The Phobia List
There are many hundreds of named phobias, and this is the most complete list of which we know.
Although there are many hundreds of 'different' phobias, all phobias are in fact very similar: a particular stimulus, be it spiders, snakes, or pretty well anything else triggering the phobic individuals fear response when it isn't appropriate.
The Phobia List: A
Ablutophobia — Fear of washing, bathing, or cleaning
Acarophobia — Fear of itching or the insects that cause itching
Acerophobia — Fear of sourness or things that are sour
Achluophobia — Fear of darkness or the dark
Acousticophobia — Fear of noise or sound
Acrophobia — Fear of heights or high levels
Aeroacrophobia — Fear of open high places
Aeronausiphobia — Fear of vomiting secondary to airsickness
Aerophobia — Fear of draft, swallowing air, or airbourne noxious substances
Agateophobia — Fear of insanity or becoming insane
Agliophobia — Fear of pain
Agoraphobia — Fear of open spaces, leaving a safe place, or crowded public places
Agraphobia — Fear of sexual abuse
Agrizoophobia — Fear of wild animals
Agyrophobia — Fear of streets or crossing the street
Aichmophobia — Fear of needles, pins, or pointed objects
Ailurophobia — Fear of cats
Albuminurophobia — Fear of kidney disease
Alektorophobia — Fear of chickens
Algophobia — Fear of garlic
Alliumphobia — Fear of opinions or beliefs
Altophobia — Fear of dust
Amathophobia — Fear of riding in cars
Amaxophobia — Fear of walking
Amnesiphobia — Fear of amnesia
Amychophobia — Fear of scratches or being scratched
Anablephobia — Fear of looking up
Androphobia — Fear of men
Anemophobia — Fear of wind or air drafts
Anginophobia — Fear of angina, choking, or narrowness
Anglophobia — Fear of England, English Culture, or English People
Angrophobia — Fear of anger or becoming angry
Ankylophobia — Fear of immobility of a joint
Anthophobia — Fear of flowers
Anthropophobia — Fear of people or society
Antlophobia — Fear of floods
Anuptaphobia — Fear of staying single
Anxiety — Fear of Anxiety
Apeirophobia — Fear of infinity
Aphenphosmphobia — Fear of being touched
Apiphobia — Fear of bees
Apotemnophobia — Fear of persons with amputations
Arachibutyrophobia — Fear of peanut butter sticking to the roof of the mouth
Arachnephobia — Fear of spiders
Arithmophobia — Fear of numbers
Arsonphobia — Fear of fire or flames
Asthenophobia — Fear of fainting or weakness
Astraphobia — Fear of thunder and lightning
Astrophobia — Fear of stars and celestial space
Asymmetriphobia — Fear of asymmetrical things
Ataxiophobia — Fear of ataxia (muscular incoordination)
Ataxophobia — Fear of disorder or untidiness
Atelophobia — Fear of imperfection
Atephobia — Fear of ruin or ruins
Athazagoraphobia — Fear of being forgotton, being ignored, or forgetting
Atomosophobia — Fear of atomic explosions
Atychiphobia — Fear of failure
Aulophobia — Fear of flutes
Aurophobia — Fear of gold
Auroraphobia — Fear of Northern lights
Autodysomophobia — Fear of one that has a vile odor
Automatonophobia — Fear of ventriloquist's dummies, animatronic creatures or wax statues
Automysophobia — Fear of being dirty
Autophobia — Fear of solitude, being alone, oneself, or being by oneself
Aviophobia — Fear of flying
The Phobia List: B
Bacillophobia — Fear of microbes
Bacteriophobia — Fear of bacteria
Ballistophobia — Fear of missiles or bullets
Barophobia — Fear of gravity
Basiphobia — Fear of inability to stand or falling
Bathmophobia — Fear of stairs or steep slopes
Bathophobia — Fear of depth
Batophobia — Fear of heights or being close to high buildings
Batrachophobia — Fear of amphibians, frogs, newts, or salamanders
Bibliophobia — Fear of books
Blennophobia — Fear of slime
Body Dysmorphic Disorder — Fear of having ugly or unattractive features
Bogyphobia — Fear of bogies or the bogeyman
Bolshephobia — Fear of Bolsheviks
Botanophobia — Fear of plants
Bromidrophobia — Fear of bodily odor or bodily smell
Bufonophobia — Fear of toads
The Phobia List: C
Cacophobia — Fear of ugliness or things that are ugly
Cainophobia — Fear of newness or novelty
Caligynephobia — Fear of beautiful women
Cancerophobia — Fear of cancer
Cardiophobia — Fear of the heart
Carnophobia — Fear of meat
Catagelophobia — Fear of being ridiculed or ridicule
Catapedaphobia — Fear of jumping from high and low places
Cathisophobia — Fear of sitting
Catoptrophobia — Fear of mirrors
Cheimaphobia — Fear of cold
Chemophobia — Fear of chemicals or working with chemicals
Cherophobia — Fear of gaiety
Chionophobia — Fear of snow
Chirophobia — Fear of hands
Cholerophobia — Fear of anger or Cholera
Chorophobia — Fear of dancing
Chrematophobia — Fear of money
Chromatophobia — Fear of colors
Chronomentrophobia — Fear of clocks
Chronophobia — Fear of time
Claustrophobia — Fear of confined or small spaces
Cleisiophobia — Fear of being locked in an enclosed place
Cleithrophobia — Fear of being enclosed
Cleptophobia — Fear of stealing
Climacophobia — Fear of stairs, climbing stairs, or falling down stairs
Clinophobia — Fear of going to bed
Cnidophobia — Fear of stings or being stung
Coimetrophobia — Fear of cemeteries
Coitophobia — Fear of coitus, sex, or sexual intercourse
Cometophobia — Fear of comets
Coprastasophobia — Fear of constipation
Coprophobia — Fear of feces and fecal matter
Coulrophobia — Fear of clowns
Counterphobia — Fear of The preference by a phobic for fearful situations
Cremnophobia — Fear of precipices
Cryophobia — Fear of extreme cold, ice, or frost
Crystallophobia — Fear of crystals or glass
Cyberphobia — Fear of computers or working on a computer
Cyclophobia — Fear of bicycles
Cymophobia — Fear of waves or wave-like motion
Cynophobia — Fear of dogs, canines, or rabies
Cyprianophobia — Fear of prostitutes, venereal disease, or STDs
The Phobia List: D
Daemonophobia — Fear of demons or daemons
Decidophobia — Fear of making decisions
Defecaloesiophobia — Fear of painful bowels movements
Deipnophobia — Fear of dining or dinner conversation
Demophobia — Fear of crowds
Dendrophobia — Fear of trees
Dentophobia — Fear of dentists
Dermatopathophobia — Fear of skin disease or skin lesions
Dextrophobia — Fear of objects at the right side of the body
Diabetophobia — Fear of diabetes
Didaskaleinophobia — Fear of going to school
Dikephobia — Fear of justice
Dinophobia — Fear of dizziness or whirlpools
Diplophobia — Fear of double vision
Dipsophobia — Fear of drinking
Dishabiliophobia — Fear of undressing in front of someone
Doraphobia — Fear of fur or skins of animals
Doxophobia — Fear of expressing opinions or of receiving praise
Driving Phobia — Fear of driving a motorized vehicle
Dromophobia — Fear of crossing streets
Dutchphobia — Fear of the Netherlands, the Dutch, Dutch Culture
Dysmorphophobia — Fear of deformity
Dystychiphobia — Fear of accidents
The Phobia List: E
Earthquakophobia — Fear of earthquakes
Ecclesiophobia — Fear of churchs
Eisoptrophobia — Fear of mirrors or of seeing oneself in a mirror
Electrophobia — Fear of electricity
Eleutherophobia — Fear of freedom
Emetophobia — Fear of vomiting or throwing up
Enetophobia — Fear of pins
Enissophobia — Fear of having committed an unpardonable sin or criticism
Entomophobia — Fear of insects or bugs
Eosophobia — Fear of dawn or daylight
Ephebiphobia — Fear of teenagers
Epistaxiophobia — Fear of nosebleeds
Epistemophobia — Fear of knowledge
Equinophobia — Fear of horses
Eremophobia — Fear of being oneself or lonliness
Ereuthophobia — Fear of redlights, blushing, or the color red
Ergasiophobia — Fear of work, functioning, or Surgeon's operating
Ergophobia — Fear of work
Erotophobia — Fear of sexual love or sexual questions
Euphobia — Fear of hearing good news
The Phobia List: F
Francophobia — Fear of France, French people, or French culture
Frigophobia — Fear of cold or cold things
The Phobia List: G
Gamophobia — Fear of marriage
Geliophobia — Fear of laughter
Geniophobia — Fear of chins
Genuphobia — Fear of knees
Gephydrophobia — Fear of crossing bridges
Gerascophobia — Fear of growing old or old people
Germanophobia — Fear of Germany, German People, or German culture
Geumaphobia — Fear of taste
Globophobia — Fear of balloons
Glossophobia — Fear of speaking in public or trying to speak
Graphophobia — Fear of writing or handwriting
Gymnophobia — Fear of nudity
Gynephobia — Fear of women
The Phobia List: H
Hadephobia — Fear of hell
Hagiophobia — Fear of saints or holy things
Harpaxophobia — Fear of being robbed
Hedonophobia — Fear of feeling pleasure
Heliophobia — Fear of the sun
Hellenologophobia — Fear of Greek terms or complex scientific terminology
Helminthophobia — Fear of being infested with worms
Hemaphobia — Fear of blood
Hereiophobia — Fear of challenges to official doctrine or of radical deviation
Herpetophobia — Fear of reptiles or creepy, crawly things
Heterophobia — Fear of the opposite sex
Hierophobia — Fear of priests or sacred things
Hippopotomonstrosesquippedaliophobia — Fear of long words
Hobophobia — Fear of bums or beggars
Hodophobia — Fear of road travel
Homichlophobia — Fear of fog
Homilophobia — Fear of sermons
Homophobia — Fear of sameness, monotony, homosexuality, or becoming homosexual
Hoplophobia — Fear of firearms
Hormephobia — Fear of shock
Hyalophobia — Fear of glass
Hydrargyophobia — Fear of mercurial medicines
Hydrophobia — Fear of water
Hydrophobophobia — Fear of rabies
Hygrophobia — Fear of liquids, dampness, or moisture
Hylephobia — Fear of materialism or epilepsy
Hypegiaphobia — Fear of responsibility
Hypnophobia — Fear of sleep or being hypnotized
The Phobia List: I
Iatrophobia — Fear of doctors or going to the doctor
Ichthyophobia — Fear of fish
Ideophobia — Fear of ideas
Illyngophobia — Fear of vertigo or feeling dizzy when looking down
Insomnia — Fear of Inability to Sleep
Iophobia — Fear of poison
Isopterophobia — Fear of termites, insects that eat wood
The Phobia List: J
Japanophobia — Fear of Japanese
Judeophobia — Fear of Jewish People
The Phobia List: K
Kakorrhaphiophobia — Fear of failure or defeat
Kenophobia — Fear of voids or empty spaces
Kinesophobia — Fear of movement or motion
Koinoniphobia — Fear of rooms
Kolpophobia — Fear of genitals, particularly female
Kopophobia — Fear of fatigue
Kosmikophobia — Fear of cosmic phenomenon
Kyphophobia — Fear of stooping
The Phobia List: L
Lachanophobia — Fear of vegetables
Lalophobia — Fear of speaking
Lepraphobia — Fear of leprosy
Leukophobia — Fear of the color white
Levophobia — Fear of things to the left side of the body
Ligyrophobia — Fear of loud noises
Lilapsophobia — Fear of tornado or hurricanes
Limnophobia — Fear of lakes
Linonophobia — Fear of string
Liticaphobia — Fear of lawsuits
Lockiophobia — Fear of childbirth
Logizomechanophobia — Fear of computers
Logophobia — Fear of words
Luiphobia — Fear of lues or syphillis
Lutraphobia — Fear of otters
The Phobia List: M
Macrophobia — Fear of long waits
Mageirocophobia — Fear of cooking
Malaxophobia — Fear of love play
Maniaphobia — Fear of insanity
Mastigophobia — Fear of punishment
Mechanophobia — Fear of machines
Medomalacuphobia — Fear of losing an erection
Medorthophobia — Fear of an erect penis
Megalophobia — Fear of large things
Melanophobia — Fear of the color black
Melophobia — Fear of music
Meningitophobia — Fear of brain disease
Menophobia — Fear of menstruation
Merinthophobia — Fear of being bound or tied up
Metallophobia — Fear of metal
Metathesiophobia — Fear of changes
Meteorophobia — Fear of meteors
Metrophobia — Fear of poetry
Microbiophobia — Fear of microbes
Microphobia — Fear of small things
Misophobia — Fear of being contaminated with dirt or germs
Mnemophobia — Fear of memories
Monopathophobia — Fear of definite disease
Motorphobia — Fear of automobiles
Mottephobia — Fear of moths
Murophobia — Fear of mice
Mycophobia — Fear of mushrooms
Myrmecophobia — Fear of ants
Mythophobia — Fear of myths, stories, or false statements
The Phobia List: N
Narcissistic Personality Disorder — Fear of -
Necrophobia — Fear of death or dead things
Neopharmaphobia — Fear of new drugs
Nephophobia — Fear of clouds
Noctiphobia — Fear of the night
Nomatophobia — Fear of names
Nosocomephobia — Fear of hospitals
Nosophobia — Fear of becoming ill
Nostophobia — Fear of returning home
Novercaphobia — Fear of your step-mother
Nucleomituphobia — Fear of nuclear weapons
Nudophobia — Fear of nudity or nakedness
Nyctohylophobia — Fear of dark wooded areas or forests at night
The Phobia List: O
Obesophobia — Fear of gaining weight
Ochlophobia — Fear of crowds or mobs
Ochophobia — Fear of vehicles
Octophobia — Fear of the figure 8
Odontophobia — Fear of teeth or dental surgery
Oenophobia — Fear of wines
Oikophobia — Fear of houses, home surroundings, or being in a house
Olfactophobia — Fear of smells
Ombrophobia — Fear of rain or of being rained on
Ommatophobia — Fear of eyes
Oneirogmophobia — Fear of wet dreams
Oneirophobia — Fear of dreams
Onomatophobia — Fear of hearing a certain word or of names
Ophidiophobia — Fear of snakes
Ophthalmophobia — Fear of being stared at
Opiophobia — Fear of Fear of medical doctors experience of prescribing needed pain medications for patients
Optophobia — Fear of opening one's eyes
Ornithophobia — Fear of birds
Orthophobia — Fear of property
Ostraconophobia — Fear of shellfish
Ouranophobia — Fear of heaven
The Phobia List: P
Pagophobia — Fear of ice or frost
Panophobia — Fear of everything
Panthophobia — Fear of suffering or disease
Papaphobia — Fear of the Pope
Papyrophobia — Fear of paper
Paralipophobia — Fear of neglecting duty or neglecting responsibility
Paraphobia — Fear of sexual perversion
Parasitophobia — Fear of parasites
Paraskavedekatriaphobia — Fear of Friday the 13th
Parthenophobia — Fear of virgins or young girls
Pathophobia — Fear of disease
Patroiophobia — Fear of heredity
Peccatophobia — Fear of sinning
Pediculophobia — Fear of lice
Pediophobia — Fear of dolls
Pedophobia — Fear of children
Peladophobia — Fear of bald people
Pellagrophobia — Fear of pellagra
Peniaphobia — Fear of poverty
Pentheraphobia — Fear of mother-in-law
Phagophobia — Fear of swallowing or eating
Phalacrophobia — Fear of becoming bald
Pharmacophobia — Fear of taking medicine or drugs
Phengophobia — Fear of daylight or sunshine
Philemaphobia — Fear of kissing
Philophobia — Fear of falling in love or being in love
Philosophobia — Fear of philosophy
Phobophobia — Fear of phobias
Phonophobia — Fear of noises, voices, one's own voice, or telephones
Photoaugliaphobia — Fear of glaring lights
Photophobia — Fear of light
Phronemophobia — Fear of thinking
Phthisiophobia — Fear of tuberculosis
Placophobia — Fear of tombstones
Plutophobia — Fear of wealth
Pneumatiphobia — Fear of spirits
Pnigerophobia — Fear of choking of being smothered
Pogonophobia — Fear of beards
Poliosophobia — Fear of contracting poliomyelitis
Politicophobia — Fear of politicians
Polyphobia — Fear of many things
Ponophobia — Fear of overworking or of pain
Porphyrophobia — Fear of the color purple
Potamophobia — Fear of rivers or running water
Potophobia — Fear of alcohol
Proctophobia — Fear of rectums
Prosophobia — Fear of progress
Psellismophobia — Fear of stuttering
Psychophobia — Fear of the mind
Psychrophobia — Fear of the cold
Pteromerhanophobia — Fear of flying
Pteronophobia — Fear of being tickled by feathers
Pupaphobia — Fear of puppets
Pyrexiophobia — Fear of fever
The Phobia List: R
Radiophobia — Fear of radiation or x-rays
Ranidaphobia — Fear of frogs
Rectophobia — Fear of rectums or rectal diseases
Rhabdophobia — Fear of being severely punished, beaten by a rod, or severely criticized
Rhypophobia — Fear of defecation
Rhytiphobia — Fear of getting wrinkles
Rupophobia — Fear of dirt
Russophobia — Fear of Russians
The Phobia List: S
Samhainophobia — Fear of Halloween
Satanophobia — Fear of Satan or The Devil
Scabiophobia — Fear of scabies
Scelerophibia — Fear of bad men or burglars
Sciaphobia — Fear of shadows
Scoleciphobia — Fear of worms
Scolionophobia — Fear of school
Scopophobia — Fear of being seen or stared at
Scoptophobia — Fear of blindness in visual field
Scriptophobia — Fear of writing in public
Selachophobia — Fear of sharks
Selaphobia — Fear of light flashes
Selenophobia — Fear of the moon
Seplophobia — Fear of decaying matter
Siderodromophobia — Fear of trains, railroads, or train travel
Siderophobia — Fear of stars
Sinistrophobia — Fear of things to the left or left-handed
Sinophobia — Fear of China, Chinese, or Chinese culture
Sitiophobia — Fear of food or eating
Soceraphobia — Fear of parents-in-law
Social Phobia — Fear of social situations
Sociophobia — Fear of society or people in general
Somniphobia — Fear of sleep
Sophophobia — Fear of learning
Soteriophobia — Fear of dependence on others
Spacephobia — Fear of outer space
Spectrophobia — Fear of specters or ghosts
Spheksophobia — Fear of wasps
Stasibasiphobia — Fear of standing or walking
Statue Phobia — Fear of statues or effigies
Staurophobia — Fear of crosses or the crucifix
Stenophobia — Fear of narrow things or places
Symbolophobia — Fear of symbolism
Symmetrophobia — Fear of symmetry
Syngenesophobia — Fear of relatives
The Phobia List: T
Tachophobia — Fear of speed
Taeniophobia — Fear of tapeworms
Taphephobia — Fear of being buried alive or cemeteries
Tapinophobia — Fear of being contagious
Taurophobia — Fear of bulls
Technophobia — Fear of technology or computers
Teleophobia — Fear of definite plans or Religious ceremony
Telephonophobia — Fear of telephones
Teratophobia — Fear of bearing a deformed child, monsters, or deformed people
Testophobia — Fear of taking tests
Tetanophobia — Fear of lockjaw or tetanus
Textophobia — Fear of certain fabrics
Thalassophobia — Fear of the sea or the ocean
Thanatophobia — Fear of death, dying, being buried, cremation, or entombment
Theatrophobia — Fear of theaters
Theologicophobia — Fear of theology
Theophobia — Fear of gods or religion
Thermophobia — Fear of heat
Tocophobia — Fear of pregnancy or childbirth
Tomophobia — Fear of surgery or surgical operations
Topophobia — Fear of fear of certain places or situations
Toxicophobia — Fear of poison or being accidently poisoned
Traumatophobia — Fear of injury or battle
Tremophobia — Fear of trembling
Trichinophobia — Fear of trichinosis
Trichopathophobia — Fear of hair
Triskaidekaphobia — Fear of the number 13
Tropophobia — Fear of moving or making changes
Trypanophobia — Fear of injections
Tyrannophobia — Fear of tyrants
The Phobia List: U
Urophobia — Fear of urine or urinating
The Phobia List: V
Vaccinophobia — Fear of vaccination
Verminophobia — Fear of germs
Vestiphobia — Fear of clothing
Virginitiphobia — Fear of rape
Vitricophobia — Fear of step-father's
The Phobia List: W
Walloonphobia — Fear of the Walloons
Wiccaphobia — Fear of witches and witchcraft
The Phobia List: X
Xanthophobia — Fear of the color yellow or the word yellow
Xenoglossophobia — Fear of foreign languages
Xenophobia — Fear of strangers or foreigners
Xerophobia — Fear of dryness
Xylophobia — Fear of wood, wooden objects, or forests
Xyrophobia — Fear of razors
The Phobia List: Z
Zelophobia — Fear of jealousy
Zemmiphobia — Fear of the great mole rat
Zeusophobia — Fear of God or gods
Zoophobia — Fear of animals
Wednesday, July 30, 2008
Medifast Diet: Complete Review
The Medifast diet plan is popular.
Forbes recently placed the company at number 28 in their 200 best small companies list), and Medifast have even produced a book (What Physicians Have Always Known About Weight Loss).
But what is Medifast all about? One clue is the name - it contains the word fast...
The Basics
The Medifast brand has been around for a number of decades, and at one time was only available via physicians. Nowadays the products can be ordered on-line and through a number of distributors.
Medifast offer a stable of meal replacement products - all generally formulated to be low-calorie and low-fat, and containing the optimum levels of vitamins. The formula will generally take users into a mild state of ketosis.
The most popular plan is called 5 and 1. This plan (800-1000 calories daily) comprises 5 meal replacements and one "real" meal containing a lean protein and vegetables and salad. Medifast claim a weight loss of 2-5 pounds per week on this plan.
Proof?
What many people don't realize is that very few commercial weight loss programs have ever undergone any clinical studies. Medifast heavily promote the fact that a Johns Hopkins university study has shown that Medifast results in significant weight loss (67 pound average loss in males and 57 pound average loss in females). It's worth pointing out that this study looked at patients who attended Medifast clinics.
There is also an additional study that compared the Medifast program with diabetes medication. The study found Medifast more effective at controlling type 2 diabetes than an ADA-recommended program (see PR).
Both studies were led by Associate Professor Lawrence Cheskin of Johns Hopkins Bloomberg School of Public Health and were funded by Medifast.
Successes
Due to the popularity of the program, Medifast have a number of "success stories" - one of which is Nnedi Uzowihe-Igwe of Maryland, USA (currently featured on the Medifast site). She also appeared in People magazine in January 2006 describing a massive transformation that resulted in a 160lb weight loss between June 2004 and April 2005. Nnedi subsequently became pregnant and gave birth to her second daughter)
I was able to find out how Nnedi was going now, and she appears to have maintained her massive initial weight loss (and is aiming to lose the weight she put on with the second baby by the end of this year).
What you can expect
Drastic
Protein fasts and low-calorie meal replacements are a drastic solution, and in my opinion appropriate for drastic situations. Given the choice between gastric bypass surgery or Medifast, then Medifast must surely be a better answer.
The biggest test of a program such as Medifast is the long-term consequences - and in particular weaning off a program based around shakes and soups. The transition phase should be four to six weeks, and often starts off by introducing some oatmeal at breakfast, and some fruit for snacks. Also exercise must become a part of life (5 days a week). Exercise must be fairly low-key during the restrictive part of Medifast - but once transitioning - it becomes increasingly important.
Due to the level of energy intake and exercise levels - it is likely that some muscle loss will occur during the weight loss phase. Once again, the best course of action would be to gradually include strength training during the transition phase - and begin to build up muscle tone.
Costs
The Medifast 5 and 1 plan cost $275 for 4 weeks. However - that's the cost of the "5" - you will still need to buy your daily "lean and green" meal (lean protein plus salad/vegetables).
Men & Women
Different formulations are used for men and women. Some shakes are called Medifast 55 or Medifast 70. The latter has a higher soy protein content and is more suitable for men (or women who prefer higher protein).
Behavior Change Required
Behavioral changes are critical to the long-term success of Medifast. Unless these lifestyle changes are applied, then the weight could easily swing back on like a yo-yo. It's worth taking a look at the post 10 Questions To Ask Before Changing Your Diet.
Conclusion
I don't believe Medifast is for the person who wants to lose 20 pounds. This is a serious program for serious situations, and it may be advisable to follow the program while receiving regular support from a clinic, and even under medical advisement.
However ample proof exists that the program does work and can lead to significant weight loss provided the transition phase is followed correctly.
Forbes recently placed the company at number 28 in their 200 best small companies list), and Medifast have even produced a book (What Physicians Have Always Known About Weight Loss).
But what is Medifast all about? One clue is the name - it contains the word fast...
The Basics
The Medifast brand has been around for a number of decades, and at one time was only available via physicians. Nowadays the products can be ordered on-line and through a number of distributors.
Medifast offer a stable of meal replacement products - all generally formulated to be low-calorie and low-fat, and containing the optimum levels of vitamins. The formula will generally take users into a mild state of ketosis.
The most popular plan is called 5 and 1. This plan (800-1000 calories daily) comprises 5 meal replacements and one "real" meal containing a lean protein and vegetables and salad. Medifast claim a weight loss of 2-5 pounds per week on this plan.
Proof?
What many people don't realize is that very few commercial weight loss programs have ever undergone any clinical studies. Medifast heavily promote the fact that a Johns Hopkins university study has shown that Medifast results in significant weight loss (67 pound average loss in males and 57 pound average loss in females). It's worth pointing out that this study looked at patients who attended Medifast clinics.
There is also an additional study that compared the Medifast program with diabetes medication. The study found Medifast more effective at controlling type 2 diabetes than an ADA-recommended program (see PR).
Both studies were led by Associate Professor Lawrence Cheskin of Johns Hopkins Bloomberg School of Public Health and were funded by Medifast.
Successes
Due to the popularity of the program, Medifast have a number of "success stories" - one of which is Nnedi Uzowihe-Igwe of Maryland, USA (currently featured on the Medifast site). She also appeared in People magazine in January 2006 describing a massive transformation that resulted in a 160lb weight loss between June 2004 and April 2005. Nnedi subsequently became pregnant and gave birth to her second daughter)
I was able to find out how Nnedi was going now, and she appears to have maintained her massive initial weight loss (and is aiming to lose the weight she put on with the second baby by the end of this year).
What you can expect
Drastic
Protein fasts and low-calorie meal replacements are a drastic solution, and in my opinion appropriate for drastic situations. Given the choice between gastric bypass surgery or Medifast, then Medifast must surely be a better answer.
The biggest test of a program such as Medifast is the long-term consequences - and in particular weaning off a program based around shakes and soups. The transition phase should be four to six weeks, and often starts off by introducing some oatmeal at breakfast, and some fruit for snacks. Also exercise must become a part of life (5 days a week). Exercise must be fairly low-key during the restrictive part of Medifast - but once transitioning - it becomes increasingly important.
Due to the level of energy intake and exercise levels - it is likely that some muscle loss will occur during the weight loss phase. Once again, the best course of action would be to gradually include strength training during the transition phase - and begin to build up muscle tone.
Costs
The Medifast 5 and 1 plan cost $275 for 4 weeks. However - that's the cost of the "5" - you will still need to buy your daily "lean and green" meal (lean protein plus salad/vegetables).
Men & Women
Different formulations are used for men and women. Some shakes are called Medifast 55 or Medifast 70. The latter has a higher soy protein content and is more suitable for men (or women who prefer higher protein).
Behavior Change Required
Behavioral changes are critical to the long-term success of Medifast. Unless these lifestyle changes are applied, then the weight could easily swing back on like a yo-yo. It's worth taking a look at the post 10 Questions To Ask Before Changing Your Diet.
Conclusion
I don't believe Medifast is for the person who wants to lose 20 pounds. This is a serious program for serious situations, and it may be advisable to follow the program while receiving regular support from a clinic, and even under medical advisement.
However ample proof exists that the program does work and can lead to significant weight loss provided the transition phase is followed correctly.
The Best Acne Treatments
There are too many acne fighting products on the market to count, and the majority of them simply do not work. However, there are some that do work quite well. The problem is that many people who suffer from acne will spend quite a bit of time and money trying to find the best acne treatments. Teenagers often outgrow acne before they find a treatment that works.
One of the better acne treatments on the market today is ProActiv. ProActiv seems to be helping many people who could not find other solutions that worked. It has been featured on infomercials, news stories, magazine articles, and newspaper articles. Proactiv is a system that includes a renewing cleanser, revitalizing toner, and repairing lotion. Prescription grade benzoyl peroxide is the active ingredient in ProActiv. ProActiv does not require a prescription.
A treatment that is available by prescription is Accutane. Accutane is a very strong medication, that is only suitable for those who suffer from severe and persistent acne. The medication is taken internally, and there are possible side effects, including birth defects, dry and cracked lips, and liver dysfunction.
Another one of that is used topically is retin-a. Many people have had great success with retin-a, which is used to treat acne, acne scars, wrinkles, stretch marks, skin discoloration, and a variety of other skin afflictions. Retin-a is available by prescription, but some over the counter medications contain retin-a.
Not all treatments come in the form of chemicals. Certain essential oils are also beneficial in the treatment of acne. These essential oils can be applied topically for the treatment of mild to moderate acne. The best essential oils for acne treatment are: Tea Tree Oil, Bergamot Oil, Clove Oil, Lavender Oil, and Rosewood Oil. If the essential oil needs to be diluted, mix it with Grapeseed Oil for best results.
In order to find the best acne treatment for you, start with essential oils. If that doesn't work, go to the next step by trying ProActive. If ProActive doesn't work, then try a prescription alternative. You may also consider being tested for food allergies, as certain allergies can cause acne. In this case, the only treatment you need is to eliminate those certain foods from your diet.
One of the better acne treatments on the market today is ProActiv. ProActiv seems to be helping many people who could not find other solutions that worked. It has been featured on infomercials, news stories, magazine articles, and newspaper articles. Proactiv is a system that includes a renewing cleanser, revitalizing toner, and repairing lotion. Prescription grade benzoyl peroxide is the active ingredient in ProActiv. ProActiv does not require a prescription.
A treatment that is available by prescription is Accutane. Accutane is a very strong medication, that is only suitable for those who suffer from severe and persistent acne. The medication is taken internally, and there are possible side effects, including birth defects, dry and cracked lips, and liver dysfunction.
Another one of that is used topically is retin-a. Many people have had great success with retin-a, which is used to treat acne, acne scars, wrinkles, stretch marks, skin discoloration, and a variety of other skin afflictions. Retin-a is available by prescription, but some over the counter medications contain retin-a.
Not all treatments come in the form of chemicals. Certain essential oils are also beneficial in the treatment of acne. These essential oils can be applied topically for the treatment of mild to moderate acne. The best essential oils for acne treatment are: Tea Tree Oil, Bergamot Oil, Clove Oil, Lavender Oil, and Rosewood Oil. If the essential oil needs to be diluted, mix it with Grapeseed Oil for best results.
In order to find the best acne treatment for you, start with essential oils. If that doesn't work, go to the next step by trying ProActive. If ProActive doesn't work, then try a prescription alternative. You may also consider being tested for food allergies, as certain allergies can cause acne. In this case, the only treatment you need is to eliminate those certain foods from your diet.
Pick disease
form of premature dementia caused by atrophy of the frontal and temporal lobes of the brain. It resembles Alzheimer disease but is much less common. Pick disease is characterized by a progressive deterioration of intellect, judgment, and memory, resulting in increased irritability, inappropriate behaviour, depression, and paranoia. Histologically some cerebral nerve cells are swollen and contain abnormal inclusions called Pick bodies. The cause of Pick disease is unknown, but in some cases the disease appears to be inherited. Average survival from onset (generally between the ages of 40 and 60) to death is about 10 years; there is no specific treatment. The disease was first described by the German neurologist Arnold Pick.
Asthma
Asthma is a chronic condition involving the respiratory system in which the airways occasionally constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers.[1] These episodes may be triggered by such things as exposure to an environmental stimulant such as an allergen, environmental tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress. In children, the most common triggers are viral illnesses such as those that cause the common cold.[2] This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators. Between episodes, most patients feel well but can have mild symptoms and they may remain short of breath after exercise for longer periods of time than the unaffected individual. The symptoms of asthma, which can range from mild to life threatening, can usually be controlled with a combination of drugs and environmental changes.
Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children.
Signs and symptoms
In some individuals asthma is characterized by chronic respiratory impairment. In others it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise. Some or all of the following symptoms may be present in those with asthma: dyspnea, wheezing, stridor, coughing, an inability for physical exertion. Some asthmatics who have severe shortness of breath and tightening of the lungs never wheeze or have stridor and their symptoms may be confused with a COPD-type disease.
An acute exacerbation of asthma is commonly referred to as an asthma attack. The clinical hallmarks of an attack are shortness of breath (dyspnea) and either wheezing or stridor.[4] Although the former is "often regarded as the sine qua non of asthma",[4] some patients present primarily with coughing, and in the late stages of an attack, air motion may be so impaired that no wheezing may be heard. When present the cough may sometimes produce clear sputum. The onset may be sudden, with a sense of constriction in the chest, breathing becomes difficult, and wheezing occurs (primarily upon expiration, but can be in both respiratory phases).
Signs of an asthmatic episode include wheezing, prolonged expiration, a rapid heart rate (tachycardia), rhonchous lung sounds (audible through a stethoscope), the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest. During a serious asthma attack, the accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck) may be used, shown as in-drawing of tissues between the ribs and above the sternum and clavicles.
During very severe attacks, an asthma sufferer can turn blue from lack of oxygen, and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat. The person's feet may become icy cold. Severe asthma attacks, which may not be responsive to standard treatments (status asthmaticus), are life-threatening and may lead to respiratory arrest and death. Despite the severity of symptoms during an asthmatic episode, between attacks an asthmatic may show few or even no signs of the disease.[5]
Cause
Asthma is caused by a complex interaction of environmental and genetic factors that researchers do not fully understand yet.[6] These factors can also influence how severe a person’s asthma is and how well they respond to medication.[7] As with other complex diseases, many environmental and genetic factors have been suggested as causes of asthma, but not all of them have been replicated. In addition, as researchers detangle the complex causes of asthma, it is becoming more evident that certain environmental and genetic factors may only affect asthma when combined.
Environmental
Many environmental risk factors have been associated with asthma, but a few stand out as well-replicated or that have a meta-analysis of several studies to support their direct association:
* Poor air quality, from traffic pollution or high ozone levels, has been repeatedly associated with increased asthma morbidity and has a suggested association with asthma development that needs further research.[8][9]
* Environmental tobacco smoke, especially maternal cigarette smoking, is associated with high risk of asthma prevalence and asthma morbidity, wheeze, and respiratory infections.[8]
* Viral respiratory infections at an early age, along with siblings and day care exposure, may be protective against asthma, although there have been controversial results, and this protection may depend on genetic context.[8][10][11]
* Antibiotic use early in life has been linked to development of asthma in several examples; it is thought that antibiotics make one susceptible to development of asthma because they modify gut flora, and thus the immune system (as described by the hygiene hypothesis).[12]
* Caesarean sections have been associated with asthma when compared with vaginal birth; a meta-analysis found a 20% increase in asthma prevalence in children delivered by Cesarean section compared to those who were not. It was proposed that this is due to modified bacterial exposure during Cesarean section compared with vaginal birth, which modifies the immune system (as described by the hygiene hypothesis).[13]
* Psychological stress on the part of a child's caregiver has been associated with asthma, and is an area of active research. Stress can modify behaviors that affect asthma, like smoking, but research suggests that stress has other effects as well. There is growing evidence that stress may influence asthma and other diseases by influencing the immune system.[8]
The hygiene hypothesis is a theory about the cause of asthma and other allergic disease, and is supported by epidemiologic data for asthma. For example, asthma prevalence has been increasing in developed countries along with increased use of antibiotics, c-sections, and cleaning products.[12][13][14] All of these things may negatively affect exposure to beneficial bacteria and other immune system modulators that are important during development, and thus may cause increased risk for asthma and allergy.
Genetic
Over 100 genes have been associated with asthma in at least one genetic association study.[15] However, as with all association studies, replication is important before genetic variation (such as a single nucleotide polymorphism, or SNP) in a certain gene is thought to influence asthma. Through the end of 2005, 25 genes had been associated with asthma in six or more separate populations:[15]
* GSTM1
* IL10
* CTLA4
* SPINK5
* LTC4S
* LTA
* GRPA
* NOD1
* CC16
* GSTP1
* STAT6
* NOS1
* CCL5
* TBXA2R
* TGFB1
* IL4
* IL13
* CD14
* ADRB2 (β-2 adrenergic receptor)
* HLA-DRB1
* HLA-DQB1
* TNF
* FCER1B
* IL4R
* ADAM33
Many of these genes are related to the immune system or to modulating inflammation. However, even among this list of highly replicated genes associated with asthma, the results have not been consistent among all of the populations that have been tested.[15] This indicates that these genes are not associated with asthma under every condition, and that researchers need to do further investigation to figure out the complex interactions that cause asthma.
Stimuli
# Allergens from nature, typically inhaled, which include waste from common household pests, such as the house dust mite and cockroach, grass pollen, mould spores, and pet epithelial cells;[citation needed]
# Indoor air pollution from volatile organic compounds, including perfumes and perfumed products. Examples include soap, dishwashing liquid, laundry detergent, fabric softener, paper tissues, paper towels, toilet paper, shampoo, hairspray, hair gel, cosmetics, facial cream, sun cream, deodorant, cologne, shaving cream, aftershave lotion, air freshener and candles, and products such as oil-based paint.[citation needed]
# Medications, including aspirin,[18] β-adrenergic antagonists (beta blockers), and penicillin.[citation needed]
# Food allergies such as milk, peanuts, and eggs. However, asthma is rarely the only symptom, and not all people with food or other allergies have asthma.[citation needed]
# Use of fossil fuel related allergenic air pollution, such as ozone, smog, summer smog, nitrogen dioxide, and sulfur dioxide, which is thought to be one of the major reasons for the high prevalence of asthma in urban areas.[citation needed]
# Various industrial compounds and other chemicals, notably sulfites; chlorinated swimming pools generate chloramines—monochloramine (NH2Cl), dichloramine (NHCl2) and trichloramine (NCl3)—in the air around them, which are known to induce asthma.[19]
# Early childhood infections, especially viral respiratory infections. However, persons of any age can have asthma triggered by colds and other respiratory infections even though their normal stimuli might be from another category (e.g. pollen) and absent at the time of infection. In many cases, significant asthma may not even occur until the respiratory infection is in its waning stage, and the person is seemingly improving. Eighty percent of asthma attacks in adults and 60% in children are caused by respiratory viruses.[citation needed]
# Exercise or intense use of respiratory system. The effects of which differ somewhat from those of the other triggers, since they are brief. It is known that exercising regularly actually helps to cure asthma.[citation needed]
# Hormonal changes in adolescent girls and adult women associated with their menstrual cycle can lead to a worsening of asthma. Some women also experience a worsening of their asthma during pregnancy whereas others find no significant changes, and in other women their asthma improves during their pregnancy.[citation needed]
# Emotional stress which is poorly understood as a trigger.[citation needed] Emotional stress can affect breathing temporarily, however unlike something such as heart problems, it is unclear if it has any long-term effect.
# Cold weather can make it harder for asthmatics to breathe.[20] Whether high altitude helps or worsens asthma is debatable and may vary from person to person.
Pathogenesis
The fundamental problem in asthma appears to be immunological: young children in the early stages of asthma show signs of excessive inflammation in their airways. Epidemiological findings give clues as to the pathogenesis: the incidence of asthma seems to be increasing worldwide, and asthma is now very much more common in affluent countries.
In 1968 Andor Szentivanyi first described The Beta Adrenergic Theory of Asthma; in which blockage of the Beta-2 receptors of pulmonary smooth muscle cells causes asthma.[22] Szentivanyi's Beta Adrenergic Theory is a citation classic[23] and has been cited more times than any other article in the history of the Journal of Allergy.
In 1995 Szentivanyi and colleagues demonstrated that IgE blocks beta-2 receptors.[24] Since overproduction of IgE is central to all atopic diseases, this was a watershed moment in the world of allergy.[25]
The Beta-Adrenergic Theory has been cited in the scholarship of such noted investigators as Richard F. Lockey (former President of the American Academy of Allergy, Asthma, and Immunology),[26] Charles Reed (Chief of Allergy at Mayo Medical School),[27] and Craig Venter (Human Genome Project).[28]
John P. McGovern, President of the American Association of Allergy nominated Szentivanyi for The 1968 Nobel Prize in Medicine in recognition of The Beta Adrenergic Theory.
In 2006, Researchers at Harvard Medical School found evidence that asthma is caused by over-proliferation of a special type of natural "killer" cell.
Diagnosis
Asthma is defined simply as reversible airway obstruction. Reversibility occurs either spontaneously or with treatment. The basic measurement is peak flow rates and the following diagnostic criteria are used by the British Thoracic Society:[33]
* ≥20% difference on at least three days in a week for at least two weeks;
* ≥20% improvement of peak flow following treatment, for example:
o 10 minutes of inhaled β-agonist (e.g., salbutamol);
o six week of inhaled corticosteroid (e.g., beclometasone);
o 14 days of 30mg prednisolone.
* ≥20% decrease in peak flow following exposure to a trigger (e.g., exercise).
In many cases, a physician can diagnose asthma on the basis of typical findings in a patient's clinical history and examination. Asthma is strongly suspected if a patient suffers from eczema or other allergic conditions—suggesting a general atopic constitution—or has a family history of asthma. While measurement of airway function is possible for adults, most new cases are diagnosed in children who are unable to perform such tests. Diagnosis in children is based on a careful compilation and analysis of the patient's medical history and subsequent improvement with an inhaled bronchodilator medication. In adults, diagnosis can be made with a peak flow meter (which tests airway restriction), looking at both the diurnal variation and any reversibility following inhaled bronchodilator medication.
Testing peak flow at rest (or baseline) and after exercise can be helpful, especially in young asthmatics who may experience only exercise-induced asthma. If the diagnosis is in doubt, a more formal lung function test may be conducted. Once a diagnosis of asthma is made, a patient can use peak flow meter testing to monitor the severity of the disease.
Monitoring asthma with a peak flow meter on an ongoing basis assists with self monitoring of asthma. Peak flow readings can be charted on graph paper charts together with a record of symptoms or use peak flow charting software.[34] This allows patients to track their peak flow readings and pass information back to their doctor or nurse.[35]
In the Emergency Department doctors may use a capnography which measures the amount of exhaled carbon dioxide,[36] along with pulse oximetry which shows the amount of oxygen dissolved in the blood, to determine the severity of an asthma attack as well as the response to treatment.
More recently, exhaled nitric oxide has been studied as a breath test indicative of airway inflammation in asthma.
Prevention
Current treatment protocols recommend prevention medications such as an inhaled corticosteroid, which helps to suppress inflammation and reduces the swelling of the lining of the airways, in anyone who has frequent (greater than twice a week) need of relievers or who has severe symptoms. If symptoms persist, additional preventive drugs are added until the asthma is controlled. With the proper use of prevention drugs, asthmatics can avoid the complications that result from overuse of relief medications.
Asthmatics sometimes stop taking their preventive medication when they feel fine and have no problems breathing. This often results in further attacks, and no long-term improvement.
Preventive agents include the following.
* Inhaled glucocorticoids are the most widely used of the prevention medications and normally come as inhaler devices (ciclesonide, beclomethasone, budesonide, flunisolide, fluticasone, mometasone, and triamcinolone).
Long-term use of corticosteroids can have many side effects including a redistribution of fat, increased appetite, blood glucose problems and weight gain. In particular high doses of steroids may cause osteoporosis. For this reasons inhaled steroids are generally used for prevention, as their smaller doses are targeted to the lungs unlike the higher doses of oral preparations. Nevertheless, patients on high doses of inhaled steroids may still require prophylactic treatment to prevent osteoporosis.
Deposition of steroids in the mouth may cause a hoarse voice or oral thrush (due to decreased immunity). This may be minimised by rinsing the mouth with water after inhaler use, as well as by using a spacer which increases the amount of drug that reaches the lungs.
* Leukotriene modifiers (montelukast, zafirlukast, pranlukast, and zileuton).
* Mast cell stabilizers (cromoglicate (cromolyn), and nedocromil).
* Antimuscarinics/anticholinergics (ipratropium, oxitropium, and tiotropium), which have a mixed reliever and preventer effect. (These are rarely used in preventive treatment of asthma, except in patients who do not tolerate beta-2-agonists.)
* Methylxanthines (theophylline and aminophylline), which are sometimes considered if sufficient control cannot be achieved with inhaled glucocorticoids and long-acting β-agonists alone.
* Antihistamines, often used to treat allergic symptoms that may underlie the chronic inflammation.
* Hyposensitization, (also known as immunodesensitisation therapy) may be recommended in some cases where allergy is the suspected cause or trigger of asthma. Depending on the allergen, it can be given orally or by injection.
* Omalizumab, an IgE blocker; this can help patients with severe allergic asthma that does not respond to other drugs. However, it is expensive and must be injected.
* Methotrexate is occasionally used in some difficult-to-treat patients.
* If chronic acid indigestion (GERD) contributes to a patient's asthma, it should also be treated, because it may prolong the respiratory problem.
Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children.
Signs and symptoms
In some individuals asthma is characterized by chronic respiratory impairment. In others it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise. Some or all of the following symptoms may be present in those with asthma: dyspnea, wheezing, stridor, coughing, an inability for physical exertion. Some asthmatics who have severe shortness of breath and tightening of the lungs never wheeze or have stridor and their symptoms may be confused with a COPD-type disease.
An acute exacerbation of asthma is commonly referred to as an asthma attack. The clinical hallmarks of an attack are shortness of breath (dyspnea) and either wheezing or stridor.[4] Although the former is "often regarded as the sine qua non of asthma",[4] some patients present primarily with coughing, and in the late stages of an attack, air motion may be so impaired that no wheezing may be heard. When present the cough may sometimes produce clear sputum. The onset may be sudden, with a sense of constriction in the chest, breathing becomes difficult, and wheezing occurs (primarily upon expiration, but can be in both respiratory phases).
Signs of an asthmatic episode include wheezing, prolonged expiration, a rapid heart rate (tachycardia), rhonchous lung sounds (audible through a stethoscope), the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest. During a serious asthma attack, the accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck) may be used, shown as in-drawing of tissues between the ribs and above the sternum and clavicles.
During very severe attacks, an asthma sufferer can turn blue from lack of oxygen, and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat. The person's feet may become icy cold. Severe asthma attacks, which may not be responsive to standard treatments (status asthmaticus), are life-threatening and may lead to respiratory arrest and death. Despite the severity of symptoms during an asthmatic episode, between attacks an asthmatic may show few or even no signs of the disease.[5]
Cause
Asthma is caused by a complex interaction of environmental and genetic factors that researchers do not fully understand yet.[6] These factors can also influence how severe a person’s asthma is and how well they respond to medication.[7] As with other complex diseases, many environmental and genetic factors have been suggested as causes of asthma, but not all of them have been replicated. In addition, as researchers detangle the complex causes of asthma, it is becoming more evident that certain environmental and genetic factors may only affect asthma when combined.
Environmental
Many environmental risk factors have been associated with asthma, but a few stand out as well-replicated or that have a meta-analysis of several studies to support their direct association:
* Poor air quality, from traffic pollution or high ozone levels, has been repeatedly associated with increased asthma morbidity and has a suggested association with asthma development that needs further research.[8][9]
* Environmental tobacco smoke, especially maternal cigarette smoking, is associated with high risk of asthma prevalence and asthma morbidity, wheeze, and respiratory infections.[8]
* Viral respiratory infections at an early age, along with siblings and day care exposure, may be protective against asthma, although there have been controversial results, and this protection may depend on genetic context.[8][10][11]
* Antibiotic use early in life has been linked to development of asthma in several examples; it is thought that antibiotics make one susceptible to development of asthma because they modify gut flora, and thus the immune system (as described by the hygiene hypothesis).[12]
* Caesarean sections have been associated with asthma when compared with vaginal birth; a meta-analysis found a 20% increase in asthma prevalence in children delivered by Cesarean section compared to those who were not. It was proposed that this is due to modified bacterial exposure during Cesarean section compared with vaginal birth, which modifies the immune system (as described by the hygiene hypothesis).[13]
* Psychological stress on the part of a child's caregiver has been associated with asthma, and is an area of active research. Stress can modify behaviors that affect asthma, like smoking, but research suggests that stress has other effects as well. There is growing evidence that stress may influence asthma and other diseases by influencing the immune system.[8]
The hygiene hypothesis is a theory about the cause of asthma and other allergic disease, and is supported by epidemiologic data for asthma. For example, asthma prevalence has been increasing in developed countries along with increased use of antibiotics, c-sections, and cleaning products.[12][13][14] All of these things may negatively affect exposure to beneficial bacteria and other immune system modulators that are important during development, and thus may cause increased risk for asthma and allergy.
Genetic
Over 100 genes have been associated with asthma in at least one genetic association study.[15] However, as with all association studies, replication is important before genetic variation (such as a single nucleotide polymorphism, or SNP) in a certain gene is thought to influence asthma. Through the end of 2005, 25 genes had been associated with asthma in six or more separate populations:[15]
* GSTM1
* IL10
* CTLA4
* SPINK5
* LTC4S
* LTA
* GRPA
* NOD1
* CC16
* GSTP1
* STAT6
* NOS1
* CCL5
* TBXA2R
* TGFB1
* IL4
* IL13
* CD14
* ADRB2 (β-2 adrenergic receptor)
* HLA-DRB1
* HLA-DQB1
* TNF
* FCER1B
* IL4R
* ADAM33
Many of these genes are related to the immune system or to modulating inflammation. However, even among this list of highly replicated genes associated with asthma, the results have not been consistent among all of the populations that have been tested.[15] This indicates that these genes are not associated with asthma under every condition, and that researchers need to do further investigation to figure out the complex interactions that cause asthma.
Stimuli
# Allergens from nature, typically inhaled, which include waste from common household pests, such as the house dust mite and cockroach, grass pollen, mould spores, and pet epithelial cells;[citation needed]
# Indoor air pollution from volatile organic compounds, including perfumes and perfumed products. Examples include soap, dishwashing liquid, laundry detergent, fabric softener, paper tissues, paper towels, toilet paper, shampoo, hairspray, hair gel, cosmetics, facial cream, sun cream, deodorant, cologne, shaving cream, aftershave lotion, air freshener and candles, and products such as oil-based paint.[citation needed]
# Medications, including aspirin,[18] β-adrenergic antagonists (beta blockers), and penicillin.[citation needed]
# Food allergies such as milk, peanuts, and eggs. However, asthma is rarely the only symptom, and not all people with food or other allergies have asthma.[citation needed]
# Use of fossil fuel related allergenic air pollution, such as ozone, smog, summer smog, nitrogen dioxide, and sulfur dioxide, which is thought to be one of the major reasons for the high prevalence of asthma in urban areas.[citation needed]
# Various industrial compounds and other chemicals, notably sulfites; chlorinated swimming pools generate chloramines—monochloramine (NH2Cl), dichloramine (NHCl2) and trichloramine (NCl3)—in the air around them, which are known to induce asthma.[19]
# Early childhood infections, especially viral respiratory infections. However, persons of any age can have asthma triggered by colds and other respiratory infections even though their normal stimuli might be from another category (e.g. pollen) and absent at the time of infection. In many cases, significant asthma may not even occur until the respiratory infection is in its waning stage, and the person is seemingly improving. Eighty percent of asthma attacks in adults and 60% in children are caused by respiratory viruses.[citation needed]
# Exercise or intense use of respiratory system. The effects of which differ somewhat from those of the other triggers, since they are brief. It is known that exercising regularly actually helps to cure asthma.[citation needed]
# Hormonal changes in adolescent girls and adult women associated with their menstrual cycle can lead to a worsening of asthma. Some women also experience a worsening of their asthma during pregnancy whereas others find no significant changes, and in other women their asthma improves during their pregnancy.[citation needed]
# Emotional stress which is poorly understood as a trigger.[citation needed] Emotional stress can affect breathing temporarily, however unlike something such as heart problems, it is unclear if it has any long-term effect.
# Cold weather can make it harder for asthmatics to breathe.[20] Whether high altitude helps or worsens asthma is debatable and may vary from person to person.
Pathogenesis
The fundamental problem in asthma appears to be immunological: young children in the early stages of asthma show signs of excessive inflammation in their airways. Epidemiological findings give clues as to the pathogenesis: the incidence of asthma seems to be increasing worldwide, and asthma is now very much more common in affluent countries.
In 1968 Andor Szentivanyi first described The Beta Adrenergic Theory of Asthma; in which blockage of the Beta-2 receptors of pulmonary smooth muscle cells causes asthma.[22] Szentivanyi's Beta Adrenergic Theory is a citation classic[23] and has been cited more times than any other article in the history of the Journal of Allergy.
In 1995 Szentivanyi and colleagues demonstrated that IgE blocks beta-2 receptors.[24] Since overproduction of IgE is central to all atopic diseases, this was a watershed moment in the world of allergy.[25]
The Beta-Adrenergic Theory has been cited in the scholarship of such noted investigators as Richard F. Lockey (former President of the American Academy of Allergy, Asthma, and Immunology),[26] Charles Reed (Chief of Allergy at Mayo Medical School),[27] and Craig Venter (Human Genome Project).[28]
John P. McGovern, President of the American Association of Allergy nominated Szentivanyi for The 1968 Nobel Prize in Medicine in recognition of The Beta Adrenergic Theory.
In 2006, Researchers at Harvard Medical School found evidence that asthma is caused by over-proliferation of a special type of natural "killer" cell.
Diagnosis
Asthma is defined simply as reversible airway obstruction. Reversibility occurs either spontaneously or with treatment. The basic measurement is peak flow rates and the following diagnostic criteria are used by the British Thoracic Society:[33]
* ≥20% difference on at least three days in a week for at least two weeks;
* ≥20% improvement of peak flow following treatment, for example:
o 10 minutes of inhaled β-agonist (e.g., salbutamol);
o six week of inhaled corticosteroid (e.g., beclometasone);
o 14 days of 30mg prednisolone.
* ≥20% decrease in peak flow following exposure to a trigger (e.g., exercise).
In many cases, a physician can diagnose asthma on the basis of typical findings in a patient's clinical history and examination. Asthma is strongly suspected if a patient suffers from eczema or other allergic conditions—suggesting a general atopic constitution—or has a family history of asthma. While measurement of airway function is possible for adults, most new cases are diagnosed in children who are unable to perform such tests. Diagnosis in children is based on a careful compilation and analysis of the patient's medical history and subsequent improvement with an inhaled bronchodilator medication. In adults, diagnosis can be made with a peak flow meter (which tests airway restriction), looking at both the diurnal variation and any reversibility following inhaled bronchodilator medication.
Testing peak flow at rest (or baseline) and after exercise can be helpful, especially in young asthmatics who may experience only exercise-induced asthma. If the diagnosis is in doubt, a more formal lung function test may be conducted. Once a diagnosis of asthma is made, a patient can use peak flow meter testing to monitor the severity of the disease.
Monitoring asthma with a peak flow meter on an ongoing basis assists with self monitoring of asthma. Peak flow readings can be charted on graph paper charts together with a record of symptoms or use peak flow charting software.[34] This allows patients to track their peak flow readings and pass information back to their doctor or nurse.[35]
In the Emergency Department doctors may use a capnography which measures the amount of exhaled carbon dioxide,[36] along with pulse oximetry which shows the amount of oxygen dissolved in the blood, to determine the severity of an asthma attack as well as the response to treatment.
More recently, exhaled nitric oxide has been studied as a breath test indicative of airway inflammation in asthma.
Prevention
Current treatment protocols recommend prevention medications such as an inhaled corticosteroid, which helps to suppress inflammation and reduces the swelling of the lining of the airways, in anyone who has frequent (greater than twice a week) need of relievers or who has severe symptoms. If symptoms persist, additional preventive drugs are added until the asthma is controlled. With the proper use of prevention drugs, asthmatics can avoid the complications that result from overuse of relief medications.
Asthmatics sometimes stop taking their preventive medication when they feel fine and have no problems breathing. This often results in further attacks, and no long-term improvement.
Preventive agents include the following.
* Inhaled glucocorticoids are the most widely used of the prevention medications and normally come as inhaler devices (ciclesonide, beclomethasone, budesonide, flunisolide, fluticasone, mometasone, and triamcinolone).
Long-term use of corticosteroids can have many side effects including a redistribution of fat, increased appetite, blood glucose problems and weight gain. In particular high doses of steroids may cause osteoporosis. For this reasons inhaled steroids are generally used for prevention, as their smaller doses are targeted to the lungs unlike the higher doses of oral preparations. Nevertheless, patients on high doses of inhaled steroids may still require prophylactic treatment to prevent osteoporosis.
Deposition of steroids in the mouth may cause a hoarse voice or oral thrush (due to decreased immunity). This may be minimised by rinsing the mouth with water after inhaler use, as well as by using a spacer which increases the amount of drug that reaches the lungs.
* Leukotriene modifiers (montelukast, zafirlukast, pranlukast, and zileuton).
* Mast cell stabilizers (cromoglicate (cromolyn), and nedocromil).
* Antimuscarinics/anticholinergics (ipratropium, oxitropium, and tiotropium), which have a mixed reliever and preventer effect. (These are rarely used in preventive treatment of asthma, except in patients who do not tolerate beta-2-agonists.)
* Methylxanthines (theophylline and aminophylline), which are sometimes considered if sufficient control cannot be achieved with inhaled glucocorticoids and long-acting β-agonists alone.
* Antihistamines, often used to treat allergic symptoms that may underlie the chronic inflammation.
* Hyposensitization, (also known as immunodesensitisation therapy) may be recommended in some cases where allergy is the suspected cause or trigger of asthma. Depending on the allergen, it can be given orally or by injection.
* Omalizumab, an IgE blocker; this can help patients with severe allergic asthma that does not respond to other drugs. However, it is expensive and must be injected.
* Methotrexate is occasionally used in some difficult-to-treat patients.
* If chronic acid indigestion (GERD) contributes to a patient's asthma, it should also be treated, because it may prolong the respiratory problem.
Sunday, June 15, 2008
Disease from tsetse fly
In the tropical regions of Africa, the bloodsucking tsetse fly carries deadly diseases to humans and other animals. It is a brownish-colored insect, only a little larger than the common housefly. When it is at rest its wings close flat on the back and are completely overlapping, whereas those of the housefly are held somewhat erect and spread. There are 21 known species of the tsetse fly. Some carry the disease trypanosomiasis (African sleeping sickness) from one human victim to another. Others carry the disease nagana to cattle and other animals.
When the fly bites an infected victim, the insect draws into its own bloodstream a parasite called a trypanosome. After going through a stage of development in the fly, the parasite is transferred to the next victim. Thus the disease, caused by the parasite, is passed from person to person, from animal to animal, through the bite of the fly. The disease is so called because in the last stages of the illness the victim falls into a sleep, which often ends in death.
The tsetse fly breeds in brushy places in tropical forests and on the edges of rivers and lakes. The female, unlike most insects, does not lay eggs. Instead, she deposits on the ground a single full-grown larva at intervals of about two weeks. The larva hides in brush and immediately goes into the pupal stage, from which it emerges as a mature fly.
Tsetse flies belong to the genus Glossina of the family Glossinidae, which is related to the Muscidae. The scientific name of the commonest carrier of African sleeping sickness is G. palpalis. The principal carrier of nagana is G. morsitans.
When the fly bites an infected victim, the insect draws into its own bloodstream a parasite called a trypanosome. After going through a stage of development in the fly, the parasite is transferred to the next victim. Thus the disease, caused by the parasite, is passed from person to person, from animal to animal, through the bite of the fly. The disease is so called because in the last stages of the illness the victim falls into a sleep, which often ends in death.
The tsetse fly breeds in brushy places in tropical forests and on the edges of rivers and lakes. The female, unlike most insects, does not lay eggs. Instead, she deposits on the ground a single full-grown larva at intervals of about two weeks. The larva hides in brush and immediately goes into the pupal stage, from which it emerges as a mature fly.
Tsetse flies belong to the genus Glossina of the family Glossinidae, which is related to the Muscidae. The scientific name of the commonest carrier of African sleeping sickness is G. palpalis. The principal carrier of nagana is G. morsitans.
Kawasaki disease
rare disease of lymph nodes that causes acquired heart disease in children usually under age 5; characterized by prolonged fever, changes in lips and mouth, swelling of cervical lymph nodes, skin rash, reddening and swelling of hands and feet, and coronary artery damage; may be caused by virus; usually treated with high doses of aspirin; most children conquer fever and rash, but about 20 percent have weakened hearts after the disease.
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