Newpharmablog. Health News

Changes in blood pressure are orchestrated by the nervous system. Baroreceptors, specialized receptors in the aorta and arteries of the neck and thorax, send messages to the brain when modifications in blood pressure need to be made. This in turn signals changes in the rate and force of the contractions of the heart and in the diameter of the blood vessels. The vasomotor center located in the brain stem, the oldest area of your brain and the part that is responsible for the most basic needs of life, controls blood pressure. But other centers in the brain play a role as well, particularly when stress is involved.You probably know from personal experience that your blood pressure rises during periods of stress. When you are scared or anxious or feel threatened in any way, your body automatically kicks into what is called the stress response. The stress response is a natural survival tool and a carryover from the days when most of the threats humans faced were physical. Meeting up with a hostile, club-wielding tribe or a saber-tooth tiger required a “fight-or-flight” response, and our bodies immediately readied for action. Although few of our modern stressors – traffic jams, deadlines, disagreements with coworkers or family members, and the like – can be solved by running away or duking it out our bodies nevertheless respond in the same manner.During the stress response an area of the brain called the hypothalamus signals the pituitary gland to release a hormone that activates the adrenal glands. The adrenal churns out the stress hormones epinephrine (also called adrenaline) and norepinephrine (or noradrenaline). These chemical messengers stimulate beta and alpha receptors in the heart and blood vessels. Your heart rate becomes faster and more intense, and blood vessels constrict to direct blood to your muscles, so you’ll be able to run faster and fight harder. Digestion slows down as blood is transported away from the stomach, and you receive an extra burst of blood sugar for additional energy. Your brain and senses are alert and responsive. This is an automatic response, carried out by the autonomic nervous system, which manages your body’s involuntary functions. But it also temporarily raises blood pressure by increasing cardiac output and resistance on the blood vessels. So you can see how repeated stress contributes to consistently elevated blood pressure. Chronic stress is very damaging to systems throughout your body. Over time, it depletes your body of magnesium, potassium, and other essential nutrients, which further contributes to hypertension. *15/313/5*

In this surgery, an opening is made in the trachea to permit the insertion of a breathing tube which bypasses the obstructed segment of the airway. This approach is considered the “gold standard” against which the effectiveness of other treatments is often measured, especially in cases complicated by life-threatening arrhythmias (irregular heart rhythms). Again, however, there are disadvantages. The tracheostomy tube is permanent; it must be carefully cleaned and maintained, posing hygiene problems. Patients often feel a sense of disapproval from society, including friends, relatives, and co-workers who are uncomfortable in the presence of such a device. Obese patients—a significant proportion of apneics—may experience some mechanical difficulty, especially if their necks are particularly fleshy or layered. The recent trend in medicine is to reserve tracheostomy for only the most serious cases; otherwise, it is often difficult to justify its use.*147\226\8*

Such person feels that he must see himself as a star performer in his sexual life. To start wife hesitates but later on may develop interest. Seeing excited and responding woman in mirror gives a pleasure to husband.Are ears of female erotic in nature?Most of men are ignorant that ear lobule is highly erotic zone which when sucked, tickled, kissed or gently bitten makes them breathless with desire. Male can discover the erogenous zones by employing different types4>f touch on his partner end noting her facial expressions.How do you rate exciting areas of genitals of male and female?Sensitivity is determined by nerve distribution in genital area. In females clitoris is the most sensitive-area followed by labia minora, labia majora. In male most sensitive is frenulum where the glans meets the shaft followed by glans, shaft and finally the testicles. Perianal area is sensitive in both sexes.in what way touch to touch differs in exciting a partner?Type of touch expresses the mood. Caressing is affectionately reassuring rather than overtly exploratory. People who employ pinching during sex are trying to assure themselves. When a person scratches an attempt is being made to peel away the coverings and literally get under the skirl. Sense of touch breaks up rigidity of body, facilitates intimacy and overcomes sexual difficulties.Does sense of smell play any part in human sexuality?Yes, but it plays greater part in animals. Poet has compared females breath smelling of honey, her saliva of sugar almonds, her neck of chestnut leaves, and her hair of jasmine.The odor of female genitals is not very pungent except during menstruation or during prolonged intercourse. Now a days in market many types of deodorants are available to supress the body odour. Musk, the long lasting and strongest perfume, has been considered erotic in certain cultures.*100\301\2*

Historically, atherosclerosis has been referred to as a general term for thickening and hardening of the arteries, a condition that underlies many of the ischemic heart diseases. Atherosclerosis is actually a type of arteriosclerosis and is characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin (a clotting material in the blood) in the inner lining of the artery. The resulting buildup is referred to as plaque. Often, atherosclerosis is referred to as a coronary artery disease (CAD) because of the resultant damage done to coronary arteries.Atherosclerotic plaque tends to occur primarily in large and medium-size elastic and muscular arteries and can lead to ischemia (decrease in blood flow or blockage of blood flow) of the heart, brain, or extremities. Plaque may be present throughout a person’s lifetime, with the earliest formation, known as a “fatty streak,” being fairly common in infants and young children.
Early TheoriesInitially, it was thought that plaque developed in “response to injury” and tended to collect at sites of injury. Many scientists believed that the process of plaque buildup begins because the protective inner lining of the artery (endothelium) became damaged, and fats, cholesterol, and other substances in the blood tend to aggregate in these damaged areas. High blood pressure surges, elevated cholesterol and triglyceride levels in the blood, and cigarette smoking were the main suspects in having caused this injury to artery walls. As a result of national campaigns aimed at reducing dietary fats, millions of people report cutting down on animal fat and dairy products. However, despite massive lifestyle changes and the use of cholesterol-lowering drugs, cardiovascular diseases continue to be the leading cause of death in the United States, Europe, and most of Asia.
Inflammatory RisksToday, scientists are beginning to view the formation of atherosclerotic lesions in a whole new way, with a vastly expanded list of possible causes. Many experts believe that atherosclerosis is an inflammatory disease, with numerous factors contributing to plaque formation. Among these culprits are elevated and modified low-density lipoprotein, free radicals caused by cigarette smoking, hypertension, diabetes mellitus, and certain infectious microorganisms, such as herpes viruses or Chlamydia pneumoniae, and a combination of these and other factors. The bottom line is that while elevated cholesterol continues to be important in approximately 50 percent of patients with cardiovascular diseases, other factors need to be taken into consideration, particularly those that cause inflammation and subsequent injury within the artery walls.
Syndrome XJust as high-fat diets, certain infectious diseases that cause inflammation, and other factors are under scrutiny for their role in the development of CVD, yet another theory is capturing national attention. According to Gerald Reaven, endocrinologist and doctor at Stanford University, when people consume too many calories, particularly carbohydrates, their bodies eventually become insulin resistant, meaning that their cells resist, or don’t work properly in, handling blood glucose levels. Consequently, insulin and blood sugar levels remain high over time. *5/277/5*

This is another example of a painful condition which is epidemic in its increase and yet appears to be without cause. It occurs particularly in office workers who use typewriter keyboards or computer mice. It has not suddenly appeared but used to be given names, such as writers’ cramp and tennis elbow. It appears first as a tingling or numbness in the fingers. As it develops, it becomes so painful that the hand cannot be used and long rests are needed before it dies down. The pain may spread up the arm and invade the shoulder and neck. Pain and tenderness may persist after very long periods of rest. The victim becomes unable to work. The standard medical examination reveals no cause.There is a very similar disease called carpal tunnel syndrome which has almost identical symptoms. However, in this case a test to measure the ability of nerves to conduct from the hand to the arm shows that they are conducting slowly and nerve entrapment is suspected. The two major nerves to the hand could become trapped where they pass under a band of fibrous tissue on the front of the wrist. This band of tissue holds the nerves, tendons and blood vessels close to the bones of the wrist, and is called the carpal tunnel. It is believed that, with heavy continuous use, the band swell and straps the nerves. A simple operation cuts the band and liberates the nerves from the pressure on them, sometimes completely curing the condition.Repetitive strain injury (RSI) not only has no obvious signs of damage but seems to occur in outbreaks in particular workplaces. This tended to make industrial doctors, employers and insurance companies suspicious that they were dealing with some form of mass hysteria of the type we have described for low back pain. Attempts to solve the problem were made by calling in ergonomic specialists who adjusted the tilt of the keyboards, put backs on the chairs, tilted the seats and changed the lighting. Although temporary effects were achieved, the workforce returned to their old problems. In two large telephone companies in the United States, one had serious problems but the other had few complaints, despite the fact that the equipment and tasks were identical. This observation exaggerated the belief that the disease was in the mind rather than the body. The belief was further supported when a difference was noted between the two companies. The one with problems paid workers on commission for each call answered, while in the other the workers were on a weekly wage.The growing belief that it was ‘all in the head’ received a further boost when a large publishing company recognized that, unlike the so-called workshy, movement-intolerant workers of Boeing complaining of back pain, the workers who complained of RSI tended to be eager-beaver ambitious types, while their more happy-go-lucky, slobbish workmates had fewer complaints. All of this had led to angry confrontations in many countries between workers with the condition and compensation agencies who refused to recognize this as a ‘real’ disease because they believed it had no organic cause.Very recently, workers with RSI have been examined in London using an unusual but simple neurological test. The palm was tested for the ability to detect a carefully controlled vibration. To the great surprise of doctors and scientists, the ability of the RSI patients to detect vibration was greatly reduced on the palm of the hand but was completely normal on the back of the hand. Furthermore, when they tested workers from the same company with the same job who were not complaining of RSI, they found that many of them were beginning to lose their ability to detect vibration. These tests immediately put an entirely new interpretation on the disorder because they provide evidence for a subtle disorder of the peripheral nerves in the hands and arms or in the brain cells that detect vibration. If some of these nerve fibres or cells are not functioning properly, the disorder is reclassified as one of nerve damage rather than as a psycho-social disorder. It is well known that in some cases of overt single-nerve damage, the pain spreads far beyond the territory of the damaged nerve. This means that the widespread of pain on the body of these RSI patients joins a well-known category of pain, rather than being a bizarre distribution that had previously made unfriendly doctors suspicious that RSI was simply a form of hysteria.We are left with a question: if RSI is now to be awarded the honour of having a ‘real’ cause rather than a self-inflicted psycho-social cause, why has it become more common? It could be that, in the past, complainers were simply dismissed, particularly as the majority were women, but women have now learned to fight. The numbers of people who regularly type as part of their job has greatly increased with the appearance of computers and with the near disappearance of the specialist typist. And there has been a subtle change with computer keyboards. The carriage return of the old-fashioned typewriter, which gave the typist a brief rest at the end of every line, has disappeared. The use of the mouse forces the worker into very fast, detailed movements and puts them almost into the category of violinists. Musicians have been famously plagued with painful cramps similar to RSI. Finally, forced pace and the additional task of making running corrections may have increased the mechanical strain of muscles and nerves.There are important consequences of the transition of RSI to a disease with a cause other than the psychological inadequacy of the victim.*48\219\2*

Many of the carbohydrate addicts with whom we have worked have told us that their inability to stay on their diets grows worse over time. Their desire to cheat seems to grow. At first, they can manage to ignore their urge for forbidden foods. Gradually it becomes a deeper craving. Eventually, their desire becomes uncontrollable.At the Carbohydrate Addict’s Center, we have developed detailed descriptions of what appear to be definable Levels of Addiction. Many dieters regard their failure to stay on a diet as a kind of haphazard eating free-for-all; they think that they are eating anything in sight. But we have found that the carbohydrate addict does not elect to cheat at random. While the carbohydrate addict may believe that he or she is eating more or less by chance (“Who could have known the boss would bring donuts in this morning?”), chance has very little to do with it.In fact, there is usually a clear pattern to their selection of foods. We have discerned that pattern, and we can pretty much predict the sequence of food cravings. The sequences of predictable eating make up the Levels of Addiction. We have found that we can usually predict with a high degree of accuracy what kinds of foods carbohydrate addicts are likely to eat at any given stage in the addictive process.The carbohydrate addict’s eating is almost always progressive. While the desire to cheat at times seems to disappear, it is never truly gone. Even if the addictive process seems to vanish for extended periods of time, it will always return. The carbohydrate addict’s movement through the Levels of Addiction is marked by strong and increasing urges to eat.Let’s take a look at the three Levels of Addiction.Addiction Level 1At this level, the addict’s desire for carbohydrates is partly hidden by his or her desire for food of all kinds. The carbohydrate addict seems to feel satisfied by eating what he or she has been taught is a good, balanced diet.The carbohydrate addict rationalizes that vegetables, whole-grain breads, potatoes, and meat, fish, or chicken are healthful foods. When dieting, the Level 1 carbohydrate addict gives in to the desire to eat by consuming great quantities of foods of all kinds without feeling that anything has been lost. “These foods aren’t really that fattening” is a common rationale. In the later stages of this level, there may be a desire for fruit as a regular snack. Fruit juices may also be the beverage of choice.Carbohydrate addicts at Level 1 tend to think that they simply love to eat. For a time they may think that they are in control of their eating.For the carbohydrate addict, this sense of control is only an illusion. Level 1 is only rarely recognized for what it is—the first stage of a progressive disorder. “There’s no harm in eating a lot of good food,” they tell themselves. But soon the drive to eat progresses and the carbohydrate addicts’ weights will often rise as well.
Addiction Level 2The kinds of foods that the carbohydrate addict eats begin to change at Level 2. Although a wide range of foods is still eaten at this level, the desire for vegetables, protein, and fruit soon begins to fade. In its place, starches such as bread, bagels, pasta, rice, and potatoes begin to seem very important and highly satisfying. Snack foods, such as potato chips, popcorn, and pretzels, become more attractive.Part of the appeal of starchy and snack foods at Level 2 is that, when they are eaten, they deliver an initial sense of physical satisfaction, a sense of relaxation. Unfortunately, this sense of satisfaction is temporary, and within a few days the same starches and snack foods begin to produce a new and greater urge to eat more of them. At the same time, satisfaction seems to decrease.Some people have reported a desire for beer or wine at this level, though many do not. Level 2 is often marked by the experience of recurring tiredness, especially after meals or in the middle of the afternoon.When carbohydrate addicts first reach Level 2, they often deny their own fear (“I’m not out of control”). Gradually the dieter becomes increasingly concerned with issues of eating, weight, and weight loss. The false confidence of Level 1 begins to fade, and more concern is focused on progress (or rather, the lack of progress) in the weight-loss program.Gradually, the carbohydrate addict realizes he or she is only rationalizing and is in fact no longer in control.Addiction Level 3While cravings for starches and snack foods (e.g., bread products, pasta, rice, potatoes and potato chips, pretzels, and popcorn) continue at Level 3, the drive for sweets can become very strong. At this level, snack foods and desserts are preferred.With the consumption of cakes or cookies or chocolate, the earlier desire for vegetables and even fish, meat, or fowl as well as fruits decreases or even disappears. Most meat or other protein is consumed with bread as a sandwich.Meals seem incomplete without a sweet dessert. Although sweets provide an initial surge of relief, they soon lose their ability to satisfy the carbohydrate addict.At this level, many of the people we work with report eating when they are not hungry, when they don’t have an urge to eat, and when they don’t even want to eat. Food doesn’t seem to taste especially good. The experience of eating becomes more of a compulsion or duty. The carbohydrate addict at Level 3 is eating because of a driving need to eat—a physical, inner demand to eat—rather than out of enjoyment.Normal mealtimes, periods of eating that are distinct from periods of noneating, gradually disappear. The carbohydrate addict may eat at any time, usually small or large snacks that include sandwiches, snack foods, and/or sweets. Rather than separate meals, the carbohydrate addict finds him- or herself eating continuous snacks. Sandwiches take the place of meals. Some people report that they have a diminished consciousness of their eating habits. As one dieter who came to the Center expressed it, “It’s almost like being half-aware of what you’re doing, like being half-hypnotized.”Others have commented that they felt as if they were not really aware of what they were doing until after they had put food into their mouths. Tiredness, self-blame, and feelings of hopelessness often mark this level.*18\236\2*

There are three main medicines in this group. Detailed below are their recommended doses and their interactions with other medicines.Nevirapine: Two hundred milligrams of this medicine is recommended four times a day for the first fourteen days followed by the same dose twice a day. Common side-effects include rash, hepatitis and increased levels of an enzyme called transaminase. Nevirapine interacts with oral contraceptives, some medicines used for treatment of tuberculosis (such as rifampicin), protease inhibitors (recommended for treatment of HIV infection) and triazolam (used for management of sleep disorders including sleeplessness).Delavirdine: The recommended dose of this medicine is four hundred milligrams three times a day. Common side-effects  include   rashes  and headache. Delavirdine is not recommended with tranquillisers or some medicines used for management of sleep disorders (such as alprazolam, triazolam, midazolam, etc.) medicines used for epilepsy (such as phenytoin, carbamazepine and phenobarbitol), cisapride (a medicine used for management of vomiting, increased acids in the stomach) and amphetamines.Delavirdine increases the level of some medicine such as dapsone (recommended for management of leprosy), clarithromycin (antibiotic), quinidine (used for treatment of malaria) and protease inhibitors such as indinavir and saquinavir (used for management of HIV infection).Antacids can interact with delavirdine and therefore a gap of about one hour is recommended between taking these two medicines.Efavirenz: The recommended dose is six hundred milligrams four times a day. Common side-effects include rash, dizziness, sleeplessness, abnormal dreams, confusion, lack of concentration, loss of memory, hallucinations, etc. Efavirenz interacts with medicines such as cisapride, midazolam, triazolam, etc., and is therefore not recommended with them. It also decreases the levels of two protease inhibitors including indinavir and saquinavir and increases the level of two other protease inhibitors including nelfinavir and ritonavir. Efavirenze can interact with some medicines such as rifampicin, pheynytoin, etc., and is therefore recommended only under direct supervision by a medical practitioner.*21\288\2*

Like Alice in the strange world of Wonderland, sometimes we feel totally at the mercy of our environment. Either the fast-food lunches our coworkers carry past our desks, or the attitudes of the people in our lives – loved ones, friends, and acquaintances, people who say, “Oh, come on – you can have just one . . .” or “You’re not really fat. . .” or “Are you trying to prove you’re a saint?” It’s tough to face the hurt look in your sister’s eyes when you turn down her liver pate or not be offended yourself by the envy-inspired taunts of unsupportive “friends” who say, “You don’t look like you’ve lost that much weight!” Sometimes the world can seem like a mine field when you’re attempting to make healthy changes in what you eat – full of temptations and unhelpful comments, all seemingly geared to put you off track.Being aware of what’s working for or against you is the first step in learning to engineer your environment so that you’ve got the best chance of success. Here are some more tips:- Take a good look at your family role models: Did anyone – or does anyone now – rely on eating (particularly junk food) to combat emotions? What excuses do other members of your family make when they eat the wrong foods, if they do? How much value do they place on health and fitness? Will they support you in your efforts to lose weight and/or reduce disease risk factors?- Communicate as openly and actively as you can with your family and friends: Tell them what you want and be specific about how you’d like them to support you. You may even find that one or more of the people closest to you will want to join in! It can be a tremendous boon to stick to a good healthy plan with another person: Support is crucial. To get your kids to support you, let them know how good you feel about what you’re doing. It’s never too early to start sending the message that our health depends on what we do to, and for, ourselves.- There’s another side to the coin, of course: Don’t turn into a pushy evangelist. This may be harder to do than you can foresee. Just be your own best example; simply do what you know is right for yourself, and your actions will be more persuasive than a lecture could possibly be. You want to cultivate support – not resentment – in the people around you. And it helps to get as much support, especially at the beginning, as you can!- Identify the non-supportive people, or “saboteurs,” in your midst, the ones who will try to undermine your efforts. Consciously or not – and for a variety of reasons ranging from envy to their inability to cope with change – even your closest loved ones may try to thwart you by bringing home candy or coaxing you to have second helpings of fish, meat, or poultry. Seek out, to the degree you can, those people whose values and goals most closely match your own. Once the ones who really care about you get the message that you’re serious, you may be surprised at the result. - As we’ve suggested before, keep problem foods out of sight – or, better still, out of your kitchen and home entirely!- Bring fresh fruit, whole-grain bread, or raw vegetables to work, to enjoy at coffee break. And keep a supply of herb tea bags to use instead of coffee. If there’s an office party, offer to bring in some Tortilla Chips and Artichoke Pate to replace the predictable high-fat canapes – then, even if everyone else is wrapped up in their pigs-in-blankets, at least you’ll have something to eat! (They’ll be delighted, too, when they discover how good the food you’ve brought in is.) When you’re feeling stressed out and you’ve got a few minutes, take off and do a little stretching or a simple relaxation exercise: It’s guaranteed to relax you when you need it.- Keep a comfortable pair of walking shoes at your desk so you can take a brisk walk during lunch hour; use the stairs instead of the elevator, if it s feasible. You can build in a little extra activity in a lot of different ways that will occur to you throughout your day.There are so many other ways to set yourself up for success. You’ll find yourself thinking of them spontaneously – like cultivating friends who are as committed to staying slim and healthy as you are. Being around people who’ve mastered what you’d like to learn is one of the best ways of learning it yourself. And soon you’ll be the powerful example to others, who’ll see how complete a transformation they, too, can experience.*53/345/5*

The HIV test results can have a major impact on the psychological status of the person tested, family, relationship with other members, employment opportunities, etc. This is why HIV testing should not be done without informed consent. This means that the person being tested should understand the consequences of the test results. It is also important to keep the test results confidential. In India, scientifically tested treatment options for people with HIV infection are limited. This is mainly because of the excessive cost. Also, none of the currently available treatment options can cure HIV infection. This is why HIV testing is not routinely recommended even for those who are at a higher risk of getting infected.HIV testing without consent is done for all blood samples collected for transfusion and during sentinel surveillance. The test results are however confidential and anonymous. Testing the blood for HIV without informed consent is ethically wrong and is strongly discouraged by the Government of India and all agencies involved in prevention and control of HIV/ AIDS in India.It is important to remember that the HIV test does not provide any information to the present state of the person tested. It also does not provide information on the source of infection or whether the infection has been transmitted to others or not.Since it is not possible to identify people with HIV infection by just looking or interacting with them, and HIV testing is not likely to alter the course of the infection, if any, preventive measures are the only current hope for controlling HIV/AIDS.*17\288\2*

The decisions of microbe hunters about what to look for is not the only thing that could foster the second round of the germ theory. The infrastructure of scientific information gathering could be altered as well. In particular, anecdotal information could be used more effectively than it has in the past.The CDC and the FDA jointly administer a program called VAERS, which stands for Vaccine Adverse Event Reporting System. VAERS accepts reports from physicians, patients, and family members who have observed problems that might be attributable to the administration of vaccines. VAERS is a good idea—it gives the health sciences antennae to sense problems far earlier than if recognition depended on some insightful person somewhere mustering the time and effort to make a case for adverse effects of vaccines. With the current standard of vaccine safety, one physician may never witness enough adverse effects to get a sense of whether they are truly effects of the vaccine or simply coincidences, unimportant anecdotal observations. If the people receiving the flood of anecdotal information are astute and insightful, they will see associations that warrant detailed, carefully controlled studies.But VAERS does not go far enough. A parallel reporting system is needed for detection of positive effects of treatments on chronic diseases. Let’s call it EARS, for Effects of Antimicrobials Reporting System. I have received a great deal of mail from readers describing anecdotal associations between the use of a drug and improvement in a chronic disease. Many of these associations may be spurious, but one cannot tell one way or the other from anecdotal reports, just as one cannot tell whether an adverse event that occurred after a vaccine was an effect of the vaccine or a coincidence. If hundreds of thousands of such reports were accumulated in one database, the real effects of a drug could leave behind telltale statistical associations that could provide the basis for controlled epidemiological and clinical studies to determine whether, in fact, it does have a positive effect. If so, the logical next step would be to investigate whether the positive effect results from an antimicrobial action.If such a system had been put in place in the 1940s, antibiotic cures of ulcers could easily have become part of mainstream medical practice by 1955. Some important treatments of chronic disease have been recognized by just such anecdotal observations. The effectiveness of the antimalarial drug Plaquenil (hydroxy chloroquine sulfate) against the autoimmune disease lupus was revealed anecdotally when a lupus patient improved after taking Plaquenil prophylactically during a visit to a malaria-ridden area. The drug also works against rheumatoid arthritis. Does Plaquenil help ameliorate these conditions by an antimicrobial action? No one seems to know.Sometimes insight may come from the reciprocal association: a drug used for a chronic disease shows effectiveness against a known infectious disease, thus implicating infection in the chronic disease. Lithium treatment of schizophrenia and depression offers an illustration: when patients were treated with lithium, their herpes infections improved. This association is one more piece of evidence implicating viral causation of these mental illnesses.The historical record reveals that many such associations would probably be found. Any one of them might fail to turn up an infectious cause. The beneficial effects of Plaquenil on lupus and rheumatoid arthritis, for example, might result from the suppression of another pathogen that is triggering a malfunction in the immune system; or the beneficial effects may result from direct interference with an overreactive immune system. Even if the benefits uncovered by a surveillance program turn out not to result from an antimicrobial effect, the information on their effectiveness against chronic disease is useful. If they do have an antimicrobial effect, then they may point the way to the causative infectious agent. No one knows how many more bits of valuable anecdotal information are being lost because we do not have such a surveillance system in place. If peptic ulcers are any indication, the consequences might translate into additional decades of ineffective treatment and many thousands of people needlessly suffering and dying from chronic diseases with infectious causes.*46\225\2*