Feb 29, 2012

Post-polio syndrome (PPS) Neural fatigue

The precise mechanism that causes post-polio syndrome is unknown. It shares many features in common with myalgic encephalomyelitis, a form of chronic fatigue syndrome that is apparently caused by viral infections, but unlike those disorders it tends to be progressive, and can cause tangible loss of muscle strength.Treatment is primarily limited to adequate rest, conservation of available energy, and to supportive measures, such as leg braces and energy-saving devices such as powered wheelchairs, plus pain relievers, sleep aids, etc.

Neural fatigue

The most widely accepted theory is the "neural fatigue" one. Motor neuron fibers were originally damaged by the polio virus and were subsequently over-stressed because too few surviving neurons activated too many muscles. Eventually these neurons become fatigued and die, leading to the slowly advancing loss of muscle function that is typical of post-polio. This scenario may be accelerated by the fall-off in production of nerve growth factor (NGF) that occurs with menopause/andropause.

Mitochondrial disruption

This theory assumes that the major symptoms of PPS are a result of some interference with the action of mitochondria in the muscles and possibly the nerves. Failure of the mitochondria to produce sufficient energy would result in the muscle pain typical of PPS, and would, over time, cause muscle death (rhabdomyolysis) due to exerting the muscle beyond its ability to recover. The cause of this interference with mitochondrial action is presumably a change in the body's hormone balance, as mediated by the hypothalamus and other lower brain areas that control hormones (and which were, presumably, damaged by the original polio virus infection). As with the neural fatigue theory, menopause/andropause accelerates the process, though this time by most likely disrupting the NOTCH pathway that controls cell differentiation and damage repair. One significant argument in favor of the mitochondrial disruption theory is that it explains the fatigue and cognitive difficulties ("brain fog") symptoms that usually accompany post-polio better than the neural fatigue theory does.

Reticular activating system damage

Damage to the reticular activating system and related areas such as the thalamus can also produce most of the fatigue, "brain fog", and dysautonomia symptoms of post-polio, and may be able to cause hormonal changes that result in progressive muscle weakness. Post-mortem examinations of polio patients have shown damage to these areas, and some PPS patients show lesions in these areas when examined by MRI. Many authorities believe that these areas are damaged by the initial polio infection, either as a direct result of the polio virus, or due to an autoimmune reaction following the polio infection. One problem with this theory, though, is that it doesn't easily explain the delayed onset of PPS. It may be that this theory needs to be combined with one of the others to explain delayed onset.

Mechanical overwork

The stresses placed on nerves, muscles, and joints in a polio survivor are in many cases several times those experienced by other people. Problems with gait, in particular, can greatly over-stress joints and the surviving muscles, and the polio survivor is also likely to compensate for weakened arms by jerking more when lifting/pulling something. Over time (and again with menopause/andropause), this results in fatigue and damage 


Treatment for post-polio is primarily palliative, as very few reliable therapies to reverse symptoms are known.
Very often fatigue is the most disabling symptom of PPS, and many of those with the disease have discovered that by carefully managing energy expenditure they can prevent or reduce the worst fatigue episodes. Further, for many this "energy management" approach appears to reduce pain. Though most authorities agree that rest is an important component of post-polio treatment, there is significant disagreement as to how much rest is necessary. Some hold that the best approach is to expend the absolute minimum amount of energy necessary to enjoy a reasonable lifestyle, while others feel that there is some threshold below which energy conservation is not helpful and may in fact be harmful (due to the general effects caused by lack of exercise).
Leg braces and other orthotics can reduce the stress on joints and, in some cases, muscles, and so may slow the progression of joint and muscle damage related to PPS. However, some authorities feel that many PPS patients rely on such items too much and for too long when they should be graduating to a wheelchair. Wheelchairs (particularly powered wheelchairs) and "scooters" (small battery-powered vehicles) are useful both to conserve energy and to reduce the stress on weakened joints and muscles. Non-powered wheelchairs, however, are not generally recommended since they place too much stress on arm muscles and joints and may take too much energy to operate. In some cases even the scooters are not recommended since operating the "tiller" of the typical scooter can be tiring to arm muscles. A standing frame can be used in conjunction with the wheelchair to provide alternative positioning and prevent secondary complications. http://www.livingwithcerebralpalsy.com
México a la vanguardia en el Síndrome de Post Polio

Feb 26, 2012

The World Health Organisation (WHO) on Saturday said the alleged fake immunisation conducted by Dr Shakil Afridi had nothing to do with polio campaigns as DNA cannot be collected orally.

WHO rejects polio rumours

Pakistan’s polio campaign came under immense pressure when people in Khyber Pakhtunkhwa and other parts of the country refused to administer drops to their children after reports that Dr Afridi had managed a fake polio campaign for taking DNA of Osama Bin Laden in Abbottabad.
In an interview with Dawn, WHO’s special envoy on global polio eradication and primary healthcare, Dr Hussain A. Gezari said:
“This person (Dr Afridi) was not supported either by the government of Pakistan or any international donor agency for any immunisation campaign, and secondly, we don’t collect blood samples during vaccination campaigns.”
Dr Afridi is currently under the custody of intelligence agencies and has been booked by the government on the charge of treason.
Setting aside rumours linked with efficacy of the vaccination in some section of the media, Dr Gezari said: “The vaccine being
used to eradicate polio globally is verified, cleared and checked for quality by WHO and has nothing to do with any type of transmission of disease to any child. No one has ever died or can die of the vaccine. The polio vaccine is sent to any country only for a short period of time and there is no chance for it to expire.
“This is nonsense if someone says that the vaccine will cause death and such people should not be taken seriously,” he insisted.
Read More  http://www.dawn.com/2012/02/26/who-rejects-polio-rumours.html

Feb 24, 2012

Protecting every girl—and boy

Protecting  every  girl—and  boy


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“Herd immunity” is a theory in immunology that holds that an entire population doesn’t need to get vaccinated against an infectious disease because once a significant portion of that population is vaccinated, even the un-vaccinated will be protected. As more and more people are vaccinated against an infectious disease such as polio, say, or measles, the chances of new infections among even the unprotected begin to fall.
Of course, the ideal is universal vaccination (who wants to take chances, right?). But as theorists of herd immunity propose, “in contagious diseases that are transmitted from individual to individual, chains of infection are likely to be disrupted when large numbers of a population are immune or less susceptible to disease” since there is less probability that an individual would come into contact with an infectious individual.
Herd immunity is one reason medical authorities now propose giving the anti-HPV vaccines to men and boys apart from women and girls. The HPV or human papillomavirus has been identified as causing over 80 percent of all cases of cervical cancer, a disease that afflicts only women. But as Dr. Ricardo Manalastas of UP-PGH pointed out in a talk at a recent Scientific Meeting of
AOGIN-Philippines, HPV, which Manalastas described as “ubiquitous” or common in humans, (it is also responsible for genital warts) has been implicated in other forms of cancer as well: penile and anal cancer and oral and oropharyngeal (mouth and throat) cancer among men; and vulvar and genital cancers among women.
But even if one were concerned only with cervical cancer, Manalastas points out that if men and boys were likewise vaccinated against HPV, then the chances of a woman being infected with HPV and risking cervical cancer (HPV is sexually transmitted) would fall as well. Vaccinated males would also in turn protect MSMs or men having sex with men, a side benefit.
The good news is that HPV vaccination for men and boys has already been approved by the local Food and Drug Administration. There are currently two types of HPV vaccines: the bivalent, which protects against infection by the two most common cancer-causing types of HPV; and the quadrivalent, which protects not just against the two most common cancer-causing types, but also the two most common types that cause genital warts.
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