Η Βιταμίνη C προστατεύει το DNA

συγγραφέας Δαλαμάγκα Μαρία

Το 1976 ένας γιατρός σε ένα μικρό ερευνητικό Ινστιτούτο στο Menlo Park της Καλιφόρνια , μια κωμόπολη έξω από το Σαν Φρανσίσκο έκανε κάτι , που κανείς δεν είχε κάνει ποτέ πριν.
Πήρε 100 ασθενείς , με επίσημη διάγνωση καρκίνου τελικού σταδίου και πρόσθεσε στη διατροφή τους 10 γραμμάρια μιας συστατικής ουσίας κάθε μέρα.
Και έζησαν .
Όχι μόνο για λίγες μέρες , ούτε για λίγους μήνες…
Ο μέσος όρος ζωής τους ήταν περίπου ένα χρόνο. Ο γιατρός σύγκρινε αυτούς τους 100 ασθενείς με άλλους 1000 επίσης τελικού σταδίου καρκίνου . Ο μέσος όρος ζωής τους ήταν μόνο 38 ημέρες.
Το όνομα του γιατρού ήταν Linus Pauling και η συστατική ουσία ήταν η βιταμίνη C .
Ο Pauling και ο συνάδελφος του Dr. Ewan Cameron δημοσίευσαν τα αποτελέσματα τους στην Εθνική Ακαδημία των Επιστημών.
Η βιταμίνη C είναι ένα αντιοξειδωτικό. Αφοπλίζει μόρια τα οποία ονομάζονται ελεύθερες ρίζες , οι οποίες επιτίθενται στα υγιή κύτταρα. Η βιταμίνη C απενεργοποιεί τις ελεύθερες ρίζες, πριν αυτές προκαλέσουν οξείδωση των κυττάρων , η οποία ενεργοποιεί την ανάπτυξη του καρκίνου.
Οι επιστήμονες το γνωρίζουν αυτό από το 1980 , αλλά σήμερα γνωρίζουμε περισσότερα για την οξειδωτική βλάβη.
Αυτό που ξέρουμε σήμερα είναι ότι τα τελομερή , που είναι τα προστατευτικά καλύμματα στις άκρες του DNA είναι πολύ ευαίσθητα στη οξείδωση. Η βράχυνση των τελομερών , επιταχύνει τη γήρανση των κυττάρων και τα ευαισθητοποιεί στο καρκίνο.
Σε μια Ιαπωνική μελέτη εξέτασαν τη δράση της βιταμίνης C στα τελομερή .Διαπιστώθηκε ότι η αύξηση των επιπέδων της βιταμίνης C , επιβράδυνε τη μείωση των τελομερών έως και 62%.
Η βιταμίνη C επιβραδύνει τη διαδικασία της γήρανσης. Προστατεύει το DNA.
Πλούσια σε βιταμίνη C είναι : το θυμάρι και το μαϊντανό , φυλλώδη λαχανικά , πιπεριές , μαύρες σταφίδες , παπάγια , πορτοκάλια , φράουλες και κεράσια .
1 Cameron, E. and Pauling, L. “Supplemental ascorbate in the supportive treatment of cancer.” Proc. Natl. Acad. Sci. USA. 1976. 73:3685-3689.
2 E. Cameron and A. Campbella. “An ‘unpublishable’ clinical trial of supplemental ascorbate in incurable cancer.” Medical Hypotheses, November 1991; Volume 36, Issue 3, Pages 185-189
3 Sebastian J. Padayatty, Hugh D. Riordan, Stephen M. Hewitt, Arie Katz, L. John Hoffer and Mark Levin. “Intravenously administered vitamin C as cancer therapy: three cases.” CMAJ,March 28, 2006; 174 (7).
4 Maramag C, Menon M, Balaji KC, Reddy PG, Laxmanan S. “Effect of vitamin C on prostate cancer cells in vitro: effect on cell number, viability, and DNA synthesis.” Prostate. 1997 Aug 1;32(3):188-95.
5 Furumoto K. et al. “Age-dependent telomere shortening is slowed down by enrichment of intracellular vitamin C via suppression of oxidative stress.” Life Science 1998, vol. 63, no. 11 pp. 935-48
6 Yokoo S, Furumoto K, Hiyama E, Miwa N. “Slow-down of age-dependent telomere shortening is executed … by anti-oxidative effects of pro-vitamin C.” J Cell Biochem. 2004 Oct 15;93(3):588-97.
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Mind

When you’re young, your mind is sharp, you’re quick-thinking, you’ve got clarity and focus … you feel like you’re “on top” of every situation. When you get a little older, your mental functions decline … your thinking and reaction time slow. It’s probably natural. But is it unavoidable?
As it turns out, you don’t have to become one of those slow-lane drivers just because you’re “getting older.” In fact, despite what you may have heard, cognitive decline is not inevitable.
You can improve your memory, mental focus and clarity starting today, and I’m going to show you how.
The good news is, it has little to do with genetics, and even less to do with drugs.
You can boost your mental performance and have a sharper, more agile mind by doing two simple things:
Exercising your brain and feeding your brain.
Let me explain …
When you were very small, you couldn’t do a whole lot of things. You couldn’t add numbers together, tie your shoes or even walk. But you had the ability to learn those things.

That’s because your brain has millions of cells called neurons. And they all have tiny branches coming off of them just waiting to connect to other neurons.
When you’re born, most of them are not connected to each other. But when you learn things, the messages travel from one neuron to another, creating connective pathways called synapses. The more of these connections, or synapses, you can develop between brain cells, the better your brain will perform.
And, if you can keep the connections you have, and constantly create new pathways, you’ll activate you mind and boost your brain performance no matter your age.
So, how do you it?
One way is to keep your mind challenged – keep it guessing – and create your own mental exercise program.
The Seattle Longitudinal Study of Adult Intelligence has followed more than 5,000 people since 1956, reporting on their cognitive abilities every seven years. The findings are remarkable.
Two-thirds of the people following any kind of mental exercise program showed significant improvement in brain performance. And 40 percent returned to pre-decline cognitive performance levels. What’s more, they maintained these benefits indefinitely.
Improving your brain’s abilities can be as simple as playing games. It’s true. Games aren’t just fun… many are just the kind of mental exercises that keep your brain young.
Take crossword puzzles, which are a favorite of mine. Even the simple ones get you thinking about people, places and things you may not ever think of, or even try to remember.
Other good mental exercises include word and math games.
The Internet and your local library are filled with articles, books and exercises that can help you use numbers, math, logic and puzzles so you can constantly create new synapses and keep your brain performance humming along.
One fun book you can buy at your local bookstore is called “Arithmetricks: 50 Easy Ways to Add, Subtract, Multiply, and Divide Without a Calculator” by Edward Julius. Another is “21 Games for The Mind that Won’t Shut Up!” by AT Lynne. There’s also “Mind Hacks: Tips & Tricks for Using Your Brain” by Tom Stafford and Matt Webb.
A couple of good places to start on the Web are:
SharpBrains
Brainist.com
NeuroMod online memory improvement test
MindTools
brain rules by John Medina
Mempowered
The Original Memory Gym
Boost Your Brain to a New Level
Your brain wants to be fed all the time. It has a huge appetite for energy so it can keep going even while you sleep. And if you don’t feed it the right way, you’re not going to keep creating new pathways in your brain so it can work faster and give you better focus.
You probably already know all about “brain food” like eggs, fish and blueberries. But we’re talking about improving your sharpness and clarity, not just maintaining it. And to use nutrition to take your brain’s performance to another level means you should do two things:
Boost your neurotransmitters – These are the chemicals your brain cells use to send and receive signals between neurons.
Fight free radicals with antioxidants – Free radicals are a product of oxidation. Oxidation is what I like to call “slow burn” of living. All the work your cells do and all the energy you produce throws off unstable molecules called free radicals that attack your healthy cells and drain them of energy and strength. In your brain, they cause many of the symptoms associated with aging, and even tissue damage.
Your body’s way of neutralizing free radicals is with antioxidants. The more antioxidants you give your brain, the better it will perform.
Fortunately, there are plenty of nutrients that can give your neurotransmitters a boost, and help you fight free-radical damage in your brain. And you can use them right now to feed your mind so it can stay focused, clear and perform better.
1. Acetyl L-carnitine (ALC) – ALC provides a range of brain protection, improving mood and memory. It protects the brain from damage due to poor circulation. ALC helps injured nerve cells to repair and function normally again. ALC also increases the release of the memory neurotransmitter, acetylcholine.
Researchers have found that ALC is so powerful that it protects brain cells from damage even when blood flow is temporarily blocked.2 ALC keeps the cell energy going even when there is little or no blood flow for short amounts of time.
I recommend 250 mg a day.
2. Choline – This is the major building block for acetylcholine, which lets your nerve cells fire along all those new pathways and through the synapses you’ve created in your brain.
You need it for all the basics like thought, memory and sleep. It even controls how you move. Your muscles receive commands from your brain via acetylcholine. That means your sense of balance and stability is controlled by this key transmitter.
You need at least 425 mg a day as a woman, 550 mg if you’re a man. The best sources from food are eggs, chicken and turkey liver and pork.
If you would like to supplement, there are several forms available. For a brain performance boost, you would have to take a high dose of the bitartrate or chloride forms, which can give you diarrhea. And the phosphatidyl form doesn’t give you much active choline.
That’s why my favorite form is choline citrate. You get a lot of active choline, and the only side effect is is a clean rush of energy for your brain.
3. DMAE – This is the natural, brain-stimulating nutrient found in some fish. Studies show it increases levels of acetylcholine. Degenerative brain conditions like Alzheimer’s and Parkinson’s are connected to the loss of brain cells that produce acetylcholine. DMAE replaces this chemical naturally and can ease symptoms.
DMAE can also temper mood and ease behavioral and learning problems. In one study, 50 hyperactive kids showed improvement in just 10 weeks.3 In another study, children with learning disabilities did better in concentration and skill tests with this nutrient.4 And there were no side effects like jumpiness, or an increase in heart rate and blood pressure like with drugs.
You need at least 35 mg per day. The best sources are wild-caught fish like salmon and small, oily fish like pilchards.
4. Vitamin B12 – This vitamin is crucial to brain function and the overall health of your nervous system because it’s the engine behind your body’s ability to make blood. That’s because B12 forms a protective layer around the nerve cells in your brain. Without that protective layer your brain can’t function properly.
In fact, a study, published in the prestigious journal Neurology, used M.R.I. scans to measure brain volume, and blood tests to record vitamin B12 levels. They divided the subjects into three groups, based on their level of the vitamin, and followed them for five years with annual scans and physical and mental examinations.
The group with the lowest levels of vitamin B12 lost twice as much brain volume as those with the highest levels.5 You should try to get at least 500 mcg per day.
5. Phosphatidylserine (PS) – This is vital to accurate brain functioning. It is highly concentrated in brain cells. Its job is to house neurotransmitters and regulate their release. As we age, we need more help from PS.
Neurology published a well-done study, which proves that PS supplementation can restore cognitive function. Researchers gave the subjects either a regimen of PS or a placebo for 12 weeks. Volunteers were between the ages of 50 and 75 with memory impairment due to age.
The PS subjects had an improvement in learning and recalling names. They were better at face recognition, remembering telephone numbers, remembering misplaced objects, and concentrating. Subjects began to improve in as little as 3 weeks.6
I recommend taking 100-200 mg of PS a day.
6. SAM-e – This nutrient is what’s called a “co-enzyme,” which means that it enables other chemical compounds to perform a number of essential functions. SAM-e is one of the main building blocks your brain needs to produce neurotransmitters.
SAM-e raises levels of another neurotransmitter called dopamine. Dopamine enhances learning, memory, motivation, and even helps with attention and sleep. It’s also the key to experiencing pleasure and maintaining an overall sense of well being and a good mood.
For over 20 years, SAM-e has been widely used in Europe to treat depression. And in 2002, The American Journal of Clinical Nutrition published a study that confirmed its efficacy. The study gave one group of people SAM-e and the other the antidepressant imipramine for 6 weeks. Both groups reported the same amount of improvement in mood. Better yet, the SAM-e group also reported significantly fewer side effects.7
You can get SAM-e at your local health-food store. I recommend you take 200 mg a day to start. If after two weeks you’re not seeing considerable improvement, increase to 400 mg.
7. Coenzyme Q10 (CoQ10). You may know that CoQ10 is your heart’s best friend because it gives the heart so much energy. But did you know that CoQ10 protects your brain at the same time? That’s because CoQ10 blocks the loss of dopamine, and is a powerful antioxidant for your brain.
Brain levels of CoQ10 start to decline in your 20s and are lowest in stroke victims and those with brain and nerve cell diseases, such as Parkinson’s and Huntington’s. So it makes sense that getting more CoQ10 could help increase your brain performance.
The best food source is red meat – but make sure that it’s grass-fed. Grass-fed beef contains more CoQ10 than any other meat on the planet. But it is still hard to get enough CoQ10 from your diet alone.
I recommend taking 50 mg of ubiquinol CoQ10 daily. The ubiquinol form is 8 times more powerful and stays in your bloodstream longer than conventional CoQ10.
8. Creatine – You may have heard that weightlifters use creatine because it builds muscle. But what we know now is that using creatine along with CoQ10 can give you a real brain boost.
An animal study published in the Journal of Neurochemistry shows that taking CoQ10 and creatine blocks the loss of dopamine in the brain (a hallmark of Parkinson’s disease), protects cell membranes (they leak with age), and reduces oxidative damage.8
Your body – primarily the liver – makes creatine naturally. You can also get it from foods like grass-fed beef, fish and apples. For every 2 lbs. of beef you eat, you will gain 5 grams of creatine.
The amount you should take is related to body weight and gender.
Source: The Colgan Institute, San Diego.

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1 Schaie, K. “The Seattle Longitudinal Studies of adult intelligence,” In M. Powell Lawton & Timothy A. Salthouse (eds) essential papers on the psychology of aging, Warner 1998; 263-271
2 Calvani, M. et al, “Attenuation by acetyl-l-carnitine of neurological damage and biochemical derangement following brain ischemia and reperfusion,” Int. J. Tissue React. 1992; 21(1): 1-6
3 Coleman, N., Dexheimer, P., Dintascio, A., et al, “Deanol in the treatment of hyperkinetic children,” Psychosomatics 1976; 17:68-72
4 Geller, S. J., “Comparison of a tranquilizer and a psychic energizer,” JAMA 1960; 174:89-92
5 Vogiatzoglou, et al, “Vitamin B12 status and rate of brain volume loss in community-dwelling elderly,” Neurology 2008; 71:826-832
6 Crook, T. et al, “Effects of phosphatidylserine in age-associated memory impairment,” Neurology May 1991; 41(5): 644-649
7 Delle, C, et al, “Efficacy and tolerability of oral and intrramuscular S-adenosyl-l-methionine …” Am. J. Clin. Nutr. Nov. 2002; 76(5): 1172S-1176S
8 Yang, L., et al, “Combination therapy with coenzyme Q10 and creatine produces additive neuroprotective effects in models of Parkinson’s and Huntington’s diseases,” J. Neurochem. June 2009;109(5):1427-39

Exercise

Whether you’re 9 or 90, abundant evidence shows exercise can enhance your health and well-being. But for many people, sedentary pastimes, such as watching TV, surfing the Internet, or playing computer and video games, have replaced more active pursuits.
Millions of Americans simply aren’t moving enough to meet the minimum threshold for good health — that is, burning at least 700 to 1,000 calories a week through physical pursuits. The benefits of exercise may sound too good to be true, but decades of solid science confirm that exercise improves health and can extend your life. Adding as little as half an hour of moderately intense physical activity to your day can help you avoid a host of serious ailments, including heart disease, diabetes, depression, and several types of cancer, particularly breast and colon cancers. Regular exercise can also help you sleep better, reduce stress, control your weight, brighten your mood, sharpen your mental functioning, and improve your sex life.
A well-rounded exercise program has four components: aerobic activity, strength training, flexibility training, and balance exercises. Each benefits your body in a different way.
Aerobic exercise is the centerpiece of any fitness program. Nearly all of the research regarding the disease-fighting benefits of exercise revolves around cardiovascular activity, which includes walking, jogging, swimming, and cycling. Experts recommend working out at moderate intensity when you perform aerobic exercise — brisk walking that quickens your breathing is one example. This level of activity is safe for almost everyone and provides the desired health benefits. Additional health benefits may flow from increased intensity.
Strength or resistance training, such as elastic-band workouts and the use of weight machines or free weights, is important for building muscle and protecting bone.
Bones lose calcium and weaken with age, but strength training can help slow or sometimes even reverse this trend. Not only can strength training make you look and feel better, but it can also result in better performance of everyday activities, such as climbing stairs and carrying bundles. Stronger muscles also mean better mobility and balance, and thus a lower risk of falling and injuring yourself. In addition, more lean body mass aids in weight control because each pound of muscle burns more calories than its equivalent in fat.
Stretching or flexibility training is the third prong of a balanced exercise program. Muscles tend to shorten and weaken with age. Shorter, stiffer muscle fibers make you vulnerable to injuries, back pain, and stress. But regularly performing exercises that isolate and stretch the elastic fibers surrounding your muscles and tendons can counteract this process. And stretching improves your posture and balance.
Balance tends to erode over time, and regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm-up portion of a workout. Many strength-training exercises also serve as balance exercises. Or balance-enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and Pilates.
In a nutshell, exercise can:
reduce your chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
lower your risk of developing hypertension and diabetes.
reduce your risk for colon cancer and some other forms of cancer.
improve your mood and mental functioning.
keep your bones strong and joints healthy.
help you maintain a healthy weight.
help you maintain your independence well into your later years.

Childhood obesity

Early introduction of solid foods is linked to a risk for early childhood obesity, according to the results of a prospective prebirth cohort study reported online February 7 in Pediatrics.
"Parental feeding practices during early infancy, such as the timing of solid food introduction, may be 1 key modifiable determinant of childhood obesity," write Susanna Y. Huh, MD, MPH, from the Division of Gastroenterology and Nutrition, Children's Hospital Boston in Boston, Massachusetts, and colleagues. "Data suggest that the introduction of solid foods earlier than 4 months of age is associated with increased body fat or weight in childhood or with greater weight gain during infancy, which itself predicts later adiposity. Other studies have found no association between the timing of solid food introduction and body fat or an association between delayed introduction of solid foods after 6 months and greater adiposity."

The goal of the study was to evaluate the association between timing of introduction of solid foods during infancy and obesity at age 3 years, defined as a body mass index for age and sex at the 95th percentile or above, using a cohort of 847 children enrolled in Project Viva. Timing of introduction of solid foods was categorized as younger than 4 months, ages 4 to 5 months, and 6 months or older. Logistic regression models were applied separately for infants who were breast-fed for at least 4 months ("breast-fed"; n = 568; 67%) and for infants who were never breast-fed or in whom breast-feeding was stopped before age 4 months ("formula-fed"; n = 279; 32%). These models were adjusted for child and maternal factors, including change in weight-for-age z score from 0 to 4 months as a marker of early infant growth.
Obesity was present in 75 children (9%) at age 3 years. The timing of solid food introduction was not associated with odds of obesity in breast-fed infants, (odds ratio, 1.1; 95% confidence interval [CI], 0.3 - 4.4). However, introducing formula-fed infants to solid foods before age 4 months was associated with a 6-fold increase in odds of obesity at age 3 years, which was not explained by rapid early growth (odds ratio after adjustment, 6.3; 95% CI, 2.3 - 6.9).
"Among infants who were never breastfed or those who stopped breastfeeding before the age of 4 months, the introduction of solids before the age of 4 months was associated with a sixfold increase in the odds of obesity at the age of 3 years," the study authors write.
Limitations of this study include possible residual confounding; some loss of the cohort to follow-up; limited generalizability to more socioeconomically disadvantaged populations; and small numbers in some cells, leading to possible chance results.
"Among infants breastfed for 4 months or longer, the timing of the introduction of solid foods was not associated with the odds of obesity," the study authors conclude. "Increased adherence to guidelines regarding the timing of solid food introduction may reduce the risk of obesity in childhood."

Cerebral Venous Thrombosis

The American Heart Association/American Stroke Association has unveiled its first scientific statement on cerebral venous thrombosis. The recommendations will help clinicians identify this uncommon cause of stroke that mostly affects young people.
"The diagnosis and management of cerebral venous thrombosis requires a high level of suspicion," told committee chair Gustavo Saposnik, MD, from the University of Toronto in Ontario, Canada. "The guidelines are intended to improve awareness and recognition."
The committee includes a multidisciplinary group of experts from the United States, Canada, Mexico, Portugal, and Argentina. The guidelines were published online February 3 in the journal Stroke. They have been endorsed by
• The American Academy of Neurology;
• The American Association of Neurological Surgeons;
• The Congress of Neurological Surgeons;
• The Ibero-American Stroke Society; and
• The Society of NeuroInterventional Surgery.
Cerebral venous thrombosis is caused by clots in the dural venous sinuses and accounts for 0.5% to 1% of all strokes. It disproportionally affects women who are pregnant or taking oral contraceptives and people 45 years and younger.
The incidence of cerebral venous thrombosis during pregnancy and post partum ranges from 1 in 2500 deliveries to 1 in 10,000 deliveries in Western countries, according to the guidelines. The greatest risk periods are during the third trimester and in the first 4 postpartum weeks. Up to 73% of cerebral venous thrombosis in women occurs during the time immediately after childbirth. However, the risk for complications during future pregnancies is low, report the guideline authors.
They recommend patients with suspected cerebral venous thrombosis undergo blood studies to see whether they have a prothrombotic factor, such as protein C or S, antithrombin deficiency, antiphospholipid syndrome, prothrombin G20210A mutation, and factor V Leiden.
"A predisposing condition to form clots or a direct cause is identified in about two-thirds of patients with cerebral venous thrombosis,” Dr. Saposnik said.
An estimated 30% to 40% of patients with cerebral venous thrombosis may develop an intracranial hemorrhage. "It’s important to distinguish a hemorrhage caused by rupture of a brain artery from those associated with cerebral venous thrombosis," he said. "The mechanisms — and treatment — of the bleeding are quite different."
The guidelines suggest that patients having a brain hemorrhage with an unclear cause undergo imaging of their cerebral veins.
Headache Most Common Symptom
According to the International Study on Cerebral Venous and Dural Sinuses Thrombosis, headache is the most common symptom and was recorded in about 90% of patients (Stroke. 2005;36:1720–1725).
"The usual appropriate acute treatment includes prevention of complications and anticoagulation therapy," Dr. Saposnik said. The guidelines emphasize that magnetic resonance imaging and magnetic resonance venography are the most sensitive and therefore recommended tests.
In the emergency department, computed tomography may be useful when magnetic resonance imaging is not readily available, Dr. Saposnik added.
For patients who develop a stroke, he emphasized the importance of care in an appropriate setting, such as a stroke unit, for the prevention and management of complications.
"Testing for prothrombotic conditions in the acute phase has limited value," he noted. "Thorough blood work should be completed later. And the duration of anticoagulation therapy should ultimately depend on the underlying etiology."
Dr. Saposnik said , there is limited evidence regarding endovascular treatment or thrombolysis in patients with cerebral venous thrombosis. "Based on that, the current guidelines recommend this approach only in patients with progressive neurological deterioration despite the best medical treatment."
"As with any guideline," Dr. Saposnik said, "the current one provides a general approach analyzing the available evidence. It doesn't address individual situations."

Headaches

Headaches are familiar to nearly everyone: in any given year, almost 90% of men and 95% of women have at least one. In the vast majority of cases, however, the pain isn’t an omen of some terrible disease.
About 95% of headaches are caused by such common conditions as stress, fatigue, lack of sleep, hunger, changes in estrogen level, weather changes, or caffeine withdrawal. The three most common types of headache are tension, sinus, and migraine (see table below).
Mixed headaches
As understanding of the different types of headaches has evolved, researchers have altered some of their beliefs about tension and migraine headaches and the relationship between the two. This is largely because of the realization that some headaches don’t neatly fit either category. “Mixed” headaches have characteristics of both types, and because they’re hard to classify, treatment can be challenging.
For instance, the more intense a tension headache gets, the more it resembles the sharp, throbbing pain of a migraine headache. Likewise, when a migraine headache becomes more frequent, its pain begins to feel like that of a tension headache. Thus, experts now believe that headaches fall along a continuum ordered by their characteristics: the occasional tension headache is at one end and the migraine headache is at the other. In between are chronic tension headache and chronic migraine, which are often lumped together as chronic daily headache.
This doesn’t mean that all headaches share the same mechanisms. Experts still generally believe that tension headaches are stimulated by muscle tightness, while migraine headaches are caused by the dilation and inflammation of blood vessels. However, if you have migraine headaches frequently, you may develop muscle tightness, which can trigger more headaches, creating a vicious cycle.
Headache caused by a medication or illness
Some headaches are actually symptoms of another health problem. Many non-life-threatening medical conditions, such as a head cold, the flu, or a sinus infection, can cause headache. Some less common but serious causes include bleeding, infection, or a tumor. A headache can also be the only warning signal of high blood pressure (hypertension). In addition, certain medications — such as nitroglycerin, prescribed for a heart condition, and estrogen, prescribed for menopausal symptoms — are notorious causes of headache.
Because the following symptoms could indicate a significant medical problem, seek medical care promptly if you experience:
• a sudden headache that feels like a blow to the head (with or without a stiff neck)
• headache with fever
• convulsions
• persistent headache following a blow to the head
• confusion or loss of consciousness
• headache along with pain in the eye or ear
• relentless headache when you were previously headache-free
• headache that interferes with routine activities.
Always take children who have recurring headaches to the doctor, especially when the pain occurs at night or is present when the child wakes in the morning.
Common types of headaches
Type What it feels like Who gets it How often and for how long
Tension Mild to moderate steady pain throughout the head, but commonly felt across the forehead or in the back of the head. Generally not accompanied by other symptoms. Can affect children, but is most common in adults. Frequency varies. Generally hours in length.
Sinus Mild to moderate steady pain that typically occurs in the face, at the bridge of the nose, or in the cheeks. May be accompanied by nasal congestion and postnasal drip. Affects people of all ages. People with allergies seem most vulnerable. Frequency varies. Generally hours in length. Often seasonal.
Migraine Moderate to severe throbbing pain, often accompanied by nausea and sensitivity to light and sound. The pain may be localized to the temple, eye, or back of the head, often on one side only. In migraine with aura, visual disturbance precedes the pain. Typically occurs from childhood to middle age. In children, migraine is slightly more common among males, but after puberty, it’s much more common in females. Attacks last a day or longer. They tend to occur less often

Νευροπαθητικός πόνος

συγγραφέας Δαλαμάγκα Μαρία

Ο νευροπαθητικός πόνος προκύπτει σαν αποτέλεσμα βλάβης ή νόσου στο σωματοαισθητικό σύστημα , επηρεάζει το 1.5 % του πληθυσμού και η διάγνωση και θεραπεία του είναι αρκετά δύσκολη.
Ο νευροπαθητικός πόνος μπορεί να ταξινομηθεί σύμφωνα με :
• Την υποκείμενη νόσο ( διαβητική νευροπάθεια , σκλήρυνση κατά πλάκας )
• Τη θέση της βλάβης ( περιφερική νευρική βλάβη , νωτιαίος μυελός )
• Και τον υποκείμενο μηχανισμό
Ο νευροπαθητικός πόνος μπορεί να σχετίζεται με :
Διαβητική νευροπάθεια
Μετεγχειρητικό χρόνιο πόνο
Κάκωση νωτιαίου μυελού
Νευραλγία τριδύμου
Σκλήρυνση κατά πλάκας
Πολυνευροπάθεια
Ακρωτηριασμό
Μεθερπητική νευραλγία
Μέλος φάντασμα
Αλκοολισμό
Χημειοθεραπεία του καρκίνου
Αγγειακό εγκεφαλικό επεισόδιο
Ισχιαλγία
Σημαντικός και επίμονος χρόνιος πόνος απαιτεί περαιτέρω έλεγχο. Κοινωνικοί και ψυχολογικοί παράγοντες θα πρέπει να αξιολογηθούν από τα πρώιμα στάδια. Η διάγνωση του νευροπαθητικού πόνου βασίζεται σε ακριβή ιστορικό και εξέταση . Τα διαγνωστικά εργαλεία βαθμολόγησης όπως το DN4 ή το LANSS μπορεί να φανούν χρήσιμα.
Χαρακτηριστικά του νευροπαθητικού πόνου :
• Αυτόματη έναρξη, ανεξάρτητη ερεθίσματος
• Συνεχής αίσθηση καύσου
• Διαπεραστικός πόνος
• Δυσαισθησία (παθολογική και δυσάρεστη αίσθηση)
• Παραισθησία
• Υπεραλγησία (αυξημένη απάντηση σε φυσιολογικά επώδυνα ερεθίσματα)
• Αλλοδυνία (πόνος από μη επώδυνα ερεθίσματα )
Κλινική αξιολόγηση του πόνου:
• Ιστορικό και έναρξη των συμπτωμάτων
• Εντόπιση , ποιότητα , ένταση και διάρκεια του πόνου
• Αξιολόγηση της επίδρασης του πόνου στις συνήθεις δραστηριότητες καθώς και τυχόν διαταραχές ύπνου
• Επίδραση του πόνου στη ψυχολογική σφαίρα του ασθενή
• Απάντηση ή μη σε προηγούμενες θεραπείες
Αρχικές επιλογές θεραπείας για το νευροπαθητικό πόνο:
Μη φαρμακολογικές θεραπείες:
• Διατήρηση της δραστηριότητας και της εργασιακής απασχόλησης
• Κινητοποίηση , άσκηση , TENS , Βελονισμός
Φαρμακολογικές θεραπείες
• Οπιοειδή , Αντικαταθλιπτικά , αντιεπιλεπτικά
Διάφορες θεραπείες
• Τοπικοί παράγοντες όπως Lidocaine 5%
• Οπιοειδή όταν οι άλλες θεραπείες αποτύχουν
Αναλγητικά όπως:
• Παρακεταμόλη , ήπια οπιοειδή (τραμαδόλη , κωδεϊνη) και Μη Στεροειδή Αντιφλεγμονώδη φάρμακα.
Επεμβατικές τεχνικές – Neuromodulation - Νευροδιαμόρφωση : Μια σειρά από θεραπείες που στόχο έχουν να αλλάξουν την αντίληψη του πόνου μετά από διέγερση ή αναστολή των νευρικών οδών.
Διέγερση νωτιαίου μυελού: σε ανθεκτικό νευροπαθητικό πόνο γίνεται εισαγωγή ενός ή δύο επισκληρίδιων ηλεκτροδίων , τα οποία στη συνέχεια συνδέονται σε ηλεκτρική πηγή , όπως για παράδειγμα αυτή του βηματοδότη.
Παλμική ραδιοσυχνότητα :Μια μεμονωμένη βελόνα εισάγεται στη περιοχή της νευρικής βλάβης. Η παραγόμενη θερμότητα δημιουργεί μια προσωρινή βλάβη του νευρικού ιστού.


References:
Attal N, Cruccu G, Haanpaa M, Hansson P, Jensen TS, Nurimikko T, Sampaio C,
Sindrup S, Wiffen P; EFNS Task Force (2006) EFNS Guidelines on pharmacological
treatment of neuropathic pain. European Journal of Neurology 13(11): 1153-69
Bennett M. (2001) The LANSS Pain Scale: the Leeds Assessment of Neuropathic
Symptoms and Signs. Pain 92(1-2): 147-157
Bennett M, Simpson K, Knaggs R, Lloyd S, Poole H, Taylor A, Kocan M, Johnson M,
Archard G, Baranidharan G; Neuropathic Pain Advisory Group (2006) Neuropathic
Pain Integrated Care Pathway Evidence Base. Prepared in association with and
supported by NAPP Pharmaceuticals Limited
Bennett MI, Smith BH, Torrance N, Lee AJ (2006) Can pain be more or less
neuropathic? Comparison of symptom assessment tools with ratings of certainty by
clinicians. Pain 123(3): 289-94
Bennett MI, Smith BH, Torrance N, Potter J (2005) The S-LANSS score for identifying pain of predominately neuropathic
Turk DC (2002) Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain. Clinical Journal of Pain 18 (6): 355-366
Turner JA, Jensen MP, Warms CA, Cardenas DD (2002) Catastrophizing is associated with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain after spinal cord injury. Pain 98 (1–2): 127-134
Van Tulder MW, Ostelo R, Vlaeyen JWS, Linton SJ, Morley SJ,
Assendelft WJ (2000) Behavioural treatment for chronic low back pain: A systematic
review within the framework of the Cochrane Back Review Group. Spine 25 (20): 2688- 2699
Watson CP, Moulin D, Watt-Watson J, Gordon A, Eisenhoffer J (2003) Controlledrelease oxycodone relieves neuropathic pain: a randomized controlled trial in painful diabetic neuropathy. Pain 105(1-2): 71–8
Watson PJ, Booker CK, Moores L, Main CJ (2004) Returning the chronically
unemployed with low back pain to employment. European Journal of Pain 8(4): 359-369
Williams AC de C, Richardson PH, Nicholas MK, Pither C, Harding VR, Ridout KL,
Ralphs JA, Richardson IH, Justins DM, Chamberlin JH (1996) Inpatient vs. outpatient
pain management: Results of a randomised controlled trial. Pain 66(1): 13-22
Williams AC de C, Nicholas MK, Richardson PH, Pither C, Fernandes J (1999)
Generalising from a controlled trial: The effects of patient preference versus
randomisation on the outcome of inpatient versus outpatient chronic pain management. Pain 83(1): 57-65