What is Sleep Bruxism?

Sleep Bruxism is a condition in which you may clench, grind or gnash your teeth while you sleep.  This condition can also occur unconsciously during the day, when you are not asleep, known as simply Bruxism.  It can be caused by a variety of reasons including both physical and psychological.  Some of the suspected causes include stress, suppressed frustration or anger, misalignment of the upper and lower teeth, it can be in response to ear pain or complications of other disease processes such as Parkinson’s or Huntington’s Disease.  Uncommonly, it is a side effect of some psychiatric medications.

Signs and Symptoms of Sleep Bruxism

Many people who have Sleep Bruxism may not even be aware of the disorder.  It is important to be aware of the signs and symptoms which can include:

• Chewed tissue inside your cheek or indentions on your tongue
• Frequent Headaches or Jaw Pain
• Grinding or clenching of the teeth, your sleep partner may be able to hear this, the sound can be loud enough to awaken them from sleep
• Damaged teeth – teeth may be chipped, fractured, worn down or flattened
• Tooth sensitivity
• Pain or tightness in your jaw muscles
• Chronic facial pain
• Earaches

Treatments for Sleep Bruxism

Sleep Bruxism may be mild and sometimes does not require any treatment. Some cases may be more frequent and severe leading to disorders of the jaw, damage to the teeth, headaches and other potential harmful conditions. Usually children who experience sleep Bruxism will outgrow it and most cases in adulthood can be managed by managing the cause and are usually not severe enough to require treatment.

If treatment is necessary it can include use of a dental splint or a mouth guard at night, these can be custom fit for your mouth by your dentist.  Correction of misaligned teeth or jaw can help if this was the cause.  If you have damaged your teeth you may require dental intervention to repair the damage and prevent further complications.

Sleep Bruxism caused by stress may be managed with stress management strategies such as relaxation, meditation, exercise or professional counseling.

What is Schizophrenia?

Schizophrenia is a disorder of the brain that interferes with the way in which the affected person thinks, how they feel and act or react. This interference causes them difficulty in distinguishing what is imagined and what is real.  Because of their inability to make this distinction they can become delusional about themselves and those around them.

This condition can interfere with the person’s ability to experience emotions others might come by naturally in social relationships.  This can lead to withdrawal from socialization. This condition impacts ordered thinking.  This causes inability to concentrate and decreased attention span.

Symptoms of Schizophrenia

Symptoms of Schizophrenia are separated into four categories which include:

• Hallucinations – This includes seeing, smelling, hearing or tasting what is not there. The most common example of schizophrenic hallucination is hearing voices and the voice telling them to do or not to do specific things.
• Delusions – This category includes false beliefs about either themselves or those around them.  Thinking that someone is out to get them or harm them, watching them even when there is evidence to prove this is not the case. False beliefs about themselves such as believing they are from another planet or that they are someone other than themselves is a sign of delusion.
• Disorganized thinking and nonsensical speech – This disorder can cause communication problems.  The conversation can change from one topic to the next very rapidly.  Sentences may seem out of place or irrelevant, even contain made up words.
• Social Withdrawal and Apathy – Loss of interest in their surrounding or in life in general.  This is usually due to their emotional unresponsiveness and lack of motivation in social situations.

Treatment of Schizophrenia

This disorder is not curable, it is treatable however.  Symptoms can be managed with the use of antipsychotic medications.  Most patients respond rather quickly to the use of these medications.  If the patient is extremely depressed and withdrawn an antidepressant medication may be included in drug therapy to help reduce this symptom. Some patients are hospitalized initially until symptoms are manageable on an outpatient basis. It is important that the patient stay on the medication regimen as stopping the medications used to manage the symptoms will cause the return of the symptoms.

Individual talk and cognitive therapy is used in some cases to help teach coping strategies for stressful situations and thought processes. Family and social support is imperative and doctors can provide referrals to community support groups and services.

According to the Centers for Disease Control and Prevention, syphilis has been on the rise throughout the world but most particularly in the United States since 2000. Also according to the CDCP, syphilis has been known to affect sexually active individuals of all ages, all genders and all ethnicities but it is most prevalent among young homosexual African-American men than any other group.

All through the ages, syphilis has been so widespread, so dreaded and so demonized that it’s appeared in countless pieces of literature (scientific journals, poetry and prose) and in the fine arts throughout the world.

Stages of Syphilis Symptoms

Syphilis is a complex disease that goes through a series of distinct yet overlapping four stages:

1. Primary Syphilis. Roughly around ten to ninety days after exposure to the disease, a lesion called a chancre develops at the point of contact which is usually on the genitals but it can also appear in other parts of the body that had made the contract (mouth, fingers, anus, etc.)

The chancre is a painless ulceration which can last for up to six weeks and will disappear without medical intervention. However, the lymph nodes will begin to swell and remain swollen for the duration of the disease.

2. Secondary Syphilis. Patients are most contagious during the secondary syphilis stage which appears six to eight weeks after Primary Syphilis.

Rashes may emerge on the chest, back, arms and legs as well as on the palms of the hands and the soles of the feet. Such rashes are usually red or pink, symmetrical and do not cause irritation or itching.

White lesions known as condylomata lata, flat pale rashes and mucous patches may also show up in the genital areas and the mouth.

Other common symptoms that also materialize are fever, sore throat, spontaneous weight loss, headaches, rigidity of the neck (meningusmus) and general feeling of illness. In very rare cases, additional symptoms or complications such as meningitis, hepatitis, arthritis and others may develop.

3. Latent Syphilis. Is a stage which can last for 24 months or longer and it may show no symptoms or clinical evidence of the disease. Although latent syphilis patients are still infectious during this stage the intensity of the infection is not quite as powerful as it had been during the first two stages (the Primary and Secondary).

4. Tertiary Syphilis. Tertiary syphilis can last for up to 20 years from the time of initial contact and it is characterized by the development of chronic little inflamed tumors which are called granulomas and they may appear anywhere in the body.

Also during tertiary syphilis, a degeneration of the joints may occur and it’s known as the neuropathic joint disease.

Treating Syphilis

Unlike during the pre-antibiotic eras in which victims of syphilis would most like die of the disease and its complications, syphilis is easily treatable today. And the most effective course of treatment of the disease is a series of antibiotics such as penicillin which are usually administered via intramuscular injections.

When left untreated or to run through its own natural process, however, syphilis can cause permanent damage to the heart, the aorta, the brain, the nerves, the joints, the liver, the eyes and the bones, and such damages can lead to death.

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What Happened?

Sunburn is a sneaky ailment, as the pain which would warn you, develops hours after the event. This delayed-onset pain is part of a spectrum of symptoms which can appear 2-48 hours after the sun exposure event. Sunburn is often noticed by other people before being felt by the victim. By that time, the condition is irreversible and the damage has been done. Sunburn is a common ailment and inspires concern in others.

Inflammatory Process

Acute inflammation is triggered by sunburn, causing a release of fatty acids which metabolize and regulate stages of the inflammation, until resolution. Resolution happens when small molecules called photolyases attempt to heal the damage. The UV light causes damage to the DNA, and if the photolyase enzyme cannot make repairs, the cells will die in a process known as apoptosis, and a radiation, not thermal, burn occurs.

Repairs are attempted at an atomic level, as the molecule attempts to break chemical bonds caused by UV light. Photolyase injects a proton and electron into the injured strand of DNA and can heal damage in a few billionths of a second. Irretrievably broken cells go through cell death, and cell death causes the pain commonly associated with sunburn.

Pain is Warning

The body’s intelligent design acts to save your life by impacting you where it hurts. Pain alerts you to wake up and pay attention. In the short-term, the body gives you pain in order that you might remove yourself from the light source, or make an escape The pain further encodes in your brain, or sets a neural pathway to interrupt and remind you of the pain, so that you might avoid overexposure to sunlight in the future. The most difficult time, most painful time will likely be between 12-36 hours after the event.

Not Usually Life Threatening

Sunburn is an event, not a disease or a chronic condition, but it’s not an event to take lightly. Serious reactions include dehydration, signs of shock and extreme exhaustion. Calling a health care provider immediately is the safest course of action after overexposure to solar radiation. Most people, however, do not seek medical attention, but use over-the-counter medications and home remedies.

Sunlight-Positive and Negative

Life on earth is made possible with sunlight, which activates many processes including photosynthesis for plants and trees. In turn, plant life creates oxygen that all life uses. Energy from sunlight triggers a chemical process to produce oxygen for the atmosphere, for organisms to breathe and indirectly to produce food. Vitamin D synthesis in our skin is triggered by sunlight. Bone health in children and adults is contingent on adequate Vitamin D production. Other health conditions benefit from the influence of vitamin D.

UV Index

Measuring the actual intensity of the sun provides data on the risks. At higher doses, UV rays cause normal sunburn, compromise the immune system, damage DNA and lead to cancer. Seasonal changes, weather variations and ozone depletion affect the UV index. In the U.S., every day in mid-afternoon, the National Weather Service publishes the forecast for the next day at the EPA, Environmental Protection Agency website. You can sign up for email alerts including UV alerts which warn of significantly high risks, or see the range of risks on a scale from 1 (low) to 11+ (extremely high). Most countries and weather websites list the UV index as part of the weather forecast.

UVA vs. UVB

Long-wave rays, UVA and short-wave rays, UVB come from our six billion year old sun. UVC rays also emanate from the sun but are mostly absorbed by the atmosphere. 95% of the rays reaching the surface are UVA rays, which is why science has mostly focused on the long wave rays. However, the other 5% of rays, the UVB rays, are under increased scrutiny by scientists and prevention/treatment recommendations may change.

Both kinds of rays are harmful, so make sure to get a sunscreen with an SPF of 15 or higher, that blocks or neutralizes UVA and UVB rays. UVB rays target the top layers of skin and are the main culprit in sunburn. UVA rays go into the deeper layers of the skin and can trigger allergic reactions. Be sure to use the recommended amount of sunblock and reapply as needed.

Sunlight Positive Effects

Tanning, evolutionarily speaking, served as a useful adaptation to ultraviolet radiation. Tanning, or the darkening of skin pigment, is seen when societies migrate from low level UV areas to high UV areas. Skin darkening serves to defend against microorganisms, stop overproduction of Vitamin D, protect against skin cancer, shield blood vessels and sweat glands, and adapt to environmental temperatures.

Sun avoidance is not recommended as solar rays trigger a cascade of beneficial events. Precursor chemicals are activated in the presence of sunlight to produce vitamin D, which plays a protective role against cancer.

Dosing or regulating the amount of sunlight becomes important, as does adjusting for differences in geographical location, latitude, and altitude.

Solar rays are also associated with positive mood and behavior. Serotonin levels are lowest in the winter during reduced sunlight availability. Serotonin is called the happy molecule. This neurotransmitter not only affects mood, but also memory, learning, mate search, as well as appetite and movement. Sun therapy is accepted for depressive disorders, insomnia, and seasonal affective disorders.

Sunlight Negative Effects

Negative consequences occur when overdosing on sunlight. Sunburn, poisoning, illness and even death are the result of miscalculating proper sun exposure. Physicians say that intentional tanning, or a calculated browning of the skin, seen as desirable by many, is not normal and a myth. Premature aging of the skin is the result of unprotected sun exposure.

Short-term Consequences

Comfort is compromised by sunburn. A painful, itchy and irritated feeling is likely to result from an acute overdose of sunlight or UV radiation (UVR). Comfort and a feeling of safety with other people will decline as a result of hypervigilance to not being touched. Clothing may rub on the skin and cause pain. Bed sheets may cause friction while trying to sleep. Almost all activities will be uncomfortable as skin may feel tight and painful with any kind of movement. Appearance or presentation to others will suffer. The red tint to the skin is unnatural and noticed immediately by others. Peeling skin is unsightly and unpleasant to others. The aesthetic or beauty reasons for sun seeking or tanning become invalid when the opposite result is reached.

Long-term Consequences

Skin damage is permanent. When the skin burns, free iron is released inviting free radical formation. Free radicals are molecules which cause cell damage and aging. They proceed to trigger a cascade of negative cellular events like knocking down dominoes, especially when interacting with DNA.

Skin cancer: The 3 major forms of skin cancer are cutaneous malignant melanoma, basal cell carcinoma; and squamous cell carcinoma. Thought to be the result of reactions between free radicals and DNA, half of all cancers are skin cancers caused directly and indirectly by sun exposure, especially as child.

Melanoma, the most deadly or lethal form of skin cancer is one of the few cancers increasing in incidence and becoming a world-wide health burden. The risk for invasive malignant melanoma is 1 in 59. In the 1930’s, it used to be 1 in 1,500, meaning for every fifteen hundred people back then, one person was likely to develop melanoma. Now, one person in every fifty-nine people will suffer and likely die from melanoma, and rates are expected to increase over the next twenty years.

• Development of melanoma is directly related to a lifetime of sunburns and sun overexposure. A molecular pathway, not a specific gene, is mutated by UV light and triggers melanoma development. Sunburn is the most significant risk factor for melanoma development but other factors do exist:
  • first-degree relative with melanoma
  • blistering sunburns
  • atypical mole syndrome
  • UV exposure at tanning salons
  • immunosuppression

Appearance – damaged or dead skin cells do not look good. Premature aging from photoaged skin is characterized by loss of collagen and elasticity. Wrinkled, leathery, patchy, and discolored skin is the result of long-term UVR exposure.

Reproduction – Overexposure to sunlight can cause a reduction in folate levels. Folate is a B vitamin which aids in cell growth and impacts sperm quality and reproductive success in pregnancy.

Symptoms

• 3^rd degree burns – all layers of the skin are damaged. Nerves and tissue in the skin are damaged and skin looks white or burnt. No pain may be felt due to nerve damage.
• 2nd-degree burns – very painful, produces blisters, red, swollen or splotchy skin.
• 1^st degree burns – red, painful, swollen and may peel after a few days.

Common Symptoms

Symptoms are temporary but can cause real pain and disability.

• dehydration – the process of removal of water from the body. May have dry mouth, dizziness, trouble enunciating words or thinking clearly.
• dizziness – an unsteady or lightheaded feeling.
• pink or red skin – known as erythema.
• sensitive skin – sensation of warmth, able to feel the slightest touch, air or wind, hyper responsive to physical stimuli including perspiration, clothing, and touch.
• blisters – skin is raised or elevated with fluid or air inside a bulbous form, blisters burst easily and can trigger infection.
• itching – pruritus, or an irritating sensation provoking a need to scratch or claw at the skin in hopes of pain relief.
• peeling skin – flaking of outermost skin due to cell death.
• pain – acute discomfort, anguish, emotional distress, skin tenderness.
• difficulty sleeping – pain and discomfort may cause problems going to sleep and waking in the middle of night.

Severe Symptoms

Serious reactions also known as sun poisoning can make one feel very ill.

• nausea – physical disgust in a state preceding vomiting
• vomiting – forced or uncontrollable ejection of stomach contents though the mouth.
• fever – elevation of body temperature, frequently caused by infection.
• chills – shivering, goose bumps, clammy and moist skin and/or pale skin.
• headache – pain in the head or neck.
• skin infections – bacterial, viral or fungal.
• major blisters – blisters which cover a significant portion of the body. 5-15 % blistering needs medical attention.
• fast pulse or breathing – rapid respiratory rate.
• extreme thirst – sudden, insatiable desire to drink liquids.

Life Threatening Symptoms

In 1999, in Arizona, USA an elderly Alzheimer’s patient was left alone outside on a patio for hours and suffered burns on the exposed parts of her body. She subsequently died from the sunburn. Deaths from sun overexposure stem from the skin’s failure to protect against infection, preserve fluids and control body temperature. Much depends on other complicating factors like heart, kidney or lung disease. A person’s age, general health, and ability to heal are factors as well.

Diagnosis and Treatment

Seeking advice and treatment is a worthwhile effort after a sunburn event. Your physician or health practitioner will begin with questions about your current symptoms, conduct a physical exam and make a visual inspection of your skin and order diagnostic tests if needed. Your sun exposure habits and sunburn history may be part of the evaluation. Common questions may include:

• When did the sunburn occur?
• Where did exposure occur?
• Did you use a sunblock or sunscreen? What type of sunblock and what strength level?
• Do you get sunburn often?
• Which parts of the body were burned?
• What medicines do you take? – Some medications, treatments or topical lotions can make sunburn worse such as the antibiotic doxycycline.
• What else are you feeling?
• Rate the pain on a scale of 1 to 5, five being the worst.
• Do you have itching or blisters?
• Do you have a history of sunburns?
• Does your family have a history of sunburns?

Testing

Photo-testing – not commonly ordered because the test is usually negative in sunburn cases. This procedure tests for the least amount or the minimal doses of sunlight, UVA and UVB, which causes a erythemal or redness reaction.

Photo patch – sunlight reacts with some substances or allergens to produce a skin disorder, which this procedure tests for.

Photoprovocation – tests for differing reactions to UVA/UVB radiation. One arm is dosed with UVA, with the equivalent of a half hour of sun, three days in a row. The other arm is dosed with the UVB.

Skin Biopsy – invasive sampling of the skin rarely used in sunburn cases.

Other tests – not commonly used for sunburn, but may be ordered for complications of sunburn or for diagnosing a sun-related problem:

• Blood Tests, Blood Count, Urine/Fecal

Treatment

No treatment can reverse sun damage but pain and discomfort can be managed. Time is the best healer as NSAIDs, antioxidents, oral and topical corticosteroids, and antihistimines have little effect on recovery time.

Pain Management – pain arrives on your doorstep as cells die, within 2-48 hours after sun overexposure. Pain medication may be prescribed during this time, and as needed afterwards. Medications like analgesics, topical anesthetics, corticosteroids, and anti-inflammatory agents like ibuprofen are commonly recommended.

Remedies – Compresses applied before the application of lotion is the accepted treatment. A compress of aluminum acetate, an astringent with antiseptic properties, can dry and heal. Aluminum acetate is commercially available. A cold damp washcloth, cool shower or bath may help. Some people add milk to the cold compress, and vinegar or oatmeal to the bath.

How to make a cold compress: Fill a bowl with water and add ice cubes. Let the ice chill the water for a few minutes. Take out the ice cubes. Add desired compress agent like milk, aluminum acetate, vinegar, peppermint oil, or green tea. Immerse a washcloth into the water. Take out and wring out until dry. Apply to affected area until compress is not cold anymore. Repeat as needed.

Keeping the skin moisturized by applying bland emollients, also known as lotion, can encourage skin healing. A bland emollient is skin lubricant or moisturizing lotion. Lotions do not add moisture to the skin. They trap moisture in the skin. Hypo allergenic products are preferred, fragrance and dye free.

Best moisture trappers are oils like petroleum jelly, however some physicians feel it also traps unwanted heat as well. Creams are second best and then lotions. Aloe Vera, a common home treatment, shows no advantage in clinical studies. Apply after bathing, each time skin is washed and periodically through the day.

Nutrition – drinking lots of water moisturizes the skin and speeds healing. Nutritional therapies include eating foods with high water content like celery. Anti-inflammatory foods such as salmon, berries and greens could jump start the immune system.

Time to endure/heal – sunburn can take about 2 weeks to subside.

• 3^rd degree burns take a long time to heal.
• 2nd-degree burns take 2 to 3 weeks healing time.
• 1st-degree burns can heal in 3 to 6 days.

Comfort – avoid touch, ask spouse to sleep elsewhere, choose clothing and bed sheets which minimize friction. Avoid wool and nylon, and choose cotton fabrics instead. Cornstarch or talcum powder sprinkled on bed sheets may help.

Behaviors to avoid – breaking or puncturing blisters or peeling and removing skin can expose you to the possibility of infections. Avoid lotions with alcohol, which dries the skin. Avoid products with benzocaine unless directed by a physician.

Apply antibiotic ointment to blisters and cover with a sterile bandage.

Hospitalization – to monitor vital signs and administer IV fluids. Children with 10% blistering and adults with 15% to 25% blistering may need hospitalization.

Prevention

Exposure

• Avoid the sun during peak sun ray intensity of 10 am and 4 pm.
• Stay in the shade of trees, buildings or umbrellas.
• Check the UV Index before going out.
• Take extra precautions with children, elderly and disabled.

Apparel

• Hats – Wear any kind of hat to protect your head and eyes, but a wide brimmed hat is better.
• Clothing – tightly woven, long sleeved pants and shirts, any kind of covering at all to protect yourself. SPF treated clothing and swimwear is available.
• Sunglasses – UV protection, blocks rays and protects eyes.
• Laundry detergent – agents like bis-ethylhexyloxyphenol methoxyphenyl triazine improve fabric’s ability to block UV rays.

Sunscreen Products

Sunblock acts as a filter, barrier, reflector or absorber for UVA and UVB sunlight. Sunscreen’s effectiveness in the lab and packaged for production, uses a measurement of 2 mg cm. Meaning, the product must be applied in a certain amount to be protective. However, most people do not put that much on and typically do not reapply, so the SPF rating is really just a beginning. Sunbathers and workers must use a good amount and reapply when needed.

• Lip balm/stick – lips are a sensitive area that deserve sunscreen or SPF, simple zinc oxide works well.
• Lotions – Apply generous amounts of sunscreen with a sun protection factor (SPF) of at least 15 “broad spectrum” to block both UVA and UVB rays. Pay attention to your face, nose, ears, and shoulders. The higher the SPF, the greater the protection.
• Apply sunscreen 30 minutes prior to sun exposure to allow penetration.
• Re-apply every 2 hours while you are outdoors, and after swimming or washing.

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SPF Labeling and Claims

Some have pointed to the insufficiency of SPF, Sun Protective Factor labeling. Some physicians and scientists feel that sunscreen companies use emotional and inaccurate messages to promote sunscreen use. Terms such as multi spectrum or broad spectrum may not be meaningful. The Food and Drug Administration in the U.S. wants consumers to know that not all products are equal.

Studies have shown that people do not use enough of the product on their bodies which makes the sunscreen only partially effective. Sunscreen labeling using qualitative measures is recommended. Under new regulations only products that protect against both UVA and UVB rays, with a SPF of 15 or higher, will be allowed to be called, “broad spectrum.” The FDA recommends reading the label from front to back to reduce the effect of misleading claims.

Types of SPF Products/Applications

• Oils, Sprays, Lotions, Creams, Gels, Butters, Pastes, Sticks – topically applied, form a protective barrier over the skin. Personal preference determines the type used, as all offer some protection with correct application. The FDA requires that manufacturers not make claims of immediate protection upon application, or identify their products as “sunblocks”, “waterproof” or “sweatproof.”
• Pills – the active ingredient in sunblock pills is a plant native to Central America, Polypodium leucotomos (cabbage palm fern). The biological compound provides antioxidant effects, acting as a cleanser of sun damage. Some studies have shown reduced burning when taking the pill as a prophylactic, or preventative. Study results are mixed however, and manufacturer’s claims may not be supported. Children, pregnant or nursing women should not take the pill.
• Vending Machines – some high risk areas, heavily populated with sun seekers, are using vending machines to apply sunscreen. Users step into a booth and are sprayed by multiple nozzles all over the body. This type of application promotes use because of the novelty, ease of application and price. Other types of vending machines, distribute packets of sunscreen for regular application.

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SPF Ingredients

About twenty ingredients are approved by the U.S. FDA for use in sunscreens. Chemical and organic compounds like zinc oxide, titanium dioxide, avobenzone, ecamsule, oxybenzone, are included in lotions and sprays to dissipate, deflect or absorb UV energy by forming a shield on the skin. Inorganic, physical, insoluble nanoparticles can also be found in sunscreens and reflect UV rays away from the body. Zinc oxide formulas are recommended for children.

The Parent and Pediatrician Role in Childhood Prevention

Since preventing childhood sunburn is the key to avoiding cancer, the pediatrician and the parent play a vital role in education and prevention. Some studies have found that poor sun knowledge and behavior on the part of the parent is likely to be associated with sunburn in the children. When parents improve their behaviors, children get fewer sunburns and decrease their risk of cancer.

Vigilance on the part of the family doctor or children’s doctor is recommended. The pediatrician can modify the attitudes of the parents and the children. Physicians should be aware of all the major environmental issues affecting people, including chemicals in the house and other toxic substances and events like sunburn. Outdoor sports are popular activities for kids and a prime area for physicians to intervene and recommend sun safety.

Social and Behavioral Therapy

Researchers tried a novel behavior intervention with middle school students in Massachusetts. Some students were in the experiment group and others were in a control group. Both groups received a lecture on sun exposure. The experiment group received a photo of their face taken with a special filter to show UV damage, while the control group did not receive a picture.

After two months those who had received a picture reported fewer incidents of sunburn than those who did not receive a picture. Viewing the photograph appeared to have a deterrent effect on the students. Most participants agreed that it was a helpful tool and kept their picture.

After six months the effects seemed to have lessened with more sunburn reports, but still less than the control group. Impressionable teenagers can choose positive behaviors when presented with personal evidence and visual demonstration of the negative consequences of their behavior.

Marie-France Demierre, a professor of dermatology and medicine at Boston University School of Medicine, believes every child should routinely get a UV photograph of their face. A specially designed UV filter is placed over the camera lens. A wave-length of light, 400 nanometers, penetrates deeper into the skin than does visible light, recording absorption and reflection of long-wave UV light by the person.

Dermatologists can refer patients for UV photography. A reputable photographer in your community may be able to document you or your child’s skin condition photographically. Home photographers can use black and white film, as no advantage is found for color film.  Some photographers use the Kodak T-Max 400 black and white film, standard flash, and a Kodak Wratten 18A UV filter.

Social Environments

Outdoor workers, especially water instructors and lifeguards, have a high risk of sunburn and overexposure to UV radiation. This type of outdoor work, near water, increases the risk of sunburn and these occupations are normally filled with young, white females in high school and college. This age group consistently has issues with sun protection skills. Most all of these workers have experienced sunburn and half of them have a history of severe sunburn.

Researchers at Rollins School of Public Health, Emory University, Atlanta, found few workplace interventions conducted in the lifesaving occupation, where it’s most needed. Lower sunburn incidents were reported in environments which did foster sun safety programs. More importantly, researchers concluded that peers or co-workers have a positive influence in developing healthy sun habits.

Motivating people to avoid ultraviolet exposure is another means to prevent sunburn and associated ultraviolet overdosing. Health advocates call for health promotion techniques targeting differences in genders and educating the whole family, with support from school and work systems.

Sociodemographics – People and Places

The sun’s rays are strongest closer to the tropics (lower latitude) and during the hours of 10:00 a.m. to 4:00 p.m. Higher altitudes or mountainous regions can be more dangerous for sun exposure. Persons in northern latitudes, like Scandinavia, produce less vitamin D than persons in countries like Australia.

Everyone has varying reactions to the sun depending on factors like the amount of melanin produced in the body. Melanin protects against the sun. Lighter skin people have less melanin-producing cells, melanocytes. Melanocyte cells, in the bottom layer of the skin, are stimulated by UVB rays to produce melanin.

Millions of people suffer from sunburn every year. Infants, children, and people with fair skin are more likely to get sunburn. Studies show mixed results for sunburn prevalence between genders. Both male and female adults experience sunburn.

Dark skin is also susceptible to harmful effects of the sun. A dark skinned person may endure sun exposure for hours where a light skinned person could get burned within 15 minutes. T.B. Fitzpatrick, a dermatologist at Harvard, developed The Fitzpatrick Scale in 1975 to classify UV reactions in different skin types. Types range from Type 1 which never tans and always burns, to the opposite Type 6 which never burns and always tans.

Most children have sunburn every year, and a third of all children have three or more sunburn events each year. 25% of sun exposure occurs before 18 years of age. Pediatricians and researchers report poor effectiveness in protecting children from sun damage despite public health initiatives.

Some countries, like Australia, have a culture revolving around outdoor pursuits, sun-seeking and tanning. These attitudes are pervasive and influence lifestyle, social norms, customs, peer groups and business activities.

People who are more likely to use sunscreen are female, have a friend that uses sunscreen, have parents that insist on sunscreen, and know the times of safe sun exposure.

Activities

Staying in shaded areas, wearing sunscreen, hats and glasses are recommended during these pleasure pursuits. Also, being aware of the UV Index may be helpful. Postponing an activity may be wise if the risk is too high. Some recreational pursuits and locations where sunburn is likely:

• Gardening, boating, sports, beach, lake, backyard, fishing, skiing, and golfing.

Work Places

Strategies for policies and practices in the workplace regarding sun exposure are not common. In the absence of structured guidance from management, an individual may have to use common sense in occupations where sun exposure is guaranteed. Typical jobs where overdosing on sunlight is likely:

• Lifeguard, Construction, Landscaping, Trash Collector, Street Police, Crossing Guards, Road Flagger.

Related Sun Problems

Photodermatoses – contact with a plant substance which makes that area light sensitive or some metabolic disorders may cause this related problem. Primarily UVA radiation causes this hypersensitivity. Sunburn is not a photodermatose, as sunburn can happen to anyone and is mostly caused by the UVB spectrum. One type of photodermatose is when one develops eczema in reaction to sunlight. One in 10 people react this way to the sun.

In some people, rubbing a lime on the skin exposes the skin to a reaction from sunlight, with symptoms of redness, swelling, blistering, and itching like poison ivy. Figs, celery, parsley, fruits, plants, and oil of bergamot, found in fragrances, can cause a photosensitizing reaction when exposed to the skin. Treatment consists of avoidance behaviors, topical ointments, cool compresses, antihistimines, steroids and other medications. Negative consequences include permanent discoloration of the skin.

Photo-aging – called external aging, as the inflammation from long term sunbathing makes fine blood vessels and wrinkles appear more pronounced.

Solar Keratosis – scaly skin, also called actinic keratosis, can sometimes develop from patches of pink skin into large patches of brown skin and may be pre-cancerous.

Sun Addicts - “tanorexics” or sun worshippers that become addicted, exhibit similar symptoms as alcoholics, may refuse intervention, have repeated exposure and may cause concern in others. Women are three times as likely as men to become addicted. Addicts report the first thought when waking is desire to tan and guilt over not being able to stop tanning. Education about the dangers of overexposure does not deter behavior and sun addicts may become annoyed by interventions.

FAQs and Myths

1. Sunscreen is applied before cosmetic makeup. True. Sunscreen always goes first, before any other topical application, with the possible exception of acne medication.
2. Truck drivers can get sun damage only on the arm that hangs out of the window. True.
3. Effects of water magnify the sun. True. Reflections from water, sand, or snow can intensify the sun’s burning rays.
4. Sun lamps and tanning beds can cause severe sunburn. True. 16% of boys and 33% of teenage girls have visited a tanning salon at least once. Protective eye goggles are recommended and sometimes mandatory.
5. People with freckles sunburn faster. True. Sometimes the freckles can fuse together and become bigger.
6. Can fish and animals get sunburn? Yes. Koi fish and whales have been diagnosed with sunburn. Dogs, cats, reptiles, and farm animals are susceptible to overexposure to the sun.
7. UVA, unlike UVB, can penetrate window glass. True. UVA can penetrate loosely woven clothing and car windows.
8. I can’t get a sunburn on a cloudy day. False.
9. Sunscreen is a modern product. False. Zinc oxide was used by WW II sailors to deflect sunlight

Emerging Possibilities

Anti-photoaging agents are any compound or drug that interferes with the chain reaction initiated by sun overexposure, immunosuppression, free radical and DNA damage.

Honeybush, a tea extract, mangiferin, a compound found in mangos and hesperidin, a flavonoid in citrus fruits, can protect the skin from UVR. Researchers believe that these extracts may reduce oxidative damage, inflammation and possibly regulate cell signaling.

Researchers are looking for a mechanism, stimulant or compound to increase the production of a protein called caspase-14, which plays a role in skin moisture. Skin absent of caspase-14 has diminished skin barrier function. Added to sunblock lotion, this compound could offer protection against UVR.

Massive amounts of iron are released after a sunburn event, inviting free radical damage. Drugs called chelators can transport iron away from the cells. Chelators bind to iron and carry it from the body. Difficulties lie in finding chelators that don’t become toxic for the cell. Researchers are finding solutions in chelators added to sunscreen that only become active when exposed to UV radiation.

References

http://www.sciencedaily.com/releases/2010/01/100128165129.htm

http://www.fasebj.org/content/23/11/3947.short

http://psycnet.apa.org/psycinfo/1999-13573-003

http://www.ncbi.nlm.nih.gov/pubmed/19481954

http://www.sciencedaily.com/releases/2008/01/080107181411.htm

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)117375/fulltext

http://www.ncbi.nlm.nih.gov/pubmed/21277533

http://www.jstage.jst.go.jp/article/bbb/73/2/73_322/_article

http://www.sciencedaily.com/releases/2003/02/030224081837.htm

http://www.nlm.nih.gov/medlineplus/ency/article/003227.htm

http://www.ncbi.nlm.nih.gov/pubmed/21143606.

http://www.sciencedaily.com/releases/2009/04/090423082633.htm

http://www.ncbi.nlm.nih.gov/pubmed/10431670

http://www.sciencedaily.com/releases/2005/04/050420091026.htm
http://www.sciencedaily.com/releases/2011/03/110316092706.htm

http://www.sciencedaily.com/releases/2006/09/060910143024.htm

http://www.sciencedaily.com/releases/2007/05/070521141014.htm

http://www.ncbi.nlm.nih.gov/pubmed/21107312

Exposure to the Sun

Depending on the geographic location, the sun provides pleasant warmth or brutal heat. In either case, the sun also endows us with “healthy” looking tans which are dangerously deceptive as they are not healthy at all and the consequences can be dire:

(a) Over exposure to the sun can result in sunburn which can be quite painful, slow to heal and it may culminate in skin infections and permanent scarring and uneven pigmentation.

To relieve the unpleasant and unsightly symptoms of sunburns; cool baths with added baking soda, oatmeal or white vinegar may prove to be very helpful as may cold showers. Aloe Vera extracts, cold compresses, corn starch or talcum powder, sliced cucumbers, chilled teabags and plenty of moisturizers which are applied directly to the sunburn may provide needed, albeit temporary, relief.

(b) Prolonged exposure to the sun is the leading cause for irreversible skin damage and the onset of premature signs of aging. The sun dehydrates and dries the moisture out of the skin and thus leaves it wrinkled and leathery.

(c) Long and unprotected exposure to the sun is the number one cause for a variety of life-threatening skin cancers; the most common of which are basal cell carcinoma, squamous cell carcinoma and melanoma.

It is essential to always use good sunscreens and to cover up with clothing and hats whenever possible.

Insect Bites

Along with the sun and the heat; insects come to life in droves and they bite! Most insect bites are merely bothersome as the bitten sites redden, swell and itch. However, some people may have allergic reactions and thus develop more severe symptoms which can possibly require medical interventions. In the most extreme of cases, allergic reactions to insect bites may lead to anaphylactic shock and even death.

Some insects such as mosquitoes and ticks are known to carry a variety of diseases some of which are quite serious. The best policy is to avoid being bitten and to do so means staying away from where they congregate (around tall grasses and standing water), by applying insect repellants and by wearing light colored and loose clothing.

Summer Skin Rashes

Skin rashes which are triggered by the heat of the summer (prickly heat) may be caused when the sweat which is produced by healthy sweat glands gets trapped under the skin and thus shows up as red bumps that can be blistery and exceedingly itchy. Seasonal summer skin rashes may also be caused by invading parasites which, like insects, come to life in the heat of the summer months.

The onset of summer skin rashes can be prevented by wearing cool clothing that is loose against the skin, by bathing frequently with plenty of soap and water and by avoiding parasite infested waters such as ponds, etc. Application of topical antihistamines and soothing ointments will relieve the symptoms of summertime rashes.

When these microscopic sebaceous glands at the base of the eyelashes (most frequently of the upper lid of the eye) become infected, they result in a condition known as stye. When a stye develops on the inside of the eyelid, it is most often referred to as a hordeolum. Although it is quite uncomfortable and very persistent (could last about three weeks or more), a stye or a hordeolum rarely results in further complications and leaves no lasting after effects.

A stye is thought to be closely related to an eye disease known as blepharitis which is recognized as an inflammation of the edge of eyelids that causes redness, itching, irritation and grittiness.

Symptoms of a Stye

A stye can affect individuals of all ages, genders and ethnicities. However, African American and Hispanic infants and young children seem to be most prone to it.

The beginning stages of a stye are usually experienced as tender, painful and reddened swellings of the affected area. As the stye develops into its more advanced stages, the swelling increases and the eye begins to itch profusely, it incessantly discharges tears, it become sensitive to light and blinking often becomes painful. In its most advanced states, a stye will also develop a small white or yellow bump that is filled with puss and causes even more pain.

A secondary infection known as conjunctivitis frequently accompanies the stye. The two tend to run parallel courses and thus come and go in unison.

Causes of a Stye

A stye is a bacterial infection that is most frequently (95% of the time) caused by microorganisms called staphylococcus aureus which tends to attack individuals with weakened immune systems such as those suffering from a wide variety of chronic diseases including diabetes and other infections. The eruption of a stye is often triggered by emotional or psychological stress, by physiological distress such as is set off by poor nutrition and unhealthful diets, alcohol and drug abuse, as well as by substandard hygiene and pollution.

Since styes tend to be highly contagious, they can easily spread from one individual to another or from one site to another site of the same individual via contact of hands, cosmetics, towels, washcloths, pillow cases and so on.

Treating a Stye

A stye will usually run its course and dissipate with no intervention. However, topical ointments such as Polysporin or erythromycin will expedite its demise considerably.

Applications of warm compresses will promote an increased flow of blood and thus encourage the white blood cells to attack the infection. Furthermore, the heat and dampness of such compresses will help the stye drain more quickly.

Washing the affected eye with clean, cold water is not a cure, but it will sooth the discomfort and pain caused by the infectious stye.

When the stye is particularly bothersome and long-enduring, a medical professional may opt to lance (pierce) it for accelerated draining and prescribe an oral antibiotic.

In its most severe form, a stroke can very quickly result in permanent and irreversible paralysis and death of its victim.

Symptoms of a Stroke

Although individuals who have had TIA (transient ischemic attack) are classified as being at a higher risk for suffering a stroke, the later usually comes on with no forewarning. But whether it is associated with TIA or not, it is crucially important to recognize the acute symptoms of a stroke at its earliest onset. The most common among them are:

(a) Dizziness, loss of balance and/or the loss of coordination, particularly when walking.
(b) The sudden inability to speak clearly and/or coherently and the loss of common words.
(c) Significant weakness, numbness and/or paralysis on one side of the body but not the other.
(d) Sudden disturbances in the eyes and the onset of blurriness which is accompanies by black spots and double vision.
(e) A severe headache that differs from any other which may be experienced along with stiffness of the neck, overall facial pain and particularly between the eyes, uncontrolled vomiting as well as confusion and cognitive disorientation.
(f) Slackness and drooping of facial muscles and skin, usually on one side.

Risk of a Stroke

The possible factors that can lead up to a stroke are many but those which are most suspected are: individuals with family history of stroke, heart attack or TIA; those who are over the age of 55; those with high blood pressure; those with high cholesterol levels; tobacco smokers; diabetic patients; those afflicted with obesity and/or cardiovascular disease; those using hormone therapy including birth control pills; those who indulgence in alcohol and drugs

Statistics show that men and women are equally prone to get a stroke but women die of it more frequently than do men. And of all the races, African Americans are most likely to be affected by strokes.

Treating a Stroke

Early detection and urgent treatment are keys to keeping the damage caused by a stroke to its minimum as well as curtailing its possible complications.

When the cause of the stroke is due to diminished supply of blood (ischemic stroke), the first line of treatment attempts to replenish the blood and to restore it to its normal flow. Aspirin or other blood thinning drugs are prescribed to increase the flow of flood. Likewise, clot-busting drugs which are also known as tissue plasminogen activators (TPAs) may be prescribed to quickly dissolve clots which are causing the blockage. Surgery (carotid endarterectomy or angioplasty and stents) to open or widen arteries that are seriously narrowed by plaque may also be performed.

In the event that a stroke was caused by a hemorrhage, one of three surgeries is usually performed: (a) aneurysm clipping, (b) aneurysm embolization or coiling, and (c) surgical AVM removal.

The definition of stress management may be simple but there is nothing simple about its dynamics or about stress itself.

But What is Stress?

Despite its common usage, stress is in essence a bio-scientific term that characterizes the body’s unhealthful or dysfunctional reactions to environmental discomforts or threats. Furthermore, stress is a very real autonomic response to external distress that poses an emotional or a physical threat which is based on reality or imagination or a combination of the two.

Stress is a big aspect of all our lives and it is always present in one form or another and at various levels. As a matter of fact, but for stress we would have little motivation to perform the many task which we perform daily. Therefore, stress is natural and positive until it becomes overbearing and thus also overwhelming.

In situations of extreme and prolonged stress that weighs too heavily, it can cause the body to get into the fight-or-flight mode and thus promotes increased production of adrenaline and such common symptoms as irritability and anger, anxiety and fear, depression and insomnia, hostility and resentment, tension in the muscles and spasms, reduced ability to focus or concentrate, racing heart and elevated blood pressure, labored breathing, headaches and stomach pain, sweating and so on. In the most extreme cases, stress can lead to serious health problems which can ultimately even culminate in death.

Stress Management Techniques

Over years of study and research, a wide array of techniques had been founded for coping with excessive stress and those may include:

(a) Relaxation Techniques applied to the body and mind such as yoga, deep breathing, meditation, soothing music as well as spas and baths help the body deal with stress from a more healthful perspective.

(b) Cognitive Behavioral Therapy (CBT) is a form of psychotherapy which helps increase coping skills.

(c) Conflict Resolution is a process by which stress resulting from a conflict or a dispute is relieved or eliminated by resolving such adversities via actions such as dispute resolution, negotiation, mediation, diplomacy, arbitration or litigation.

(d) Physical Activity such as exercise strengthens the body as well as the mind and thus handling stress may become an easier task.

(e) Involvement in Hobbies helps focus attention away from that which causes the stress.

(f) Much like hobbies, Creative Expression of any kind can help direct attention away from the aggravating environmental situation that causes the stress.

(g) Usage of Nootropics which is a group of “smart” drugs which help enhance memory and cognition and they are found in the form of various prescribed medications, over-the-counter supplements and specific food that are said to have the properties to improve intelligence, motivation and concentration and, thus, the capability to deal with stressful situations.

(h) Alternative Methods such as acupuncture, acupressure and the various massage therapies are known to help relieve the physical and mental pressures of stress.

In cases where stress management requires more drastic measures because all else failed, a variety of antidepressants or some other mood-altering drugs may be prescribed.

Causes for the Stomach Flu

Also commonly referred to as gastroenteritis, gastro, gastric flu and tummy bug; stomach flu is caused by an infection precipitated by a variety of viruses (norovirus which is most common, rotavirus, adenovirus, astrovirus and others) by bacteria (Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia and so on), by parasites or by unfavorable reactions to toxins, pollutants, drugs (prescribed or recreational), alcohol or something ingested (spoiled or improperly prepared foods, contaminated water, etc.)

Symptoms of the Stomach Flu

Depending on it cause, the symptoms of stomach flu can vary considerably but they always include acute diarrhea which can be severe enough to be life-threatening.

The symptoms of stomach flu usually last between one and six days but they can persist even longer while the most commonly reported among them are: diarrhea of very frequent and extremely watery bowl movements which are also accompanied by pain, cramping and spasms of the stomach; nausea and vomiting (usually of bile); loss of appetite; traces of blood in the stool; blackouts, fainting spells with general weakness and lethargy; low grade fever and dehydration.  The most severe cases of stomach flu have even been known to culminate with shock, coma or death.

As a matter of fact, stomach flu is the leading cause of death among infants and young children around the world.

Treating the Stomach Flu

Because dehydration is the most critical of all the symptoms, the number one priority when treating stomach flu is to replace the fluids and the electrolytes that have been lost during the process of moving frequent bowls due to the diarrhea and/or due to the vomiting.

In the mildest of cases, stomach flu patients are simply asked to increase their intake of fluids — water, tea and soups are most recommended.

In the more serious cases of stomach flu, hydration or rehydration is usually first attempted by a method called oral rehydration therapy (ORT) and it involves having the patient drink a solution consisting of salts and sugars.  In the most severe cases of diarrhea and dehydration, and in cases where ingesting the fluids by mouth only leads to more nausea and vomiting, rehydrated is achieved intravenously.

Foods and liquids that have high contents of simple sugars (desserts, soft drinks, juices, etc.) may worsen diarrhea and should, therefore, be eliminated when dealing with stomach flu.

Contrary of many popular beliefs, fatty foods may actually be very helpful in battling diarrhea.  Conversely, the BRATT diet which had been favored for decades and makes claim that patients of the stomach flu must eat nothing but bananas, rice, applesauce, toast and tea has now been found lacking in nutrients.  The BRATT diet, therefore, is no longer recommended.

Additional treatments for stomach flu and its diarrhea are:

(a) Fermented dairy products which include yogurts (plain and unsweetened) and buttermilk.
(b) Zinc supplements are especially recommended for young children.
(c) Antidiarrheal agents calm the intestines and, therefore, also relieve diarrhea.
(d) Where stomach flu is caused by bacteria, antibiotics may be prescribed.
(e) Antiemetic drugs may help stop or decrease vomiting which also contributes to dehydration.

Symptoms of a Stiff Neck

Since the muscles of the neck and its bones are the supportive structures which carry the full weight of the head and control its every movement, a stiff neck also describes a condition of the neck that causes inflexibility and thus makes bending, turning or moving of the head difficult and painful.

Depending on its severity, the pain of a stiff neck can range from mild to excruciating. Likewise, the pain of a stiff neck can be experienced through the process of a specific set of movements of the head or even when movements are not attempted such as when the head and the neck are at complete rest. The pain of a stiff neck can be described as a continuous ache, a sporadic sharp pain or a spasm; and it can be localized and confined in the neck area or it can travel down into the back and the arms or up into the head.

Causes for a Stiff Neck

The causes for a stiff neck are wide and varied and they are grouped as external and internal (pathological) causes. The most common among them are:

Included in the group of the external causes are: low quality or poor condition of the pillow and/or the mattress, a sharp or sudden turn of the head, emotional and/or mental stress and a whiplash caused by a car accident, a fall or a blow to the area neck or head area.

Included in the group of the pathological causes are various inflammations such as cervical arthritis (inflammation in the upper spine), encephalitis (inflammation in the brain), meningitis (inflammation of the membrane surrounding the brain), ankylosing spondylitis (inflammation of the upper vertebrae), rheumatoid arthritis, subarachnoid hemorrhage (bleeding into the space that surrounds the brain), a deformity of the neck that is known as torticollis and poor posture.

Treating a Stiff Neck

A stiff neck can be debilitating enough to get in the way of performing daily activities. Thankfully, there are things that can be done to relieve it:

(1) Massage. Whether self administered or dispensed by a professional such as a physical therapist, a massage therapist, a chiropractor, etc.; a good massage promotes increased blood flow and thus brings on healing and relieve.

(2) Exercise. Very precise and targeted exercises can help loosen stiffness and melt away tension — thus resulting in relief which also encourages healing.

(3) Compresses. Applying hot and cold compresses increases the circulatory system and thus also promotes faster healing.

(4) Alternative Therapy. Alternative therapies such as acupuncture or acupressure, various relaxation techniques, occupational therapy, stress management therapy and yoga can all help expedite the natural healing process while also easing the stress which caused the stiff neck to begin with.

(5) Topicals. Application of topical (cream, ointment, location, oil) muscles relaxants and/or painkillers provides temporary relief while the affected area goes through the natural process of self healing.

(6) Oral medications. Over-the-counter and prescribed oral medications such as pain killers and non-steroidal anti-inflammatories can prove to be very helpful.

(7) Cervical collar. Cervical collars can be worn to help support the head while the neck is healing itself and they have, in fact, been prove effective.

(8) Surgery. In extreme cases, surgery and/or traction may be necessary to relieve a stiff neck when all other treatments have failed.