Filed under: Practices
Message from Hermann Keppler – Principal, CNM
The RLHH has been part of the Health Service for 150 years. It provides 40,000 homeopathic appointments per year for patients who would otherwise have no access to homeopathic treatment. In 2005, 67% of GPs and 85% of practices in it’s Primary Care Trust, referred patients to the hospital. The hospital provides effective and most importantly, COST-EFFECTIVE treatments.
We ask for an investigation into why the PCTs in Brent, Hammersmith and Fulham, Harrow, Hillingdon, Islington and Kensington and Chelsea have cancelled their contracts with the hospital or plan to cancel them this year. It is our concern that these cancelled contracts and directives from PCTs to stop referrals to the RLHH, must result in a perceived lowered patient demand, and that this self-fulfilling prophecy will then be used as the rationale for the hospital’s closure. Furthermore we assert these cancellations make no sense whatsoever if cost-effectiveness is a yardstick by which treatments are to be measured.
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Abstinence Restores the Alcoholic Brain
New evidence correlates short-term recovery of brain structure, metabolism, and function in abstinent alcoholics.
Bartsch and colleagues used automated structural brain imaging, proton MR spectroscopy, and neuropsychological testing to assess whether abstinence in alcoholics leads to brain repair. Within a few days after alcohol withdrawal and 6 to 7 weeks later, they evaluated 15 patients with DSM-IV defined primary alcohol dependence. A group of 10 normal subjects served as controls. Notably, the alcoholics did not smoke heavily, and none required medication to treat symptoms of alcohol withdrawal.
From the first to the second evaluation, alcoholics exhibited a nearly 2% increase in total brain volume (compared with no change among controls), with region-specific increases in the superior cerebellar vermis, the perimesencephalic and periventricular regions, and the frontomesial and fronto-orbital edges. Increased brain volume correlated significantly with increases in cerebellar and frontomesial levels of choline, but not with N-acetylaspartate (NAA) levels. In contrast, improved performance on a test of attention was significantly associated with increases in frontomesial NAA levels. Measures of brain water levels did not change over time.
Comment: Although longitudinal studies have demonstrated short-term recovery of brain structure, metabolism, and function in abstinent alcoholics, this is the first to combine all three measures. The metabolic data suggest that increases in brain volume were due to white matter repair rather than to increases in brain hydration. The patient population may have had a less severe form of alcoholism than is typical, because detoxification was not associated with significant symptoms of withdrawal and metabolic measures did not differ at baseline from those in the control population. This study adds to a growing body of evidence that the brain undergoes significant repair during abstinence, particularly in less severe forms of alcoholism. It is noteworthy that volume increases were observed in several brain areas that are selectively affected in Wernicke encephalopathy, a disorder of thiamine deficiency that occurs most commonly in alcoholics. Hence, it remains possible that improved nutrition as well as sobriety contributes to brain repair following abstinence.
Michael E. Charness, MD
Dr. Charness is Professor of Neurology, Harvard Medical School; Associate Chief, Department of Neurology, Brigham and Women’s Hospital; and Chief of Staff, Veterans Affairs Boston Healthcare System.
Published in Journal Watch Neurology March 20, 2007
Citation(s):
Bartsch AJ et al. Manifestations of early brain recovery associated with abstinence from alcoholism. Brain 2007 Jan; 130:36-47.
- [Original article] (Subscription may be required)
- [Medline abstract] (Free)
Outer layer: Peritoneum
= largest serous membrane of the body
(torso, map)
= Closed sac containing serous fluid
(serous fluid = watery fluid)
Supplied with many blood and lymph vessels
Barrier to local spread of infection
parietal layer: lines a cavity
visceral layer: surrounds organs
The organs are invaginated into the closed sac being at least partly covered
Greater ormentum
= fold enclosing the stomach.
It hangs in front like an apron
It stores fat
Middle layer: Muscle layer
Smooth, involuntary muscles
2 layers:
Circular muscle layer
Longitudinal muscle layer
In between:
Blood vessels, lymph vessels, a plexus
Myenteric or Auerbach’s plexus
= Network of sympathetic and
parasympathetic nerves
Movement
Contraction and relaxation in waves
= peristalsis
Moves food forward and mixes the food
Sphincters control movement
Sphincters
= increased numbers of circular muscle fibres
Act also as valves to prevent reflux
Connective tissue containing blood vessels, lymph vessels and nerves
mucous membrane
lamina propria
muscularis mucosa
Mucous membrane
In the intestinal tract: Columnar epithelial cells with mucus secreting goblet cells
Mucus lubricates and protects from digestive juices
Lamia propria
= Conncetive tissue with lymph tissue
Blood supply
The digestive organs are supplied form branches of the aorta.
Venous drainage
The portal vein drains the blood from the lower part of the oesophagus, the stomach, pancreas, small intestine, large intestine and part of the rectum.
Blood from the lower part of the rectum and the anal canal drains directly into the
iliac veins
Ingestion: Oral uptake of substances into the body.
Digestion: Mechanical and chemical conversion of food
into absorbable substances
Absorption: Substances passing through the walls in
the alimentary canal into the blood and
lymph stream.
Assimilation: Incorporation of nutritive material
into living tissue
Egestion (=elimination): Discharge of not absorbed
substances
The alimentary tract
Mouth
pharynx
oesophagus
stomach
small intestine
large intestine
rectum
anal canal
The digestive system
alimentary tract
accessory organs
digestive process
Accessory organs
3 pairs of salivary glands
pancreas
liver
biliary tract
Filed under: Assignments, Causes of disease, Digestion, Pathologies, Symptoms of disease, The Digestive System
Click here for a pdf of my study into Peptic Ulcers for my Semester I Assignment, March 2007.
