(American) A faithful woman Promice, Promyse, Promyce, Promis, Promiss, Promys, Promyss
The local effects of the tumour commonly cause headache and, less frequently, impairment of vision, particularly of the temporal ?eld of vision, as a result of pressure on the nerves to the eye. The tumour may damage the other pituitary cells giving rise to gonadal, thyroid or adrenocortical insu?ciency. The disease often becomes obvious in persons over about 45 years of age; they may also complain of excessive sweating, joint pains and lethargy. The diagnosis is con?rmed by measuring the level of growth hormone in the serum and by an X-ray of the skull which usually shows enlargement of the pituitary fossa.
Treatment The most e?ective treatment is surgically to remove the pituitary adenoma. This can usually be done through the nose and the sphenoid sinus, but large adenomas may need a full CRANIOTOMY. Surgery cures about 80 per cent of patients with a microadenoma and 40 per cent of those with a large lesion; the rate of recurrence is 5–10 per cent. For recurrences, or for patients un?t for surgery or who refuse it, a combination of irradiation and drugs may be helpful. Deep X-ray therapy to the pituitary fossa is less e?ective than surgery but may also be helpful, and recently more sophisticated X-ray techniques, such as gamma knife irradiation, have shown promise. Drugs – such as BROMOCRIPTINE, capergoline and quiangoline, which are dopamine agonists – lower growth-hormone levels in acromegaly and are particularly useful as an adjunct to radiotherapy. Drugs which inhibit growth-hormone release by competing for its receptors, octeotride and lanreotride, also have a place in treatment.
See www.niddk.nih.gov/health/endo/pubs/ acro/acro.htm
www.umm.edu/endocrin/acromegaly.htm... acromegaly
Ghisele, Ghisella, Gisela, Giselda, Gisele, Gisella, Giza, Gizela, Gizella, Gizelle, Gisel, Gisilberhta, Gisselle, Gisli, Gizi, Gizike, Gizus... giselle
Carried out as two separate exercises – one by a privately funded American team; another by an international joint venture between tax-funded American laboratories, a charitably funded British one and several other smaller research teams from around the world – the ?rst results were announced on 26 June 2000. In February 2001 the privately funded American group, known as Celera Genomics, announced that it had identi?ed 26,558 genes. At the same time the Human Genome Project consortium reported that it had identi?ed 31,000. Allowing for margins of error, this gives a ?gure much lower than the 100,000 or more human genes previously forecast by scientists. Interestingly, genes were found to make up only 3 per cent of the human genome. The remaining 97 per cent of the genome comprises non-coding DNA which, though not involved in producing the protein-initiating genetic activity, does have signi?cant roles in the structure, function and evolution of the genome.
One surprise from the Project so far is that the genetic di?erences between humans and other species seem much smaller than previously expected. For example, the Celera team found that people have only 300 genes that mice do not have; yet, the common ancestor of mice and men probably lived 100 million years or more in the past. Mice and humans, however, have around twice as many genes as the humble fruit ?y.
Cells die out when they become redundant during embryonic development: genes also die out during evolution, according to evidence from the Genome Project – a ?nding that supports the constant evolutionary changes apparent in living things; the Darwinian concept of survival of the ?ttest.
Apart from expanding our scienti?c knowledge, the new information – and promise of much more as the Genome Project continues – should enhance and expand the use of genetic engineering in the prevention and cure of disease. Studies are in progress on the gene for a receptor protein in the brain which will shed light on how the important neurotransmitter SEROTONIN in the brain works, and this, for example, should help the development of better drugs for the treatment of DEPRESSION. Another gene has been found that is relevant to the development of ASTHMA and yet another that is involved in the production of amyloid, a complex protein which is deposited in excessive amounts in both DOWN’S (DOWN) SYNDROME and ALZHEIMER’S DISEASE.... human genome
Interferon alfa – previously termed leucocyte interferon or lymphoblastoid interferon – has some antitumour e?ect in some solid tumours and lymphomas. It is also used to treat HEPATITIS B and C (chronic variety). Various side-effects include suppression of MYELOBLAST production. Interferon beta – previously termed ?broblast interferon – is used (under restricted conditions in the UK) to treat patients with relapsing, remitting MULTIPLE SCLEROSIS (MS), and interferon beta-16 is licensed for use in patients with the secondary progressive type of this disorder. The use of interferon, which has a range of side-effects, should be recommended by a neurologist.... interferon
BURSITIS, TENDINITIS and non-speci?c back pain (see BACKACHE).
Osteoarthritis (OA) rarely starts before 40, but by the age of 80 affects 80 per cent of the population. There are structural and functional changes in the articular cartilage, as well as changes in the collagenous matrix of tendons and ligaments. OA is not purely ‘wear and tear’; various sub-groups have a genetic component. Early OA may be precipitated by localised alteration in anatomy, such as a fracture or infection of a joint. Reactive new bone growth typically occurs, causing sclerosis (hardening) beneath the joint, and osteophytes – outgrowths of bone – are characteristic at the margins of the joint. The most common sites are the ?rst metatarsal (great toe), spinal facet joints, the knee, the base of the thumb and the terminal ?nger joints (Heberden’s nodes).
OA has a slow but variable course, with periods of pain and low-grade in?ammation. Acute in?ammation, common in the knee, may result from release of pyrophosphate crystals, causing pseudo-gout.
Urate gout results from crystallisation of URIC ACID in joints, against a background of hyperuricaemia. This high concentration of uric acid in the blood may result from genetic and environmental factors, such as excess dietary purines, alcohol or diuretic drugs.
In?ammatory arthritis is less common than OA, but potentially much more serious. Several types exist, including: SPONDYLARTHRITIS This affects younger men, chie?y involving spinal and leg joints. This may lead to in?ammation and eventual ossi?cation of the enthesis – that is, where the ligaments and tendons are inserted into the bone around joints. This may be associated with disorders in other parts of the body: skin in?ammation (PSORIASIS), bowel and genito-urinary in?ammation, sometimes resulting in infection of the organs (such as dysentery). The syndromes most clearly delineated are ankylosing spondylitis (see SPINE AND SPINAL CORD, DISEASES AND INJURIES OF), psoriatic or colitic spondylitis, and REITER’S SYNDROME. The diagnosis is made clinically and radiologically; no association has been found with autoantibodies (see AUTOANTIBODY). A particularly clear gene locus, HLA B27, has been identi?ed in ankylosing spondylitis. Psoriasis can be associated with a characteristic peripheral arthritis.
Systemic autoimmune rheumatic diseases (see AUTOIMMUNE DISORDERS). RHEUMATOID ARTHRITIS (RA) – see also main entry. The most common of these diseases. Acute in?ammation causes lymphoid synovitis, leading to erosion of the cartilage, associated joints and soft tissues. Fibrosis follows, causing deformity. Autoantibodies are common, particularly Rheumatoid Factor. A common complication of RA is Sjögren’s syndrome, when in?ammation of the mucosal glands may result in a dry mouth and eyes. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) and various overlap syndromes occur, such as systemic sclerosis and dermatomyositis. Autoantibodies against nuclear proteins such as DNA lead to deposits of immune complexes and VASCULITIS in various tissues, such as kidney, brain, skin and lungs. This may lead to various symptoms, and sometimes even to organ failure.
Infective arthritis includes: SEPTIC ARTHRITIS An uncommon but potentially fatal disease if not diagnosed and treated early with approriate antibiotics. Common causes are TUBERCLE bacilli and staphylococci (see STAPHYLOCOCCUS). Particularly at risk are the elderly and the immunologically vulnerable, such as those under treatment for cancer, or on CORTICOSTEROIDS or IMMUNOSUPPRESSANT drugs. RHEUMATIC FEVER Now rare in western countries. Resulting from an immunological reaction to a streptococcal infection, it is characterised by migratory arthritis, rash and cardiac involvement.
Other infections which may be associated with arthritis include rubella (German measles), parvovirus and LYME DISEASE.
Treatment Septic arthritis is the only type that can be cured using antibiotics, while the principles of treatment for the others are similar: to reduce risk factors (such as hyperuricaemia); to suppress in?ammation; to improve function with physiotherapy; and, in the event of joint failure, to perform surgical arthroplasty. NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) include aspirin, paracetamol and many recently developed ones, such as the proprionic acid derivatives IBUPROFEN and naproxen, along with other drugs that have similar properties such as PIROXICAM. They all carry a risk of toxicity, such as renal dysfunction, or gastrointestinal irritation with haemorrhage. Stronger suppression of in?ammation requires corticosteroids and CYTOTOXIC drugs such as azathioprine or cyclophosphamide. Recent research promises more speci?c and less toxic anti-in?ammatory drugs, such as the monoclonal antibodies like in?iximab. An important treatment for some osteoarthritic joints is surgical replacement of the joints.... joints, diseases of
A single virus particle, known as a virion, comprises an inner core of NUCLEIC ACID which is surrounded by one or two protective coverings (capsid) made of protein. Sometimes the capsid is enclosed by another layer called the viral envelope (also a protein structure). The envelope often disintegrates when the virus invades a cell. Viruses enter cells and then indulge in a complex and variable process of replication using some of the cells’ own structure. Viruses may stay in a host’s nucleus, being reactivated months or years later. There are more than a score of large families of viruses, from papoviruses, which cause WARTS, through HERPES viruses (cold sores, CHICKENPOX, SHINGLES) and orthomyxoviruses (in?uenza), to corona viruses (common cold) and retroviruses (AIDS/HIV). Viral diseases are more dif?cult to treat than those caused by bacteria: ANTIBIOTICS are ine?ective but INTERFERON, a group of natural substances, shows promise. IMMUNISATION is the most e?ective way of combating viral infections; smallpox, poliomyelitis, MUMPS, MEASLES and RUBELLA are examples of viral diseases which have been successfully combated. Research is progressing to ?nd a vaccine against HIV.... virus
Causes: exposure to chemicals, X-rays or radioactive material. Genetic factors are believed to predispose. The condition may be acute or chronic and may follow chemotherapy.
Remissions are known to have been induced by a preparation from the Periwinkle plant (Vinca rosea) now re-classified as Catharanthus roseus.
“Smokers suffer a significantly increased risk of developing acute myelocytic leukaemia.” (“Cancer”: 1987 vol 60, pp141-144)
Acute Leukaemia. Rapid onset with fatality within weeks or months. Fever. Proliferation of white cells in the bone marrow which are released and blood-borne to the liver, spleen and lymphatics. There may be bleeding from kidneys, mouth, bowel and beneath the skin. (Shepherd’s Purse, Yarrow) The acute form is known also as acute lymphoblastic or acute myeloblastic leukaemia. May be mis-diagnosed as tuberculosis.
Chronic Leukaemia. Gradual onset. Breathlessness from enlargement of the spleen. Swelling of glands under arms, in neck and groin. Loss of weight, appetite, strength, facial colour and body heat. Anaemia, spontaneous bleeding and a variety of skin conditions. Diarrhoea. Low grade fever.
No cure is known, but encouraging results in orthodox medicine promise the disease may be controlled, after the manner of diabetes by insulin. Successful results in such control are reported by Dr Hartwell, National Cancer Institute, Maryland, USA, with an alkaloid related to Autumn Primrose (Colchicum officinale). Vinchristine, a preparation from Periwinkle is now well-established in routine treatment. Red Clover, also, is cytotoxic to many mammalian cells. Vitamin C (present in many herbs and fruits) inhibits growth of non-lymphoblastic leukaemia cells. Good responses have been observed by Dr Ferenczi, Hungary, by the use of raw beet root juice.
Also treated with success by Dr Hartland (above) has been lymphocytic leukaemia in children which he treated with a preparation from Periwinkle.
Choice of agents depends largely upon the clinical experience of the practitioner and ease of administration. Addition of a nerve restorative (Oats, Kola, Black Cohosh or Helonias) may improve sense of well-being. To support the heart and circulatory system with cardiotonics (Hawthorn, Motherwort, Lily of the Valley) suggests sound therapy.
Herbal treatment may favourably influence haemoglobin levels and possibly arrest proliferation of leukaemic cells and reduce size of the spleen. It would be directed towards the (a) lymphatic system (Poke root), (b) spleen (Tamarinds), (c) bone marrow (Yellow Dock), and (d) liver (Blue Flag root).
An older generation of herbalists prescribed Blue Flag root, Yellow Dock, Poke root, Thuja and Echinacea, adding other agents according to indications of the particular case.
Tea. Formula. Equal parts: Red Clover, Gotu Kola, Plantain. 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes. 1 cup thrice daily.
New Jersey tea (ceanothus). 1 teaspoon to each cup boiling water. Half-1 cup thrice daily.
Periwinkle tea (Vinca rosea). 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Decoction. Formula. Equal parts: Echinacea, Yellow Dock, Blue Flag root. 1 teaspoon to each cup water gently simmered 20 minutes. 1 cup before meals thrice daily.
Formula. Red Clover 2; Yellow Dock 1; Dandelion root 1; Thuja quarter; Poke root quarter; Ginger quarter. Dose: Liquid Extract: 1 teaspoon. Tinctures: 1-2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Vinchristine. Dosage as prescribed. In combination with other medicines.
Wheatgrass. Juice of fresh Wheatgrass grown as sprouts and passed through a juicer. Rich in minerals. One or more glasses daily.
Beetroot juice. Rich in minerals. Contains traces of rare rabidium and caesium, believed to contribute to anti-malignancy effect. (Studies by Dr A. Ferenczi, Nobel Prize-winner, published 1961)
Diet: Dandelion coffee.
Supplements. B-complex, B12, Folic acid, Vitamin C 2g morning and evening, Calcium ascorbate 2g morning and evening. Copper, Iron, Selenium, Zinc.
Childhood Leukaemia. Research has linked the disease with fluorescent lighting. “Fluorescent tubes emit blue light (400mm wavelength). Light penetrates the skin and produces free radicals. Free radicals damage a child’s DNA. Damaged DNA causes leukaemia to develop. The type and intensity of lighting in maternity wards should be changed. This could be prevented by fitting cheap plastic filters to fluorescent lights in maternity wards.” (Peter Cox, in “Here’s Health”, on the work of Dr Shmuel Ben-Sasson, The Hubert Humphrey Centre of Experimental Medicine and Cancer Research, Jerusalem)
Treatment by hospital specialist. ... leukaemia
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