Here are some clues on How to Be an Active Patient.

People who are actively involved in their medical care stay healthier, recover quicker when they're ill and live longer, healthier lives, says the Agency for Healthcare Research and Quality.

Active patients participate as partners in their health care with their doctors and other providers. They don't make health care decisions on their own, but they're in charge of the process because they schedule appropriate visits to their health care providers, plan ahead to get the most out of those visits, learn about their conditions and medications, and follow through on treatments and lifestyle changes as agreed upon by them and their doctors.

Being informed about any health conditions you have can keep you from passively agreeing to tests and treatments.

Decide what you want to get out of an appointment before you walk into the office. Write down any questions you have and any issues you want to discuss beforehand. Bring your notes and refer to them.

Other ideas:

• Bring a list of all the prescribed and over-the-counter drugs, herbs, and supplements you take and note your dosages.
• Bring a list of any medicines to which you are allergic.
• Keep a health diary. If you have a chronic condition or specific health concern, make a dated log of your general health, taking special note of symptoms or changes. This will remind you to discuss certain things with your health care provider and also will help him or her chart any change in your symptoms over time.
• If you're seeing a new health care provider or a specialist for the first time, bring copies of your medical history and information on diseases, conditions, and cause of death of family members. This will help build your medical profile and put your current state of health into perspective. Write or call your previous health care provider and request that copies of your records and lab and X-ray reports be given to you or sent directly to the new provider.

Schedule and keep appropriate medical appointments.

Answer your health care provider's questions completely and truthfully. For example, if you're worried you'll have difficulty with a suggested treatment, say so.

Avoid saying what you believe your provider wants to hear. If you don't think your treatment is helping you, speak up. Share your fears and concerns about your condition. Ask what to expect while you're getting better and how long your provider thinks it will take before your illness is cured or your symptoms are under control. It's essential to speak openly about symptoms because your doctor uses the information you provide to make a diagnosis and determine a treatment plan. Plus, a problem will remain untreated if you don't discuss it.

Other ideas:

• Follow your provider's instructions. For example, be sure to take any medicine prescribed, as scheduled, and follow any other physical and dietary regimens he or she recommends. If you feel worse or you don't believe the treatment is working, call your doctor immediately. This feedback will help the two of you work together to adjust your treatment and find therapies that work best for you.
• Listen closely. Listening carefully to what your provider says about your condition is as important as giving him or her an accurate assessment of your health. Take notes during your visit if you think you may forget part of your treatment regimen.
• Be ready to answer specific questions. Your provider needs to know your specific symptoms, when they started, and if they appear at certain times of the day or after certain activities, such as eating.
• Advise your health care provider if you're pregnant. This will affect the treatment a physician recommends.
• Take all medications as directed. Follow drug dosages precisely. Taking more of a medication could be dangerous; taking less could delay your recovery.
• Make positive lifestyle changes to reinforce your medical treatment. Stop smoking, limit your alcohol intake, improve your diet, get enough rest, and exercise regularly; these can improve your immunity and your body's ability to heal itself.

Understanding your condition can help you manage and control chronic illnesses, such as asthma or heart disease.

Ask your health care provider to recommend additional sources of information if you want to know more about your condition. Libraries, valid Internet sites, support groups, and associations can be helpful. Be aware that advice given on some health-related Web sites and chat rooms may be hearsay.

If you have a serious condition, ask if there are other treatment options besides the one your doctor recommends.

You have a right to get the information you need to make decisions about your care.

This information may include:

• Explanations of the purpose of tests and procedures that may be costly, painful, or risky
• Explanations of the purpose and expected effectiveness, and side effects of treatments
• Clarification on any medical advice or words you don't understand

One of your doctor's primary roles is to prescribe and monitor your medication use. Your responsibility is to take the right amount at the right time.

Be sure you know the following before taking a prescription or OTC medication, herb, or supplement:

• The medicine's name and what it's supposed to do
• How often you should take it
• Any medicines, foods or beverages to avoid when taking it
• Its possible side effects
• What you should do if you forget a dose

Depressed Kids Need Help

A new label on some antidepressants, a so-called black box warning, cautions that they may make kids feel more suicidal. But that warning shouldn't stop parents from considering their use for depressed teens, psychiatrists say.

In short, teen depression is a serious illness. The benefits of getting help, including taking medications if needed, far outweigh the potential risks.

A specific group of antidepressants called selective serotonin reuptake inhibitors (SSRIs) has been shown to help children and teens with depression, according to the National Institute of Mental Health (NIMH). The black box warning applies to these SSRIs and the U.S. Food and Drug Administration (FDA) says that suicidal thoughts or behavior are more likely in the first four weeks of use or when dosages are changed. Psychiatrists say the warning was meant, in part, to alert other doctors and parents to the need for closer monitoring.

The FDA says that children and teens who begin taking SSRIs should be closely watched for any worsening of depression, suicidal thoughts or behavior, or any unusual changes in behavior, including sleeplessness, agitation or withdrawal from social situations.

Antidepressants don't work in every case. Prozac, for example, helps only about two-thirds of those who take it, the FDA says, and some children experience side effects such as agitation.

Suicidal thoughts are very common in adolescents. Fortunately, few succeed. Usually, they don't tell anybody about it.

Studies involving about 4,400 depressed kids led to the new warning. Those who took antidepressants were twice as likely to express suicidal thoughts as those who took placebos (sugar pills). The numbers were small—4 percent for those on the drugs versus 2 percent on placebos. There were no actual suicides.

If you think your child might have depression, don't worry about trying to define what it is, just get it checked out. See a mental health professional and get a comprehensive evaluation. The good news is that if it is depression, most kids can be helped.

Here are some suggestions from the NIMH:

• Realize that depression in your child or teen is a serious condition that should be treated and monitored.
• Your child should be thoroughly evaluated by a health care provider to determine if medication is appropriate. If an SSRI is prescribed, the child should be closely monitored, particularly during the first four weeks. And if suicidal thoughts or agitation develop, notify your provider at once.
• Medications are not the only treatment for depression, but are usually required if the depression is more than mild. Many times psychotherapy is given as the first treatment for mild forms of depression. For more severe forms, medication may be given in combination with psychotherapy.
• If your child expresses suicidal thoughts or behavior or even intimates these, or has nervousness, agitation, irritability, sleeplessness or easily changeable moods, have him/her evaluated without delay.
• If your child is already taking an SSRI, he/she should not stop taking the medication without discussing it with a health care provider. The child also should continue to be monitored to see that the medication is helping.
• Realize that any medication may have side effects. Talk to your health care provider if you have concerns about side effects.

Why is the Doctor pressing your abdomen? check it out.

For those trained in such touching, pressing on your abdomen can provide significant clues to potential problems.

The external examination with the hands gives doctors information about such important structures as the liver, spleen, kidneys, intestines, pancreas, bladder, gallbladder, appendix, abdominal aorta (the major blood vessel from your heart to your legs), and in females, the uterus and ovaries.

When the doctor presses on your abdomen, he or she is feeling to see if any of these are enlarged or tender, making them painful to touch, which could indicate disease.

Doctors use two different techniques to examine your abdomen: palpation and percussion.

A diagnosis is rarely made from only a manual examination of the abdomen, but this procedure can turn up what appear to be abnormalities, warranting further examination or testing.

Palpation means pushing down to see if the organs can be felt. For example, the aorta that supplies blood to the lower extremities runs directly beneath the navel and should be only an inch wide; if it is wider than that, there could be a problem such as an aneurysm.

The doctor also looks for tenderness, or pain that you experience when he depresses then quickly lifts his hands off your stomach (rebound tenderness). Such pain indicates that the peritoneum, or the membrane that lines the abdominal cavity, is inflamed--as often happens when the appendix becomes diseased, the bowel is perforated or there is peritonitis.

Then there's the spleen. If you're a healthy adult, the doctor shouldn't be able to feel it. If he can, that means the spleen is enlarged. The next step is finding the reason for the enlargement--possibly disease, such as infectious mononucleosis or leukemia.

Percussion means tapping the abdomen and listening to the sounds. It's similar to the tapping done by shoppers who know a ripe watermelon sounds different from an unripe one. When the doctor taps below the rib cage, he can hear the sounds made by a normal liver. But when he taps beyond where the liver should extend, the same sound could indicate an enlarged liver. Fluid in the abdominal cavity (ascites), a result of heart, liver or kidney disease, can sometimes be detected by percussion.

Why the Doctor Asks for your Urine Sample.

It's probably safe to say that no one really likes giving a urine sample. But the fact is that few tests can match the routine urine analysis for telling your doctor about what's going on inside your body.

The bladder can hold almost 2 cups of urine for two to five hours comfortably, and excretes about 2 quarts of waste products and additional water daily. And just as you use a dipstick to check your car's engine oil, doctors rely on a specially treated "dipstick," a plastic stick that has segments imbedded with different chemical indicators on it, to test urine. Unusual amounts of certain substances in your urine can indicate conditions ranging from minor urinary tract infections to diabetes and other more serious conditions.

One portion of the dipstick, for instance, measures the specific gravity (a measure of the amount of substances dissolved in the urine). The higher the specific gravity, the more concentrated the urine is. Using a numerical scale, the dipstick shows whether you're drinking enough fluids and how well your kidneys are filtering wastes from your body. Very concentrated urine suggests you are probably not drinking enough fluids, making it harder for your body to flush wastes. Urine is normally darker--more concentrated--in the morning, because your body's been storing wastes all night.

The dipstick registers the presence of a variety of chemicals that the kidneys filter, such as glucose (sugar) or minerals. Healthy people generally don't excrete sugar in their urine. Its presence may mean that you have diabetes or another condition that prevents your body from efficiently converting blood sugar into energy.

The urine test also can indicate infections by measuring nitrites and leukocytes. Bacteria produce an enzyme that converts nitrates, which are normally present in urine to nitrites. Leukocytes are the white blood cells that fight infection. The presence of either indicates that your body may be fighting an infection in the bladder or somewhere else along the urinary tract. They also can indicate something even more serious, such as a tumor, but further tests are needed to confirm these findings.

The dipstick gauges protein and pH levels. Urine shouldn't contain much, if any, protein, although some perfectly normal people do excrete tiny amounts. Urine pH, or acidity, normally ranges between 4.5 and 8, with most people's urine falling between 5.5 and 6.5. Significantly high protein or pH levels can suggest kidney or other renal dysfunction.

Ketones can be detected by dipsticks. They are substances produced when fat is used by the body for energy. They are eliminated from the body in the urine. Large amounts of urinary ketones indicate a diet low in carbohydrates, starvation, or, in a person with diabetes, a dangerous condition known as diabetic ketoacidosis.

Advantages and Disadvantages of having a home birth

Can I have a home birth?

You can 'book' a home birth with your GP, or direct with a community midwife. You can also do this through an independent midwife, although you will have to pay.

There are some health and pregnancy issues that make a home birth less suitable for some women, but it’s still your choice. Things you need to think about before reaching a decision are:

Advantages

• You'll be in a familiar, relaxing and private environment
• There should be no quick dash to hospital once you go into labour – you can stay put
• You can choose who you want there during labour, so if you want your other children around that's fine
• You may feel more in control at home
• After your baby's born, you can get into your own bath and your own bed

Disadvantages

• There may be fewer options for pain relief at home
• You may have to transfer to hospital if there are complications and this may be an issue if you live some distance away
• There is no emergency paediatric care on hand if your baby needs it

How do I arrange a home birth?

Once you've had your pregnancy confirmed, talk to your GP or midwife about a home birth. They'll discuss your choice and make the necessary arrangements.

If your GP's concerned about your choice, contact the manager of your local community midwifery services.

The earlier in your pregnancy you decide on a home birth, the easier it is to arrange one, and you can change your mind and opt for a hospital birth at any point.

Once labour begins, your community midwife may visit you once, twice, or more. When your baby's birth is imminent she'll stay with you.

Will I need any special equipment?

Your midwife will bring all the equipment she needs. You don't need to provide very much, but you should ensure your home is warm.

You'll need:

• Plastic sheets to protect your bed and carpet
• Warm towels and warm clothes for your baby
• A bright lamp so the midwife can see what she's doing
• A packed overnight bag, including baby clothes, in case you need to be transferred to hospital

If you'd like to use a birthing pool at home, these are available for hire.

What if I need to go to hospital?

If there are complications during your labour, the midwife may decide you or your baby would be safer in hospital.

She'll discuss this with you and your partner, and will call an ambulance. She'll go with you and may continue with your care depending on how many hours she's already worked.

If you use an independent midwife she may not be able to assist you at the hospital, although she can remain with you as a supporter.

After a home birth

Your midwife will stay for some time after the placenta has been delivered, and will check your baby and help you to breastfeed.

Your midwife, or one of her colleagues, will visit you every day for a few days and your GP will carry out a complete check on your baby.

Disclaimer

All content within Ask-Med-Blog is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Ask-Med-Blog is not responsible or liable for any diagnosis made by a user based on the content of this Blog. Ask-Med-Blog is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites.  Always consult your own GP if you're in any way concerned about your health.

3D images may help treat cancer

Three-dimensional images of tissue samples could help spot cancer early, say researchers.

Scientists from the University of Leeds have created a technique to generate hi-resolution, colour 3D images of a piece of tissue.

The images can be rotated on a computer screen and examined from any angle.

Cancer Research UK said the technology could help researchers understand how cancer grew and spread, and learn how to treat it more effectively.

The findings are published in the American Journal of Pathology.

Digital microscopy is not new - tissue scanning first appeared a decade ago, replacing the conventional method of manually cutting ultra-thin slices of tissue one by one to then examine them under a microscope.

But these scanners, which are now used around the world, produce two-dimensional images, revealing only one cross-section of that particular piece of tissue.

And this has drawbacks, according to Dr Derek Magee, one of the researchers involved in the study.

Realistic image

"The tissue is of course three-dimensional, and in a lot of applications this three-dimensional nature is important," he told BBC News.

"For example, if you take a blood vessel, which is a branching network of tubes, and you take a slice of it, the 2D image that you get is an ellipse.

"This tells you absolutely nothing about the connectivity, or the specific branching, of that particular network of blood vessels, which could be particularly important for cancer specialists."

A 3D image could help provide much more information than a simple 2D scan.

To create one, a piece of tissue must be cut with an ultra-precise machine called microtome into hundreds of very thin slices.

Each slice is then put onto a 1mm-thick piece of glass and loaded into a digital scanner.

The scanner then creates 2D impressions of each cross-section, and this is where the new technology comes into play.

The software developed by the Leeds University team generates a three-dimensional shape from these virtual slides, creating a realistic image that a researcher can manipulate and spin around.

Spotting cancer

"This may help spot small tumours that could be missed by conventional approaches," said Dr Magee.

"Also, if there is a major blood vessel fairly nearby, it will be possible to see if a tumour has reached it.

"And if it has not, you can probably cut it out very safely."

It is the same with organs, added Dr Magee - if a surgeon wants to remove a tumour near a very sensitive organ, the main question is about the safety of the procedure.

It is also possible to reconstruct 3D images of whole sections - as seen with this mouse embryo, created with 200 slides

This technology could help researchers understand more about the disease, and how to treat it more effectively, said Dr Kat Arney, science information manager at Cancer Research UK.

"We're beginning to understand just how complex cancer is," she told the BBC.

"A tumour is a complex three-dimensional 'organ' made of cancerous and healthy cells, including blood vessels, immune cells and other 'normal' cells.

"It will be fascinating to see how this exciting new technique is taken forward by cancer researchers, and what secrets it can yield about the disease."

In the past, there have been attempts to create 3D images of tissue samples.

But the images were low resolution and hence not very detailed, generated after taking photos of slides on a microscope with a camera, one by one, and then assembling them digitally.

But the Leeds University team said that their approach was the first time a standard digital scanner had been used to produce high-resolution images.

"Up until now, the use of 3D imaging technology to study disease has been limited because of low resolution, and the time and difficulty associated with acquiring large numbers of images with a microscope," said lead researcher Dr Darren Treanor.

Intake of Vitamin C in Large Doses May Lower BP

A new study has revealed that intake vitamin C in large doses may moderately reduce blood pressure. 

However, the researchers from Johns Hopkins University stopped short of suggesting people load up on supplements. 

"Our research suggests a modest blood pressure lowering effect with vitamin C supplementation, but before we can recommend supplements as a treatment for high blood pressure, we really need more research to understand the implications of taking them," Edgar "Pete" R. Miller III, the study leader, said. 

Roughly 30 percent of adults in the United States have high blood pressure, or hypertension, an important risk factor for heart disease and stroke. Successful treatment may include drugs, exercise, weight loss, and dietary changes such as reducing salt intake. 

Some experts believe that large amounts of vitamin C, an essential micronutrient found primarily in fruits and vegetables, could lower pressure as well, but randomized, controlled dietary intervention studies - the gold standard of nutrition research - have produced mixed results. 

Miller and his colleagues reviewed and analyzed data from 29 randomized, controlled, previously published clinical trials that reported systolic and/or diastolic blood pressure values and also compared vitamin C intake to a placebo. 

What they found is that taking an average of 500 milligrams of vitamin C daily - about five times the recommended daily requirement - reduced blood pressure by 3.84 millimeters of mercury in the short term. Among those diagnosed with hypertension, the drop was nearly 5 millimeters of mercury. 

By comparison, Miller said, patients who take blood pressure medication such as ACE inhibitors or diuretics can expect a roughly 10 millimeter of mercury reduction in blood pressure. 

500 milligrams of vitamin C is the amount in about six cups of orange juice. The recommended daily intake of vitamin C for adults is 90 milligrams. 

"Although our review found only a moderate impact on blood pressure, if the entire U.S. population lowered blood pressure by 3 milliliters of mercury, there would be a lot fewer strokes," Miller said. 

The study has been published in the American Journal of Clinical Nutrition.

Blood Sugar Levels can be Reduced by Naturopathic Care .

Researchers have revealed that type 2 diabetes patients who received naturopathic care had lower blood-sugar levels, better eating and exercise habits. They also had a stronger sense of control over their condition than did patients receiving only conventional care. 

The findings resulting from a new joint study by Group Health Research Institute and Bastyr University Research Institute show that complementary and alternative medicine (CAM) may have several positive effects on people with type 2 diabetes. 

"The news is encouraging for those fighting the disease," said Ryan Bradley, ND, MPH, director of the Center for Diabetes and Cardiovascular Wellness at Bastyr University and its clinic, the Bastyr Center for Natural Health. 

"Patients involved in the study cited the benefits of trying different approaches to find the best ways to minimize the effects of type 2 diabetes. In many ways, that strategy mirrors our partnership with Group Health in this research study-working together to discover the best possible solutions," he stated. 

Forty study participants received counselling on diet, exercise, and glucose monitoring from four naturopathic physicians (NDs) in addition to conventional diabetes care from their medical doctors, including prescription medications. 

Many of the participants also received stress-management care and dietary supplements. Researchers then compared these 40 participants with 329 patients receiving only conventional diabetes care. 

In six months and about four naturopathic treatment visits, participants demonstrated improved self-care, more consistent monitoring of glucose, and improved moods. 

Hemoglobin A1c rates (a measure of blood-sugar control) were nearly a full percentage point lower for those patients. This compares with a drop of only 0.5 percent over the same time period for 329 clinically similar patients receiving only conventional diabetes care. 

The encouraging findings from this small observational study will need to be confirmed by a randomized trial with larger numbers of participants, according to Dr. Bradley. 

The finding has been published in BMC Complementary and Alternative Medicine.

Reasons Why 60 Percent of Salesmen Are Bald.

A new study has found stress as the major cause for men in sales who have either lost their hair or have a receding hairline. 

According to a poll, the sales industry is Britain's baldest with 60 percent of them going bald. 

Half of them believe long working hours and the pressure to sell in a difficult economic environment are the main causes of their hair loss. 

Most of them had a full head of hair when they started their job but began losing it within four and a half years. 

Web developers and software engineers were the second most likely group of workers to lose their hair, according to the poll of 1,903 men. 

Of all those who admit they hair is thinning, a quarter blame the stresses of their job. 

"Hair loss in men still carries a major stigma as this survey shows," the Daily Express quoted Nicola Reid, brand manager for Regaine for Men Foam. as saying. 

"On average, hair loss affects 40 per cent of men under 35," Reid added.

Link Discovered Between Estrogen And Tobacco Smoke

The hormone estrogen may help promote lung cancer - including compounding the effects of tobacco smoke on the disease - pointing towards potential new therapies that target the hormone metabolism, according to new research presented at the AACR Annual Meeting 2012 by scientists at Fox Chase Cancer Center in Philadelphia. 

"This research provides the link between estrogen and tobacco smoke," says study author Jing Peng, Ph.D., postdoctoral associate in the lab of Margie L. Clapper, Ph.D., also a co-author on the paper. 

The researchers found that estrogen is metabolized into toxic derivatives in the mouse lung. The level of these toxic metabolites increased when mice were exposed to tobacco smoke. The results suggest that new therapies which prevent estrogen from being converted into toxins could one day help treat - or even prevent - lung cancer, says Peng. "In the future, we would like to target estrogen-metabolizing pathways as a form of treatment or prevention of lung cancer." 

Researchers have long known that tobacco smoke is the number one cause of lung cancer. But recent findings suggest that estrogen may also play a role in the disease. If so, it wouldn't be the first form of cancer linked to estrogen - this hormone is known to promote breast cancer as well as other gynecologic cancers. 

To investigate, Peng, Clapper and their colleagues examined the lungs of healthy mice and found that they contained high levels of estrogen metabolites, known as 4 hydroxy- estrogens (4-OHEs), which are carcinogenic. Specifically, these 4-OHEs help activate processes that promote cell growth, and generate free radicals that damage cells. 

When the researchers exposed the mice to tobacco smoke for 8 weeks, they found that the levels of 4-OHEs increased. "We believe that these metabolites of estrogen can damage cells and contribute to lung cancer," says Clapper. 

Female mice had twice as much 4-OHE in their lungs compared to male mice after controlling for the level of total estrogen present. Whether this is the same in humans remains to be determined. "While lung cancer is not more common in women, the number of nonsmokers who develop lung cancer is greater for men than for women," explains Clapper. 

In the future, Peng and Clapper hope these results will help researchers develop new therapies that target estrogen metabolism as a way to treat or prevent lung cancer. Already, patients are enrolling in clinical trials that are using anti-estrogen drugs to treat lung cancer. 

"We believe that levels of these toxic estrogen metabolites may one day be useful in predicting a person's lung cancer risk or prognosis", adds Peng. "If levels are particularly high, for instance, that may suggest the person is more prone to developing the disease, or has a worse prognosis. We'd definitely like to be able to use this information to develop a more personalized treatment approach," she says.