Health related information and news from around the world.

1. Damage to the dermis (a) Because the UVA wavelengths are longer than the UVB wavelengths, they penetrate deeper and can cause damage to the supportive layers of the skin which house the collagen and elastic fibres. Celtic skin is unable to adequately repair this damage, due it is thought to certain blood vessel changes, as well as cellular mutations. As a result, abnormal cells are formed which may lead to skin cancer. The elastic tissue also becomes abnormal and loses its elasticity, and the collagen tissue disintegrates and disappears. Consequently the skin becomes thin, ‘liver spots’ appear, dryness occurs, and wrinkles develop—all features of premature ageing— and in time skin cancer will occur.

(bj Although UVB radiation predominantly causes epidermal rather than dermal damage, resulting in burning and later tanning, it also has long-term cumulative detrimental effects on the skin. UVA radiation has been shown to aggravate the effect of UVB radiation. Consequently, sun exposure shortly before or after exposure to a solarium will result in more severe skin damage.

(c) Recent evidence indicates that exposure to less intense UVA and UVB radiation over a longer period of time is more likely to cause permanent skin damage, including cancer, than the same energy applied over a short period. This accounts for the particularly damaging effects of chronic exposure on the face and hands. With solariums, the total body area irradiated is much larger, and therefore the potential for damage and cancer is much greater.

(d) Sunburn is nature’s warning of excessive sun exposure. This warning is absent when solariums are used as a tanning source. People who frequent solariums are either sold a certain number of possible exposures, or unlimited access for a period of months. The incentive to attend frequently to keep up the short-lived tan, together with the absence of the discomfort caused by burning, results in damage far in excess of what would occur in the sun.

2. Photosensitivity Because solarium operators have a strong financial incentive to process as many people as possible, have no medical training, and are not governed by any health regulations, a number of medical problems may arise.

It is not widely recognized that various internal and external preparations may make a person’s skin allergic to ultraviolet light and UVA radiation in particular. External agents include various soaps, perfumes, cosmetics, creams, and plants. Internal agents include many antibiotics, some diuretics, birth control pills, tranquillizers, and oral anti-diabetic drugs.

Also, there are also a number of diseases which are aggravated by UVA radiation; some of these may be latent, and only brought on by exposure to radiation from a solarium.

3. Bye damage Perhaps the greatest hazard concerns the eyes, which in most cases are given no protection during therapy. In fact, the implication that solariums are so safe that not even eyes need to be protected is emphasized in advertising. There is, however, conclusive evidence both from animal studies and experiments performed on animal and human eyes, that UVA exposure results in permanent damage to the lens, and sometimes mho to the retina. Initially, the lens of the eye becomes discoloured, and then opaque, and finally a cataract forms. This may eventually lead to blindness. Cataracts are the second most common cause of blindness in Australia and the United States. This high and increasing incidence of cataracts is thought to be largely due to the increasing exposure of the population to sunlight.

4. Advertising hazards Various advertising brochures present different inaccuracies. There are, however, three fundamental inaccuracies which most of them contain.

The first is the claim made for the enormous benefits of UVA radiation for the body! They reject the ‘blazing and potentially dangerous sun’, only to promote ‘the rich golden tan, which gives you that healthy, confident, affluent look*. Who could resist, especially as they say that the radiation which produces a tan is also the major source of vitamin D. In fact the major source of vitamin D is dairy products and fish oils, not sunlight. Moreover such supplementation of vitamin D is hardly necessary in our society: vitamin D deficiency results in rickets, a virtually non-existent condition in developed countries.

*98\44\4*

It is normal and natural to lose oestrogen at the time of the menopause. If, like our forebears, we didn’t live much beyond the age of 50-ish, this wouldn’t cause many problems. Just as women in past ages were starting to get hot flushes and night sweats, along would come the Grim Reaper and their troubles in this world would be over. Few would live to experience the long-term effects of low oestrogen, such as osteoporosis, heart attacks and strokes.

We have looked at how and why oestrogen and progesterone levels fall. Now we will look at what effect this has, and why replacing these hormones — in the form of hormone replacement therapy (HRT) – can help.

Most women probably know about hot flushes, unpredictable moods and loss of sex drive, but what else might there be?

‘You won’t believe this, but I just didn’t realise my problems were due to the menopause. Of course I recognised the hot flushes, but not anything else. Over the course of 18 months I lost count of the number of times I went to my doctor – we got sick of the sight of each other. I went to him about pains in my joints (he gave me paracetamol), about insomnia and night sweats (he suggested a milky bedtime drink and sleeping tablets), depression (‘Why not do some charity work?’).

Other things I decided not to see him about, such as sexual difficulties and general mood changes. I couldn’t understand what was happening to me as I’d been such a normal, healthy person. Luckily one day I saw another doctor in the practice. She explained that all these things were probably due to the menopause, and she talked to me about HRT, gave me a check-up (which proved I was quite normal!), and I’ve been on HRT ever since.’

The consequences of low or falling oestrogen are grouped in three categories: (a) early symptoms that, for most women, last between about six months and two years, (b) rather later symptoms that tend to become more noticeable as the years go by, and (c) conditions that may not start for many years and then get steadily worse.

*8\42\4*

Psychological factors. For reasons that are unclear, women who are scheduled for hysterectomy are more than twice as likely as average to be distressed as indicated by psychological tests. It may be that symptoms such as chronic pain and heavy bleeding, and uncertainty about the future, have produced this psychological distress. Or else, an underlying psychological condition may have reduced tolerance of minor symptoms. Whatever the truth of the matter, improvement in gynaecological complaints, however this is achieved, tends to result in a marked reduction in psychological symptoms. On rare occasions such women may ask about, or be advised to have, a hysterectomy.

Post-pregnancy complications. Emergency hysterectomy may be the only option when uterine bleeding is uncontrollable. This is a rare occurrence after childbirth and may be caused by rupture of the uterus or damage to major blood vessels. Other situations that may give rise to hysterectomy include life-threatening infection of the endometrium (a very occasional complication of abortion), or the removal of an ectopic pregnancy in a woman who has finished her family.

*23\198\4*

As a person becomes older his sleep pattern changes. He has many more awakenings throughout the night. His sleep is much lighter, and he rarely enters stages 3 and 4; instead these are replaced by a lot of awakenings and there is a kind of natural insomnia. However, most older people do not understand that they no longer need so much sleep. They feel distressed lying in bed alone at night, and some still want to recapture the feeling of ‘sleeping like a baby’.

My advice to the elderly is that we are becoming wiser and more respected as we grow older. We should be proud of our grey hair and hard-earned senior status in society. We should feel lucky that we have outlived our unfortunate associates. We are no longer babies, and do not need all that sleep anymore. We can relax and rest at night, and should keep ourselves more active both physically and mentally in the daytime. During the day, if we are inactive, we may have a lot of microsleeps. Microsleeps are brief periods of sleep activity which can be recorded on the EEG. These microsleeps last only a few seconds, but, if all these microsleeps during the day are added together, they will replace most of the need to sleep at night.

Many of my older patients regularly sleep three hours a night and have one hour of afternoon nap. They are all healthy and they function perfectly well in the day. They understand that they do not need all that sleep. It is sad to see older people, who biologically need only a few hours of sleep each night, extending their sleep time artificially with sleeping pills.

To summarise, the two different kinds of sleep, REM and NREM, alternate with each other, and we have a few sleep cycles each night. We used to think that sleep is passive and peaceful and mat if we dream a lot we have had a poor sleep. Now, with the help of the sleep laboratories, we know that we have at least four or five dream periods at night and at least one-quarter of our sleep is spent in dreams, although we cannot remember most of them. The other surprise is that it is normal to wake up in the middle of the night. These findings have dispelled the myth that good sleep means no dreams and no awakenings in the night.

*23\174\4*