release digestive enzymes that decompose things around them, turning them into food. The fungus then absorbs the dissolved foods through the walls of its cells.

Fungi have adapted various ways of doing this:
  • Parasitic fungi - several species of fungi exist as parasites, feeding on live hosts, which might be animals, plants or even other fungi. Some of these parasitic fungi damage our crops, sicken farm animals, and harm or completely destroy trees. Dutch elm disease, caused by the fungus Ophiostoma ulmi destroyed hundreds of millions of elm tress worldwide. The rice blast fungus Magnaporthe oryzae can devastate rice crops.

    The following fungi can cause serious diseases to humans: aspergilloses, candidoses, coccidioidomycosis, cryptococcosis, histoplasmosis, mycetomas, and paracoccidioidomycosis. An example is vaginal yeast infection.

  • Saprobes or saprophytes - these break down dead organisms and substances that contain organic compounds and feed on them when they have rotted. Humans welcome saprobes and also fear them. They are useful decomposers of organic material, but also damage wood products and spoil our food. When ships used to be made of wood they were often rendered unusable by wood-digesting saprobes (polypores).

  • Symbiosis - this is when one living thing builds up a relationship with another for the mutual survival of both. Some fungi form mycorrhizae which enhance a plant-root's capacity to absorb nutrients. The plant synthesizes nutrients the fungus needs and exchanges these nutrients for minerals the fungus absorbs from the soil - i.e. the plant and the fungus trade nutrients.

    Some leaf-cutting ants eat nothing but a type of fungi that lives in their nests. The fungi live on nothing but the leaves the ants carry in for them. If the ant starved the fungi and killed them the ant would have no food and would die; if the fungi found a way of poisoning the ants and killing them off, the fungi would have no food and would die. They both depend on each other for survival.

The structure of fungi

The majority of fungi - except for the one-celled oranisms - are composed of hyphae; threadlike tubular filaments. Hyphae is the plural of hypha.

A hypha has a rigid wall around it generally made of chitin. The outer skeletons (exoskeletons) of insects are also made of chitin.

The hyphae may be partitioned by dividing cross walls called septate hyphae - and are called septate hyphae, while those without cross walls are called nonseptate, or coenocytic hyphae.

The cells of all species of fungi contain cytoplasm - a mixture of nutrients and fluids. The cytoplasm flows inside the hyphae and nourishes any part that requires it.

The tips of a hypha grow by elongation and branch out to form an interwoven mat known as the mycelium. As the mycelium gets bigger it may produce structures (fruiting bodies) that contain spores.

The fruiting bodies generally grow above the soil or other surfaces so that the spores can blow in the wind and spread. The mycelium is generally beneath the surface of whatever the fungus is decomposing. The umbrella-like structure of a mushroom is its fruiting body and is typically above the surface of whatever animal, plant or substance it is decomposing, while its mycelium is below the surface.

How do fungi reproduce?

Most fungi reproduce by making spores. A puffball may contain trillions of spores.
  • Sexual reproduction - fungi generally undergo a reproductive cycle that includes the production of sexual spores. A sexual spore contains one nucleus that has set of chromosomes; just half of the total set of the fungal-cell chromosomes - they are haploid. Human sperm and eggs are haploid; they contain 23 chromosomes each, half of the 46 that exist in human cells. Some spores contain two or more nuclei.

    When a spore germinates it eventually develops into a mycelium that produces fruiting bodies with sexual spores - and so the reproductive cycle starts all over again.

  • Asexual reproduction - asexual spores may be produced directly from the hypha in some fungi - without the need for fruiting bodies. The spores then germinate and produce additional mycelium, which spreads rapidly. Experts say this allows more rapid dispersal than sexual reproduction.

  • The dikaryon stage - There are two mating strains of hyphae which exist in the mycelium - the plus and the minus strain. They both look the same, but are different. Sexual reproduction occurs when the plus and minus strains fuse. Their nuclei will remain separate during the initial stages - this intermediate stage is called the dikaryon. Dikaryon means a pair of associated but unfused haploid nuclei of a fungus cell capable of participating in repeated cell division as separate entities before their eventual fusion - i.e. two nuclei, each with one half of the chromosome pairs, participating in cell division, but with nuclei not fusing yet, before the nuclei eventually fuse.

    With some species the dikaryon stage may last for several years, while with others it may be just a question of weeks. Eventually the two nuclei fuse and become one nucleus with the pairs of chromosomes joined up (two sets containing half the total chromosomes each), forming a diploid cell.

    The diploid cell then divides producing daughter cells with half the parent cell's genetic material - this process is called meiosis. Usually four genetically unique haploid spores are produced, and the cycle restarts. This form of procreation using genetically different spores helps fungi adapt more effectively to novel diseases and environmental changes. If all the fungi were genetically identical they could all be destroyed by a single disease or a significant environmental change.

  • Fragmentation - in some types of fungi the hyphae fragment, with each fragment developing into a new separate organism. With the single cell of yeast, a bump forms on the cell which eventually breaks off and ultimately becomes a new yeast cell.

How are fungi classified?

The classification of fungi has long been a subject of controversy among experts. Pier Antonio Micheli, an Italian botanist, was the first to describe fungi in scientific terms we are used to today. He classed them as plants. For a long time the study of fungi (Mycology) was a subdivision of botany.

Robert H. Wittaker (USA, 1920-1980) a vegetation ecologist introduced a 5-Kingdom taxonomy, granting fungi equal status with animals and plants. The 5-Kingdom taxonomy included:
  • Kingdom Animalia (animal kingdom)

  • The Kingdom Plantae (plant kingdom)

  • Kingdom Fungi (fungi kingdom)

  • Kingdom Protista (types of eukaryotic organisms; containing complex structures enclosed within membranes)

  • Kingdom Monera (types of microscopic single-celled organisms whose genetic material is loose in the cell, instead of being held in the cell's nucleus)
Today some countries, such as the USA use a 6-Kingdom system:
  • Kingdom Animalia
  • Kingdom Plantae
  • Kingdom Fungi
  • Kingdom Protista
  • Kingdom Archaea
  • Kingdom Bacteria
  • Archaea are single-cell microorganisms with no nucleus or other microscopic organ-like parts (organelles).
while many British, Irish and Australasian scientists use a 5-Kingdom system:
  • Kingdom Animalia
  • Kingdom Plantae
  • Kingdom Fungi
  • Kingdom Protista
  • Kingdom Prokaryota/Monera
Current mycologists say that as some slime molds, mildews and water molds have similar feeding stages to amoebas, plus some other qualities, they should be part of a separate kingdom called Kingdom Protista, while others talk about Kingdom Stremenopila for water molds and downy mildews that have no chitin, as well as some other characteristics.

Kingdoms are divided into phila

Today, the main criteria for fungus classification is the type of spores and fruiting bodies it produces. All Kingdoms are divided into phyla (singular: phylum). A phylum is a primary division of a kingdom. Fungi are commonly divided into four broad phyla:
  • Chytridiomycota (Chytrids) - these are microscopic fungi and are mostly found in freshwater or damp/drenched soil. The majority of chytrids are parasites of algae and animals. Some are saprobes (living on decomposed organic matter). A chytrid called Batrachochytrium dendrobatidis causes disease in amphibians. Scientists have identified over 800 species of chytrids.

  • Zygomycota - these mold that forms on bread and many other foods. The mold has tiny black dots (sporangia) which produce sporangiospores - asexual spores. Many types of zygomycota are insect and spider parasites.

  • Ascomycota - there are about 33,000 identified species of ascomycetes that feed on both living and dead matter. Ascomycetes are primary decomposers of plants. They are also important causes of plant and human diseases. They are used in brewing, baking, winemaking, and as sources of therapeutic drugs. They are also used in the production of some cheeses, such as Camembert, Roquefort and Stilton.

  • Basidiomycota - Both edible and poisonous mushrooms are types of basidiomicetes. They cause devastating plant diseases. Basidiomicetes are commonly found in birds' nests. Most decomposition of living or dead wood that occurs in forests as well as inside man-made structures is caused by basidiomicetes. Leaf ants live exclusively on a type of basidiomicetes, as do some termites.

    Cryptococcosis, a human infection caused by inhaling a basidiomicetes fungus called Cryptococcus neoformans, commonly infects patients with weakened immune systems, such as those with HIV/AIDS, or people receiving medications that suppress their immune system. Infection is usually limited to the lungs, but can spread to other parts of the body, causing meningitis.

What do humans use fungi for?

  • Fungi as a food or used in food preparation

    Humans have been eating fungi since before we started walking on our hind legs. Today we eat an enormous variety of edible fungi, including truffles, mushrooms, quorn, shitake and hundreds others.

    We also use fungi, e.g. yeast, in food manufacturing. Yeast is needed for the fermentation of wine, beers and other alcoholic drinks. We add yeast to dough to make the bread rise when we bake it.

  • Fungi used in industry and agriculture

    Fungi are used in the production of ethanol. They are used extensively to produce industrial chemicals, such as citric acid, gluconic acid, malic acid, and biological detergents. The production of many deliberately faded garments would be much more difficult without using fungi. They are used in bioremediation - the detoxification of polluted water or soil.

    Fungi are also used in agriculture for pest control and to protect crops from diseases.

  • Fungi used in medicine

    • Antibiotics - Many types of antibiotics come from fungi, such as penicillin (Penicillium chrysogenum), cephalosporin (Acremonium) , and griseofulvin (Penicillium griseofulvin). Penicillin works by destroying the wall of a bacterial cell. Fungal antibiotics are extensively used for treating tuberculosis, syphilis, and leprosy, to name but a few diseases.

    • Chemotherapy - Antibacterial chemotherapy uses fungi. Lentilan, a drug used in cancer treatment, is sourced from the shiitake mushroom.

    • Immunosuppressants - Cyclosporin is a medication that transplant patients take to suppress their immune system. It is produced by the fungus Beauveria nivea and significantly lowers the risk of transplanted organ refection. Many successful transplant procedures could not have occurred without this drug.
    Laboratory studies indicate that Agaricus blazei may stimulate the human immune system and could have major implications for human health - especially in the treatment of many cancers.

    US researchers reported that a rapid production of therapeutic human drugs using modified mushrooms may help mount a quicker response to various public health problems.

    The reishi mushroom (Ganoderma lucidum) and green tea may both enhance the body's immune functions and hold the potential for treatment and prevention of many types of cancer, scientists from Pharmanex BJ Clinical Pharmacology Center in Beijing reported.

    Extracts of the mushroom Phellinus linteus may halt breast cancer growth , according to scientists from the Methodist Research Institute in Indianapolis, USA.

  • Traditional Chinese Medicine includes several types of mushrooms, such as Agaricus, Ganoderma, and Cordyceps among its various therapies.

Fungi that cause human diseases - pathogenic fungi

Mycosis is a disease caused by a fungus (plural: mycoses). Fungi that cause diseases are called pathogenic fungi. Mycoses can be divided into four broad groups; these groups are classified according to how deeply the fungus penetrates into the body:
  • Superficial mycosis

    The fungus does not penetrate at all. It is present only on the surface of the skin or on the patient's hair. This may include various types of ringworm (tinea), including athlete's foot, scalp ringworm, and body (skin) ringworm.

    Candida albicans is a yeast that causes candidiasis. As a superficial mycosis candidiasis usually affects the vagina of females or the mouth of both males and females. It exists normally in the vagina or gastrointestinal tract, but may multiply rapidly, especially if the person is ill or has a weakened immune system. Taking antibiotics may sometimes result in rapid reproduction of Candida albicans. Fungi that obtain nutrients from keratinized material are called dermatophytes. Dermatophytes cause superficial and cutaneous mycosis (below).

  • Cutaneous mycosis

    The infection is generally limited to the nonliving keratinized layers of skin, hair, and nails - no living tissue is invaded. Also includes tinea (ringworm), as well as candidiasis of the skin, mucus membranes and nails (Candida albicans and related species).

  • Subcutaneous mycosis

    The fungi reach below the skin and infect subcutaneous (area just below the skin), connective and bone tissue. These infections are usually chronic (long-lasting) and often occur when the skin is pierced or wounded, allowing the fungi to enter, usually in the form of vegetable matter. These infections may be hard to treat and often require removal of damaged skin (debridement). Subcutaneous mycoses are much more common in the tropics.

    Sporotrichosis caused by Sporothrix schenckii is an example of subcutaneous mycosis. Sporotrichosis used to be common in Europe, but is very rare there today. It is more common in Australia, South Africa and in the warmer regions of the Americas. Infection may occur as a result of an insect bite, a thorn prick or a scratch from any sharp object. Infection risk is higher among florists, farmers, gardeners and people who work with hay and moss.

  • Systemic mycosis

    This is a fungal infection that may reach any part of the body, including the brain and heart, as well as the bloodstream. The fungi usually enter via the lungs, gastrointestinal tract or intravenously.

    An example of systemic mycosis is cryptococcosis, which is caused by Cryptococcus neoformans, a type of yeast. It can cause subacute or chronic meningitis. The fungi enter the body by inhalation. Infected patients may also develop lung infections. Cryptococcus neoformans may be found in pigeon droppings.
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What Is Eczema? What Causes Eczema?

Eczema is also known as atopic dermatitis, or atopic eczema (the most common form of eczema). Atopic eczema mainly affects children, but it can continue into adulthood or start later in life. The word eczema comes from the Greek word ekzein meaning "to boil out"; the Greek word ek means "out", while the Greek word zema means boiling.

Eczema is a chronic skin condition in which the skin becomes itchy, reddened, cracked and dry. Approximately 30% of all skin-related GP visits in Western Europe result in a diagnosis of atopic eczema. It affects both males and females equally, as well as people from different ethnic backgrounds. Most GPs (general practitioners, primary care physicians) in Western Europe, North America and Australia say the number of people diagnosed each year with eczema is has been rising in recent years.

Atopy is the hereditary predisposition toward developing some hypersensitivity reactions, such as hay fever, asthma, chronic urticaria, and some types of eczema. Atopic eczema, therefore, means a form of eczema characterized by atopy - in other words, inherited eczema.

Approximately 80% of atopic eczema cases start before the age of 5, and a sizeable number develops it during their first year of life.

Scottish researchers reported that children with severe eczema feel their quality of life is impaired to the same extent as those with chronic illnesses such as epilepsy, kidney disease and diabetes.

Many young children who get atopic eczema develop asthma months or years later, this is called The Atopic March. Scientists at Washington University School of Medicine in St. Louis found that a substance secreted by damaged skin circulates through the body and triggers asthmatic symptoms in laboratory mice when exposed to eczema-causing or dermatitis-causing agents, also known as allergens.

There are many types of eczema. This article focuses on atopic eczema.

What are the symptoms of eczema?

As atopic eczema is a chronic disease symptoms are generally present all the time. A chronic disease is a long-term one; one that persists for a long time. However, during a flare-up symptoms will worsen and the patient will probably require more intense treatment.

Below are some common symptoms of atopic eczema (without flare-up):
  • The skin may be broken in places.
  • Some areas of the skin are cracked.
  • The skin usually feels dry.
  • Many areas of skin are itchy, and sometimes raw if scratched a lot.
  • Itching usually worse at night.
  • Scratching may also result in areas of thickened skin.
  • Some areas of skin become red and inflamed.
  • Some inflamed areas develop blisters and weep (ooze liquid).
  • The skin has red to brownish-gray colored patches.
  • Areas of skin may have small, raised bumps.
Although the patches may occur in any part of the body's skin, they tend to appear on the hands, feet, arms, behind the knees, ankles, wrists, face, neck, and upper chest. Some patients have symptoms around the eyes, including the eyelids. Scratching around the eyes may eventually lead to noticeable loss of eyebrow and eyelash hairs. Babies tend to show symptoms on the face.

When there is a flare-up the previous symptoms still exist, plus some of the ones below:
  • The skin will be much more itchy.
  • Itchiness and scratching will make the skin redder, raw and very sensitive.
  • Many of the affected areas will feel hot.
  • The skin will be much more scaly and drier.
  • The raised bumps will be more pronounced and may leak fluid.
  • Blisters will appear.
  • The affected areas may be infected with bacteria.
Flare ups can last from a day or two to several weeks.

Patients with mild atopic eczema will generally have only small areas of dry skin which may itch sometimes. When symptoms are severe large areas of skin become very dry and the itching is constant. Many areas will ooze fluid.

A vicious circle can set in. It starts with unpleasant itching, then scratching which makes the itching worse, which makes the patient scratch more - eventually the skin can bleed. Children who get into this cycle can suffer serious sleep disruption and may find concentrating at school extremely challenging.

The following may worsen the symptoms of atopic eczema:
  • Prolonged hot showers or baths.
  • Allowing the skin to stay dry.
  • Mental stress.
  • Sweating.
  • Rapid temperature changes.
  • Dry air.
  • Certain fabrics for clothing, such as wool.
  • Cigarette smoke.
  • Dust.
  • Sand.
  • Some soaps, solvents, or detergents - a Swedish study found that linalool, the most common fragrance ingredient used in shampoos, conditioners and soap is a powerful allergen for a significant number of people.

What are the causes of atopic eczema?

Experts say that people with eczema are born with it - it is a genetically inherited condition. It can be worsened with exposure to external or environmental factors such as pollen or pet fur, and internal factors such as hormone levels and stress.

In 2006, scientists from the University of Dundee, with collaborators in Dublin, Glasgow, Seattle and Copenhagen, discovered the gene that causes dry, scaly skin and predisposes individuals to eczema.

In 2009 a study carried out by scientists at the University of Edinburgh concluded that the defects in a particular gene known as the filaggrin gene are linked to a considerably amplified risk of developing allergic disorders such as eczema, rhinitis, and asthma.

The oily (lipid) barrier of skin is usually reduced in people with atopic eczema, compared to other people. The lipid barrier helps prevent water loss. If your barrier is reduced you will lose water faster and your skin will be drier. Several studies have been confirming this, including this one.

The immune system cells of people with atopic eczema release chemicals under the skin's surface which may cause inflammation. Experts are not 100% sure why this happens. They just know that it is an immune system overreaction.

Even though scientists are fairly sure genetics are the primary cause, they do not yet know what the exact genetic cause is. The above-mentioned studies are giving us a better idea - but a great deal of further research is needed. 60% of children with atopic eczema have one parent with the same condition. Studies have shown that children run an 80% risk of developing eczema if both their parents have the condition.

Recent studies are starting to reveal a picture of early life lifestyle habits that may reduce the risk of developing eczema later on, either during early childhood or later on in life. An infant diet that includes fish before the age of 9 months curbs the risk of developing eczema, a Swedish study reported.

Environmental factors that make atopic eczema symptoms worse

Some scientists say that environmental factors are the ones causing the number of recent eczema cases in the developing world to rise. They argue that it is highly unlikely that genetic factors would change in such a short time.

Environmental factors are also known as allergens - they cause the body's immune system to overreact; an allergic reaction.

The three most common allergens for atopic eczema are:
  • House dust mites (bed bugs)
  • Pollen
  • Pet fur - children who are exposed to cats soon after birth may have an increased risk of developing eczema, according to a study carried out by researchers at the University of Arizona in Tucson, USA.
These three allergens are also the main ones that trigger asthma and hay fever.

Hard water

Several scientists have suggested that hard water may be bad for people with eczema. Scientists from the University of Portsmouth, England, are carrying out a study to find out whether installing a water-softener in the home might improve the symptoms of children with eczema. Results of their study should appear around the end of 2009.

Foods that may make atopic eczema symptoms worse

These are foods that typically cause allergic reactions in people with sensitive immune systems. These include:
  • Milk (cow's)
  • Eggs
  • Nuts
  • Soya
  • Wheat
About 10% of children with atopic eczema are affected by food allergens. Foods rarely affect the symptoms of adults with eczema.

Hormones can worsen symptoms

A significant proportion of women with eczema report that their symptoms worsen during their menstrual cycle. 30% of women have flare ups during the days preceding their menstrual period. 50% of women with eczema say their symptoms got worse when they were pregnant. These are all periods when a woman's hormone levels change.

Mental stress can make eczema symptoms worse

Doctors are not sure what exactly it is that causes a worsening of symptoms during mental stress. Atopic eczema patients commonly report that their symptoms are likely to get worse when they are mentally stressed. It is possible that a vicious cycle could develop - the symptoms of eczema stress the patient, the resulting stress exacerbates the symptoms, etc.

Winter is usually worse than summer

Most patient who do not live near the equator find that their symptoms are worse in the winter than the summer, even though pollen is an important trigger.

Diagnosis of eczema

No laboratory test or skin test currently exists which can diagnose atopic eczema.

A GP is able to diagnose atopic eczema after examining the patient and asking some questions about his/her symptoms and medical history - this will include questions about the presence of eczema in close family relative. The doctor will also ask about some other allergy-related conditions, such as asthma and hay fever.

A number of diagnostic criteria to confirm diagnosis

A doctor in the UK will assess the patient's skin against a number of diagnostic criteria in order to confirm an eczema diagnosis. The criteria include:
  • A long period with itchy skin - the patient has had itchy skin for the last 12 months.
Plus at least three of the criteria below:
  • Itching and irritation - itchiness and irritation in skin creases, such as the front of elbows, behind the knees, front of ankles, around the neck, or around the eyes.

  • Asthma or hay fever - the patient either has asthma or hay fever or has had them in the past. If the child is under four, the doctor will ask whether a close relative (brother, sister, mother, father) has asthma or hay fever.

  • Dry skin - the patient's skin has been dry for the last 12 months.

  • When it started - the condition started when the patient was two years old, or less. (If the patient is under four years of age this criterion is not used).

  • Joints - eczema is present either where skin covers the joints or the parts of the body that flex, such as wrists, knees, or elbows.
If the patient meets these criteria (the first, plus at least three of the others) the UK doctor will not usually have to carry out any further testing to confirm diagnosis.

Identifying trigger factors during diagnosis

The doctor will try to find out what triggers worsen the patient's symptoms. He/she will ask the patient questions about lifestyle, soaps and detergents used, diet, home environment, pets, where exactly the house is, etc.

Some doctors will ask the patient to keep a diary - the patient will note down such data as eating habits, clothes worn, what time of day symptoms are better or worse and where the patient was during those times, etc. The aim here is to identify as many trigger factors as possible.

What is the treatment for atopic eczema?

There is currently no cure for atopic eczema - there is no treatment that gets rid of it for good, as might be the case with surgery to cure blindness caused by cataracts. However, there are a variety of treatments which focus on the symptoms, as well as strategies to avoid triggers, and may improve the patient's quality of life considerably.

A significant proportion of children with atopic eczema will find that their symptoms will improve as they get older.

Self-care - What the patient can do
  • Avoid scratching

    Itchiness is a common part of eczema, and scratching is a natural reaction to deal with itching. Unfortunately, scratching will invariably further aggravate the skin and make symptoms worse. Scratching also raises the risk of infection.

    Getting an adult to control his/her scratching is hard enough - it is even harder for children. Children will often not be able to control the urge to scratch. It is important that nails are kept short and clean. Babies may benefit from anti-scratch mittens.

  • Avoid trigger factors

    A good doctor will have established a list of factors that trigger eczema flares. The patient should try to avoid them as much as possible. Parents/guardians need to remind children of triggers and help them devise strategies to avoid them - younger children may need to be reminded frequently.

    People with atopic eczema usually avoid clothes made of synthetic fibers and opt for natural materials, such as cotton.

    We know that dust mites are likely triggers for many people. However, most studies have shown that trying to eradicate them from your home is very time consuming and does not seem to be very effective in reducing the frequency and severity of flare-ups. Several patients have written into Medical News Today saying that when they get up in the morning they pull their sheets right back and do not make their beds for several hours, allowing the bed to be ventilated - this has helped them (bear in mind this information is not a study, and must be taken as anecdotal).

  • Nutrition

    It is important to check with your doctor before undergoing any large change in diet, especially if the patient is a child. Breastfeeding mothers whose babies have atopic eczema should check with their GP before embarking on any significant diet change. Milk, eggs, and nuts are common triggers.

    The German Institute for Quality and Efficiency in Health Care stresses that parents should be cautious about eliminating important foods like milk from their baby's or child's diet. In fact, their report says that avoiding foods may do more harm than good for children with atopic eczema, unless your child has a proven food allergy.

    If you have identified the triggers you should avoid them. However, if a child's trigger is milk he/she will need an alternative source of calcium. Always check with your doctor or a qualified nutritionist first before taking a major food source out of your or a child's diet.
Complementary therapies

These are very popular among patients with atopic eczema. They include aromatherapy, massage, homeopathy, and some herbal remedies, to mention but a few. It is important to remember that although patients do report benefits, a lot of information one reads in books and on the internet is anecdotal. For therapy to be convincing, it should undergo proper clinical tests, usually carried out and compared to a placebo (dummy treatment). Before undergoing any complementary/alternative therapy, check it out carefully.

Researchers at Mount Sinai Hospital in New York reported that treatments consisting of Erka Shizheng Herbal Tea, a bath additive, creams and acupuncture, effectively treated patients with persistent atopic eczema. Their findings were presented at the 2009 Annual Meeting of the American Academy of Allergy, Asthma & Immunology.

Another study, carried out by Scientists at the Chinese University of Hong Kong, found that a traditional Chinese herbal concoction, consisting of Flos lonicerae (Japanese honeysuckle), Herba menthae (peppermint), Cortex moutan (root bark of peony tree), Atractylodes Rhizome (underground stem of the atractylodes herb) and Cortex phellodendri (Amur cork-tree bark) may help people with eczema and reduced their needs for medications.

Bleach baths

Researchers from the Northwestern University Feinberg School of Medicine reported that bleach baths offer an effective treatment for kids' chronic eczema.


An emollient is an agent that softens and smoothes the skin - it can be a cream, lotion or ointment. They keep the skin supple and moist. Emollients are an important part of atopic eczema treatment. The skin of people with eczema is usually dry; emollients help keep them moisturized, which helps prevent cracking and irritation.

Finding the right emollient may be a question of trial-and-error at first. The patient may have to try several different ones before hitting on a suitable one. Patients usually end up needing different types of emollients for different parts of their body.

Some emollients are specific for very dry skin, while others are aimed at less dry skin. Ointments are generally prescribed for drier skin, while creams and lotions are usually prescribed for other skin types.

It is not uncommon for patients to find that an emollient is not longer as effective as it used to be. Others may start experiencing skin irritation after long-term use. If either case happens to you or your child, you should see your GP.
  • Applying an emollient - apply smoothly to the skin, following the direction the hair grows. Do not rub it in as this may irritate the skin. Gently dry the skin after washing and apply the emollient as soon as the skin is dry. Emollients must not be shared.

  • Creams and lotions are generally used for red, inflamed areas.

  • Ointments are usually used for dry areas that are not inflamed.

  • Apply often - Frequency is the key for effective emollient use. Do not stop applying it when the skin seems to be clear. Frequent use on known affected areas will significantly reduce the number of flare-ups, as well as their severity. Patient's whose skin is very dry should have repeat applications every two to three hours. During flare-ups frequency of use is paramount - this is when the skin needs the most moisture. Applications during a flare-up should be both frequent and generous.

    If your child has atopic eczema it is important that you liaise with his/her school. In the UK it is common for a child to have emollient supplies at home and at school.

  • Emollient instead of soap - emollient treatments should be used in place of soap. Soap irritates the skin if you have atopic eczema. In many countries it is possible to purchase emollient bath and shower additives. This measure will make a significant difference in the patient's frequency and severity of flare-ups.

  • Side effects of emollients - some patients may develop a rash with certain ingredients in a specific emollient. That is why people commonly have to try out different ones when they first start. Some emollients contain paraffin and can be a fire hazard - store them carefully and do not use them near a naked flame. Emollients may make the surface of the bath and the floor of the shower cubicle more slippery.
Topical corticosteroids

In medicine topical means "applied on to the skin". Corticosteroids rapidly reduce inflammation. If the patient's skin is very red and inflamed the doctor may prescribe a topical corticosteroid.

Many parents or adult patients react with alarm when the doctor utters any word with "steroid" in it. They imagine anabolic steroids that bodybuilders use. Corticosteroids are not anabolic steroids, and when used correctly, they are a safe and effective treatment for eczema.
  • Applying a corticosteroid - apply to the affected area sparingly. Follow the instructions on the leaflet carefully. You can also ask the doctor, and if you cannot remember, ask a qualified pharmacist.

  • Applying a corticosteroid during a flare-up - the corticosteroid should not be applied more than twice daily. Most patients will only require one application per day. After the flare-up has cleared up you should continue for another 48 hours.
If the patient is using corticosteroids on a long-term basis, he/she should check carefully with the doctor on how and when to apply it.

If you have tried corticosteroids and symptoms have not improved you should see your doctor.

Alitretinoin (Toctino)

Alitretinoin is used for patients with severe, chronic hand eczema who have not responded to other treatments. A specialist skin doctor (dermatologist) needs to supervise treatment with alitretinoin. Alitretinoin is a retinoid, a type of medication that helps lower levels of irritation and itchiness associated with eczema. Treatment usually consists of swallowing one tablet a day for 12 to 24 weeks.

Alitretinoin must NOT be taken by pregnant women or breastfeeding mothers. In most countries alitretinoin is not recommended for women of child-bearing age.

Side effects of alitretinoin include headaches, dry skin, flushed skin, joint pain, and muscle pain. The following extremely rare side-effects also exist: hair loss, blurred and distorted vision, and nose bleeds. Anybody who experiences blurred vision when taking this medication should contact the dermatologist immediately.


This type of medication stops the effects of histamine, which our body releases when in contact with an allergen. If the effects of histamine can be stopped or reduced, symptoms of eczema, hay fever, and some other allergic conditions are often significantly reduced.
  • Sedating antihistamines can make some people feel drowsy and are generally prescribed for itchiness at night - their drowsiness side-effect will help some patients get a good night's sleep. Sedating antihistamines are not usually prescribed for more than a couple of weeks at a time. They should be taken about one hour before going to bed. Sometimes drowsiness is still present the following day - it is important that the child's school knows this. If the patient is an adult and feels drowsy the following morning he/she should not drive or operate heavy machinery.

  • Non-sedating antihistamines may be used on a long-term basis. They will help ease itching but will not make the patient feel drowsy.

If the eczema becomes infected the patient will probably need an antibiotic.
  • Oral antibiotic - An oral antibiotic will be prescribed if symptoms are very severe and infection has affected a large area. The most commonly prescribed antibiotic is flucloxacillin, which should be taken for seven days. If you or your child are allergic to penicillin a different antibiotic will be prescribed, perhaps erythromycin or clarithomycin.

  • Topical antibiotic - if symptoms are not so severe and the infection does not cover a large area the patient will most likely be prescribed a topical antibiotic - one that is applied directly onto the affected area. This will usually be an ointment or a cream.
The doctor may prescribe new supplies of topical medications in case your current ones have become infected.

Patients who have areas which are prone to recurrent infection may be prescribed a topical antiseptic, which is applied directly onto the targeted area of skin. Examples include chlorhexidine and triclosan.

Light Therapy (Phototherapy)

This involves the use of natural or artificial light. In its most simple form, all the patient has to do is expose himself/herself to controlled amounts of natural sunlight.

Other forms of phototherapy include using artificial ultraviolet A (UVA) or ultraviolet B (UVD) light, either on its own or in combination with drugs.

Light therapy is very effective. It is important that it is done with a qualified health care professional. Exposure to sunlight has many beneficial effects, but it does, however, also have risks if not controlled properly. Examples of risks include premature skin aging and a higher risk of developing skin cancer.

When to see a specialist

The GP may refer a patient to a specialist skin doctor (dermatologist) if:
  • The patient has not responded to treatment.
  • The GP is uncertain about what is causing the eczema.
  • The patient insists the GP refers him/her or the child to a specialist.
  • The GP thinks the patient would benefit from specialist treatment, such as ultraviolet light exposure, bandaging treatments (wet wraps), or calcineurin inhibitors.

Complications of atopic eczema


If the skin becomes dry and cracked there will be an opportunity for bacteria to penetrate. The likelihood of this happening is greater for people with eczema. Scratching the eczema increases the risk of infection further.

A bacterium called Staphylococcus aureus (S. aureus) commonly infects people with eczema. An infection with S. aureus will make the eczema much worse, causing increased redness, oozing of fluid and crusting of the skin, making it virtually impossible for the skin to heal naturally (without antibiotics).

Psychological effects

The mental stress of living with eczema can have a psychological impact on the sufferer, especially if it started very early in life. Children with atopic eczema are much more likely to have behavioral problems at school, compared to their peers who do not have it. Parents sometimes comment that their child with atopical eczema is much more clingy than their other children.

The stress can also come from other people. More than a quarter of patients with atopic eczema have been bullied or teased because of their skin condition, according to an international study.

Children with eczema frequently suffer from a lack of self-confidence. Family support and encouragement is a crucial factor in helping them overcome this. If your child's self-confidence appears to be seriously undermined, talk to a health care professional, as well as the staff at his/her school.

Sleep problems

The majority of children with atopic eczema have sleep-related problems. Lack of sleep can have an impact on the patient's physical and mental health.
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