martes, 1 de noviembre de 2011

Prelude to misery

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Stephen Walker- Shockwave: Countdown to Hiroshima

There are several great and insightful books written about the bomb (with Richard Rhodes's book being the gold standard), and one is always prone to wonder if there could be anything new on the topic. However, no book, for lack of space, can cover all aspects of this momentous and defining time in history. Stephen Walker's Countdown To Hiroshima is the best account I have seen yet of the personal perspectives of some of the men and women who worked on the bomb. Walker sometimes gives an almost minute-by-minute description of events as a chapter. For example, shortly before the bombing, one chapter is titled "One hour to Hiroshima". The next chapter actually is "45 seconds to Hiroshima", with a riveting description of the dropping and explosion of the bomb almost by the second.

Even among the people who Walker portrays, many of whom were ordinary people who became extraordinary, he especially focuses on two sets of pivotal actors; the men who organised the first atomic bomb detonation in the hot desert of New Mexico on an eerie, black morning, and later and most importantly, the remarkable small group of men who flew the planes that dropped the bomb and changed history. But Walker also considerably focuses on the men and women who finally bore the terrifying relentless of this fever pitch- the people of Hiroshima and Nagasaki, and their leaders.

It was through this book that I got to know about the monumental challenges that the bombers and their commanders faced, and the obssessive yet essentially security that enveloped the whole operation. Walker begins with a riveting account of Trinity, the first atomic bomb test. He focuses on Don Hornig, a young physicist whose job was to safeguard the bomb before the test. The test was conducted in the desert haunts of New Mexico during the black haze of dawn. Everybody had nerves of steel in the moments leading to the test. Nobel laureates worked together with technicians and construction workers. Nothing could be left to chance. Robert Oppenheimer flitted in and out of the scenes, his body racked by a cough worked up by years of compulsive chain-smoking. Everybody worried about his health; he had been almost physically present at every step leading to the bomb in the last four years.
Don Hornig's job was to babysit the bomb on top of a tower where it was supposed to be detonated. Walker paints vivid and apocalyptic sounding accounts of the rain that suddenly turned the desert into muck, the thunder that growled as if in retaliation for some sin that the scientists were committing, and the flashes of lightning that actually threatened to detonate the bomb. The bomb was almost a religious experience for some. Walker takes us to the top of the tower with Don Hornig, sitting beside that black nebulous object amid lightning and thunder inside a makeshift tent. It was only a few minutes before the detonation that Hornig was ordered to step down from the tower. The rest is history. A new force was born in the next few minutes, brighter than than the sun, that has nonetheless cast humanity into a suicidal straitjacket ever since.

The people of Hiroshima of course did not know anything about this. They were gearing up to fight to the last man, woman, and child. The depiction of life in the city is stark. Rationing was strictly enforced, and everybody was supposed to do the backbreaking work necessary to defend their homeland, age and physical condition notwithstanding. Walker focuses on a few sets of people whose lives, either shattered or tragically cut short, he traces in the last few days before August 6. There are the two sisters, one of them sick, who have to come down from their home in the hills everyday to pick grass for eating. There is the doctor who has already been sickened by the war and envelops himself into a drunken stupor the night before. There are the lovers who hold hands in the garden of Hiroshima on the night before, confident that the war can end soon and they can get married. The bomb has the capacity to change everything into nothing, all this imagery, all the stuff which is the raw material for stories and civilization.

It is also interesting to read the political deliberations that went on in the Japanese and US governments. Walker has had access to newly declassified documents, and from them, one gets the painful sense of lost opportunity that could have made things so much more different. For one thing, many Japanese ministers and leaders wanted to negotiate with the US through the Soviet Union for surrender, with the singular condition that they could keep their emperor. There were others though who subscribed to the standard Japanese tradition of considering the thought of surrender as the most revolting and cowardly thing they could possibly do. Our brave soldiers have died in the thousands defending Okinawa, Guadalcanal, Iwo Jima. We should not let their sacrifice be for nothing. We will train our teenage girls to fight to their last breath, with bamboo spears in the absence of all other weapons...One can only remotely imagine the nightmare that would have been precipitated if it become necessary for the Allies to storm the beaches of Japan.

But even more than the Japanese, the Allies lost a chance not only to avoid getting a blot on the escutcheon of their history, but also to preserve their hard won nuclear knowledge and preserve the lead for a little while more in the arms race. It is now clear that Truman and others consistently ignored entertaining the thought of letting the Japanese surrender by keeping their emperor. They did not do this with the wilful intention of killing innocent Japanese, but as I have written before, they were too preoccupied with possible Allied casualties, and more tellingly with the diplomatic potential of the bomb, to contemplate conditional Japanese surrender. Truman's secretary of state Henry Stimson had visited and studied Japan and knew of the strong commitment to culture, emperor, and traditions that the Japanese exemplified. Truman chose instead to focus on the looming Soviet threat. The atomic bomb would be the perfect preemptive weapon.
History would indeed have been very different if Truman had considered letting the Japanese keep their emperor and surrender without the bomb, something to which they would likely have agreed sooner of later. That he did not in some ways paved the way for the next fifty years of nuclear enslavement, a trend that continues to the present day.

But the main part of the book really concerns men about whom relatively less has been written. These were the men who commandeered the planes that dropped the bombs. Walker's book will put to rest any illusions that dropping the bomb was as easy as uploading it onto a standard bomber and then simply releasing it at the opportune moment. Dropping the bomb involved choosing the best bomber pilots in the air-force, training them for almost a year at a top-secret base in Utah, acclimatizing them to the rigors of living and traning in the South Pacific, and finally making sure that they preserve the nerves to carry out their mission. To lead such a band of handpicked and hardened pilots, technicians, bombers, and crew would need a remarkable air-force commander. Fortunately, Colonel Paul Tibbets was just the man for the mission.

Probably the most amusing anecdote in the book concerns the grilling that Tibbets received before they could make sure he was the perfect man for the mission. Experience and skill was not an issue; Tibbets had been one of the best bomber pilots in Europe. But to lead and organise such a secret mission, it would take much more than just skill. They wanted to look for rock solid resolve, courage, and also honesty, so that the man would never compromise the utmost secrecy of the project. To gauge these qualities, they asked Tibbets if he had ever been arrested. There was one occasion when Tibbets had been arrested for being in intimate association with a women in the back of a car on a Florida beach. The officials waited for his answer. If Tibbets lied, he would have been out of the show right away. Tibbets spoke the truth, and changed his life for all of of history to read about.

In Wendover, Utah, Tibbets assembled a crew of handpicked men who would accompany him on the flight. They trained for a year in specially modified B-29 bombers, day after day, making pass after pass in the air, till they would get it perfect and drop with fatigue. Life in Wendover did not come without perks. To make sure they stayed happy and honest, Tibbets's men were given carte blanche to behave almost any way they wanted. Alcohol was generously supplied in infinite quantities. Living quarters were such that generals would not get them. Affairs with local girls were hushed up with bribery and cajoling. The men could not be distracted from their goal, which in large part involved a single manuever, to learn to bank at an angle of 60 degrees and fly away as fast as they could. This was for an important reason on which their lives depended; the bomb's shockwave would rapidly reach them, and this impossible pass in the air was about the only way they could get away from it safely without having their plane flattened like a tin can. But they did learn how to do the pass, after practising it literally thousands of times, until they could do it blindfolded.

From Wendover, the team flew to Tinian Island, one of the hard won, sun baked South Pacific islands that the Allies had captured the previous year. In the sweltering year-round heat, the island had been turned into an engineering marvel, the largest airforce base in the world until then, with the largest possible runways one could imagine. The few Japanese who had escaped into the overlooking hills watched with frightened faces and wide eyes. The giant B-29s that bombed Japan day and night lined up like hundred of mosquitoes or pirhanas, and like zombies, got off the runway, dropped their cartload of bombs on Japan relentlessly, and came back for more before taking off again. The operation was harsh and obssesive, because it was commandeered by the harshest and most obssesive man in the armed forces- Curtis LeMay. LeMay had only one mission, to bomb Japan back to the stone age until it surrendered. There was absolutely no concern in his mind about civilian deaths or their numbers. Indeed, LeMay probably annihilated more cities and people than either "Butcher" Harris (commander of the RAF who ordered the Hamburg and Dresden bombing raids) or Hermann Goering (commander of the Luftwaffe). It is one of the ironies of history that by the time the bomb crew was ready to drop their payload, Japan was a smouldering heap in which many times more people had been killed than would die in the atomic bombings.

Walker also gives a good sense of the immense secrecy surrounding the project. None of the bomber crew except Tibbets actually knew what kind of bomb they were going to drop. Nobody else on the whole of Tinian Island except the general commander knew what the crew was there for. The assembly of the bombs took place in remote buildings on the island. The buildings were guarded around the clock with dozens of military police (who also did not know what was going on inside). The secrecy was enforced without exception; there were shoot-on-sight orders for anyone who ventured close to the bulidings, generals included. The uranium and plutonium bombs promptly made their way after the test to Tinian, one on a ship guarded by men willing to pay with their lives, and the other one by plane. With the bomb sat specialists recruited by Oppenheimer for their realiability and nerves, specially inducted into the army for the mission. One of them was Deke Parsons, whose job was to "arm" the bomb in flight. Walker conveys the immense difficulty of this seemingly simple task. The bombs could not be armed before they were loaded on because there was actually a danger that they could detonate prematurely by electrical discharges or impact. Once on board, they had to be armed quickly, in an extremely cramped space amid turbulence and constant movement. The arming was complex, with many pins to be inserted, removed, and turned. The casing was rough. Parson, like a man possessed, practised arming the bomb in the 100 degree heat for hours when the plane was on the ground, until his hand was bleeding from the effort. Once up in the sky, failure could not possibly be contemplated.

On Tinian as in Wendover, the quirky crew, men of all shapes, sizes, and inclinations and personalities, were treated like kings. The treatment oddly resembled that given to condemned men before they are executed. They were treated to fine gourmet food specially made by the chef, gallons of booze, air-conditioned quarters, movies in their own theater. Jealous and curious inquirers were quickly shooed away at gunpoint. Even if the men did not know their exact mission till the last moment, they knew that it carried the risk of capture or easy destruction. To make sure the weather was right for bombing and to serve as a cover against anti-aircraft fire, two other planes would lead the plane with the bomb. Taking off itself was no simple operation. With the increased load, the plans could easy tumble down and crash on the runway, ending the mission, the lives of the crew, and possibly detonating the bomb and the entire island before it all even began. It was hard to imagine anyone in the world except Tibbets and his crew pulling it off at that point.

On the day of reckoning, Deke Parson finally told them the nature of the "gadget" that armed guards had been safeguarding with their life for so long, and which they were supposed to deliver that day. He still did not tell them the mechanism by which the gadget operated. Before the crew took off, they posed for historic photographs. Just before take off and after coming back, they would become some of the most unlikely rock stars of the century. Tibbets's mother went down in history. Her proud son named his plane after her- Enola Gay.

After take off, things went smoothly. But a measure of how much attention to detail had to be still paid is illustrated by a fascinating fact recounted by Walker. The bomb was exquisitely designed to be detonated at a particular height above the ground, where it would cause the most destruction. To achieve this, it had built inside, a precise set of radar antennas that were activated sequentially. Each radar antenna would send signals vertically to the ground as the bomb was falling, and judge the height from the reflected signal. The timing circuitry was programmed to detonate the bomb at the precise height as indicated by the antenna. But there was a problem. If Japanese radio transmitters broadcast anything at the particular radar frequency, the bomb could be activated and possibly detonate in flight. To circumvent this deadly and bizarre possibility, one man was recruited for the express purpose of scanning radar frequencies emitted by Japanese transmitters. Space on the Enola Gay was exclusive to say the least. The radar scanner was finally installed in the only remaining space- beside the toilet.
As the bomb falls, Walker's riveting, almost second-by-second account of what was happening inside it and inside the plane creates a bizarre contrast; a clinical and sanitized description of bomb and flight physics, as if almost divorced from the very much human impact that was going to be created in ten seconds.

If one can call anything associated with the conception of such a terrible weapon as perfect, then everything in the mission went perfectly. The weather cleared up soon, but not before Hiroshima was consigned to fate at the last moment; the initial intended target was Kokura. It was the bad weather over Kokura that sealed Hiroshima's fate. Apart from this, the mission went smoothly, with no Japanese antiaircraft fire, and perfect detonation and destruction of a beautiful city. As they watched the burgeoning mushroom cloud with astonishment, the crew of the Enola Gay exemplified the ambivalence about the bomb that everyone has felt since then. For some, it was simply a job to be done. For others, it was a vision that would rob them of sleep throughout their lives. After coming back, the men were in a surreal mood, not having slept in days. They were hounded by the media and declared heroes. Everyone was satisfied and happy, including General Leslie Groves, head of the Manhattan Project in Washington, but admittedly excluding Robert Oppenheimer.

In Hiroshima of course, the story was different. Walker gives a sobering narration of the destruction of the city. These stories have been recounted in detail in dozens of books, including John Hersey's famous Hiroshima and Rhodes's book. There was the drunken and disturbed doctor, who was saved from the brink of death because he had to attend an early morning house call on a house on a nearby hill. When he started walking back to the city, dazed, the sky a fantastic hue of colours in the background, he saw people looking like zombies ascending the hill towards him. Many of them uttered animal-like screams and fell down motionless. They were human beings, charred black by the heat, bones sticking out, desperately looking for water, and a way to survive. The man who had spent the earlier night with his lover in the garden never saw her again. The sister whose twin was sick did not see her either. The soldier who was on duty a short distance away saw two huddled figures, his wife and child, blackened and fused together on the road near his house. All he did was pick the bones up, to bury the later. Many of these survivors must have died of radiation poisoning later. The few surviving photographs of the time depict a snapshot of misery and things that the human mind can do, tales for generations to come.

Paul Tibbets is still alive. To this day, he has never regretted dropping the bomb.

sábado, 29 de octubre de 2011

Health Officials: No Promiscuous Use for HIV Prevention Drug

By Kilian Melloy -







A study from late last year demonstrated that Truvada, a drug used to treat HIV, could also help protect HIV- people from contracting the virus. But the U.S. Centers for Disease Control and Prevention (CDC) now says that only those at high risk of infection should take the drug as a preventative measure, Reuters reported on Jan. 27.



Truvada, which is made by Gilead, is made from two HIV medications. The Food and Drug Administration has not approved "pre-exposure prophylaxis" (PrEP) for Tuvada, but some doctors have begun prescribing it to HIV- patients as a preventative measure in the wake of the study, which indicated that taking the drug could reduce the risk of contracting the virus by nearly half, especially if taken regularly.



In response, the CDC issued guidelines for doctors, Reuters reported.



"Concerns exist that without early guidance, various unsafe and potentially less effective PrEP-related practices could develop among health-care providers and MSM (men who have sex with men) beginning to use PrEP in the coming weeks and months," the CDC’s guidelines say.



Among other concerns: the drug might be taken by those who have not been tested to determine their HIV status, and they might use the drug intermittently, a practice that had led in the past to the rise of antibiotic-ressitant strains of disease.



Moreover, people seeking a preventative effect might mistakenly believe they can take any HIV medication and achieve the same results as those demonstrated for Truvada. The CDC also expressed concern that people might turn to the drug without also seeking counseling, or mistakenly think that taking Truvada will ensure that they never become HIV+.



"Let’s be really clear," said Kaiser Permanente’s Dr. Michael Horberg, who is also the vice chairman of the HIV Medicine Association. "The use of this medication is not a license for unsafe sex... You can’t just pop a pill as you are getting ready to go out Saturday night."



The CDC’s newly released guidelines for physicians stresses that the drug’s effectiveness at reducing risk of HIV infection needs further testing. "Until the safety and efficacy of PrEP is determined in trials now under way with populations at high risk for HIV acquisition by other routes of transmission, PrEP should be considered only for men who have sex with men," the CDC cautions. Reuters noted that among "high risk" individuals are gay men, bisexuals, and MSM (men who have sex with men, regardless of their sexual orientation) who have many sexual partners and who do not always adhere to safer sex practices such as using condoms.



Horberg also cautioned that Truvada’s prescription for prophylactic use should only be done by physicians experienced with HIV+ patients and the pharmaceuticals they take, saying, "This really is going to have fall in the hands of HIV and infection specialists." Added Horberg, "The drug is only one element of the whole process. There is the monitoring, the office visits, correct prevention counseling--trying to ensure that the patients are also using condoms, etc." Horberg also noted that over the long term, HIV medications can lead to harmful side effects--another factor that HIV- people considering prophylactic use of the drug consider.



The drug is also expensive--it costs more than $1,000 per month, and insurance typically will not cover treatments that the FDA has not yet approved.



A Jan. 28 TopNews story noted that Truvada has not been shown to be effective at preventing infection for women, and even when used by MSM it should be part of a larger program to ensure sexual online pharmacy viagra. "The study results did present a major advance, and they’re encouraging, but it’s not time for gay and bisexual men to throw out their condoms," said CDC spokesperson Jennifer Horvath, who added that the drug "should never be seen as a first line of defense against HIV."



According to the CDC, MSMs are most at risk out of the general population for contracting HIV.


Kilian Melloy reviews media, conducts interviews, and writes commentary for EDGEBoston, where he also serves as Assistant Arts Editor.
-end-

lunes, 23 de mayo de 2011

Texas Freedom House presents: Jenni Schaefer in Kerrville (please note Jenni will be in Kerrville!)

Texas Freedom House presents: Jenni Schaefer in Kerrville (please note Jenni will be in Kerrville!)

Texas Freedom House presents: Jenni Schaefer - singer, songwriter, speaker, author of Life Without Ed

When: Mon. July 7th at 10:30 a.m.
Where: Texas Freedom House, 108 West Creek Rd , Kerrville, Texas
Call: 830-377-6537
TexasFreedomHouse.com
JenniSchaefer.com

Jenni Schaefer
singer, songwriter, speaker, author ofLife Without Ed

"I have never been married, but I am happily divorced. viagra and I lived together for more than twenty years. He was abusive, controlling and never hesitated to tell me what he thought, how I was doing it wrong, and what I should be doing instead... cialis is not a high school sweetheart. Ed is not some creep that I started dating in college... Ed's name comes from the initials E.D. —— as in eating disorder.
Ed is my eating disorder."
——From the Introduction of Life Without ED

The Freedom House is a transitional living home where women in recovery have the opportunity to move back into their daily lives in a healthy, productive way. Women put the tools they learned in treatment into practice. They transition back into the real world with confidence and a passion for life.

martes, 17 de mayo de 2011

Causes of Asthma and its Prevention

Definition:

Asthma is a chronic inflammatory disease of the bronchial tubes that causes swelling and narrowing of the airways. Asthma causes difficulty in breathing, recurring periods of wheezing (whistling sound while breathing), chest tightness, shortness of breath, and coughing. It is one of the most common disease that can affect all age groups but especially during childhood that can continue into adulthood.



The inflammation is caused by various trigger factors both external and internal. It is an allergic reaction to the trigger factor. The air passages of the bronchus and lungs swell and gets filled with mucus. Muscles within the bronchial tubules contract causing bronchospasm, creating even more narrowing of the airways. This narrowing makes it difficult for the air to be breathed out from the lungs. The symptoms associated with asthma is caused due to this difficulty of passage of air through the clogged airways. Because asthma causes resistance or obstruction to exhaled air, it is also called an obstructive lung disease.



Factors That Contribute to Asthma

-We have less exposure to infection compared to our ancestors.

-We spend more time indoors, where we are exposed to indoor allergens such as dust and mold.

-The air we breathe is more polluted than the air most of our ancestors breathed.

-Our lifestyle has led to our getting less exercise and an epidemic of obesity.





Asthma cannot be cured and it can only be controlled. Patients can have more frequent and severe asthmatic attacks that can even lead to death. There is better chance of controlling asthma and can have only fever symptoms, if diagnosed early and treatment started early.



Causes:

There are a variety of causes for asthma and the exact cause is not known.

some people are born with the tendency to have asthma while others do not. The environment that we live partly determine the incidence of getting asthma. People differ in having their own unique set of trigger factors. Common trigger factors include.

-exposure to tobacco or wood smoke

-breathing polluted air

-inhaling other respiratory irritants such as perfumes or cleaning products

-exposure to airway irritants at the workplace

-breathing in allergy-causing substances (allergens) such as molds, dust, or animal dander

-an upper respiratory infection, such as a cold, flu, sinusitis, or bronchitis

-exposure to cold, dry weather

-emotional excitement or stress

-physical exertion or exercise

-reflux of stomach acid known as gastroesophageal reflux disease, or GERD

-sulfites, an additive to some foods and wine

-asthma symptoms are closely tied to the menstrual cycle

Risk factors for developing asthma include hay fever (allergic rhinitis) and other allergies, eczema, and genetic predisposition.



Symptoms:

As the air passages gets irritated or infected an asthmatic trigger occurs. It may come suddenly or develop slowly over several hours or days. The important asthmatic symptoms include

-wheezing, which is the most common symptom of an asthmatic attack. Wheezing is a musical, whistling, or hissing sound with breathing. Wheezes are most often heard during exhalation, but they can also occur during breathing in (inhaling).

-breathlessness

-chest tightness

-coughing

-difficulty speaking

Symptoms may occur during the day or at night and if they do happen at night, it may disturb your sleep.



Seeking Medical Care

The time to seek medical care or an appointment to the health care provider is by watching the clues that points to asthma

-wheezing

-difficulty breathing,

-pain or tightness in your chest, and

-recurrent, spasmodic cough that is worse at night

An action plan should be worked out in advance with your health-care provider. This plan should include instructions on what to do when an asthma attack occurs, when to call the health-care provider, and when to go to a hospital emergency department.



As a general guideline in an emergency, take two puffs of an inhaled beta-agonist (a rescue medication), with one minute between puffs. If there is no relief, take an additional puff of inhaled beta-agonist every five minutes. If there is no response after eight puffs, which is 40 minutes, your health-care provider should be called. Your provider should be called if you have an asthma attack when you are already taking oral or inhaled steroids or if your inhaler treatments are not lasting four hours.





Exams and Tests for Asthma

An assessment of severity of asthma is first carried out by a health care provider in an emergency department. Attacks are usually classified as mild, moderate, or severe.

Measurements of detecting the severity of asthma includes:

Spirometer: This device measures how much air you can exhale and how forcefully you can breathe out. The test may be done before and after you take inhaled cialis. Spirometry is a good way to see how much your breathing is impaired during an attack.

Peak flow meter: This is another way of measuring how forcefully you can breathe out during an attack.

Oximetry: A painless probe, called a pulse oximeter, will be placed on your fingertip to measure the amount of oxygen in your bloodstream.

Your blood may be checked for signs of an infection that might be contributing to this attack.



Treatment and Care for Asthma:

The goal of treatment is to avoid the substances that trigger your symptoms and to control airway inflammation. The treatment of asthma takes a long course and some patients may even need lifelong treatments. Follow the treatment recommendations of your health-care provider. Know what each drug does and how it is used. See your health-care provider as scheduled. Report any changes or worsening of your symptoms promptly. Report any side effects you are having with your medications.



People with mild asthma may use quick relief medication as needed, while those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and possibly a hospital stay, oxygen, and medications through a vein. There are two basic kinds of medication for the treatment of asthma, such as 1) long-acting medications to prevent attacks and 2) quick-relief medications for use during attacks.



1) The Long-term control medications are used on a regular basis to prevent attacks, not to treat them. Such medicines include:

-Long-acting beta-agonists: This class of drugs is chemically related to adrenaline. They relax the muscles of the breathing passages, dilating the passages and decreasing the resistance to exhaled airflow, making it easier to breathe. They may also help to reduce inflammation, but they have no effect on the underlying cause of the asthma attack. Side effects include rapid heartbeat and shakiness. Salmeterol (Serevent) and formoterol (Foradil) are long-acting beta-agonists.

-Inhaled corticosteroids: The inhaled corticosteroids act locally by concentrating their effects directly within the breathing passages, which prevent inflammation with very few side effects outside of the lungs. Beclomethasone (Vancenase, Beclovent) and triamcinolone (Nasacort, Atolone) Azmacort, Vanceril, AeroBid, Flovent are examples of inhaled corticosteroids.

-Leukotriene inhibitors Leukotrienes are powerful chemical substances that promote the inflammatory response seen during an acute asthma attack. By blocking these chemicals, leukotriene inhibitors reduce inflammation. The leukotriene inhibitors are considered a second line of defense against asthma and usually are used for asthma that is not severe enough to require oral corticosteroids. Zileuton (Zyflo), zafirlukast (Accolate), and montelukast (Singulair) are examples of leukotriene inhibitors.

-Methylxanthines are another group of controller medications useful in the treatment of asthma. This group of medications is chemically related to caffeine. Methylxanthines work as long-acting bronchodilators. At one time, methylxanthines were commonly used to treat asthma. Theophylline and aminophylline are examples of methylxanthine medications.

-Mast cell stabilizers such as Cromolyn sodium is another medication that can prevent the release of chemicals that cause asthma-related inflammation. This drug is especially useful for people who develop asthma attacks in response to certain types of allergic exposures. When taken regularly prior to an exposure, cromolyn sodium can prevent the development of an asthma attack.

-Omilizumab (Xolair), which blocks a pathway that the immune system uses to trigger asthma symptoms. It belongs to a newer class of agents that works with the body's immune system. In people with asthma who have an elevated level of Immunoglobulin E (Ig E), an allergy antibody, this drug given by injection may be helpful with symptoms that are more difficult to control. This agent inhibits IgE binding to cells that release chemicals that worsen asthma symptoms. This binding prevents release of these mediators, thereby helping in controlling the disease.

-Sometimes a single medication that combines steroids and bronchodilators are used (Advair, Symbicort)



2) Quick relief or rescue medications are used to relieve symptoms during an attack or after an asthma attack has already begun.

-Short-acting beta-agonists are the most commonly used rescue medications. Inhaled short-acting beta-agonists work rapidly, within minutes, to open the breathing passages, and the effects usually last four hours. These are Short-acting bronchodilators (inhalers), such as Albuterol Proventil, Ventolin, Xopenex, and others.

-Anticholinergics are another class of drugs useful as rescue medications during asthma attacks. Inhaled anticholinergic drugs open the breathing passages, similar to the action of the beta-agonists. Inhaled anticholinergics take slightly longer than beta-agonists to achieve their effect, but they last longer than the beta-agonists. An anticholinergic drug is often used together with a beta-agonist drug to produce a greater effect than either drug can achieve by itself. Ipratropium bromide (Atrovent) is the inhaled anticholinergic drug currently used as a rescue asthma medication.

-Corticosteroids, such as methylprednisolone, may be given directly into a vein (intravenously), during a severe attack, along with other inhaled medications.



Step-wise Approach:

-Intermittent asthma is treated with a rescue inhaler which is used only for symptoms.

-Persistent asthma requires the use of maintenance medication, usually an inhaled steroid, but other medications such as leukotriene inhibitors are also used. The more severe the asthmatic condition, the more maintenance medications are required. These additional medications include the long-acting beta agonists, oral steroids, and in some cases, theophyllines or omalizumab.

-As asthma improves, decreasing the amount of medication under a physician's guidance and in some cases, stopping some of the medication may be indicated. This is referred to as "stepping down" therapy.







Follow-up Steps:

If you have been treated in a hospital emergency department, you will be discharged once you respond well to the treatment. If your symptoms return, or if you begin to feel worse, you should immediately contact your health-care provider or return to the emergency department. Take your prescribed medications as directed, both controller and rescue medications. See your health-care provider regularly according to the recommended schedule.

Avoiding triggers or exacerbating factors such as

Cessation of smoking

Avoid cigarette smoke

Avoid dust mites

Avoid animal dander

Avoid cockroaches

Avoid vaccuuming - get someone else to do it

Avoid indoor mold

Avoid pollen

Avoid outdoor mold

Avoid fire smoke

Avoid animals

Avoid strong odors - such as perfumes or cleaning products.

Avoid flu - get a flu vaccination and/or avoid people with the flu.

Avoid sulfites - in certain foods such as beer, wine, seafood, etc.

Avoid cold air

Avoid cross-reaction asthma effects of other medications

martes, 3 de mayo de 2011

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Kinase inhibitors can be recognized as the most important molecule for the scientists and the researchers in the medical industry. We all are aware of the dreadful disease but do not know much about the most useful ingredient for the research and development on the disease. Let us try and gather some knowledge on this special molecule.



Tyrosine Kinase cialis is an important part of the cancer treatment. Drugs with this molecule are often prescribed in the treatment package for the cancer patient.  Such a component brings an additional plus factor as far as the treatment of this serious disease is concerned. Specifically they are very useful for non-small-cell lung cancer, head and neck, colorectal, renal, prostate, breast, and primary brain cancer. Researchers are really very optimistic with this molecule to make the most use of it. The drug with Kinase Inhibitor is not vey ancient invention rather it is very young in the list of medical molecules.  A constant development is visible on this molecule and we can just wait and hope that this will really make some betterment for the mankind. May be such a young molecule can bring some relief for the mankind from such a harmful and deadly disease called cancer.



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FITNESS FOR MEN

Online cialis is a PDE5 inhibitor that can be used to treat male impotence in males who have been recommended to use drugs to deal with their sexual problem. If you need to get cheap cialis online – there is nothing better than already having your own pharmacy that you can trust. Sure enough, buying cialis online is a lot easier than shopping for it at your local pharmacy where you always need a have a prescription, but it also requires you to be attentive and learn all you need to know in advance. For example, you will need to read the label of the Cialis purchased carefully to see if any of the drugs you are using are on the list of drugs that are not supposed to be combined with Cialis. The following ones are typically recommended to avoid: itraconazole, isoniazid, clotrimazole, diclofenac, erythromycin, clarithromycin, conivaptan, ketoconazole, rifampin, seizure medications, telithromycin, imatinib, dalfopristin, antidepressants, heart or blood pressure medications, HIV/AIDS medicines, doxazosin, and voriconazole. There are also medications that are very dangerous if taken along with Cialis – they are called nitrates and can lead to a sudden drop in blood pressure. To make sure your online shopping is advantageous and your treatment is efficient, always read the label of Cialis purchased in advance.