Polycystic Ovary Syndrome | Current Thoughts

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POLYCYSTIC OVARY SYNDROME | Current Thoughts Polycystic Ovary Syndrome affects more than 5 million women most of whom fail to realize their potential danger.  While this leading cause of infertility seems to identify it as principally as a gynecologic disorder, PCOS significantly increases the risk for heart disease, stroke, diabetes and more. Unfortunately the name suggests the major manifestation involves cysts within the ovary.  Actually this feature probably represents a complication of the underlying disease process and need not be present for the diagnosis.  In fact these so-called ovarian cysts do not even represent true cysts but rather immature follicles that fail to mature and release an egg.  Normal ovaries often demonstrate these findings which by themselves do not indicate any medical disease. Subtle hormone abnormalities remain central to PCOS. …
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Fibroids | Concepts | Treatment | Medical | Surgical

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FIBROIDS | Concepts | Treatment | Medical | Surgical Although generally small, fibroids of the uterus create havoc for many women and lack a consensus regarding the most effective and least invasive therapy.  Most women harbor generally innocent but sometimes troublesome tumors within the lining of their womb.  Fortunately these nodules of smooth muscle combined with varying amounts of connective tissue remain benign, non-cancerous, throughout their course.  Variously known as myomas, fibromas or leiomyomas, most commonly they are referred to simply as fibroids. Depending on the thoroughness of medical investigation, estimates suggest up to 8 out of 10 women will develop fibroids.  Clinical examination in a doctor’s office places the incidence at 1 in 3 females.  Ultrasound studies raise the frequency to 50% while more complete microscopic evaluation of the…
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Claritin | Buy Generic Loratadine Instead

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Whether Claritin now available as the generic loratadine actually works at the currently approved dose remains an issue. Originally an FDA examiner believed no less than 40 mg was necessary to provide effective relief of allergic nasal symptoms. Unfortunately at this dose drowsiness occurs and the label could no longer boast of non-sedating qualities. At the current daily dose of 10mg, the drug works somewhat better than a placebo. For most people troubled by seasonal or perennial allergies, Flonase, Rhinocort or Nasonex remain more effective. A barrage of direct-to-consumer advertising introduced Claritin to the marketplace.  Claritin along with a competitor Allegra almost overnight became synonymous with anti-histamines and anti-allergy medication.  At first requiring a prescription, these costly drugs siphoned exorbitant financial resources away from more critical areas of need.  Finally…
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Trintellix | Costly Therapy

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Trintellix is a costly therapy for depression that basically offers the same anti-depressant activity as the generic forms of Prozac, Zoloft, Paxil or Celexa but at a much greater price.  Nowhere in the barrage of televised advertising is there mention that the daily cost of the drug exceeds $10 versus $3-10 for one month of the generic versions of similarly acting selective serotonin reuptake inhibitors. How well this drug works for depression remains the subject of controversy.  Most people enrolled in trials suffered from moderate rather than severe depression.  While study outcomes appeared statistically significant, the practical real world benefit may not be clinically relevant. An estimated 5-10% of patients in a family doctor's office may suffer from symptoms of depression with the number rising to as many as 15%…
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Sleep Problems – How to Deal With Insomnia

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Sleep Problems - How To Deal With Insomnia Almost everyone experiences sleep problems - insomnia.  Although a fortunate few routinely enjoy refreshing sleep, most of us at least occasionally suffer through less than restful nighttime hours.  While individual requirements for sleep vary considerably, the optimal range typically hovers around seven hours.  Either too little or too much sleep may be associated with negative health consequences. Definition Medically speaking insomnia refers to difficulty falling asleep, staying asleep throughout the night, awakening early and being unable to return to sleep or arising in the morning feeling unrefreshed.  Generally a combination of these symptoms occur in those affected. By definition insomnia must persist for at least three months and requires at least three weekly episodes of problem sleep together with a negative impact…
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Amlodipine | Norvasc | Calcium Blocker

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Amlodipine or Norvasc is a calcium blocker that treats high blood pressure. This inexpensive, generically available drug relaxes smooth muscle cells lining arteries and reduces the force against which the heart must pump. Additionally the drug helps protect against chest pain or angina. It ranks among the World Health Organization List of Essential Medicines. An estimated 14 million people take this drug either by itself or combined with other antihypertensive therapy.  The most consistent benefit of treating high blood pressure involves lowering the risk of stroke adn to a lesser extent heart disease.  Obviously Amlodipine only treats rather than cures elevated blood pressure. Those at greatest risk receive the most benefit.  This translates to a greater reduction in risk among those with also have diabetes and elevated cholesterol. Traditionally diuretics…
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Hydrocodone | Usually Unnecessary

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Hydrocodone and its relative oxycodone result in more than 2 deaths every hour - daytime and nighttime - throughout the year. Sadly more than 90% of the world’s hydrocodone is consumed in the United States, yet it regularly fails to perform up to expectations. Governmental authorities who once championed prescriptions for chronic back pain, arthritis and fibromyalgia.  They now realize the monster they created. Current recommendations suggest severe restrictions on this compound. First synthesized in the early 1920s in Germany the drug languished until approval in the United States in 1943.  Problems with addiction and dependence were noticed in the early 1960s.  In spite of this, various state medical authorities mandated treating pain be considered a priority.   It was considered inappropriate for a doctor not to simply assume a patient's…
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Lisinopril | High Blood Pressure Drug

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Generic lisinopril remains one of the standards in drug therapy for high blood pressure.  Also sold as Zestril and Prinivil, this generic ACE inhibitor is inexpensive and generally safe.  The compound successfully combats hypertension and protects both the heart and brain. Additionally it also reduces the likelihood of death after a heart attack and prevents kidney damage especially in diabetics. Unfortunately most individuals believe treating high blood pressure simply revolves around taking a pill.  While for some this may indeed be sufficient, attention to diet, salt intake, alcohol, cigarettes, excess body weight and exercise is generally required. Simply taking a pill fails to provide the benefits most people assume stems directly from therapy.  For a 200 pound individual who prizes highly salty food and rarely exercises, reality suggests two or…
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Lyrica | Useful in Relieving Pain?

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Is Lyrica useful in relieving pain? Heavily promoted as treatment for relieving pain due to diabetic neuropathy and fibromyalgia, Lyrica advertisements blanket the airways. While some studies demonstrate a small benefit when compared to an inactive placebo, others fail to show any difference. Marketed both as an anticonvulsant and as an antidote to nerve related pain, this drug finds indiscriminate use in for a wide assortment of painful conditions in addition to diabetic neuropathy, infuriating discomfort after the shingles and fibromyalgia. While the drug may indeed offer an alternative to narcotic pain medicines, its ability to improve pain appears almost indistinguishable from a cheap placebo.  Lyrica seems more likely to lead to side effects, dependence and abuse.    It can lead to lack of coordination, loss of sexual desire, muscle…
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High Blood Pressure | When to Treat

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 HIGH BLOOD PRESSURE | WHEN TO TREAT  When to treat high blood pressure (HBP) remains a major topic of conversation with confusing recommendations issued by different organizations.  Without question HBP ranks as a major cause of hardening of the arteries, stroke, heart attacks, heart failure, kidney malfunction, cardiovascular related death and dementia.  Actually HBP related conditions represent the second leading cause of preventable death in the United States behind only cigarette smoking. While medical experts express unanimity in their clarion call to treat HBP with appropriate therapy, agreement falters and arguments begin over the most basic elements on what constitutes HBP, how to measure it, when does the risk of harm become sufficiently great to warrant treatment and whether to begin a regimen of lifestyle modification versus oral medication. BLOOD…
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