WHAT ARE DOPAMINE AGONISTS?

Dopamine agonists are drugs that do not convert to dopamine in the brain, but instead mimic the effect of dopamine on the brain. Dopamine agonists supplement function that has been lost as dopamine-producing neurons die.
While some dopamine agonists have been around for years, new dopamine agonists have been developed that attempt to better manage side effects.
Dopamine agonists can be used alone or in combination with Levodopa/Carbidopa.
Pros
Dopamine agonists cause motor fluctuations, including dyskinesias, less frequently than Levodopa/Carbidopa.
No protein effects as seen with Levodopa/Carbidopa.
Agonists offer potential for alternate forms of delivery (such as a skin patch) that may offer certain advantages over oral administration.
Cons and Complications
Dopamine agonists have not been shown to slow the progression of the disease.
Dopamine agonists are not as effective as Levodopa/Carbidopa for the treatment of motor symptoms.
They may also cause other side effects including daytime sleepiness, sudden unanticipated sleep (“sleep attacks”), hallucinations and risk-taking behavior, such as gambling and sexual obsessions.
Not effective at treating all symptoms of Parkinson’s disease. Posture, depression and cognitive problems are not responsive to dopamine agonists.






NEW ED DRUG MAY WORK IN 15 MINUTES!

Look out Viagra – there’s a new erectile dysfunction drug in town.
It’s called Stendra (aka Avanafil) and it’s newly approved by the Food and Drug Administration, making it the first ED drug to come out in almost 10 years.

Although Stendra has not been tested against what is known as the “Little Blue Pill,” drug makers say that – for some men – it may work faster.
“If things are heated up, theoretically you can get improved function earlier, within 15 minutes, with this drug,” said Dr. Irwin Goldstein, director of sexual medicine at Alvarado Hospital in San Diego, and co-author of a recent study about Stendra in the Journal of Sexual Medicine.
“You can argue this is the first potential on-demand drug.”
The “on-demand” drug could end up in high demand for men with ED who do not respond to drugs like Viagra, Cialis and Levitra.






GO FOR A BRAIN HEALTHY DIET!

According to the most current research, a brain-healthy diet is one that reduces the risk of heart disease and diabetes, encourages good blood flow to the brain, and is low in fat and cholesterol. Like the heart, the brain needs the right balance of nutrients, including protein and sugar, to function well. A brain-healthy diet is most effective when combined with physical and mental activity and social interaction.
Increase your intake of protective foods. Current research suggests that certain foods may reduce the risk of heart disease and stroke, and appear to protect brain cells.
In general, dark-skinned fruits and vegetables have the highest levels of naturally occurring antioxidant levels. Such vegetables include: kale, spinach, Brussels sprouts, alfalfa sprouts, broccoli, beets, red bell pepper, onion, corn and eggplant. Fruits with high antioxidant levels include prunes, raisins, blueberries, blackberries, strawberries, raspberries, plums, oranges, red grapes and cherries.
-Cold water fish contain beneficial omega-3 fatty acids: halibut, mackerel, salmon, trout and tuna.
-Some nuts can be a useful part of your diet; almonds, pecans and walnuts are a good source of vitamin E, an antioxidant.






PERIPHERAL NERVE DISORDERS

There are many types of peripheral neuropathy, often brought on by diabetes; genetic predispositions (hereditary causes); exposure to toxic chemicals, alcoholism, malnutrition, inflammation (infectious or autoimmune), injury, and nerve compression; and by taking certain medications such as those used to treat cancer and HIV/AIDS. Researchers are working toward earlier and better diagnosis and treatment, and ultimately prevention of these debilitating nerve diseases. The following are the major types of peripheral neuropathy:
-Neuropathy is the disease of the nervous system in which there is a disturbance in the function of a nerve or particular group of nerves. The three major forms of nerve damage are: peripheral neuropathy, autonomic neuropathy, and mononeuropathy. The most common form is peripheral neuropathy, which mainly affects the feet and legs.
-Sciatica is pain, tingling, or numbness produced by an irritation of the sciatic nerve. Sciatica is a pain in the leg due to irritation of the sciatic nerve. Sciatica most commonly occurs when a branch of the sciatic nerve is compressed at the base of the spine.
-Carpal tunnel syndrome occurs when tendons in the wrist become inflamed after being aggravated. Tendons can become aggravated when the carpals (a tunnel of bones) and the ligaments in the wrist narrow, pinching nerves that reach the fingers and the muscle at the base of the thumb.
-Polyneuropathy is any illness that attacks numerous nerves in the body, sometimes causing weakness and/or pain. It tends to be a systemic problem that affects more than one nerve group at a time. Polyneuropathies are relatively symmetric, often affecting sensory, motor, and vasomotor fibers simultaneously.
-Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. These conditions usually result from diabetic microvascular injury involving small blood vessels that supply nerves (vasa nervorum).
-Autonomic neuropathy is a group of symptoms caused by damage to nerves supplying the internal body structures that regulate functions such as blood pressure, heart rate, bowel and bladder emptying, and digestion.
-Postherpetic neuralgia is pain that persists after an episode of shingles (herpes zoster) has resolved, resulting from damaged nerve fibers from the shingles.






A SLEEPWALKER IN THE HOUSE?

Sleepwalking is classified as a parasomnia — an undesirable behavior or experience during sleep. Sleepwalking is a parasomnia of arousal, meaning it occurs during deep, dreamless (non-rapid eye movement, or NREM) sleep. Someone who is sleepwalking may:
-Sit up in bed and open his or her eyes
-Have a glazed, glassy-eyed expression
-Roam around the house, perhaps opening and closing doors or turning lights on and off
-Do routine activities, such as getting dressed or making a snack — even driving a car
-Speak or move in a clumsy manner
-Scream, especially if also experiencing night terrors, another parasomnia in which you are likely to sit up, scream, talk, thrash and kick
-Be difficult to wake up during an episode
Sleepwalking usually occurs during deep sleep, early in the night — often one to two hours after falling asleep. Sleepwalking is unlikely to occur during naps. The sleepwalker won’t remember the episode in the morning.
Sleepwalking episodes can occur rarely or often, including multiple times a night for a few consecutive nights.
Sleepwalking is common in children, who typically outgrow the behavior by their teens, as the amount of deep sleep they get decreases.






WHAT CAN WE EXPECT AFTER A STROKE?

After a stroke, you may have:
-Physical difficulties (particularly in the arm, leg, and face on one side of the body)
-Cognitive (thinking) problems
-Speech and language problems

You can expect some degree of “spontaneous recovery” in the days, weeks, and months immediately following the stroke. During this time, physical, cognitive, and communication deficits may improve on their own as the brain heals. Physical therapy, occupational therapy, and speech-language pathology services can enhance this spontaneous recovery.
Speech-language pathologists (SLPs) are trained to work with people with a variety of speech and language disorders, including aphasia, dysarthria, and apraxia. An SLP can help the person improve communication skills beyond what will naturally occur after the stroke. SLPs also teach strategies to overcome communication deficits.
If you experience a stroke, you should expect some degree of spontaneous recovery in the first 6 months or so after the stroke. Recovery may continue for over a year. Your degree of recovery depends on the severity and location of the stroke. It is very difficult to predict. Many times, improvements in physical abilities occur more rapidly than in communication and cannot be used as a predictor for future speech and language improvements.






CAUSES FOR BAD CIRCULATION IN HANDS

Most of the time this is the biggest cause. When it gets cold, our body’s natural method for protecting our vital organs is to direct most of our blood to those organs. Because we can survive without our hands, but not our heart, these along with our feet are the first things to be sacrificed.

Smoking: A huge cause of poor circulation to the extremities, cigarettes contain carbon monoxide, which inhibits our body’s ability to carry oxygen.
Diabetes: A common side effect of diabetes is a breakdown in the circulatory system in the hands and feet. This can often have dire consequences if left untreated.
Arteriosclerosis: caused by fatty plaques, which cause the arteries to effectively become narrower, thus inhibiting blood flow. These can build up anywhere in the body, but as the arteries become smaller, such as in the hands, they can become more noticeable and have a lot more symptoms.
High Blood Pressure: Often linked with the causes above and below, high blood pressure can eventually lead to your circulatory system becoming strained and less able to carry vital nutrients to the hands.
High Cholesterol: This is linked as a cause of arteriosclerosis and high blood pressure.
Caffeine & Alcohol: both of these substances can constrict the blood vessels all over the body, but often it is felt acutely in the hands.
Heart Disease: There will likely be other symptoms rather than just those associated with poor circulation in hands, but various forms of heart disease can lead to circulatory problems in the hands.
Inactivity: When sitting still for an extended period of time or when your hands and arms aren’t moving or working, circulation in the hands is likely to decrease. See why here
Obesity: A leading cause of circulation problems in general, obesity leads to a harder working heart and more micro circulation systems that the heart needs to supply.
Injury: You will likely know if this is the cause. Injuries to the arms or hands can disrupt circulation to the extremities.






DOES ASTHMA GO AWAY?

There is no once-and-for-all cure. However, about half of the children who develop asthma grow out of it by the time they are adults.
For many adults, asthma is variable with some good spells and some spells that are not so good. Some people are worse in the winter months, and some worse in the hay fever season. Although not curable, asthma is treatable. Stepping up the treatment for a while during bad spells will often control symptoms.
Some other general points about asthma:
It is vital that you learn how to use your inhalers correctly. In some people, symptoms persist simply because they do not use their inhaler properly, and the drug from the inhaler does not get into the airways properly. See your practice nurse or doctor if you are not sure if you are using your inhaler properly.
See a doctor or nurse if symptoms are not fully controlled, or if they are getting worse. For example, if:
-A night-time cough or wheeze is troublesome.
-Sport is being affected by symptoms.
-Your peak flow readings are lower than normal.
-You need a reliever inhaler more often than usual.
An adjustment in inhaler timings or doses may control these symptoms.






CHOLESTEROL AND STATINS

Statins are a family of medications that lower cholesterol. Even more important, they lower the chances of having a heart attack or stroke. Statins include atorvastatin (generic, Lipitor), fluvastatin (generic, Lescol), lovastatin (generic, Mevacor), pitavastatin (Livalo), pravastatin (generic, Pravachol), rosuvastatin (Crestor), and simvastatin (generic, Zocor). The new guidelines recommend a statin for:
-anyone who has cardiovascular disease, including angina (chest pain with exercise or stress), a previous heart attack or stroke, or other related conditions
-anyone with a very high level of harmful LDL cholesterol (generally an LDL above greater than 190 milligrams per deciliter of blood [mg/dL])
-anyone with diabetes between the ages of 40 and 75 years
-anyone with a greater than 7.5% chance of having a heart attack or stroke or developing other form of cardiovascular disease in the next 10 years.
How is this different from the previous guidelines? They recommended specific cholesterol targets for treatment. For example, people with heart disease were urged to get their LDL cholesterol down to 70 mg/dL. The new guidelines essentially remove the targets and recommend basing treatment decisions on a person’s heart risk profile.
In other words, anyone at high enough risk who stands to benefit from a statin should be taking one. It doesn’t matter so much what his or her actual cholesterol level is to begin with. And there’s no proof that an LDL cholesterol of 70 mg/dL is better than 80 or 90 mg/dL. What’s important is taking the right dose based on heart attack and stroke risk.






UNDERSTANDING ADULT OBESITY

When we eat more calories than we burn, our bodies store this extra energy as fat. While a few extra pounds may not seem like a big deal, they can increase your chances of having high blood pressure and high blood sugar.These conditions may lead to serious health problems, including heart disease, stroke, type 2 diabetes, and certain cancers.
Today, more than two-thirds of adults in the United States are considered to be overweight or obese. More than one-third of adults have obesity. This fact sheet will help you find out if you may be at risk of developing weight-related health problems. It will also explain how overweight and obesity are treated and give you ideas for improving your health at any weight.
How can I tell if I am at a normal weight?
Body mass index (BMI) is one way to tell whether you are at a normal weight, overweight, or obese. The BMI measures your weight in relation to your height.
The BMI table below will help you to find your BMI score. Find your height in inches in the left column labeled “Height.” Move across the row to your weight. The number at the top of the column is the BMI for that height and weight. Pounds are rounded off. You may also go to the Resources section at the end of this page for a link to an online tool for measuring BMI.
A BMI of 18.5 to 24.9 is in the normal range. A person with a BMI of 25 to 29.9 is considered overweight, and someone with a BMI of 30 or greater is considered obese.
However, because BMI doesn’t measure actual body fat, a person who is very muscular, like a bodybuilder, may have a high BMI without having a lot of body fat. Please review your findings with your health care provider if your BMI is outside of the normal range.