Sprains & Strains: What is Recommended?
A sprain occurs when ligaments are stretched or
torn, commonly in the area of the ankle. A strain
occurs when a muscle or tendon is stretched or torn,
commonly in the lower back or hamstring. Ligaments are a
connective tissue, connecting one bone to another.
Tendons connect muscles to bones. Both sprains and
strains cause pain, swelling, and limitations of
movement of the affected area. Bruising may occur in
association with sprains, while strains may be
accompanied by muscle spasms.
Properly warming-up prior to exercise can help to
prevent both sprains and strains. Sprained ankles can be
managed with RICE (rest, ice, compression, elevation).
Rest can be achieved through the use of crutches or
avoiding placing weight on the affected ankle. Ice may
be applied every couple of hours at fifteen minute
intervals to decrease swelling in the affected area.
Wrapping the ankle with a bandage can also reduce
swelling. Also, the affected foot should be raised above
the level of the heart. Nonsteroidal anti-inflammatory
drugs (NSAIDs) available over-thecounter, such as
ibuprofen (Advil, Motrin), or acetaminophen (Tylenol)
may be suggested by a physician to relieve pain. If the
injury is severe, a brace or splint may be used to
stabilize the affected area. Surgery may be needed to
correct the injury.
Treatment Options for Adult Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune condition of
the central nervous system (CNS). The immune system
attacks myelin, the protective layer surrounding nerves
in the CNS (the attack is called demyelination).
Symptoms of MS include vision loss, sensations of
numbness or tingling, and muscle weakness. The condition
occurs in a relapsingremitting (RRMS) or progressive
manner. MS is most commonly diagnosed between 20 and 40
years of age, and occurs more commonly in women than in
Glucocorticoids, such as methylprednisolone (Medrol)
and prednisone, are used for treatment of acute MS
attacks. Disease-modifying therapies such as glatiramer
acetate (Copaxone), interferon beta-1b (Betaseron),
and interferon beta-1a (Avonex, Rebif) may be
prescribed for remitting MS. These medications modulate
the immune system to decrease the amount of relapses and
the progression of disability. Natalizumab (Tysabri)
is reserved only for persons who no longer respond to
other treatments, due to potentially life-threatening
side effects. Figolimod (Gilenya) interferences
with the immune system’s destructive effects on the CNS.
Mitoxantrone (Novantrone) works to modulate the
immune system in individuals with progressive MS who are
unresponsive to other available therapies.
Prevention of Malaria for Travelers
Malaria is transmitted by the bite of a mosquito that is
infected with a malaria-causing parasite. Travelers to
malaria endemic areas are at a high risk of malaria
because they generally do not have previous exposure and
thus no pre-existing immunity has developed. After a
bite from an infected mosquito, symptoms typically
appear after about 1 to 2 weeks or longer. Symptoms
include fatigue, chills, headache, sweating, muscle
aches, and stomach pain.
Travelers can take measures to prevent mosquito bites,
such as wearing protective clothing, using insect
repellant (DEET and picaridin), and
staying indoors when possible. Additionally, medicines
for malaria prevention are available for travelers to
malaria endemic areas. The Yellow Book, available at the
Centers for Disease Control and Prevention (CDC)
website, contains current information regarding use of
antimalarials for travelers. Preventive therapy should
be started prior to travel and should continue for a
period of time beyond departure from the travel
destination, depending on the medication. These
medications work to prevent malaria by causing
damage to the parasite. They include atovaquoneproguanil
(Malarone), chloroquine (Aralen),
hydroxychloroquine (Plaquenil), and mefloquine.
Treatment for Friedreich’s Ataxia
A condition called Friedreich’s ataxia is a rare
genetic neurological condition, characterized by muscle
weakness, loss of sensations, and the loss of control of
body movement (ataxia). The central and peripheral
nervous systems, heart, and pancreas are affected.
Approximately 1 out of 50,000 Caucasians are affected.
Initial signs and symptoms typically occur around the
second decade of life. Several years after disease
onset, the ability to speak may be severely affected.
Difficulty swallowing may also occur, however later in
the progression of the condition. The abilities to walk,
stand, and sit unsupported are generally lost after 10
to 15 years of disease progression.
There is currently no cure or treatment to halt the
progression of Friedreich’s ataxia. Idebenone (Catena)
is an antioxidant medication that is structurally
related to the antioxidant co-enzyme Q10. Since
oxidative stress potentially plays a role in the
destruction caused by the condition, the antioxidant may
decrease this effect. This medication may work to
improve adverse cardiovascular effects of this
condition. This medication is not yet approved by the
FDA for use in the U.S. Currently, individuals affected
by the condition in the U.S. may be eligible to obtain
this medication through a special program currently in
Medicines Prescribed for Meniere’s Disease
Meniere’s disease is a condition of the inner ear,
characteristic of episodes of vertigo, progressive
hearing loss, and ringing in the ears (tinnitus). Nausea
and vomiting may occur during severe attacks. A
sensation of pressure in the ear may also occur.
Although the exact cause of Meniere’s disease is
unknown, a virus, allergy, genetics, or abnormal immune
response could lead to the condition.
There is currently no cure for Meniere’s disease,
although treatments are available to alleviate symptoms.
However, progressive hearing loss will likely occur over
time despite available treatments for other symptoms
associated with the condition. A hearing aid may assist
with hearing loss. Meclizine (Antivert, Dramamine)
works in the inner ear to treat vertigo. Promethazine (Phenergan)
works in the brain to treat nausea and vomiting
associated with vertigo. Pressure in the ear due to
excess fluid may be relieved by a diuretic medication,
such as triamterene-hydrochlorothiazide (Dyazide,
Maxzide). An injection of gentamicin to the
inner ear during local anesthesia may decrease vertigo
attacks. This antibiotic has toxic effects on the inner
ear, which minimize the balance function of the affected
ear and allow the unaffected ear to properly assume