Kids Research Express

Hyperopia

Hyperopia, also called farsightedness, refractive error or abnormality in which the cornea and lens of the eye focus the image of the visual field at an imaginary point behind the retina (the light-sensitive layer of tissue lining the back and sides of the eye). The retina thus receives an unfocused image of near objects, though distant objects may be in focus. Hyperopia frequently occurs when an eye is shorter than normal from front to rear; the lens is then unable to increase its convexity sufficiently to focus the images of close objects onto the retina. Corrective lenses for hyperopia are designed to supply the additional convexity needed for focusing. Hyperopic laser in situ keratomileusis (H-LASIK) and photorefractive keratectomy for hyperopia (H-PRK) are common surgical methods that reshape the cornea to improve vision in hyperopic patients.

Macular Degeneration

Macular Degeneration, leading cause of irreversible vision loss in the United States. This incurable condition attacks the central portion of the retina, the part of the eye that receives light patterns and transmits them to the brain. Macular degeneration progressively damages or destroys the part of vision used for reading and seeing fine details, while leaving the peripheral vision generally unaffected. People who have this disorder develop an area of vision loss that increases in diameter until they are unable to read or even see groups of two to three words at normal reading distance. Macular degeneration usually develops in both eyes, with one eye generally more affected than the other.

Although children can develop forms of macular degeneration such as Stargardt's disease, 99 percent of the cases occur in older people. Age-related macular degeneration (AMD) may affect as many as 15 million Americans over the age of 50, and one-fifth of people over 75 show at least some symptoms. This article focuses on AMD, the most common form of the disease.

AMD targets the most sensitive part of the retina, a cluster of cells called the macula located directly in its center. There are two forms of AMD, dry AMD and wet AMD. In the dry form, which accounts for about 90 percent of AMD cases, the macular cells slowly waste away, causing gradual vision loss. In most cases this vision loss progresses no further than permanent blurring of the central field of vision. In the wet form, abnormal growth of blood vessels beneath the macula causes bleeding and scarring. The result is severe damage to the macula that may completely destroy the patient’s central vision.

Ophthalmologists (medical doctors with special training in diagnosing and treating eye disorders) diagnose AMD with a thorough eye exam. Visible light imaging and infrared imaging, procedures that use cameralike devices that make it easier to see abnormal blood vessels, are useful in identifying wet AMD. An ophthalmologist injects a patient with fluorescent dye that travels to the eye through blood vessels. These imaging devices snap a series of 15 to 30 pictures over a five-to ten-minute period that track the progression of dye leakage from damaged blood vessels beneath the macula.

Although the cause of AMD is still unknown, people with light-colored eyes or a family history of macular degeneration are more vulnerable to AMD. Through research on the mutated gene that causes Stargardt’s disease, scientists have discovered what they believe to be a genetic trigger for the disease. Researchers have found that 16 percent of AMD patients have alterations in this same gene. Through this growing body of research, many scientists now consider heredity to be a significant risk factor in AMD. Some evidence suggests that smokers—particularly women—and people who spend a great deal of time outdoors without eyewear that offers protection from the sun’s ultraviolet rays may have a higher rate of AMD. Hypertension also appears to increase a person’s risk of developing AMD.

No treatment is available for most cases of macular degeneration. In a small percentage of early-stage cases of wet AMD, laser surgery can seal off the leaking blood vessels to slow vision loss, but the leaks frequently recur. Medical researchers are experimenting with cellular transplants designed to replace damaged macular cells with healthy cells. New drug treatments being studied include the use of thalidomide, which slows the growth of blood vessels.

Sparse scientific evidence exists to support controversial theories that nutrition and other lifestyle factors can reduce the risk or progress of macular degeneration. However, researchers believe that vitamins A, C, and E may slow the progression of the disease.

As scientists continue to search for ways to prevent this disease or halt its progression, patients must rely on special magnifying devices that help them read and watch television. High-powered eyeglasses, handheld or mounted magnifiers, telescopes, special illumination lamps, and extra-large type are all available to AMD patients, and new devices are under development. However, people who develop this disorder generally continue to live very independent lives and can still drive if their vision complies with vision regulations for day and evening driving.

Thalidomide

Thalidomide, drug introduced in 1953, initially prescribed for its sedative properties and widely used by women to alleviate the nausea and vomiting common in the early stages of pregnancy. Thalidomide gained notoriety in 1961 when it was found to cause severe malformations in the growing fetus such as stunted development or the complete absence of limbs. More than 10,000 children were born with these disabling abnormalities before the drug was taken off the market. This disaster triggered more rigorous government regulations for drug testing. Today thalidomide is used in the treatment of leprosy, and experimentally in bone-marrow transplant patients and certain immune system disorders.

HISTORY

While its commercial distribution was halted, thalidomide continued to be used in experimental studies for a variety of diseases. A series of studies beginning in the mid-1960s showed that thalidomide was effective in treating a leprosy-related disorder, erythema nodosum leprosum (ENL). A serious skin disorder, ENL usually develops in leprosy patients after they begin taking antibiotics to combat the leprosy-causing bacterium Mycobacterium leprae. ENL is believed to be caused by an abnormal immune reaction to the killed bacteria.

The FDA approved thalidomide for the treatment of ENL in July 1998, at the same time placing unprecedented restrictions on the drug’s use. Under these restrictions, thalidomide can only be obtained from selected doctors and pharmacies that have agreed to follow a strict protocol designed to prevent birth defects from the drug. Both men and women taking the drug must use birth control during sexual intercourse, and women must also agree to undergo periodic pregnancy tests.

Thalidomide’s success in treating ENL, although not fully understood, triggered extensive studies into the drug’s effects on the immune system. Some studies suggest that thalidomide reduces the production of tumor necrosis factor-alpha (TNF-a), a protein made by immune cells that may cause problems such as wasting, or chronic weight loss, when produced in excessive amounts. Thalidomide has also been proven to heal painful canker sores in the mouth of patients with acquired immunodeficiency syndrome (AIDS) or other patients with impaired immune systems. Canker sores in these patients do not heal as readily as in people with normal immune systems, and the sores make eating difficult.

Early evidence suggests that thalidomide effectively suppresses the body’s rejection of donor bone marrow that sometimes occurs in bone-marrow transplant patients. Thalidomide is also being studied as a possible treatment for various cancers and other diseases because of its ability to inhibit growth of new blood vessels. This inhibition could slow or completely prevent growth of cancerous tumors that require new blood vessels in order to thrive.

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Do You Have Leaky Gut Syndrome?

Do You Have Leaky Gut Syndrome?
by Dr. Leo Galland

Because it is something of a mystery disease that can show itself as a bewildering array of other conditions, you could have Leaky Gut Syndrome and not even realize it.

The reason is that Leaky Gut Syndrome is one of the many concepts in medicine that cuts across the boundary lines of specific diseases.

It is a major example of an important medical phenomenon: distress in one organ causes disease in another.

Conditions that Can Signal Leaky Gut Syndrome

Do you have:

Psoriasis,

Chronic fatigue syndrome or fibromyalgia?

Then you may also have Leaky Gut Syndrome, because it causes or contributes to these conditions.

That’s why getting a better understanding of Leaky Gut Syndrome may help you find a more effective solution to your condition.

I am telling you about Leaky Gut Syndrome because it is a vitally important, but often undiagnosed, condition that is key to recovering from many illnesses and regaining robust good health.

An Integrated Approach to Leaky Gut Syndrome

I’ve been evaluating patients for Leaky Gut Syndrome for over twenty years, and have been writing about my integrated approach to this condition. My article “Leaky Gut Syndromes: Breaking the Vicious Cycles” is available at the Foundation for Integrated Medicine website.

Through my clinical experience and further research I came to understand how gastrointestinal health in general, and Leaky Gut Syndrome in particular, contributes to many seemingly unrelated conditions.

To share my knowledge and help my colleagues learn more about this important topic I wrote a chapter titled “Integrative Approach to the Gastrointestinal System” for the textbook Integrative Medicine: Principles for Practice in 2004 and authored the book-length monograph Gastrointestinal Dysregulation: Connections to Chronic Disease, in 2008.

I have found Leaky Gut Syndrome especially relevant for many people with chronic fatigue syndrome.

Scientific Research Connects Leaky Gut with Chronic Fatigue and Depression

Recent research from Belgium confirms my observations about Leaky Gut Syndrome and chronic fatigue syndrome and suggests a treatment plan that can alleviate chronic fatigue and also major depression.

The Belgian researchers found that people in their study with either chronic fatigue syndrome or major depressive disorder showed laboratory evidence of Leaky Gut Syndrome, when compared to a healthy control group.

More importantly, they demonstrated that treatment with diet and specific nutrients not only reversed laboratory signs of the Leaky Gut Syndrome, but also improved symptoms of fatigue, malaise and depression.

I’ll describe my approach to this condition, and what lessons we can take away from the research from Belgium.

But first, I want to give you some background on Leaky Gut Syndrome and explain why the concept is still so controversial.

What is Leaky Gut Syndrome?

Because it connects apparently unrelated disorders, Leaky Gut Syndrome is one of the most misunderstood concepts in medicine today.

To begin with, Leaky Gut is not a single disease or syndrome; it’s a pathological condition that occurs as part of many different diseases and syndromes. The term refers to an abnormal increase in the permeability of the small intestine. Increased intestinal permeability is a component of many different disorders.

Leaky Gut Syndrome is associated with:

Inflammatory and infectious bowel diseases

Several types of arthritis

Acne

Psoriasis

AIDS

Chronic liver disease

Pancreatic disease

as well as numerous conditions triggered by food allergy, including eczema, hives, and irritable bowel syndrome

Why is increased small intestinal permeability such a problem?

The small intestine is the largest organ in your body and two-thirds of your immune system lies within its walls. The small intestine continuously activates itself by sampling the molecules that pass through the intestinal lining.

Leaky Gut Syndrome is increased permeability of this lining, and it alters the molecules which prime your immune system for action by allowing molecules that don’t ordinarily pass through the gut lining to get access to your immune system.

Sometimes, Leaky Gut Syndrome plays a primary role in the evolution of an illness.

Crohn’s disease is a serious chronic intestinal disorder that effects almost a million people in the United States. People who develop Crohn’s disease may have a genetically induced increase in intestinal permeability that creates the inflammation in the bowel. This predisposing leakiness can be found in close relatives of patients with Crohn’s diseases, suggesting that it precedes the development of inflammation.

Leaky Gut Syndrome can occur as a result of another disease.

Celiac disease is an inherited intolerance to gluten, a group of proteins found in wheat, barley and rye. Celiac disease affects about one person in a hundred in North America and often goes undiagnosed, even when people have severe symptoms. The inflammation caused by active celiac disease causes the leaky gut, which in turn causes some of the complications associated with celiac disease.

Leaky Gut Syndrome can also be caused by the treatment for another disease.

In rheumatoid arthritis, for example, the drugs used to relieve pain and inflammation can damage the intestinal lining, leading to Leaky Gut Syndrome within two weeks. Leaky Gut Syndrome, in turn, is associated with aggravation of arthritis.

For most conditions, the precise role of Leaky Gut Syndrome remains unclear, but it seems to be part of a vicious cycle that makes the condition get worse over time. Allergic reactions to food, for example, cause a transient increase in intestinal permeability. If this happens frequently, it may increase the number or severity of food allergies.

In chronic fatigue syndrome and major depressive disorder, Leaky Gut Syndrome activates the intestinal immune system to produce chemicals called cytokines that spread inflammation through your body.

Inflammation is an important trigger for symptoms like fatigue, malaise, pain, and depression.

When should you suspect Leaky Gut Syndrome?

If you have:

pain in multiple joints

a chronic skin condition

chronic diarrhea or abdominal pain,

chronic fatigue,

chronic depression,

malaise,

a feeling of being infected but your doctor can’t find the infection…

or if you use aspirin or anti-inflammatory drugs on a regular basis, or if you’re a heavy drinker of alcohol.

Recent research in animals has indicated that Leaky Gut Syndrome may also be associated with difficulty losing or gaining weight, but its association with obesity is still under investigation.

How can the possibility of Leaky Gut Syndrome be evaluated?

There are only a few laboratories that test for Leaky Gut Syndrome and all require a doctor’s order. Talk to your doctor about what test might be appropriate. High levels of antibodies to common food proteins or to normal intestinal bacteria may indicate increased intestinal permeability. Many research studies have used a challenge test involving a special solution consisting of two sugars, and seeing how much of each appears in urine. A blood test for celiac disease is essential.

Five Steps to Help Heal Leaky Gut Syndrome

Get rid of anything that might be causing or contributing to increased intestinal permeability:

1) Stop drinking alcohol for at least a month.

2) Stop using aspirin, ibuprofen, naproxen and other non-steroidal anti-inflammatory drugs (NSAIDS).

3) Have a stool test for intestinal parasites. There is extensive medical literature on intestinal parasites causing symptoms like fatigue, joint pain and skin disorders, without causing diarrhea. I discuss these in a chapter I wrote titled, “Intestinal Protozoan Infestation and Systemic Illness”, for the Textbook of Natural Medicine, 3rd Edition, in 2005.

4) Adopt an anti-inflammatory dietary pattern. I explain the benefits of eating to reduce inflammation, and provide a plan to achieve that, in my book, The Fat Resistance Diet. The principles are simple to understand: avoid foods with added sugar and refined starches, made from white flour. Decrease consumption of saturated fat and most vegetable oils, using extra virgin olive oil instead. Eat at least 9 servings of fruits and vegetables a day and at least 4 servings of fish per week.

5) There are dietary supplements that help the small intestine heal and restore its functional integrity. The most important of these are the amino acid L-glutamine and the amino sugar N-acetyl- glucosamine, which are readily available in health food stores.

These are but a few introductory steps toward an integrated approach to this condition. There is a vast amount of scientific literature on Leaky Gut Syndrome, a sample of which appear in the references below from journals such as The Lancet, The British Medical Journal and The Annals of Internal Medicine.

References:

1) Townsend Letter for Doctors, August/September 1995, p. 63. “Leaky Gut Syndromes: Breaking the Vicious Cycles.” Galland L. Online version available at http://www.mdheal.org/leakygut.htm
2) J Affect Disord. 2007 Apr;99(1-3):237-40.”Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS): indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability.” Maes M, Mihaylova I, Leunis JC.

Why Medication Can Be Dangerous to Your Health

by Dr. Leo Galland

Did you know that the majority of FDA approved drugs have serious potential side effects that were not detected before marketing approval? (1)

That about three quarters of a million people a year are rushed to emergency rooms in the U.S. because of adverse drug reactions, according to the CDC? (2)

That the number of medication-related deaths in the U.S. is estimated at over 200,000 a year, making medications the third or fourth leading cause of death in this country? (3)

That even common pain relievers called NSAIDs, examples of which include Advil, Motrin, Aleve and aspirin, account for an estimated 7,600 deaths and 76,000 hospitalizations in the U.S. every year? (4)

It sounds like the cure could be worse than the disease in far too many cases.

Thankfully, there is an option, an innovative approach to healing that seeks to restore balance and healthy function, instead of simply treating symptoms with drugs and suffering the side effects. I call it integrated medicine, and it is a powerful and effective way to address chronic illness…more on that in a moment.

But first, let me explain in brief why the everyday medications Americans rely upon are so dangerous.

The reason is simple and based upon the basic nature of modern drug therapy.

Most drugs used today are intended to act like biochemical strait jackets. They suppress cellular functions that appear to be overactive.

You can see this by looking at the names given to categories or classes of drugs. Almost all include “blocker,” “inhibitor” “anti-“ in the description: beta-blockers, calcium blockers, ACE inhibitors, proton pump inhibitors, anti-histamines, and anti-inflammatories. These drugs are developed to treat disease by interfering with the biochemical processes involved in illness.

But they also interfere with the natural and healthy functions of the body.

It’s like throwing a wrench into a sophisticated machine in an effort to fix it.

Furthermore, the biochemical processes they inhibit are rarely the cause of the illness. They are just part of the many changes in the body that accompany disease. Outside the setting of disease these biochemical processes all play important roles in normal cellular function.

It’s no wonder that many of these drugs have side effects that are a direct extension of their therapeutic actions. (5) They are not restoring normal cellular function; they are merely inhibiting cellular hyperactivity.

NSAIDs (nonsteroidal anti-inflammatory drugs) are an excellent example and include common over the counter drugs such as aspirin (Bayer, Bufferin and Excedrin), ibuprofen (Advil, Motrin and Nuprin), and naproxen (Aleve). They relieve pain and inflammation by blocking an enzyme called cyclo-oxygenase (COX).

Although COX activity contributes to pain and inflammation, this enzyme also performs important functions such as:

Protecting the stomach from the corrosive effects of its own acid,

Regulating circulation of blood to the kidneys,

Modulating the activity of the immune system.

NSAID use can have severe side effects, which are a direct result of COX inhibition.

The documented side effects of chronic NSAID use include:

Stomach ulcers

Intestinal bleeding

Kidney failure

High blood pressure

Aggravation of immune system disorders like asthma, Psoriasis and Colitis.

When you took an NSAID, let’s say for a headache, were you aware that you could just be trading one problem for another?

The search for a safer type of NSAID led to the development of drugs called selective COX inhibitors. As their name suggests, they’re selective in their effect, designed to inhibit only the so-called “bad” COX enzyme, without inhibiting the so-called “good” COX enzyme.

This approach created one of the most highly anticipated drug releases in the history of medicine: Vioxx.

Vioxx was a disaster; it increased the death rate from heart attacks and strokes and was withdrawn from the market.

What the scientists behind Vioxx failed to recognize is that all forms of the COX enzyme are important for health. (13)

So instead of giving us a safer drug therapy, it was like tossing a different type of wrench into the machine.

The idea that there are “bad” enzymes and “good” enzymes or “bad” hormones and “good” hormones is a total misrepresentation of how the body works. But the pharmacology underlying conventional medical treatments is based upon that misrepresentation.

Fortunately there is another way of looking at health and healthcare that addresses the underlying causes of illness: integrated medicine.

The great value of integrated medicine is that it provides alternative strategies for healing, based upon enhancing normal physiological balance instead of merely attempting to suppress the hyperactive biochemistry involved in disease.

One of the powerful strategies of integrated medicine is the therapeutic use of nutrition. Nutritional therapy, when properly used, can achieve results that drugs cannot, because nutrients are essential components of the cellular information network. An excellent example is omega-3 fatty acids.

Thirty years ago I pioneered the therapeutic uses of omega-3 fatty acids in my research, scholarly writing and teaching of medical faculty. Seeking to educate the wider public about the importance of omega-3’s and other dietary fats I made them a cornerstone of my books Superimmunity for Kids and Power Healing.

Omega-3 fatty acids are found in fish, flax seed, walnuts, sea vegetables and leafy greens. The most potent omega-3’s, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are used by the cells of your body to make powerful chemicals that help to maintain normal cell function under conditions of stress. (14) The so-called “bad” COX, in fact, converts DHA to substances called resolvins and neuroprotectins, which play a vital role in controlling inflammation (15) and helping brain cells survive injury. (16) This is one reason the inhibition of any of the COX enzymes can be bad for your health.

Knowledge of the benefits of omega-3 fats provides an alternative strategy for controlling inflammation that is both natural and potent. The basic idea is to increase your body’s levels of DHA, the omega-3 fatty acid your body uses to make these beneficial chemicals.

Remarkable results in reducing inflammation can be accomplished by dietary changes and nutritional supplementation. Increase consumption of foods that contain omega-3 fats (mentioned above) and decrease consumption of foods that interfere with the anti-inflammatory effects of omega-3 fats, such meat, and oils, spreads and dressings made from corn, sunflower, soybean, safflower or cottonseed oil, substituting olive oil and flax oil instead. This simple approach had allowed people in research studies with severe rheumatoid arthritis to decrease their use of anti-inflammatory drugs. (17,18)

Putting these principles together, I created an anti-inflammatory dietary program called The Fat Resistance Diet. For free recipes and a one-day meal plan visit www.fatresistancediet.com

A vast amount of scientific research has been published in prestigious medical journals on the therapeutic use of nutrition. Now it is time to put all of that essential knowledge to work.

Making nutrition a cornerstone of everyone’s healthcare has been my longstanding goal and is the first step in real healthcare reform. Moving from a system based on treating symptoms to a system for achieving optimal health will enable healthcare to achieve its true potential.

References:

1) Manag Care Interface. 2005 Oct;18(10):49-52 “Preventing adverse drug reactions in the general population” Pezalla E.

2) JAMA. 2006 Oct 18;296(15):1858-66. “National surveillance of emergency department visits for outpatient adverse drug events.” Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL

3) Pezzalla E., Manag Care Interface. 2005 Oct;18(10):49-52

4) Annals of Internal Medicine, 1997, 127:429-438. “Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice.” R Tamblyn, L Berkson, WD Jauphinee, D Gayton, R Grad, A Huang, L Isaac, P McLeod, L Snell

5) JAMA 1991; volume 266: pp 2847-2851 “Computerized surveillance of adverse drug events in hospitalized patients.” Lassen DC, Pestotnick SL, Evans RS, Burke JP.

6) Annals of Internal Medicine. 1988; pp 359-363.. “Nonsteroidal anti-inflammatory drug use and death from peptic ulcer in elderly persons.” Griffin MR, Ray WA, Schaffner W

7) Gastroenterology. 1987; 93: 480-489. “NSAID induced intestinal inflammation in humans.” Bjarnasson I, Zanelli G, Smith T, et al.

Archives of Internal Medicine. 1992; 986-990. “Acute renal failure and glomerulopathy caused by nonsteroidal anti-inflammatory drugs.” Shankel SW, Johnson DC, Clark PS, Shankel TL, O’Neill WM.

9) Archives of Internal Medicine. 1993; 153: 477-484. “A meta-analysis of the effects of non-steroidal anti-inflammatory drugs on blood pressure.” Pope JE, Anderson JJ, Felson DT

10) Clin Chest Med. 1990; 11:163-175. “Drug-induced bronchospasm.” Meeker DP, Wiedemann HP.

11) J Dermatol. 1981; 8: 323-337. “Exacerbation of psoriasis induced by indomethacin.” Katayama H, Kawada A.

12) Annals of Internal Medicine. 1987; 107: 513-516. “Nonsteroidal anti-inflammatory drugs activate quiescent inflammatory bowel disease.” Kaufmann HJ, Taubin HL.

13) Cardiovascular & Haematological Disorders-Drug Targets, 2006, 6, 83-98. “Cyclooxygenase-2 Inhibitors: A Painful Lesson.” S Sanghi, EJ MacLaughlin, CW Jewell, S Chaffer, PJ Naus, LE Watson, DE Dosta.

14) Curr Mol Med. 2009;9:565-79. “Role of lipoxins and resolvins as anti-inflammatory and proresolving mediators in colon cancer.” Janakiram NB, Rao CV.

15) Proc Nutr Soc. 2010, 28:1-8 “Fish oil and rheumatoid arthritis: past, present and future.” James M, Proudman S, Cleland L.

16) J Lipid Res. 2009: 50 Suppl:S400-405. “Neuroprotectin D1-mediated anti-inflammatory and survival signaling in stroke, retinal degenerations, and Alzheimer’s disease. Bazan NG.

17) Drugs 2003; 63: 845-53. “The role of fish oils in the treatment of rheumatoid arthritis.” Cleland et al.

18) Rheumatol Int. 2003; 23: 27-36. “Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis.” Adam et al,