A Brief History of Pain

Posted on Posted in Continuing Education, Homestudy, Pain, Seminars, Webinars

first-aid-908591_640By Dr. Mary O’Brien, MD

Early humans explained the mystery of pain by associating it with evil, magic, and demons. Relief was the responsibility of sorcerers, shamans, priests, and priestesses, who treated their clients with herbs and rituals.

On stone tablets, ancient civilizations recorded accounts of pain and the treatments used, including pressure, heat, water, and sun. The Greeks and Romans were the first to advance a theory of sensation, the idea that the brain and nervous system were involved in the perception of pain. During the Middle Ages and into the Renaissance, evidence began to accumulate supporting these theories. Leonardo da Vinci and his contemporaries came to see the brain as the central organ responsible for sensation, with the spinal cord transmitting sensations to the brain.

In the 19th century, pain came to dwell under a new domain—science—which paved the way for advances in pain therapy. Physician-scientists discovered that opium, morphine, codeine, and cocaine could be used to treat pain. In the late 1800s, research led to the development of aspirin, to this day the most commonly-used pain reliever. Before long, anesthesia—both general and regional—was refined and applied during surgery.

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. There are two basic categories of pain, acute and chronic, and they differ greatly.

Acute pain usually results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly—for example, after trauma or surgery—and may be accompanied by anxiety or emotional distress. The cause of acute pain can generally be diagnosed and treated, and the pain is self-limiting—confined to a given period of time and severity. In some instances, it can become chronic.

Chronic pain is widely believed to represent a disease in and of itself. It persists over a longer period of time than acute pain and is resistant to most medical treatments. Chronic pain often persists longer than three months, or longer than expected for normal healing. It can be made much worse by environmental and psychological factors. It can—and often does—cause severe problems for patients, as pain signals keep firing in the nervous system for weeks, months, or years. There may have been an initial mishap such as a sprained back or serious infection, or there may be an ongoing cause of pain such as arthritis, cancer, or infection. However, some people suffer chronic pain in the absence of any past injury or evidence of illness.

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Estrogen and Cancer

Posted on Posted in Continuing Education, Homestudy, Seminars, Webinars

486321414_XSThe word “estrogen” actually refers to a family of related molecules that stimulate the development and maintenance of female characteristics and sexual reproduction. The most prevalent forms of human estrogen are estradiol and estrone. Both are produced and secreted by the ovaries although estrone is also made in the adrenal glands and other organs. Estriol is a third form of estrogen that is produced by the placenta and is only synthesized in significant amounts during pregnancy.

The breast and the uterus, which play central roles in sexual reproduction, are two of the main targets of estrogen. The estrogens normally promote healthy cell growth in the breast and uterus. Yet, this same propensity to stimulate cell proliferation can also increase the risk of developing breast or uterine cancer.

The apparent connection between breast cancer and estrogen has been noted for over a century, beginning with the publication of a paper in 1896 by Scottish physician George Beatson. The article, which appeared in the British medical journal, The Lancet, reviewed the case of a 34-year-old woman with advanced breast cancer who lived for four years after her ovaries were removed, a treatment now known as ovarian ablation.

Breast cancer risk increases with menstruation at an early age, late age at menopause, later age at first full-term pregnancy, and few or no pregnancies. Research suggests that the reason may be that these situations result in longer lifetime exposure to estrogen, which promotes cell division in breast tissue and possibly unregulated cell growth, leading to mutations.

BODY FAT & ESTROGEN

According to some studies, body fat and menopause appear to be important factors in the estrogen-cancer connection. Obesity has a complex relationship to breast-cancer risk that differs depending upon menopausal status. In one study published in the International Journal of Cancer, which included 176,886 European women between 18 and 80 years of age, researchers found a 65 percent increase in the risk of breast cancer for

After menopause, the adrenal glands continue to produce small amounts of a steroid called androstenedione, which is converted into estrogens by aromatase in fat tissue. Increased levels of this steroid may be the reason why menopause and obesity are associated with higher estrogen levels and increased risk of breast cancer. It is also believed that excess fat may cause the body to produce more estrogen than is necessary for normal cell growth.

In addition, fat cells secrete the pro-inflammatory chemicals, TNF-alpha and IL-6, either of which can act to increase the production of aromatase, which is directly related to increases in estrogen. Obesity is also associated with greater tumor burden in women diagnosed with breast cancer, higher-grade tumors, and poorer prognosis and/or increased mortality. Weight gain and obesity have been identified as the most important risk and prognostic factors for breast cancer in postmenopausal women. Moreover, the association between obesity and cancer has also been established for colorectal and prostate cancer.

Breast-cancer

Breast Cancer

Posted on Posted in Continuing Education, Homestudy, Webinars

breast_cancer_000014453948Over 60 studies have been published that have examined the relationship between physical activity and breast-cancer risk. Although the majority of studies indicate that physically-active women have a lower risk of developing breast cancer than inactive women, the amount of risk reduction varies widely (from 20 percent to 80 percent). Most evidence suggests that physical activity reduces breast-cancer risk in both premenopausal and postmenopausal women. Women who increase their physical activity after menopause may also experience a reduced risk compared with inactive women.

High levels of moderate to vigorous physical activity during adolescence may be especially protective. For example, a recent prospective study of the activity levels of adolescent girls in relation to their subsequent risk of benign breast disease (a risk factor for later development of breast cancer) found that adolescent girls who — as young women — walked the most were at the lowest risk. The association between adolescent physical activity and breast cancer risk was also examined among women enrolled in the Nurses’ Health Study II. An inverse association was observed between physical activity at ages 14–22 and premenopausal — but not postmenopausal — breast cancer. The association was strongest for women

Awareness may have played a role in the findings of the association between diet intake and breast cancer among Polish women who were ranked according to their level of regular physical activity. The results suggested that a higher intake of vegetables and fruits may be associated with a decreased risk of breast cancer among women who were ranked in either the lowest or highest quartiles of lifetime physical activity. In addition, there was a positive association for sweets and dessert intake among women in the lowest quartile of PA. These findings could be interpreted to suggest that a high intake of antioxidant-rich foods could confer protection in the presence of either a sedentary or extremely active lifestyle. Furthermore, the high intake of sweets in those ranked as least active could be associated with a higher risk for breast cancer.  One additional study found that physical activity performed either before or after cancer diagnosis was related to reduced mortality risk for both breast and colorectal cancer survivors.

Breast-cancer

Animal Companionship

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

girl-1561943_640By Barbara Sternberg, Ph.D

Our pets occupy a special place in our lives and our hearts partly because they love us no matter who we are. Successful or not, rich or poor, young or old, our pets not only don’t care, but remain constant as our own human fortunes ebb and flow.

We see this constancy in the way our pets greet us after we return from an absence. A pet’s greeting is always exuberant, as if they are welcoming home a long-lost, beloved family member. The pet makes no demands on us (other than to return its greeting and maybe get scratched) and harbors no ill feelings over having been left behind. This happy homecoming replenishes us and helps us feel that life is safe, that everything is as we left it, and that we have not changed.

When humans face serious trials—illness, loss of a job, the disabilities of aging— affection from a pet becomes even more important. The pet’s continued affection shows us that the essence of the person has remained unchanged. For this reason, pets can be of enormous value in the treatment of depressed or chronically ill individuals, as well as the institutionalized elderly.

Playing with a pet—a game of catch, or friendly roughhousing, has a kind of constancy to it because pet play does not involve true competition. Even a game of tug-of-war is played in fun — for the pleasure of both participants. Typical pet games, once learned, stay constant, just as the animal does. Playing games with our pets is reassuring and provides a break from life’s burdens. One of the great pleasures of pets—whether we are playing with them or just watching them—is their appeal and their ability to make us smile and laugh. Laughter is therapeutic, and our pets are able to induce it with great regularity.

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