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Welcome to
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Videos, a collection of up-to-date Monthly Health Articles,
News, and Health Videos. In each current months issue
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and informational. At XLPharmacy we care about you and your
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Viagra for Sexual Health, Herpes, HIV, AIDS, Smoking,
Women's Health, Mental Health and so much more...
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Featured Article - AIDS
/ HIV Information |
The challenges of therapy
Unless HIV replication is
controlled, trying to rebuild immune health will
ultimately fail — at least most of the time. Although
using therapy hinders HIV from replicating, it does not
eradicate the virus from your body. Many scientists fear
that it’s not possible to fully eliminate it. Others don’t
share this pessimism, pointing to newer and better drugs as
well as an ever-growing understanding of HIV disease and its
effects on the immune system. Over time, HIV can mutate or
change enough so that it’s no longer fully blocked by these
drugs.
This process is called viral
resistance and it can happen to some degree with all HIV
drugs. However, keeping HIV under control lengthens a
person’s life, and it may be possible — with truly effective
therapy — to live out a normal lifespan despite HIV.
Abundant evidence shows that using potent HIV therapy has
dramatically lowered death rates. It has also increased life
and quality of life for people living with HIV.
However, the drugs are not
without their risks of side effects. When deciding on
therapy, the possible short- and long-term side effects must
be weighed against possible short- and long-term benefits,
particularly as you consider when to start. There’s little
research on using HIV drugs in the earlier stages of
HIV disease. Many, if not most, people don’t have to decide
this immediately after learning they have HIV.
Assessing your risk of disease
progression and making decisions that you feel comfortable
with are important parts of building a successful long-term
HIV strategy.
Why use anti-HIV therapy?
When you’re first infected with HIV,
high levels of HIV replication often occur with flu-like
symptoms and a decline in the number of CD4+ cells. CD4s are
key cells in your immune system that maintain and direct
responses against disease. They are also commonly used to
measure your immune health.
Without using HIV therapy, your immune
system dramatically but incompletely suppresses the virus.
In most cases, CD4s return partially toward normal levels
and people usually regain good health for many years. Yet,
during this time an aggressive battle is waged daily between
your immune system and HIV. Over time, the immune system
becomes overwhelmed by HIV’s rapid and constant activity.
The relationship between your HIV
levels and risk of disease progression is complicated. An
influential study by John Mellors found a solid relationship
between HIV levels and risk of death over time. Other
research suggests that CD4+ counts better predict the risk
of disease progression. However, it is well established that
reducing HIV levels typically leads to a stronger immune
system and better health.
Considering these points, it makes
sense to slow down or stop HIV replication as much and for
as long as possible. All approved HIV drugs significantly
reduce HIV levels, and they almost always cause some rise in
CD4+ counts. Lower viral loads and higher CD4+ counts
indicate some improvement in your immune system.
When should I start treatment?
It remains
unclear when the best time to start therapy is. The “best”
time for one person may not be the “best” time for another.
There’s also much debate about which drugs to start with and
in what combinations. Several factors — including HIV
levels, CD4+ counts as well as how you feel about therapy —
are important to consider when deciding if and when therapy
is right for you.
Many questions can also be considered
when making these decisions. Should treatment be used
immediately when you first learn you have HIV? Should
therapy be saved until changes occur in your immune health?
Should it be saved until there’s a higher viral load, or
until symptoms of HIV develop?
In deciding when to start, switch or
change HIV therapy, three medical factors are generally
considered:
•What’s happening with measures of
your immune health (particularly CD4+ counts)?
•What’s happening with your general
health, like symptoms of HIV disease or recurrent conditions
despite treatment?
•What’s happening with your HIV
levels?
Deciding to begin treatment is not
solely a medical matter. Other factors must be considered,
including:
•Your feelings about therapy;
•Your readiness and willingness to
take therapy, including taking it as prescribed;
•The impact that therapy may have on
your quality of life;
•Possible side effects;
•How long therapy can last, and
whether or not there will be new and better drugs to replace
them if or when they fail; and,
•Your risk of disease progression in
the short-, middle-, and long-term.
When is the right time to start?
Some believe there can be no single,
right answer to the question of when to start. Some
researchers and doctors believe that nearly everyone with
HIV — regardless of their CD4+ counts, viral loads or
symptoms — should be treated. Some believe people should
start therapy only when their CD4+ counts consistently read
below 350. Others believe that only people with symptoms of
HIV disease should consider therapy.
One note of agreement is that most
researchers and doctors believe that the decision to start
should be guided by both CD4+ cell counts and overall
general health. Increasingly, information suggests that CD4+
counts provide the most accurate tool to monitor the risk of
HIV disease progression.
The most commonly used viral load
tests are Roche’s RT-PCR (polymerase chain reaction test,
called Amplicor HIV Monitor Test), Chiron’s bDNA (branch DNA
test, called Quantiplex) and Organon Teknika’s NASBA
(nucleic acid sequence based amplification test, called
NucliSens). When possible, it’s best to use the same lab and
same test every time. For example, RT-PCR results are
consistently higher than those obtained with bDNA.
Similarly, different labs might get somewhat different
results when running a CD4+ count.
Because the earlier you start
treatment, the less loss you have of key memory cells and
other important cells in the immune system. That's becoming
more and more clear in recent years. It wasn't practical to
put people on treatment really early in previous years
because of the toxicity of the drugs. But we're dealing with
a new generation of drugs now that are nowhere near as toxic
as before. So it becomes practical for people to start
treatment at a very early stage. When they do, it's probably
possible to preserve more of the immune system and therefore
make the idea of a cure easier.
Quality of life issues
Your ability to tolerate side effects,
drug interactions and the demands of a regimen can be as
important as the potency of a drug. If you can’t take a drug
as prescribed, its potency is irrelevant. Not adhering to
therapy contributes to developing drug resistance, and
developing resistance to one drug might lead to
cross-resistance to other drugs in the same class.
When choosing therapy, consider the
daily pill count of everything you take. These include the
HIV drugs, drugs to prevent and treat other infections or
conditions, supplements, etc. Consider when they have to be
taken and whether or not they can be taken with other
medicines or food. It’s easiest to combine drugs that
require similar conditions, such as with or without food.
Otherwise, one’s life can become dominated by drug
schedules.
It’s also best to avoid mixing drugs
with similar side effects, though sometimes that is
impossible. It’s critical to learn about the possible side
effects of each drug that you take as well as possible drug
interactions before mixing them together.
Not everyone experiences side effects.
Learning about possible side effects and drug interactions
before starting therapy allows you to be aware of what to
check for and to consider ways to prevent or manage them,
before they happen. The more informed you are, the less
likely you will come across severe or life-threatening side
effects. Also, the more prepared you are, the less likely
that side effects and drug interactions will interfere with
adhering to your regimen.
One side effect of particular concern
is changes in body composition and metabolism, generally
called lipodystrophy. They include fat accumulation (lipohypertrophy)
and/or fat loss (lipoatrophy) and/or changes in lab values
of fats (dyslipidemia) or sugars/insulin (diabetes). Some
HIV drugs contribute to these conditions more than others.
Chart of
Side Effects
The key to coping with your side
effects
The key to coping with side effects is
knowing what to watch out for and having a plan in place to
respond if problems occur. If a drug you are taking or are
planning to take has a side effect that may be
life-threatening, it’s important to know what early symptoms
of that effect are and to monitor for them. It is also
possible to prevent or reduce the seriousness of some side
effects by taking certain preventive therapies a few days
before or at the same time as starting a new regimen.
Before starting any therapy, talk to
your doctor about the risk of side effects from various
drugs. This information usually comes from studies conducted
on the drug. Ask how often side effects were reported.
What to look for; what to do?
Many people experience an adjustment
period when starting a new therapy. This period usually
lasts about four to six weeks as your body adapts to the new
drug. During this time, you may experience headache, nausea,
muscle pain in your arms and occasional dizziness. These
kinds of side effects typically lessen or disappear as your
body adjusts.
Learn to recognize, monitor and manage
side effects should they arise. Often, simple solutions
exist to lessen many side effects. In other cases, a
particular side effect may be an important signal that
requires immediate medical attention.
Once you notice any unusual reactions
after starting or changing a drug, report the side effects
to your doctor. If possible, talk to others who have used
the same drug. They may be able to offer solutions.
Caring for your whole self
Some conditions believed to be side
effects may actually be due to anxiety, depression or
stress. Caring for your whole self—including your emotions,
thoughts and general health, as well as specific anti-HIV
strategies—can help minimize negative feelings and their
effects.
There are some things you can do that
may make the adjustment period easier. If possible, take
some time off work or lighten your schedule to allow
yourself to adjust to the change. If things get hard, see if
someone can help out around the house or with children or
other obligations.
Take time to re-prioritize your health
needs, and make sure you get plenty of sleep and rest. Eat
well and keep foods on hand that help combat common side
effects like nausea and diarrhea. Try to get a little
exercise during the day—even if just taking a walk.
Most importantly, reach out for
support—be it your family, friends or support group. If you
can, let them know what’s going on. Sometimes just talking
helps, but they may also have ideas to help ease side
effects that your doctor might not mention.
A word about switching
Sometimes people facing serious side
effects will switch drugs simply to improve their quality of
life, even though the drugs were controlling HIV well. This
is one way to deal with the side effects linked to that
drug.
Switching a drug solely because of
side effects may also save that drug as a future treatment
option. In fact, side effects that you have with a drug at
one time may not occur again if or when you try that drug
again.
However, it is dangerous to simply
stop taking one drug in your regimen, reduce its dose
without talking to your doctor or pharmacist, or decide only
to take it periodically. This can do more harm than good as
it leads to drug resistance, making that drug—and perhaps
others—less useful for you now or in the future.
Getting a handle on side effects
Side effects often occur after
starting a new anti-HIV drug but lessen or disappear after a
few weeks. Other times they persist as long as that drug or
combination is used.
Many symptoms related to drug side
effects are also conditions that people face when they have
other health conditions. This may include infections,
hormonal imbalances, pregnancy, depression or HIV itself.
Whenever you have symptoms, it’s
important to talk to your doctor to diagnose the cause. But
regardless of how severe or persistent the side effects are,
you can try some things to manage them.
Diarrhea
Aside from being annoying, the biggest
concern is that diarrhea can cause dehydration. So the first
course of action is to replenish lost liquids by drinking
plenty of fluids, like Gatorade, ginger ale, chicken or beef
broth, herb tea or just plain water. Chronic diarrhea may
lead to weight loss. Foods that provide nutrients, calories,
and absorb liquid (like the BRAT diet—bananas, rice,
applesauce and toast) are good tools in dealing with
diarrhea.
Anti-diarrhea medications like Lomotil,
Kaopectate, Imodium, or Pepto-Bismol can help. So can
bulking laxatives like Metamucil. Nutritional supplements,
such as L-Glutamine, Provir or Shaman Botanicals-Normal
Stool Formula (SB-NSF) may also help, but can be expensive.
Tips for diarrhea
•Eat foods high in soluble fiber,
which slows diarrhea by absorbing liquid. In addition to the
BRAT diet, these foods include oatmeal, cream of wheat,
grits and soft bread (not whole grain).
•Try psyillium husk fiber bars
(another source of soluble fiber). A recent study showed
that two bars eaten one hour before bedtime with a large
glass of water can really help diarrhea. They can be found
at health food stores.
•Avoid foods high in insoluble fiber,
like the skins of vegetables and fruits. These foods can
make diarrhea worse.
•Try to avoid milk products and
greasy, high-fiber, or very sweet foods. They tend to
aggravate diarrhea.
•Try taking calcium supplements (500mg
twice a day).
•Prevent dehydration by drinking lots
of fluids.
Weight loss
Weight loss can be a serious problem
in HIV disease. It can result from some of the side effects
discussed in this section—like vomiting, nausea, dry mouth,
anemia or fatigue.
Unfortunately, even though the signs
of weight loss can be obvious, it is not always seen as a
problem. In fact, many positive women who lose weight due to
HIV-related problems are praised and told they “look good.”
If you’re losing weight and it’s not
because you altered your diet or exercise patterns for that
purpose, it’s never a good thing. Talking to a doctor to
identify its cause is critical to treating unwanted weight
loss.
Tips for weight loss
•Monitor your weight. If you are
losing weight, work with your doctor to determine the cause.
Is it stress-related? Is it accompanying nausea or vomiting?
Has it occurred after starting a new medication? What other
things are going on?
•Try high protein shake mixes, like
Med-Rx or Metabol. Look for products high in protein and low
in sugar. These are available at most health food and
vitamin stores.
•Ask about discounts at health food
and vitamin stores. They sometimes provide people with
life-threatening diseases special savings on nutritional
products.
Project Inform
We are also placing brochures
under our Health Links, Files & Videos section on the right
to help you in your quest to learn more about this disease
and we sincerely hope you find them helpful.
You may also find
many of our articles on HIV and AIDS in our Newsletter
Article Index.
The
National Library of Medicine
has an extensive Help page
to guide you in AIDS / HIV education.
|
Current Month Story - Coping
with Menopause |
Tips on Coping with Menopause
What to do if menopause
makes you miserable?
Start with a visit to your
doctor.
A good doctor will do
an exam to make sure menopause is what is causing your
symptoms, take stock of which ones are most bothering you,
and help you weigh the benefits and risks of treatment
options with your medical history in mind.
For example, women bothered most by sleep problems may find
a non-hormone solution. Ditto for vaginal dryness.
Hormone therapy
—
taking estrogen, progestin or both — works. It tames hot
flashes, improves sleep, keeps bones strong and prevents
vaginal dryness. It also can raise the risk of cancer and
heart problems. However, studies show that the risk is small
to an individual woman who starts on the pills at normal
menopause age and uses them for fewer than five years.
Experts suggest:
•If you use hormones, use the lowest dose for the shortest
time possible, and try to quit or cut down every few months.
•Ask about ways to use hormones other than taking pills,
such as estrogen patches that can be cut to adjust the dose,
or estrogen-secreting vaginal rings. Some preliminary
research suggests these modes may be safer than taking
pills.
•Do not take hormones to try to prevent heart disease or
dementia. If you take them to keep your bones strong, talk
with your doctor about possible alternatives.
•If you were taking birth control pills for symptoms during
the transition into menopause, check with your doctor about
whether to continue. Many oral contraceptives contain far
more estrogen and progestin than traditional hormone
replacement therapy does.
•For hot flashes, try to figure what triggers one, such as
hot drinks, spicy foods, alcoholic drinks, stress, hot
weather, or a warm room. Dress in layers, and keep your
office and home cool.
•Eat a healthy diet to keep bones strong, maintain a healthy
weight, get regular exercise, and don't smoke.
•To sleep better, go to bed and wake up at the same time
every day, eat regular meals at regular times, and not late
at night. Limit caffeine. Avoid nightcaps: Alcohol may make
you feel drowsy, but it interferes with sleep patterns.
•Creams can help with vaginal dryness.
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Current Month Story -
Curry Ingredient for Cancer |
Curry Compound Kills Cancer
A molecule found in a curry ingredient can kill esophageal
cancer cells in the laboratory, suggesting it might be
developed as an anti-cancer treatment, scientists said on
Wednesday.
Researchers at the Cork Cancer Research Center in Ireland
treated esophageal cancer cells with curcumin, a chemical
found in the spice turmeric, which gives curries a
distinctive yellow color, and found it started to kill
cancer cells within 24 hours.
The cells also began to digest themselves, they said in a
study published in the British Journal of Cancer.
Previous scientific studies have suggested curcumin can
suppress tumors and that people who eat lots of curry may be
less prone to the disease, although curcumin loses its
anti-cancer attributes quickly when ingested.
But Sharon McKenna, lead author of the Irish study, said her
research suggested a potential for scientists to develop
curcumin as an anti-cancer drug to treat esophageal cancer.
Cancers of the esophagus kill more than 500,000 people
across the world each year. The tumors are especially
deadly, with five-year survival rates of just 12 to 31
percent.
The curcumin used "an unexpected system of cell messages"
that caused the cancer cells to die, McKenna said.
Normally, faulty cells die by committing programmed suicide,
or apoptosis, which occurs when proteins called caspases are
"switched on" in cells, the researchers said.
But these cells showed no evidence of suicide, and the
addition of a molecule that inhibits caspases and stops this
"switch being flicked' made no difference to the number of
cells that died, suggesting curcumin attacked the cancer
cells using an alternative cell signaling system.
In 2007, U.S. researchers said they had found curcumin may
help stimulate immune system cells in Alzheimer's disease.
Copyright Reuters
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Current Month Story - Why Discuss Erectile
Dysfunction in our Newsletters |
Why write about erectile dysfunction?
Because there is so much
misinformation out there regarding this condition. It's also
a topic many people want to avoid or don't want to talk
about. If our spouse or partner has occasional performance
issues that's one thing. If it happens more frequently it
becomes personal and we can sometimes presume it's a
reflection of our own appeal and we let it affect our
personal self esteem. And let's be clear - having a healthy
and vibrant sex life is extremely important to most
relationships.
Now of course, as with any physical act - an occasional
malfunction can occur. What you want to avoid is second
guessing yourself or having it turn into a big deal. Men and
women have moments when it just "isn't meant to happen."
Maybe you are incredibly stressed, extremely fatigued or
just preoccupied and not in the mood. What you also want to
avoid is a situation where certain lifestyle choices you are
making or medications you are taking or a physical condition
is the actual cause of ED- and you don't remedy the
situation. You can end up missing an easy solution or
treatment or you may not be connecting the dots and
realizing that a much more serious physical condition is
ongoing and putting your general health at risk - and that
ED is merely a symptom.
Our hope at XLPharmacy Blog is to raise consciousness with
our monthly newsletters, and help you learn more about this
condition. We also want to shed a little light on all the
things that can and cannot cause ED - and let you know the
latest treatments and news in the world of erectile
dysfunction. Use your doctor or health professional as a
resource. And, of course, feel free to post comments, to ask
questions or just to share in our feedback area at the
bottom of the page.
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Healthy Recipe of the
Month - Roasted Salmon with Maple Glaze |
Roasted Salmon with Maple Glaze
Ingredients
1/4 cup maple syrup
1 garlic clove, minced
1/4 cup balsamic vinegar
2 pounds salmon, cut into 6 equal-sized fillets
1/4 teaspoon kosher or sea salt
1/8 teaspoon fresh cracked black pepper
Fresh mint or parsley for garnish
Directions
Preheat the oven to 450 F. Lightly coat a baking pan with cooking spray.
In a small saucepan over low heat, mix together the maple syrup, garlic and balsamic vinegar. Heat just until hot and remove from heat. Pour half of the mixture into a small bowl to use for basting, and reserve the rest for later.
Pat the salmon dry. Place skin-side down on the baking sheet. Brush the salmon with the maple syrup mixture. Bake about 10 minutes, brush again with maple syrup mixture, and bake for another five minutes. Continue to baste and bake until fish flakes easily, about 20 to 25 minutes total.
Transfer the salmon fillets to plates. Sprinkle with salt and black pepper, and top with reserved maple syrup mixture. Garnish with fresh mint or parsley and serve immediately.
Nutritional Analysis
(per serving)
| Serving size: 1 fillet |
| Calories |
314 |
Cholesterol |
69 mg |
| Protein |
25 g |
Sodium |
152 mg |
| Carbohydrate |
21 g |
Fiber |
1 g |
| Total fat |
14 g |
Potassium |
624 mg |
| Saturated fat |
3 g |
Calcium |
31 mg |
| Monounsaturated fat |
5 g |
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