Archive for June, 2010


Although babies born with defective immune systems are rare, the world is experiencing the horror of defective immunity in thousands of people who have AIDS (acquired immune deficiency syndrome). They acquired this condition from infection with a virus that knocks out a key white blood cell in the body’s delicate immune system. Without effective immunity, AIDS patients fall prey to bacteria and fungi that live harmlessly on the skin or inside healthy persons. Resultant infections ravage the body. AIDS can kill almost all who contract it, making it the most deadly illness of modern times. In 1996, scientists discovered medicines that slow down the growth of the AIDS virus in an infected person. At the same time, other drugs plus antibiotics control the lethal infections that commonly afflict people with AIDS. This new era in AIDS control has reduced the growth of the AIDS virus to extremely low levels so as to be immeasurable. People with AIDS, who at first expected to live 2 or 3 years, can now look forward to staying alive for at least 10 years.
The new knowledge about immunity has allowed scientists to move fast against AIDS. The first cases in the United States were reported in 1981 as a strange pneumonia. But, in a year or two, scientists had pinpointed the defect in immunity. In 1984, they isolated the killer virus. Although researchers hailed the identification of HIV as signaling the development of a vaccine, over 10 years have elapsed without a usable one. That’s because the AIDS virus is constantly changing (somewhat like the influenza virus, but much more rapidly).
Herpes viruses live forever in nerve cells. Some scientists believe they are triggered by cold, heat, fever, chemicals, or menstruation. The virus grows out of the affected nerve cells and attacks other tissues. Shingles is really the reactivation of an old chicken pox virus, responding, some theorize, to the same triggers.
Four major discoveries have brightened the promise of immunology:
•   The unraveling of the complex way in which the different types of white blood cells cooperate to attack foreign substances that get into the body
•   The discovery of chemicals released by the cells that give signals for white cell action. Interferon and interleukin, for instance, are both promising cancer treatments.
•   The development of genetic engineering. Scientists now know how to alter the biology of common sewage bacteria so that the germs can create unlimited amounts of human chemicals like insulin, interferon, and interleukin.
•   The creation of a strange and wonderful cell called a hybridoma. These hybrid cells can produce boundless amounts of antibodies – chemicals that attack invading viruses, bacteria, or fungi. Hybridoma antibodies also hold promise against cancer.


Counseling may take place at the bedside of a patient, in a clinic, or in the home. Regardless of the setting it is essential that privacy be maintained, that interruptions be avoided, and that there be no distracting noise. A patient is more likely to be attentive some time following a meal than he would be when he is hungry or when he has just finished his meal.
Effective counseling takes time. An initial session during which the diet history is obtained requires one-half to one hour. Later sessions might require as little as 15 minutes. For patients in the hospital it is often advantageous to break up the initial counseling into several shorter sessions. In this way the patient is more alert, and also has opportunity to think about the content between sessions and to raise questions.
Dietary counseling requires constant interaction between patient and counselor. It is not a one-sided lecture by the counselor telling the patient what to do.
The dietary counselor must be able to interpret the principles of dietary change into practical terms that the patient can understand. She believes that the individual can change his dietary habits, but also realizes that change is likely to occur gradually. She understands the patient’s needs and values. She is able to communicate at the level of the person being counseled. She respects the individual’s dignity and maintains confidentiality.
The patient is an active participant in the counseling process. He provides the information pertaining to his diet history and food intake; listens to the counselor’s evaluation of his food patterns and the reasons why changes are recommended; sets his own goals for what he can realistically accomplish; studies the materials that he is given; and makes notations of questions he needs to ask.