Blog About Health & Medicine

The fourth anthropometric test to help ascertain nutritional status is measurement of mid-arm muscle circumference (MAMC), which estimates skeletal muscle mass. This is also a quick and easy test, in which a measuring tape is used to determine the circumference of the arm, midway between the elbow and the shoulder (where the triceps skin-fold measure was taken). Having measured the mid-arm circumference, the next step is to subtract the fat, which is represented by the triceps skin-fat thickness measurment. What remains represents muscle and lean body tissue. Plug your mid-arm circumference into this formula to derive your mid-arm muscle circumference:

•Summary of the finding of Frisancho, A.R. Am. J. Clin. Nut, 34:2540, 1981.

MAMC (cm) = mid-arm circumference—(TSF [mm] x 0.314) MAMC = mid arm muscle circumference TSF = triceps skin fold cm = centimeter mm = millimeters

Then take your MAMC and rate yourself on the chart below:

Mid-arm muscle circumference (in centimeters)*

A MAMC of 20 percent or more below the numbers on the table above would help support a diagnosis of loss of lean body mass.

These four tests—height, weight, triceps skin fold and mid-arm circumference-are not the only anthropometric measurements that can be taken. But these four are quick and easy to do and provide a good starting point for further investigation.

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A low blood/body level of iron is the most common mineral deficiency in the world. Iron is part of the hemoglobulin molecule that binds oxygen to red blood cells. A lack of iron can result in poor oxygen delivery to the various parts of the body. This can cause all sorts of problems, including immune-system deficits.

In the absence of adequate iron, the thymus and other lymphoid glands may shrink, the number of T- and B-cells in the blood can fall, and the ability of cell “eaters” to ingest and destroy bacteria may be impaired. The ability of the body to respond to antigen challenge is thus diminished.

Years ago, doctors gave iron tonics to patients who suffered from multiple infections. The tonics helped, but today we know that iron shouldn’t automatically be given to patients with low blood levels of iron.

Bacteria need iron to flourish. So, during infections, the body sequesters iron in the bone marrow and other organs to keep it away from the bacteria. That’s pretty smart of the body, hiding the bacteria’s food. For this reason, I advise my patients not to take iron when they’re suffering from an infection.

If you have symptoms of anemia (such as fatigue), don’t self-medicate by taking iron—or anything else, for that matter. The anemia may be caused by a serious medical problem that requires attention. In men, the problem may be cancer of the colon, gastritis, esophagitis or peptic-ulcer disease. Taking iron may make you feel better, but it won’t do anything for the underlying problem. And because you feel better, you may not seek the treatment you need. Women should also be checked out when suffering from symptoms of anemia. This may sound like a very conservative approach, but through the years I’ve seen too many people who treated their anemia by taking iron, not knowing until it was too late that the anemia was caused by a serious medical condition that could have been corrected had it been attended to earlier.

Too much iron can also be a problem, and it may suppress the immune system.

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SARCOIDOSIS: we don’t know what causes it; possibly a virus.

Signs and Symptoms: may be fever; pains in joints; generalized body aches; cough; weight loss. Can have shortness of breath, lumps on the skin; enlarged liver; inflammation of a portion of the eye, which can lead to glaucoma and loss of vision. May get into heart and cause chest pain. Usually gets into lungs, causing shortness of breath. Many times I have made the diagnosis of sarcoidosis from the characteristic appearance of the X-ray, which shows enlarged lymph glands in the chest.

SCLERODERMA (progressive systemic sclerosis): chronic disease with generalized fibrosis (thickening) of the skin, joints and many internal organs.

Signs and Symptoms: joint pains; stomach upsets; heartburn; weight loss; malaise; difficulty in swallowing; shortness of breath. Skin of fingers and face becomes thick. Normal creases on the fingers and face disappear. Fingers become purple and hurt when exposed to cold. Face become thick, like a mask, and blood vessels on face, lips and tongue become prominent. Other symptoms may be esophogitis; (inflamations of the esophagus); pleurisy; pericarditis (inflammation of the sac surrounding the heart); heart irregularities; muscle weakness. Death from pneumonia often occurs.

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ANKYLOSING SPONDYLITIS: a progressive, inflammatory arthritis characterized by fusion of various joints, especially of the spine, that leads to years of suffering. Norman Cousins described his experience with ankylosing spondylitis in his bestselling book, Anatomy of an Illness.

Signs and Symptoms: fatigue; malaise; weight loss; low back pains; sacroiliac pains; sometimes pain down the back of the legs; stiffness of the back, especially in the morning; stiffness and pain spreading up to involve the rest of the back; hips and shoulders ache and feel stiff; in advanced stages there is forward flexion of the spine, forcing the person to walk with his head facing the ground (almost like an exaggerated Groucho Marx walk).

BACTEREMIA: a condition in which bacteria invade the circulating blood. The bacteria can come from a small abcess on the skin, dental drilling or manipulations, infections in the urinary tract or female organs, lung infections, intravenous drug use, indwelling intravenous catheters, urinary catheters, surgical procedures, and almost any other way bacteria can get into your blood.

Signs and Symptoms: fever; fatigue; rapid heart rate; rapid breathing; cool, pale extremities; can lead to confusion or disorientation; shortness of breath.

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This assumes that the affected person makes IgE antibodies to the synthetic chemical concerned (see p25), or responds with some other inappropriate and damaging immune reaction. Since the chemicals concerned are too small to act as antigens in their own right, they would have to combine with body proteins and act as haptens.

It has been suggested that this can happen with some food additives, particularly preservatives and synthetic colours. These cause chronic urticaria (nettle-rash) in some people, and urticaria is sometimes due to an allergic reaction. There are also isolated cases of tartrazine (a synthetic colouring) causing acute asthma attacks, or a severe reaction that resembles anaphylactic shock in some very susceptible people. Other food colourings, particularly the synthetic ones, have been known to cause allergic dermatitis, mainly in food workers exposed to large amounts. The preservative, sorbic acid, has occasionally caused allergic dermatitis when used in medicinal creams.

In most of these cases, the tests to show that the reaction really is an allergic one have not been carried out. And when a group of patients who were apparently allergic to tartrazine were tested for IgE antibodies, none were found. So it looks as if these are not allergic reactions at all, even though they produce allergy-like symptoms. Doctors suspect that tartrazine produces symptoms in these people by directly affecting the immune response in some way – perhaps by stopping the synthesis of immune regulators called prostaglandins, or by triggering mast cells directly. In the case of synthetic chemicals apparently causing asthma, the effect may be due to irritation rather than an allergic reaction. This is well known for metabisulphites and sulphur dioxide.

These are cases where the symptoms provoked by chemicals at least looked like allergic symptoms. In the majority of chemical-sensitive people, the symptoms are not those commonly associated with allergy. So it seems unlikely that chemical sensitivity is allergic in origin. It is possible, however, that synthetic chemicals might affect the immune response in some way. This has indeed been shown for some chemicals, but the usual effect is to lower resistance to disease, rather than to make allergies more likely.

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Once a diagnosis is made regarding the knee’s status, treatment can take one of many forms. Since the knee is an easily damaged joint, you should see your doctor, who will probably take an X ray of the knee and manually examine the knee as well as the way you’re walking. She will tell you to test the knee and take aspirin or Advil to ease the pain and inflammation.

If, however, your doctor determines that your X rays reveal a torn meniscus that requires surgery to remove, you will undergo arthroscopic surgery, which involves inserting a stainless steel surgical tube through a tiny incision at the side of the kneecap and suctioning the torn cartilage out. This popular operation has enabled people to indulge in their chosen sport within a week after surgery, if not the next day.

Tips and Precautions

Preventing knee injury consists of two components: warm-up and conditioning. Walking rapidly for five minutes will serve as a warm-up before your regular exercise session, and being in shape will give you sufficient strength to get through your workout. Injury occurs most often when you’re tired or when you push past your energy reserves.

Stretching the hamstrings and other joints that surround the knee will also lessen the chance of injury to the knee. And if you strengthen the inside of the quadriceps, or thigh muscle, with a combination of stretching and walking, it’ll pave the way for smoothing the movement of the femur within the groove of the kneecap.

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For some reason, Mother Nature had it in for women when she designed their external genitalia. I once heard someone compare the urethra, vagina, and rectum to a highway where the exit tamps are all too close together.

A fourth physical flaw can be added: the woman’s urethra, or the tube that leads from the bladder to the outside of the body, is very short compared to a man’s. This shortness is what helps create urinary tract infections, since the bacteria don’t have very far to travel before they start to cause an infection in the urethra. The major symptoms of a urinary tract infection are a burning pain during urination and foul-smelling urine. A urinary tract infection can occur in different parts of the urinary tract. An infection of the urethra is called urethritis; if it spreads to the bladder, a bladder infection can occur. An infection of either the bladder or the urethra can be quite painful. Because urethrtis is often caused by intercourse, when bacteria are pushed up into the urethra, it is often called honeymoon cystitis.

Rarely, the infection will proceed to the kidney; this condition is called pyelonephritis. This can cause permanent kidney damage, so it’s important to treat urethritis in the early stages before it has a chance to spread.

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Description and Possible Medical Problems

A health columnist at a popular women’s magazine has said that two of the most commonly asked questions from readers are (1) Why do I have hairs growing around my nipples? and (2) What can I do about my inverted nipples?

Although she could answer the same two questions in her column every month, making her readers happy, she limits the appearance of each question to once a year. Her answers: (1) They’re perfectly normal—pull them out with tweezers and (2) They’re perfectly normal— ignore them.

Inverted or retracted nipples are perfectly normal if you’ve had them since puberty. Only if the inverted nipples have developed recently could they be a sign of trouble—that is, cancer.

Treatment

If your nipples have recently turned inward, see your doctor right away. Any change in the skin of the nipple—whether a color change or an inversion—could be a sign of cancer. She will do a routine breast exam and a mammogram if she suspects you have a tumor.

Otherwise, if you’ve had them all your life, you have nothing to worry about.

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When I first began my medical practice, one of the first patients I saw was an elderly gentleman who came into my office off the street because he couldn’t stop belching; he was also mildly short of breath. He thought all he had was a severe case of indigestion. However, I admitted him to the emergency room because he was actually having a heart attack, though he didn’t believe me. At times a person may have heart attack symptoms—such as belching—without any significant chest pain.

In fact, if you have been diagnosed with heart disease and show some of the risk factors for a heart attack, if you start belching and can’t stop, go to the hospital immediately!

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Because there are so many reasons why your throat may be sore, the treatment will depend on the cause. If you think pollution is causing your sore throat, your only remedy is to stay inside more and to venture outside only in the early morning and on days when the air pollution index is low.

If you have a sinus infection, antihistamines can help alleviate a sore throat by stopping the postnasal drip. If your mouth is dry because of the sinus infection, sipping water frequently during the day will help keep your throat moist and more comfortable.

If I think a patient has strep throat, I’ll take a throat culture. It’s important to seek treatment for strep throat right away, since it can lead to scarlet fever or rheumatic fever if left untreated. If the culture comes back positive, I’ll treat it with penicillin or erythromycin for a 10-day period. Although strep throat occurs more frequently in children than adults, you should know that if you have strep throat, you can easily pass it to your children.

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