Women are up to nine times more likely to suffer from cold hands and feet than men, I read last week. We feel changes in temperature and the seasonal chill more. Did this surprise me? Not a bit.

I am always moaning about how bitter the weather is; how if my feet and hands are cold, then I just can't get warm anywhere else. In fact, my extremities are so often freezing that I spend my life buying woollen bed socks and pairs of gloves that I inevitably lose.

I try so many different ways to get warm. I bury my hands deep in pockets. I buy extra-thick gloves, or lined ones, or ones that promise to 'banish cold hands for ever'. But there I still am - cold fingers, cold toes and miserable.

My lack of warmth drives my husband mad. 'Do you have to have the heating on so high?' he'll say when he comes in of an evening to find me warming my feet and hands on the radiator.

In bed, things get even worse. I am for ever wanting to use him as a human hot-water bottle. As I try to tuck my feet into the warmth of his legs or back or whatever bit of his warm flesh that is nearest, he shudders and moves away. 'Get them off me!' he says.

I totally understand his hatred of my cold feet. Really, it is a curse. Even I hate them. All that palaver with thick tights and extra socks. I have taken to wearing tights under trousers but even that hasn't been enough with the recent snow. But it gets much worse than fashion dilemmas.

When my feet get cold, my toes cramp and I writhe around in pain. This has happened to me ever since I was a little girl and the only way I know for me to combat it is to wrench my toes slightly out and then hopefully they will eventually go back into their sockets. This involves me taking off my shoes and socks and tugging away, which is not possible on a packed train - which, nine times out of ten, is when it happens.

So if my feet get cold and my toes become disjointed, I have to sit there with a painful grimace on my face, incapable of doing anything about it. But at least I now know I am not alone.

I had thought the reason my husband didn't feel the cold was because he's a Northerner and I'm a Southerner. However, it turns out it is much more to do with our physiognomy than where we originate from.

A new survey has found that women are nine times more likely to develop cold in their extremities than men. We are also more likely to suffer from Raynaud's disease - a recognised condition where not enough blood gets to the fingers and toes, causing extreme pain.

There are many theories as to why women suffer from this problem. Women have more evenly distributed fat layers, providing internal insulation. But while the result is that our blood supply favours protecting our core organs and trunk over our extremities, it means less blood flows to the hands and feet.

Men on the other hand have more heat-generating muscle mass, better supplied by blood vessels, increasing blood flow and, therefore, warmth.

Foot expert Margaret Dabbs says another reason why women's feet in particular get colder than men's is because our skin is thinner.

'The skin on our feet is thinner and has less subcutaneous fat than men's, so it is very hard for us to keep warm. You can see how women's faces get thinner as they get older, well, so does the skin on their feet and this is why the blood finds it hard to get to them and warm them up.

'People often come to my clinic complaining of extremely cold feet, but I find it usually only seriously affects women in the 40-plus age group as our skin gets thinner as we age.'

Dr Neetu Nirdosh, a doctor who specialises in anti-ageing, agrees. He says: 'It can certainly be to do with ageing as, once we get older, our once buoyant blood supply becomes limp. Blood no longer flows through our skin with a full dynamic force, and the consequence of this is distal hypothermia - cold extremities.

'The hands and feet are first to suffer as they contain a diffuse micro network of tiny capillaries which easily become damaged or blocked, and women feel this impact on a greater scale than men.

'Also, women can suffer from iron deficiency - anaemia - as they hold less iron in the body than men. Since iron is needed to transport oxygen around the blood, a lack will hamper blood flow.'

Apparently, the fact that some of us women seem to suffer from permanently cold feet can also be attributed to our hormones. Health advisor Nicola Stewart explains: 'Our circulation is linked to our hormonal system, and when we get a lack of iron in the thyroid we get cold as it is this that regulates our body temperature.'

She suggests a diet rich in pumpkin seeds, nuts, fish and watermelon to overcome the problem. So would a different diet help me? And is there anything else we women with cold hands and feet can actually do about it, bar eat sushi and seeds before we go to bed? Dr Nirdosh says there is.

'Lifestyle factors also massively accelerate age damage and weaken blood supply to the extremities,' he explains. 'With age, nutrients are not so well processed by the body.

'The combination of a poor diet which lacks vital vitamins and minerals such as B12 and folate, plus sleep deprivation, loss of muscle tissue due to inappropriate exercise and smoking all damage the blood supply.

'Extreme emotional instability and extreme cold conditions can obviously also cause cold extremities. But these are all things we can do something about.

To take action against age-related body breakdown, you need to implement a proper nutritional plan high in dark green and dark red vegetables such as spinach and beetroot, complete protein sources like eggs and chicken, as well as daily supplementation with targeted vitamins and minerals, such as a complete vitamin B complex.

'Furthermore, to boost hormone activity and enhance muscle tissue, it's essential to exercise, and ensure you get six to eight hours sleep per night as this is when the body repairs itself.'

So, the answer is to eat iron-rich food, sleep more, exercise more and try to curtail those hormones. One blindingly obvious way to combat cold feet, I find, is to go to bed with a hot-water bottle. Men, though, tend to hate women having them. For a start, it makes the bed too hot for them.

There is also something slightly old lady-ish about going to bed with a fleece-covered water bottle. But, as I explain to my husband, it must be better for me to be sleeping peacefully than constantly shoving my cold feet into his back.

■ CHOOSE THE RIGHT SHOES

The circulatory system is the body’s own unique central heating system and the blood pumped around your body provides a kind of heat maintenance. So, if you wear tight shoes, this can cut off

the circulation to your feet, leaving them feeling cold.

■ WATCH WHAT YOU EAT

Vitamin K is important; it helps to strengthen the cardiac muscles in your heart as well as the blood capillaries. It also improves circulation around your body, including your feet, therefore keeping them warmer. Ginger, fish, parsley, salad, spring onions, apricots and celery are all good sources of Vitamin K.

■ EXERCISE REGULARLY

Regular exercise — whether it be a brisk walk, cycle or run — helps keep the heart healthy and strong, and so more efficient at pumping blood around the body.

■ USE A FOOT SPA

If you have very cold feet, it’s important not to warm them up too quickly, such as with a hot-water bottle or against a radiator — in the worst case scenario, you could end up with chilblains. The most effective way is bathing your feet in warm water or using a foot spa. This will warm up your feet slowly and naturally, and also keep them hydrated from the outside, improving circulation.

■ DRINK PLENTY OF WATER

When you are dehydrated your hands and feet get colder, too, as dry skin fails to maintain a good moisture balance and so does not retain heat.

■ WEAR NATURAL SOCKS

Cheap, synthetic, man-made fibres are so closely woven together that there are no air pockets in which to retain your natural body heat. Natural wool and cotton socks have more textured fibres and are less tightly bound, so they hold more warm air around the feet.

■ MOISTURISE

Lanolin, (available in cream form from Boots and Superdrug) helps to retain moisture in the skin, helping to improve blood flow and, therefore, retain heat.

What is brucellosis?

Brucellosis is an infectious disease caused by bacteria from the genus Brucella. It is an infection that affects mainly animals, including goats, sheep, camels, pigs, elk, deer, cattle, and dogs. Humans develop brucellosis when they come in contact with contaminated animals or animal products. The symptoms of brucellosis often resemble a flu-like illness.

Human brucellosis is a disease that is found worldwide, and it has an annual occurrence rate of more than 500,000 cases. Brucellosis tends to occur more commonly in regions with less established animal-disease-control programs and in areas where public-health initiatives may be less effective. High-risk areas include the Mediterranean Basin (Portugal, Spain, Southern France, Italy, Greece, Turkey, and North Africa), South and Central America, Eastern Europe, Africa, Asia, the Caribbean, and the Middle East. In the United States, brucellosis is much less common, with only 100-200 human cases reported each year. This decrease in cases in the United States is felt to be due to effective animal vaccination programs and milk pasteurization.

What is the history of brucellosis?

Brucellosis is a disease that is thought to have existed since ancient times, as it was first described more than 2,000 years ago by the Romans and Hippocrates. It was not until 1887 that a British physician, Dr .David Bruce, isolated the organism that causes brucellosis from several deceased patients from the island of Malta. This disease has had several names throughout its history, including Mediterranean fever, Malta fever, Crimean fever, Bang's disease, and undulant fever (because of the relapsing nature of the fever associated with the disease).

In the mid-20th century, the Brucella bacteria was also developed for use as a biological weapon by the United States. The use of brucellosis for biological warfare purposes was later banned in 1969 by President Nixon.

What causes brucellosis?

Brucellosis is a systemic infectious disease transmitted from certain animals to humans (zoonotic disease). Brucellosis in humans is predominantly caused by four different species of Brucella bacteria: Brucella melitensis (goats, sheep, camels), Brucella suis (pigs), Brucella abortus (cows, buffalo, elk, camels, yaks), and Brucella canis (dogs). Though all of these species can cause human brucellosis, Brucella melitensis is the most prevalent worldwide, and it is felt to cause the most severe cases of brucellosis.

How is brucellosis transmitted?

Brucellosis is transmitted from animals to humans in several ways. The most common route of transmission occurs when humans consume raw milk or cheese from infected sheep and goats. Infected animals shed the organism into their milk, and if humans eat or drink unpasteurized dairy products from these affected animals, they can develop brucellosis.

Brucellosis can also be transmitted to humans via inhalation of the organism or by direct contact with infected animal secretions. The bacteria can gain entry into the body through the inhalation of aerosolized secretions, through breaks in the skin, or through exposure of the mucous membranes/conjunctiva from the splashing of infected secretions. With these routes of entry, brucellosis is an occupational disease that can affect veterinarians, slaughterhouse workers, butchers, hunters, laboratory personnel, and those individuals who work closely with livestock (for example, farmers and shepherds).

Finally, an accidental injection with the livestock vaccine used against Brucella abortus can also lead to brucellosis in humans. Human-to-human transmission is very rare (via sexual contact and breastfeeding).

What are the symptoms and signs of brucellosis?

The symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism (incubation period). While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms.

The signs and symptoms of brucellosis are extensive and they can be similar to many other febrile illnesses. They include

• fever (the most common finding, and it may be intermittent and relapsing),



• sweating,



• body aches,



• joint pain,



• fatigue,



• weakness,



• dizziness,



• headache,



• depression,



• irritability,



• loss of appetite,



• weight loss,



• cough,



• difficulty breathing,



• chest pain,



• abdominal pain,



• enlarged liver and/or spleen.

Other symptoms and signs may also be present with brucellosis. Certain variables such as the severity of illness, the chronicity of illness, and the development of complications can all impact the clinical findings associated with the disease.

How is brucellosis diagnosed?

Making the diagnosis of brucellosis can sometimes be difficult because of the similar symptoms and signs shared with other febrile illnesses. An accurate history obtained by your health-care provider (including travel history, occupation, animal exposure, etc.) may be very helpful in raising the suspicion of brucellosis as a possible diagnosis.

In general, blood tests and blood/tissue cultures are necessary for making the diagnosis of brucellosis. Common blood tests used to make the diagnosis include testing for antibodies against the bacteria and isolating the organism from blood cultures. A biopsy of body tissue (from the bone marrow or the liver, for example) can also assist in making the diagnosis. Additional blood tests may demonstrate anemia, low platelets, a low white blood cell count, and elevated liver function tests.

Other imaging studies and procedures may also be performed initially depending on the individual's signs and symptoms. These tests may include CT scan, MRI, X-ray, ultrasound, lumbar puncture (spinal tap), joint aspiration, or an electrocardiogram (ECG).

What is the treatment for brucellosis?

The cornerstone of treatment for brucellosis is antibiotics. Because of the high relapse rate associated with the disease, the use of a multidrug (two or more) antibiotic regimen is recommended. The antimicrobials most commonly used include doxycycline (Vibramycin), streptomycin, rifampin (Rifadin), gentamicin (Garamycin), and trimethoprim-sulfamethoxazole (Bactrim, Septra). The combination of antibiotics used will vary based on disease severity, age and pregnancy.

In general, a full six-week course of antibiotics is recommended, and prompt treatment can lead to an improvement in symptoms and may also prevent the complications associated with brucellosis. However, relapse rates of the disease are still about 5%-10%, even with treatment. Depending on the severity of illness, the associated complications (if any) and the timing of treatment, recovery may take from a few weeks to a few months.

Rarely, surgical intervention may be needed for certain complications associated with brucellosis, such as abscess formation or heart-valve infection. Your health-care provider may need to consult other physicians, including surgeons, infectious disease specialists, or a neurologist.

What are the complications of brucellosis?

In general, if treated appropriately with antibiotics in a timely manner after the onset of symptoms, the prognosis for patients with brucellosis is excellent. The mortality rate is low (<2%).>

• Bones and joints



• Sacroiliitis, spondylitis, and osteomyelitis



• Cardiovascular



• Endocarditis (a primary cause of death), myocarditis, and pericarditis



• Central nervous system (neurobrucellosis)



• Meningoencephalitis



• Gastrointestinal



• Hepatitis, hepatic abscess, colitis, and spontaneous peritonitis



• Genitourinary



• Orchitis



• Pulmonary



• Pneumonia



• Ocular



• Optic neuritis and uveitis

How can brucellosis be prevented?

The prevention of brucellosis can be achieved through various measures. The most important step in preventing brucellosis in humans begins with the control and/or eradication of the infection in animals who serve as a reservoir. This requires a coordinated effort between local public-health organizations and animal-disease-control entities. The most effective measures to achieve this objective include animal vaccination programs, animal testing, and the elimination of infected animals. There is no human vaccine currently available.

In areas where eradication of the disease may not be possible, preventive measures are aimed at reducing the risk of transmission to humans. These measures may include

• pasteurization of dairy products;



• avoiding the consumption of unpasteurized dairy products, including milk and cheese;



• avoiding the consumption of undercooked meat;



• using appropriate barrier precautions (goggles, gloves, masks, etc) to avoid exposure to aerosols and body fluids for those with an occupational risk for brucellosis;



• warning laboratory workers about potentially infected specimens so that appropriate biosafety level III precautions can be taken.

Brucellosis At A Glance

• Brucellosis is an infectious disease caused by bacteria from the genus Brucella.
• Brucellosis is an infection of certain animals that is transmitted to humans.
• Humans acquire brucellosis when they come in contact with contaminated animals or animal products, most commonly from the ingestion of raw milk or cheese.
• The symptoms of brucellosis may include fever, sweating, body aches, and joint pain.
• Brucellosis is typically diagnosed through blood tests and by isolating the organism from blood and other body tissues.
• A multidrug antibiotic regimen is the cornerstone of treatment for brucellosis.
• The complications of brucellosis may involve various organ systems.
• Brucellosis can be prevented by animal-disease-control measures, avoidance of unpasteurized dairy products, and occupational protective measures.

REFERENCES:

Al Nassir, Wafa, Michelle V. Lisgaris, Robert A. Salata. "Brucellosis." eMedicine. Feb. 3, 2009. .

Maloney Jr., Gerald E. "CBRNE-Brucellosis." eMedicine. Apr. 29, 2009. .

Switzerland. "Brucellosis (Human)." World Health Organization..

Switzerland. "Brucellosis." World Health Organization. .

United States. "Brucellosis." Centers for Disease Control and Prevention. Dec. 7, 2007. .

source

Vaginal yeast infections can be both uncomfortable and embarrassing. Those who suffer from yeast infections will experience vaginal discharge which resembles cottage cheese, pain or discomfort during $exual intercourse or urination, itchiness, redness, and irritation. The good news is that you do not need to continue suffering from symptoms of a vaginal yeast infection. Here are some tips on how to get rid of a vaginal yeast infection naturally.

Bacterial vaginosis is a condition in which the vagina contains harmful bacteria. According to the Centers for Disease Control and Prevention, bacterial vaginosis is the most common vaginal infection among women of childbearing age. It is also known to be quite common among pregnant women. Although bacterial vaginosis can be caused by other factors aside from $ex, such as douching and smoking, it can be spread through $exual intercourse. Here are some of the common signs of bacterial vaginosis.

Vaginal Discharge

All women experience vaginal discharge at some point. If you notice that your vaginal discharge is a lot heavier than usual, this could be a sign of bacterial vaginosis. Most women who have bacterial vaginosis will have heavy white or gray vaginal discharge. Unlike with a yeast infection, it is usually thick in texture, rather than cottage cheese-like.

Foul Odor

Vaginal discharge may be foul in odor when you have bacterial vaginosis. This is why many women are known to experience a foul odor, especially after they have had $exual intercourse. Since the vagina produces a lot of natural lubrication at this point, discharge may increase and cause a foul odor.

Burning

One of the easiest to recognize symptoms of bacterial vaginosis is a burning or painful sensation. It will usually occur during $exual intercourse or urination. Many women with bacterial vaginosis notice this burning or pain periodically throughout the day at any time, however.
Itching

Many women with bacterial vaginosis experience some sort of itching. Itching may only be minimal, but for others it may be severe. Any time that you notice severe or persistent vaginal itching, it is important to get checked out by a doctor, however. This is a symptom which is experienced with many STDs.

Keep in mind that the symptoms of bacterial vaginosis are known to be very close to the symptoms that are experienced with certain STDs, such as chlamydia and gonorrhea. If you notice any of the symptoms of bacterial vaginosis listed above, it is important to visit a gynecologist.

There has been a lot of talk recently about acai berry. The berry, which is known to offer a lot of health benefits, is believed to be a key component for effective weight loss. Many people are spending tons of money on acai berry diet supplements in hopes of losing weight. Will acai berry really work for you, however? Should you think about using it? Here are some of the things that you should know about acai berry before incorporating acai berry into your weight loss plan.

The Real Benefits of Acai Berry

It is important for you to be aware of what the real benefits of acai berry are. A lot of people are under the impression that acai berry will help you lose weight because it is an appetite suppressant. This is not true. Acai berry is known to cleanse or detoxify the body, which is why it is believed to be a great option for weight loss. Acai berry also is known to increase energy levels, helps regulate digestion, improves sleep routines, and may improve pain for arthritis sufferers.

Acai Berry Testimonials

There are many people who claim to have lost a lot weight by using acai berry. When reading any acai berry testimonial, it is important to be cautious of where it is coming from. If the testimonial that you are reading is on a website that is selling acai berry products, it is probably not entirely true. If you are reading testimonials on sources like Yahoo Answers or diet review websites, you may be able to believe them a bit more. Be sure to look for acai berry testimonials that include both the pros and cons.

Using Acai Berry Alone is Not Ideal

In order to lose weight, you should not believe that acai berry alone will do the trick. If you are going to try out an acai berry dietary supplement, the best thing that you can do is combine it with diet and exercise. Otherwise, it is unlikely that acai berry is going to work for you. Acai berry also may not provide you with the quick and effective results that you are hoping for. Taking an acai berry supplement may help boost energy levels and will cleanse your body, but it will not have an effect on your appetite.

It is ideal to be cautious when using any dietary supplement. Acai berry is unlikely to lead to long-term weight loss. Using acai berry in addition to a healthy diet and exercise is the best thing that you can do if you are interested in using it to lose weight.

source

How to Get Rid of Wrinkles?
No one likes wrinkles, which are caused when collagen breaks down deep in your dermis, far below the skin's top layer. The key to improving or preventing wrinkles is two-fold: You need to stimulate collagen production while keeping free radicals such as the sun, stress & pollution from causing more damage. You have a number of options available to help you turn back time a bit without going under the knife.

Here's a rundown of 5 options currently on the market that are created to minimize the appearance of wrinkles. Better yet, most of these can be bought over-the-counter:

1. Sunscreen. Sun damage is the #1 cause of wrinkles. Wonder what your skin would look like if it was never exposed to the sun? Look at your bottom. Wrinkle-free, eh? That's what your skin would look like it it was kept under cover all the time as well. A good rule of thumb: If it's daylight outside, you need sunscreen, no matter how cloudy it is. In the June, 2005 issue of InStyle Magazine, Dr. Fredric Brandt, dermatologist to the stars, suggests using a 'two-finger scoop' of sunscreen daily to the face & neck. Also, don't forget the top of your hands. Dermatologists report seeing women with young faces & old hands all the time. Check out this list of the best sunscreens on the market. Note which sunscreen is the absolute best on the market.

2. Vitamin A (retinoid) creams. To prevent wrinkles or keep them from worsening, look for products containing vitamin A like prescription Retin-A, Differin or Renova.

Used nightly (or every other night), vitamin A creams stimulate collagen renewal & prevent skin cells from breaking down. Women in their 20s & early 30s can use these to keep fine lines from turning into deeper furrows. I've been trying one percent Retin-A on my skin for the past month & I've noticed a marked improvement even though best results can be seen in about 6 months. (Just make sure you never go out without sunscreen when you're on these Vitamin A products, your skin is extra susceptible to sun damage).

Don't want to go to a doc? A great over-the-counter anti-wrinkle product is RoC Retinol Actif Pur Anti-Wrinkle Treatment. Matrixyl is a newer ingredient that is becoming very popular and is touted as being great for sensitive skin. Check this list of products containing Matrixyl.

3. Alpha-hydroxy acids or microdermabrasion. If you're in your mid-30s & worried about wrinkles you might try exfoliating once a week with a alpha-hydroxy acid (AHAs) or a microdermabrasion kit. Don't use both & be careful not to over-exfoliate. Chemical exfoliators (the AHAs) work great on oily or combination skin, while the physical scrubs (microdermabrasion) are great for very sensitive skin (make sure it's in a creamy base).

AHA's are glycolic or lactic acid formulated to increase collagen in sun-damaged skin. They are also known to reduce pore size, redness, blotchiness & fine lines. I love MD Skincare Alpha Beta Daily Face Peel ($68 for 30 applications at Sephora or buy online here).

Microdermabrasives smooth fine lines & get rid of dead skin. I've tried several kits & like Dr. Brandt Microdermabrasion In A Jar. I also like Lancome's RESURFACE-C MICRODERMABRASION Resurface-C Microdermabrasion Kit. A less expensive, but still excellent option, is L'Oreal ReFinish Microdermabrasion Kit.

4. Antioxidants. Free radicals -- the unstable oxygen molecules produced by pollution, stress & sun -- are a skincare nightmare. They attack healthy skin cells & cause collagen breakdown, all of which lead to wrinkles. Antioxidants like green tea, vitamins C & E, & coenzyme Q10 work together to neutralize free radicals. A cocktail of these antioxidants are like a multi-vitamin for skin, according to dermatologist Dr. Dennis Gross.

The most popular antioxidant on the market right now is prescription Prevage, a cream that is made with idebenone, a synthetic antioxidant & 'star chemical' dermatologists swear by. Another excellent (over-the-counter) option is Skinceuticals C E Ferulic serum, which clinical studies show reduced sunburned cells by a whopping 96 percent. Elizabeth Arden's Prevage Anti-Aging Treatment also gets high marks from dermatologists.

It's Time to Know Your Diet Pill

Rheumatoid arthritis often starts in young adults and flares up in middle age. The condition is more common in women than in men. The causes of rheumatoid arthritis are complex and not perfectly understood.

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that is characterized by the destruction of joint cartilage and inflammation of the synovium (joint fluid) (Abbas et al., 1994). The joints of the extremities, particularly the metacarpophalangeal, interphalangeal, and wrist joints, are the primary diseased sites, but as the disease progresses, the larger joints, especially the knees, can also be affected. The disease is an inflammatory arthritis that involves stiffness, pain, swelling, and erythema. As the disease progresses, osteoporosis of the contiguous bone, destruction of joint cartilage, bone resorption, and displacement by ankylosis occur. Subcutaneous nodules may also form at pressure points, particularly on the anterior side of the forearms, in 15-20% of reported cases. Systemic complications include damage to various organs (lungs, pleura, pericardium, myocardium, eyes, and central nervous system) due to inflammatory reactions. The outcome of the disease varies among patients, ranging from complete recovery to total incapacitation within years of the onset of the disease. In the most severe cases, vasculitis may occur. Women represent 75% of the reported cases of RA. There are two major peaks of incidence with regard to age: one between 30 and 40 years and one between 50 and 60 years (Bach, 1982).

Early experimental work focused on the importance of B-cells in the pathology of RA. Later interest has focused on T-cells. Observations that RA is strongly associated with certain MHC (major histocompatibility complex) alleles and that activated T-cells are found in affected joints have indicated that much focus should be given to cell-mediated immune responses. Whether activated T-cells initially respond to a microbial antigen, superantigen, or self-constituent is unclear to date (Chini et al., 2002).

Immunology and the Causes of RA
The development of lesions in rheumatoid arthritis appears to include both cell-mediated and humoral responses. Early research aimed at identifying the cells present in the inflamed synovium, and it has been concluded that CD4+ T-cells, activated B-lymphocytes, and plasma cells, as well as well-formed lymphoid follicles with germinal centers (in more severe cases), are present in the synovium of patients diagnosed with RA (Abbas et al., 1994). T-cells are the dominant cell type in the synovial filtrate of patients with RA, and there is at least a partial therapeutic effect of T-cell depletion for these patients (Berner et al., 2000). Current understanding of RA suggests that TH1 cells that are specific for a particular antigen (which has yet to be identified) are present in the joints of people with RA. This antigen activates T-cells to release lymphokines that cause local inflammation at the joints. The clinical manifestations of this inflammation include swelling, accumulation of polymorphonuclear leukocytes and macrophages at the site of inflammation, cartilage damage, and, thus, destruction of the joint (Janeway et al., 2001).

T-cells are the dominant type of cell that infiltrates the synovial membrane in RA. In many patients, the lymphocytes that infiltrate the tissues are organized into follicles that are structurally similar to germinal centers, which strongly supports the idea that RA is an antigen-driven immune response. Recent studies, however, have focused on the possibility that T-cells have an alternative role besides antigen recognition in the joints. Irregularities are found in the global and synovial T-cell receptor (TCR) repertoire of RA patients. The T-cell repertoire shows an emergence of clonal T-cell populations. CD4 T-cell clones are present uniformly in circulation and infiltrate into synovial lesions. CD8 T-cells clones are also found in patients with RA; although these clones are not limited to RA patients, they are larger and more frequent in people with the disease. CD4 T-cells are autoreactive to ubiquitous antigen, do not express the CD28 molecule, and do not require costimulatory signals to secrete cytokines. A study performed at the Mayo Clinic in 2002 found that RA is associated with a generalized defect in diversity maintenance of the TCR repertoire. This results in clonal expression of peripheral T-cells and repertoire contraction. Of significance, the researchers found that these irregularities involve memory and naïve T-cells, which suggests that the abnormality is a defect in T-cell homeostasis, rather than a consequence of antigen-recognition in the synovium. Specifically, the study showed that the CD4 TCR beta-chain diversity is limited in RA patients. Loss in diversity leads to the insufficient influx of ‘novel’ T-cells. Peripheral T-cells respond by replicating vigorously to compensate for the loss of new production, and clonal populations are formed. The multiclonal T-cells proliferation and the associated repertoire contraction have important implications for the course of the disease. It appears that the T-cell clones recognize a ubiquitously distributed autoantigen in RA patients. A recent study by Kouskoff et al. describes that transgenic mice expressing a TCR that recognizes self-MHC molecules develops arthritis that resembles RA but no other autoimmune diseases. To date, however, the autoantigen remains to be elucidated (Wagner et al., 1998).

Unusual distortions of the naïve T-cell repertoire have also been examined. These defects have led researchers to conclude that abnormal T-cell development and differentiation occurs in RA; autoimmunity could be caused by the inappropriate development and maturation of T-cells. RA patients appear to have fewer naïve T-cells with atypical phenotypes as compared to controls; these data suggest abnormal T-cell proliferation and phenotypic differentiation occur in response to inflammatory stimuli in patients with RA. These atypical cells appear to have a reduced threshold for activation and may bypass lymph nodes in favor of peripheral sites, which, during an infection, can lead to autoreactivity (Ponchel et al., 2002). Following this line of thought, hyperfunctioning T-cells could secrete local mediators in the synovial fluid, leading to arthritis. This hypothesis is supported by the fact that numerous T cells are found in the synovium of affected individuals. Also, injection of T-cell culture supernatants can induce inflammatory arthritis that resembles the clinical manifestations of RA. In this scenario, immune complex formation may be caused by T-cell hyperfunction through a helper effect, and the immune complexes would cause certain symptoms, including nodules and vasculitis (Bach, 1982).

Fig. 2 The Pathogenesis of Rheumatoid Arthritis. The development of lesions in rheumatoid arthritis appears to include both cell-mediated and humoral responses. CD4+ T-cells, activated B-lymphocytes, and plasma cells, as well as well-formed lymphoid follicles with germinal centers (in more severe cases), are present in the synovium of patients diagnosed with RA. T-cells are the dominant cell type in the synovial filtrate of patients with RA. Cytokine secretion by activated T-cells leads to an inflamed synovium and the formation of pannus (Abbas et al., 1994).

Treatments
Anti-TNF-alpha Treatments
Cytokines are protein mediators that are implicated in nearly all biological processes, including cell growth, differentiation, inflammation, and immunity. In patients with RA, nearly all cytokines are expressed in RA tissue in a continuous fashion. Researchers previously thought that targeting the blockade of a particular cytokine would be an ineffective therapeutic treatment since, they supposed, other cytokines would take over the role of the blocked cytokine. Research with RA has led them to a different hypothesis. IL-1 has been shown to induce the destruction of cartilage and bone, and five signals present in the RA synovium (IFN-gamma, GM-CSF, TNF-alpha, immune complexes, and IL-1 itself) help to regulate IL-1 production. However, a study done at the Kennedy Institute of Rheumatology found that blocking TNF-alpha abolished IL-1 bioactivity. Anti-TNF antibodies were also found to downregulate GM-CSF, IL-6, and IL-8. Researchers determined that pro-inflammatory cytokines are co-regulated, and the key inflammatory cytokines are TNF-alpha and IL-2. This led the way for the development of anti-TNF-alpha treatments; both soluble-receptor antagonists and cytokine antibodies have been developed as anti-TNF-alpha therapies (Feldmann et al., 1999).

Medications Commonly Used to Treat Rheumatoid Arthritis (Rang et al., 1995)
Four types are medications are commonly used to treat rheumatoid arthritis. These include aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), immuno-suppressants, and corticosteroids (glucocorticoids).

NSAIDs have three major types of effect. They are anti-inflammatory agents; they have an analgesic effect (reduction of pain); and they have an antipyretic effect (lowering of raised temperature). Examples of these drugs include, but are not limited to, plain aspirin, buffered aspirin, ibuprofen (Advil ®, Motrin IB ®), ketoprofen (Orudis®), naproxen (Naprosyn®), celecoxib (Celebrex®), and rofecoxiv (Vioxx®).
Anti-inflammatory effects: The primary action of the drugs is to inhibit arachidonate cyclo-oxygenase and, thus, to inhibit the production of prostaglandins and thromboxanes. One type of cyclo-oxygenase, COX-2, is induced in activated inflammatory cells and is the enzyme that produces the prostanoid inflammatory mediators. NSAIDs reduce the components of inflammation that are caused by COX-2 action, which include vasodilation, edema, and pain. These drugs have no effect on the processes that contribute to tissue destruction in RA; they simply reduce the generation of toxic O2 products and inhibit lymphocyte activation.
Antipyretic effects: NSAIDs inhibit prostaglandin production in the hypothalamus. During an inflammatory reaction, macrophages release IL-1, which stimulates the generation of E-type prostaglandins in the hypothalamus, which elevate the body temperature of the individual. NSAIDs, thus, act to reduce body temperature when it is raised above normal levels.
Analgesic effects: NSAIDs are effective against pain that is caused by prostaglandins acting on nociceptors (ie. pain associated with inflammation or tissue damage). Decreased prostaglandin production leads to less sensitization of nociceptic nerve endings to the inflammatory mediators, bradykinin and 5-hydroxytryptamine (Rang et al., 1995).

DMARDs are distinct from NSAIDs in that they do more than simply alleviate the symptoms of RA. They are used to alter the course of the disease and prevent joint and cartilage destruction. Three types of DMARDs are widely used; these include gold compounds (Myochrysine®, Ridaura®), penicillamine (Cuprimine®, Depen®), and chloroquine (Plaquenil®). Although their mechanisms of action have not been fully elucidated, their effects have had a profound effect on RA patients.
Gold Compounds: Gold compounds help to stop the progression of bone and joint damage in RA. Pain and joint swelling are reduced when these drugs help to reduce the concentration of rheumatoid factor. Although the exact mechanism of action is not fully understood, any or all of the following effects can contribute to the mechanism: inhibition of mitogen-induced lymphocyte proliferation, reduction of lysosomal enzymes, reduction in the production of toxic O2 metabolites from phagocytes, inhibition of chemotaxis of neutrophils, and reduction in IL-2 production.
Penicillamine: Penicillamine prevents the maturation of newly synthesized collagen. Although the mechanism of action is not fully understood, it has been observed that joint swelling subsides, nodules disappear, and IL-1 production is reduced. About 75% of patients with RA respond to this treatment.
Chloroquine: Anti-malarial drugs cause remission of RA but do not stop bone destruction. They inhibit mitogen-induced lymphocyte proliferation and decrease leukocyte chemotaxis. They also reduce IL-1 production (Rang et al., 1995)

Immuno-suppressants, which are considered DMARDs, restrain an overly-active immune system. These drugs include cyclosporine (Sandimmune®, Neoral®) and cytotoxic agents such as azathioprene (Imuran®).
Cyclosporine: Cyclosporine suppresses both cell-mediated and humoral responses. It acts on T-lymphocytes at the induction stage to stop clonal proliferation. The transduction pathway for lymphokine synthesis is inhibited, mainly the production of IL-2. It also inhibits IL-2 receptor expression on T-cells that respond to IL-2. The induction of cytotoxic T-cells is also inhibited. B-cell responses are suppressed because lymphokine synthesis and secretion from activated T-cells is inhibited.
Azathioprine: Azathioprine is metabolized to give mercaptiopurine, which is a purine analogue that inhibits DNA synthesis. This drug depresses both cell-mediated and humoral responses since it inhibits clonal proliferation by a cytotoxic action on dividing cells (Rang et al., 1995).

Corticosteroids have anti-inflammatory and immunosuppressive effects. They include prednisone (Deltasone®, Orasone®), hydrocortisone, dexamethasone, and methylprednisolone (Medrol®). These drugs reduce vasodilation and decrease fluid exudation. In areas of acute inflammation, they decrease the number and activity of leukocytes (decreased action of T-helper cells and reduced clonal proliferation of T-cells due to decreased production of IL-2; decreased release of monocytes and increased number of neutrophils from the bone marrow). In areas of chronic inflammation, the activity of mononuclear cells is decreased. In lymphoid areas, there is decreased clonal expansion of T- and B-cells and decreased action of cytokine-secreting T-cells. These drugs decrease the production of many cytokines, including IL-1, IL-2, IL-3, IL-4, IL-5, Il-6, IL-8, TNF-alpha, and GM-CSF. They also help to decrease the complement component in the blood. Overall, they reduce chronic inflammation and autoimmune reactions. Glucocorticoids act by interacting with intracellular receptors; the steroid-receptor complex interacts with DNA to modify gene transcription. These drugs perform their anti-inflammatory and immunosuppressive actions as follows: inhibition of transcription of the gene for COX-2; blockage of vitamin-D3-mediated induction of the osteocalcin gene in osteoclasts and modification of the transcription of the collagenase gene; and increased synthesis of an anti-inflammatory mediator protein (lipocortin 1) which inhibits phospholipase A2 and blocks the production of platelet-activating factor (Rang et al., 1995).

This information is about arthritis. It covers what it is, what forms it takes, how to deal with it, and how to avoid worthless quack remedies.

The term "arthritis" covers many diseases that affect the joints, causing pain, inflammation, and other changes. Arthritis is often confused with other conditions that cause similar pain, like arthralgia, rheumatism, bursitis, and fibrositis. But these conditions may not actually affect the joints -- and arthritis does.

The most common forms of arthritis are osteo-arthritis, rheumatoid arthritis, and gout. This message will focus on osteo-arthritis and rheumatoid arthritis.

Arthritis is a painful inflammation of one or more bone joints. Sometimes, it will affect neighboring structures such as muscles -- or even organs such as the kidneys or lungs. Arthritis tends to be chronic. It may trouble you continuously -- or on-and-off at unpredictable times. In many people the effects are mild, but some people are physically disabled by it. Most victims are adults, but children can develop arthritis too.

Osteo-arthritis, or degenerative joint disease, often affects older people. Over the years, joints tend to wear out. In addition, some older women suffer a softening of the bones at the joints, due to osteoporosis. Excess weight can worsen existing osteo-arthritis -- or increase the tendency to develop this condition.

Rheumatoid arthritis often starts in young adults and flares up in middle age. The condition is more common in women than in men. The causes of rheumatoid arthritis are complex and not perfectly understood.


Although arthritis is often a chronic condition, its symptoms can be relieved by expert medical treatment. The first step is a thorough evaluation by a doctor, including special laboratory tests. The doctor will prescribe the treatment best suited to the individual case, and then follow the progress of the treatment, adjusting it as necessary. This is the only effective way to deal with arthritis.

Unfortunately, however, arthritis victims are often the targets of people who profit from the suffering of others by selling so-called "cures" that are worthless or even harmful. Worthless cures such as copper bracelets and "miracle diets" can appear to work temporarily -- because arthritis can suddenly die down by itself. If a temporary improvement happens to follow a quack "cure," it can make the cure seem effective. But it isn't, really, and the victim has paid good money for nothing. But even if a quack remedy is medically harmless, the victims still suffer because they avoid or delay obtaining sound medical treatment.


Not all treatments for arthritis are medically harmless. Some rely on massive injections of corticosteroids -- powerful drugs that are easily misused. Though this treatment can be very effective, it must be closely monitored for serious side effects. Early treatment can help control inflammation, preserve mobility, and reduce pain. But if expert medical help is delayed until the condition is more severe, then treatment cannot be as effective.

So, if you think you may have arthritis, see your regular health care provider for a complete evaluation. Follow the treatment plan tailored to your individual condition. Above all, don't experiment with any so-called treatment that has not been prescribed by your doctor. By following this plan, many people prevent their arthritis from ever becoming severe or difficult.

Please remember these key points:

• Arthritis is the name for several diseases that affect the joints.
• Arthritis cannot be cured, but it can be relieved, and in many cases controlled.
• The key to dealing with arthritis is evaluation and care by your health care provider, including a prescribed program of self-care and medication.
• Don't be tempted by other so-called "cures." Many are worthless and often expensive, they can delay the start of professional care, and they can be medically dangerous.

Dust mite allergy is an allergy to a microscopic organism that lives in the dust that is found in all dwellings and workplaces. Dust mites are perhaps the most common cause of perennial allergic rhinitis. Dust mite allergy usually produces symptoms similar to pollen allergy and also can produce symptoms of asthma.

What is house dust?

Rather than a single substance, so-called house dust is a varied mixture of potentially allergenic materials. It may contain fibers from different types of fabrics; cotton lint, feathers, and other stuffing materials; dander from cats, dogs, and other animals; bacteria; mold and fungus spores (especially in damp areas); food particles; bits of plants and insects; and other allergens peculiar to an individual home.

House dust also contains microscopic mites. These mites, which live in bedding, upholstered furniture, and carpets, thrive in summer and die in winter. In a warm, humid house, however, they continue to thrive even in the coldest months. The particles seen floating in a shaft of sunlight include dead dust mites and their waste-products. These waste-products, which are proteins, actually provoke the allergic reaction.

Waste products of cockroaches are also an important cause of allergy symptoms from household allergens, particularly in some urban areas of the United States.

How to Control Dust Mites?

Has allergy testing revealed that you react to dust mites? If so, take heart -- here are some action steps you can take to control dust mites!

• Encase your pillow and mattress with dust mite-proof covers.
• Wash linens in hot water every week.
• Maintain a dry environment in your bedroom with a dehumidifier. Keep the dehumidifier tray clean and dry.
• Consider removing carpet.
• Keep rooms clutter-free. Keep stuffed toys off the beds. Close closet doors.
• Use carpet treatment on existing carpets to kill mites.

Focus on your bedroom...

If you're allergic to dust mites -- and millions of people are -- you must take steps to minimize them in your home. Believe it or not, there can be as many as 30,000 of these tiny creatures in one ounce of dust! Dust mites are found all over the home, but the biggest problem is your bed. Dust mites are attracted to your bed because they live off the skin cells that we all shed each night.

Here's the problem: As you sleep, your skin sloughs off and works its way down into your bedding. If the air in your room is humid, dust mites get into your bed and pillow and happily grow into large colonies. Furthermore, your own body creates humidity as you breathe and perspire. Trying to kill the dust mites will only have a limited effect, because the dust mite feces that cause the problems will still exist in high concentrations.

Dust mite covers

Your first step is to encase your pillow and mattress with dust mite covers. Studies have shown that these covers are very effective at reducing dust mite allergens. This step has two main goals: to keep the existing dust mites trapped inside the barrier, so you won't be exposed to them, and to prevent new dust mites from getting into your pillow and mattress.

The material of your pillow can affect your allergies. For a long time, people with allergies and asthma have been encouraged to avoid feather pillows because they were thought to aggravate allergies more than the synthetic alternatives, which are often referred to as "hypoallergenic" pillows. However, some studies have shown that more dust mite allergen can be found in synthetic pillows than in feather pillows. Recent research reported at the 56th Annual Meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI) shows that synthetic pillows may contain more pet allergens than feather pillows. Regardless of its material, if your pillow is washable, wash it regularly. (Read the pillow manufacturer's directions for cleaning.) Or, as an alternative, fluff it occasionally in the dryer to remove dust mites, but make sure the dryer is on the hottest setting.

Wash bedding regularly

Don't forget that you continue to shed skin cells that accumulate on top of the dust mite-proof covers. To tackle this problem, make sure to wash the dust mite-proof covers with your linens in hot water (130 - 140 degrees). Buy dust mite-proof covers and linens that can withstand frequent trips to the washing machine. A small amount of bleach added to the washing machine will also help destroy the dust mite allergen on bedding, but it will also take the color out of the fabric. (Consider buying all white linens.) Since bleach can irritate the airways, have someone without asthma or allergies do the laundry.

More tricks

If you really want to get rid of those dust mites, get a stand-alone, single-room dehumidifier. Central dehumidifiers are also available, but cost more. Dust mites hate dry air. Maintain a relative humidity of 35 to 50%. Make sure to empty the dehumidifier tray frequently and keep it clean. If the tray isn't clean, mold growth will appear that could cause you more problems, like mold allergy. Be aware that if the humidity is too low (20-25%), it can irritate the sinuses and respiratory system.

Next, consider removing wall-to-wall carpeting from bedrooms and other frequently used spaces. Carpets trap dust, dust mites, skin, pet dander, mold, spores, pollen, and chemicals that can trigger allergies or asthma-like symptoms. Small, synthetic area rugs are easy to keep clean. Since removing your wall-to-wall carpet is an ambitious step, balance the cost and hassle with how miserable your allergies or asthma are making you. If you decide to keep your carpet, keep it clean! Standard upright vacuums tend to stir dust and allergens, making them airborne. A better option is a vacuum with a HEPA filter or a central vacuum.

Some experts believe that treating your carpet with dust mite pesticide powder can be effective. Others claim that carpet treatment powder can irritate airways of people with asthma and allergies. Dr. Scott Carroll, President of Atlanta Allergy & Asthma Clinic, says, "Mite treatment of carpet needs to be done every two months to be effective, and it can be expensive. This is really necessary only if kids [with dust mite allergy] are playing on the carpet."

Make it hard for dustmites to find a home...

Finally, keep your home free of clutter and dust. Wipe surfaces weekly with a damp rag. Vacuum the dust off the floor, and vacuum upholstered furniture. (If you live with someone who isn't allergic to dust mites, have them do the vacuuming and cleaning!)

Keep stuffed toys off the beds, or wash them weekly. Consider replacing Venetian blinds or heavy cloth draperies with pull-down shades that don't collect as much dust and are easier to clean. Keep closets clean with the doors closed.

Consider using the following products:

• Allergen-impermeable bedding
• Washable pillows
• Stand-alone dehumidifiers or central dehumidifiers
• HEPA stand-alone air cleaners or central air filtration system
• HEPA-filter vacuum cleaner or central vacuum cleaning system
• Carpet treatment
• Washable toys

Along with pollens from trees, grasses, and weeds, molds are an important cause of seasonal allergic rhinitis. People allergic to molds may have symptoms from spring to late fall. The mold season often peaks from July to late summer. Unlike pollens, molds may persist after the first killing frost. Some can grow at subfreezing temperatures, but most become dormant. Snow cover lowers the outdoor mold count dramatically but does not kill molds. After the spring thaw, molds thrive on the vegetation that has been killed by the winter cold.

In the warmest areas of the United States, however, molds thrive all year and can cause year-round (perennial) allergic problems. In addition, molds growing indoors can cause perennial allergic rhinitis even in the coldest climates.

What is mold?

There are thousands of types of molds and yeast, the two groups of plants in the fungus family. Yeasts are single cells that divide to form clusters. Molds consist of many cells that grow as branching threads called hyphae. Although both groups can probably cause allergic reactions, only a small number of molds are widely recognized offenders.

The seeds or reproductive particles of fungi are called spores. They differ in size, shape, and color among species. Each spore that germinates can give rise to new mold growth, which in turn can produce millions of spores.

What is mold allergy?

When inhaled, microscopic fungal spores or, sometimes, fragments of fungi may cause allergic rhinitis. Because they are so small, mold spores may evade the protective mechanisms of the nose and upper respiratory tract to reach the lungs.

In a small number of people, symptoms of mold allergy may be brought on or worsened by eating certain foods, such as cheeses, processed with fungi. Occasionally, mushrooms, dried fruits, and foods containing yeast, soy sauce, or vinegar will produce allergic symptoms. There is no known relationship, however, between a respiratory allergy to the mold Penicillium and an allergy to the drug penicillin, made from the mold.

Where do molds grow?

Molds can be found wherever there is moisture, oxygen, and a source of the few other chemicals they need. In the fall they grow on rotting logs and fallen leaves, especially in moist, shady areas. In gardens, they can be found in compost piles and on certain grasses and weeds. Some molds attach to grains such as wheat, oats, barley, and corn, making farms, grain bins, and silos likely places to find mold.

Hot spots of mold growth in the home include damp basements and closets, bathrooms (especially shower stalls), places where fresh food is stored, refrigerator drip trays, house plants, air conditioners, humidifiers, garbage pails, mattresses, upholstered furniture, and old foam rubber pillows.

Bakeries, breweries, barns, dairies, and greenhouses are favorite places for molds to grow. Loggers, mill workers, carpenters, furniture repairers, and upholsterers often work in moldy environments.

Which molds are allergenic?

Like pollens, mold spores are important airborne allergens only if they are abundant, easily carried by air currents, and allergenic in their chemical makeup. Found almost everywhere, mold spores in some areas are so numerous they often outnumber the pollens in the air. Fortunately, however, only a few dozen different types are significant allergens.

In general, Alternaria and Cladosporium (Hormodendrum) are the molds most commonly found both indoors and outdoors throughout the United States. Aspergillus, Penicillium, Helminthosporium, Epicoccum, Fusarium, Mucor, Rhizopus, and Aureobasidium (Pullularia) are also common.

Are mold counts helpful?

Similar to pollen counts, mold counts may suggest the types and relative quantities of fungi present at a certain time and place. For several reasons, however, these counts probably cannot be used as a constant guide for daily activities. One reason is that the number and types of spores actually present in the mold count may have changed considerably in 24 hours because weather and spore dispersal are directly related. Many of the common allergenic molds are of the dry spore type -- they release their spores during dry, windy weather. Other fungi need high humidity, fog, or dew to release their spores. Although rain washes many larger spores out of the air, it also causes some smaller spores to be shot into the air.

In addition to the effect of day-to-day weather changes on mold counts, spore populations may also differ between day and night. Day favors dispersal by dry spore types and night favors wet spore types.

Are there other mold-related disorders?

Fungi or microorganisms related to them may cause other health problems similar to allergic diseases. Some kinds of Aspergillus may cause several different illnesses, including both infections and allergy. These fungi may lodge in the airways or a distant part of the lung and grow until they form a compact sphere known as a "fungus ball." In people with lung damage or serious underlying illnesses, Aspergillus may grasp the opportunity to invade the lungs or the whole body.

In some individuals, exposure to these fungi also can lead to asthma or to a lung disease resembling severe inflammatory asthma called allergic bronchopulmonary aspergillosis. This latter condition, which occurs only in a minority of people with asthma, is characterized by wheezing, low-grade fever, and coughing up of brown-flecked masses or mucus plugs. Skin testing, blood tests, X-rays, and examination of the sputum for fungi can help establish the diagnosis.

Each spring, summer, and fall, tiny particles are released from trees, weeds, and grasses. These particles, known as pollen, hitch rides on currents of air. Although their mission is to fertilize parts of other plants, many never reach their targets. Instead, they enter human noses and throats, triggering a type of seasonal allergic rhinitis called pollen allergy, which many people know as hay fever or rose fever (depending on the season in which the symptoms occur). Of all the things that can cause an allergy, pollen is one of the most widespread. Many of the foods, drugs, or animals that cause allergies can be avoided to a great extent; even insects and household dust are escapable. Short of staying indoors when the pollen count is high -- and even that may not help -- there is no easy way to evade windborne pollen.

People with pollen allergies often develop sensitivities to other troublemakers that are present all year, such as dust mites. For these allergy sufferers, the "sneezin' season" has no limit. Year-round airborne allergens cause perennial allergic rhinitis, as distinguished from seasonal allergic rhinitis.

What is pollen?

Plants produce microscopic round or oval pollen grains to reproduce. In some species, the plant uses the pollen from its own flowers to fertilize itself. Other types must be cross-pollinated; that is, in order for fertilization to take place and seeds to form, pollen must be transferred from the flower of one plant to that of another plant of the same species. Insects do this job for certain flowering plants, while other plants rely on wind transport.

The types of pollen that most commonly cause allergic reactions are produced by the plain-looking plants (trees, grasses, and weeds) that do not have showy flowers. These plants manufacture small, light, dry pollen granules that are custom-made for wind transport. Samples of ragweed pollen have been collected 400 miles out at sea and 2 miles high in the air. Because airborne pollen is carried for long distances, it does little good to rid an area of an offending plant -- the pollen can drift in from many miles away. In addition, most allergenic pollen comes from plants that produce it in huge quantities. A single ragweed plant can generate a million grains of pollen a day.

The chemical makeup of pollen is the basic factor that determines whether it is likely to cause hay fever. For example, pine tree pollen is produced in large amounts by a common tree, which would make it a good candidate for causing allergy. The chemical composition of pine pollen, however, appears to make it less allergenic than other types. Because pine pollen is heavy, it tends to fall straight down and does not scatter. Therefore, it rarely reaches human noses.

Among North American plants, weeds are the most prolific producers of allergenic pollen. Ragweed is the major culprit, but others of importance are sagebrush, redroot pigweed, lamb's quarters, Russian thistle (tumbleweed), and English plantain.

Grasses and trees, too, are important sources of allergenic pollens. Although more than 1,000 species of grass grow in North America, only a few produce highly allergenic pollen. These include timothy grass, Kentucky bluegrass, Johnson grass, Bermuda grass, redtop grass, orchard grass, and sweet vernal grass. Trees that produce allergenic pollen include oak, ash, elm, hickory, pecan, box elder, and mountain cedar.

It is common to hear people say that they are allergic to colorful or scented flowers like roses. In fact, only florists, gardeners, and others who have prolonged, close contact with flowers are likely to become sensitized to pollen from these plants. Most people have little contact with the large, heavy, waxy pollen grains of many flowering plants because this type of pollen is not carried by wind but by insects such as butterflies and bees.

"I love springtime, but the pollen drives me up the wall! I start taking my medication as soon as I see buds on the trees."

When do plants make pollen?

One of the most obvious features of pollen allergy is its seasonal nature -- people experience symptoms only when the pollen grains to which they are allergic are in the air. Each plant has a pollinating period that is more or less the same from year to year. Exactly when a plant starts to pollinate seems to depend on the relative length of night and day -- and therefore on geographical location -- rather than on the weather. (On the other hand, weather conditions during pollination can affect the amount of pollen produced and distributed in a specific year.) Thus, the farther north you go, the later the pollinating period and the later the allergy season.

A pollen count, which is familiar to many people from local weather reports, is a measure of how much pollen is in the air. This count represents the concentration of all the pollen (or of one particular type, like ragweed) in the air in a certain area at a specific time. It is expressed in grains of pollen per square meter of air collected over 24 hours. Pollen counts tend to be highest early in the morning on warm, dry, breezy days and lowest during chilly, wet periods. Although a pollen count is an approximate and fluctuating measure, it is useful as a general guide for when it is advisable to stay indoors and avoid contact with the pollen.

Preventive strategies

• Avoid the outdoors between 5-10 AM. Save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.
• Keep windows in your home and car closed to lower exposure to pollen. To keep cool, use air conditioners and avoid using window and attic fans.
• Be aware that pollen can also be transported indoors on people and pets.
• Dry your clothes in an automatic dryer rather than hanging them outside. Otherwise pollen can collect on clothing and be carried indoors.

Created by the National Institutes of Health

What is an Allergy?

When most people think of an allergy, they think of the sneezing, congestion, and itchy eyes caused by pollen. In fact, allergies can be caused by just about any substance that you inhale or swallow, or which touches your skin.

Your body's immune system is designed to attack harmful substances like bacteria and viruses. But with allergies, your body launches an assault on substances that are basically harmless -- such as pollen, mold, dust mites, pet saliva and dander, and even medications and insect sting venom.

Allergies are extremely common. About 40% of the population suffers from them, leading to millions of missed work days and school days each year. Annual medical costs exceed $4 billion.

Not only do allergies cause a range of annoying symptoms such as sneezing and itchy eyes, but they can aggravate or trigger other conditions such as asthma, sinusitis, and ear infections. For example, when allergies cause inflammation in your nasal passages, the opening to your sinuses can become blocked, leading to sinus inflammation, sinus infections, and sinus pain. Similarly, if allergies cause inflammation in your ear canal, the ears don't drain properly, which can lead to ear infections.

An allergy is your body's abnormal reaction to a foreign substance such as feathers, pollen, cat dander or strawberries. The body's defenses form antibodies to "fight" the foreign invader--even though there's no real need to. So all the antibodies do is to cause reactions within the body--reactions like stuffy nose, wheezing, hay fever, eczema, and hives. These are called "allergic reactions". Most allergic reactions happen immediately, but some show up hours or even a day later.

Allergic reactions are unpredictable. The tendency to have these reactions is usually inherited--but people don't inherit specific allergies. A tendency to have allergies continues through a person's like--but the symptoms may change over the years. For example, a baby may have eczema, which clears up in early childhood. Then later, the child may develop a nasal allergy or asthma.

panamas_allergies/allergies_panam.

Allergic reactions may also be affected by other things like climate or infection--and especially by physical or emotional stress.

Allergic reactions are caused by things called "allergens". Many common foods can act as allergens, including milk, eggs, fruits, nuts and shellfish. Many substances around us can also act as allergens--things like house dust, pollen, pets, bee stings, and mold.

allergy/images

Sometimes, the cause of an allergy is obvious. If you break out in hives every time you eat strawberries, you're probably allergic to them. If you wake up every morning with a stuffy nose, you may be allergic to your feather pillow. If you feel fine through most of the year, but have hay fever every Spring or Fall, you may be allergic to the pollen produced during those seasons.

Here is how to deal with an allergy. The basic defense is to avoid the allergen that causes it. To go back to our examples, don't eat strawberries, or replace your feather pillow with a Dacron pillow.

But what if you can't avoid the allergen? If your reaction is fairly mild, try a non-prescription antihistamine such as Chlor-trimetron or Benadryl. An antihistamine may help relieve your symptoms.

If that doesn't work, you'll need to see your health care provider. He or she may prescribe a stronger medication--or you may be referred to an Allergist for evaluation. If referred, you'll receive a very detailed questionnaire, and probably some allergy skin tests to help determine what causes your allergic reactions. Finally, the Allergist will recommend specific treatments to manage your allergies.

But no matter what methods you use to control your allergies, remember that they are affected by your physical and emotional health. If you're healthy, you can tolerate a greater amount of the things that you're sensitive to.

They include allergies to foods, pollen, medication and environmental allergens and asthma.

Remember these key points:

• Allergic reactions are caused by the body's response to foreign substances.
• The tendency to have allergic reactions can be inherited.
• Allergic reactions can last throughout life--though they may take different forms at different times.
• Try to manage an allergy by avoiding the substance that causes it, and, if necessary, by trying a mild antihistamine.
• If that doesn't work, see your health care provider for evaluation and possible referral to an Allergist.

Treatment Using Herbs, Phytochemicals and Vitamins to Soothe Your Allergies This Season

If you are one of the lucky few that doesn’t suffer from seasonal allergies, consider yourself, well lucky!! I myself have had allergy problems since before I can remember, and trust me I have gone through just about everything there is to treat them. Personally, the only relief I’ve found and felt good about using is in Complementary Medicine, be it, herbs, diet, or acupuncture. My allergies, unfortunately are not only seasonal but a vague anomaly that continues year round for a laundry list of reasons of which I am never sure of. Fortunately, dealing with your personal health and testing new ideas on yourself is a great learning tool, and one day hopefully I will have squashed all my allergy problems and live an itch free life.

I recently came across an article published in The Journal of Allergy and Clinical Immunology reviewing CAM’s history in treating various ailments of the immune system, including asthma, allergic rhinitis and dermatitis through the use of Vitamins, Herbs and Phytochemicals. If you are looking for some hope in a prescription drug free world of allergy treatment, check out the research. Some highlights of the research include:

Vitamin D: It has long been said that Vitamin D plays a vital role in your overall health, this article just reinforces the importance that Vitamin D plays in our immune system and how it can be a crucial part of dealing with allergies of any kind.

Vitamin E: Has been shown to decrease mast cell production, thereby relieving an allergic response.

Vitamin A: Has been shown to increase antibody production.

Vitamin C: Is an important mediator in the immune response.

Magnolol: As far as phytochemicals go, Magnolol is polyphenol found in plants that plays a part in the immune reaction, lending an inhibitory effect that reduces the allergic reaction.

Quercetin: Found in cherries, Quercetin plays the same sort of inhibitory role in the cascade of events causing an allergic reaction and effects the production of mast cells.

Resveratrol: Found in grape skins, it’s a powerful antioxidant that has been shown to have anti-cancer effects, it plays a role in alleviating the stress response that can be an instigator in the allergy response.

Ma Huang (or Ephedra): Which has recently been taken off the market is a great herb in the treatment of asthma and has unfortunately been misused as a diet drug and energy enhancer due to its amphetime-like effects.

As far as using these substances clinically in the treatment of allergies, there is SO much information in the article that I could hardly paraphrase any one part of it in one page, but if you are looking for specific info regarding Atopic Dermatitis, Allergic Rhinitis or Asthma, please read the article, there is quite a bit of good information in there and natural substances that are worth taking a look at. For example, some of the remedies they review are as follows:

In treating Atopic Dermatitis, Evening Primrose, Essential Fatty Acids, Rumex japonicus Houtt & Actinidia arguta are a few of the herbal remedies found to have positive effects.

For Allergic Rhinitis, Butterbur is worth mentioning as finding similar test results as the use of Fexafenadine a prescription medicine commonly prescribed for allergies. Citrus unshiu also showed positive results in treating seasonal allergies. Likewise, dietary products like grape seed extract, tomato extract, dietary spirulina, and cellulose powder have been suggested for the treatment of allergic rhinitis.

As far as Chinese Herbal Formulas are concerned Bhu-zong-yi-qi-tang is shown to have efficacious results when treating both allergic rhinitis and atopic dermatitis as well as Shi-Bi-Lin, another formula.

Also worth mentioning are a couple of other homeopathic remedies, including Apis Mel, which is helpful in acute cases for hives, bee stings and other insect bites and Histaminum which is helpful in the case of nasal congestion, hay fever, insect bites, eczema, and even food allergies. One that has been super useful for me when I’m having an acute reaction is Quantum AllerCleanse a Botanical Supplement produced by Premier Research Labs.

So, take control of your health this allergy season and look into these great natural remedies! I know some of these have done wonders for me in helping to relieve my allergy symptoms throughout the years and I hope you too can benefit as well!

Source: Mainardi, Timothy, MD, MS, Kapoor, Simi, MD, Bielory, Leonard, MD, ( Feb. 2009) Complementary and Alternative Medicine: Herbs, Phytochemicals and Vitamins and Their Immunologic Effects. The Journal of Allergy & Clinical Immunology, 123 (2), 283-294

Medication Allergies

This information is about allergies to medications. It covers what they are, how to deal with them, and how to prevent them.

Some people are allergic to certain medicines. When given these medicines they have allergic reactions such as skin rash, hives, wheezing-- or, in a very few cases, even death. These allergic reactions are not uncommon.

Almost any medication can cause an allergic reaction. Some of these medications are penicillin, sulfa, aspirin, phenobarbital, laxatives, and codeine. People allergic to penicillin will be allergic to all penicillin types of medication including Amoxicillin, Ampicillin, etc. Individuals allergic to aspirin will usually also be allergic to non-steroidal anti-inflammatory medications containing ibuprofen such as: Advil, Nuprin, Pamprin and Midol. If you are allergic to any medications, you should discuss this with your health care provider or pharmacist before taking any medications regardless of whether they are prescription or non-prescription.

An allergic reaction to a medicine can begin any time. Some people take a medication for years with no ill effect. And then suddenly, they become allergic to it.

Here's how to deal with an allergy to a medication. First, know the name of any drug you become allergic to. Then tell your doctor or nurse so he or she can record you allergy in your medical records. Tell any doctor or nurse about your allergy before receiving any injection or medication. And if you tend to have allergic reactions to medicines, it's a good idea to stay in the waiting room for 20 to 30 minutes after getting a shot--to make sure you don't develop a reaction to it.

Finally, keep a lost of your allergies with you at all times--in your purse or wallet, or on a Medic Alert wrist bracelet. That way, if you are ever in an accident or unconscious, people who are taking care of you will know about your allergies. You can get an application for a Medic Alert bracelet from your provider or pharmacy.

To determine whether you are truly allergic to a medication, discuss any reactions with your health care provider. Remember and explain exactly what happened when you took the medications, and what symptoms you experienced--like hives, nausea, wheezing, swollen joints, or dizziness. The reason is that some reactions are not due to allergy.

Since allergic reactions can appear unexpectedly, you may not be able to avoid them completely. If you suspect that you're having an allergic reaction to a medication, call your health provider. And if you develop a serious problem with large hives, wheezing, or difficulty in breathing, call your emergency phone number. If you feel this is a life threatening emergency call 911 at once!

Please remember these key points:

• Allergic reactions to medications are not uncommon; many medications can produce allergic reactions.
• An allergic reaction can begin any time--even if you've taken the medication before without ill effect.
• To prevent allergic reactions, find out the names of the medications you are allergic to.
• Discuss reactions with your doctor and have them written into your medical record.
• Inform the doctor or nurse about your allergies every time you are about to get an injection.
• Keep a list of your allergic reactions and carry it with you.