This is a question I hear many times in my daily routine from individuals wanting to buy a laptop computer. Many times people think that they want a laptop because they are “cool” or “neat.” While laptop computerss can be very useful in certain situations, they are not necessarily the best option for many people. I generally suggest that if you need the portability or if room is a major consideration, then consider a laptop. This is particularly true if you are on the road or travel a great deal. Laptops in these situations can be helpful, if you are going to take them with you. If you are not and generally use them at home, I would suggest that a PC be considered. The advantages of a PC over a laptop is that they can be configured much easier, are generally less expensive and if something breaks it is easy to fix. Additionally, it you want to add more features through putting in different computer cards, it is just a matter of opening the case and putting the new card in.

Laptops on the other hand are not easy to modify once you have one. Many of the components are built right onto the mother board. Although some items such as the hard drive or memory strips (RAM) can be switched out, most of the other components are fixed. If you have trouble with your laptop malfunctioning, it all most always needs to be serviced by a trained technician. In other words, it a particular part of the laptop fails, you will need to get it serviced under warranty or take it to a computer shop. Either option is time consuming and/or expensive. A desktop PC on the other hand can frequently be serviced by your self, with a little knowledge and help from your computer manufacturer technical support team, as long as you computer is under warranty. This is why I strongly suggest that you purchase as long of a warranty as is available, for any computer, including and particularly laptops. Additionally, desktops a functionally easier to use, being able to hook printers and scanners into them with ease. The array of custom PC cards with specialized function is also much more readily available for your PC than your laptop.

In summary, a desktop PC is much more practical, generally more powerful and less expensive than a laptop. Adding better or more sophisticated computer components (including sound systems) is much easier. Still, it you need the portability, there is nothing better than a laptop for this. The smaller screen laptops are great for traveling. If you are not going to be moving the laptop around that much, I would suggest getting a 15 or 17 inch LCD screen. Your eyes will much appreciate this. If you need portability then I would recommend the smaller laptops with 12 inch screens. General computer configurations should include Windows XP (Pro if you want to network other computers), 200-300 GB hard drive space, 1-2 GB RAM memory, DVD burner, 19-20 inch LCD screen and good video and audio card. Don’t forget to have both antivirus and spyware protection software installed and kept up to date. For reviews on various systems, try going to PC World computer reviews for desktops or laptops. PC World also has reviews on video and sound cards as well as printers. Good luck.

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Stroke occurs when a blood vessel in the brain becomes blocked or ruptures. The most common form of stroke is due to blockage of a blood vessel. Blood vessel blockage is caused by a condition known as
atherosclerosis, commonly known as “hardening of the arteries.” This is the most common type of stroke. Stroke is one of the three major leading causes of death in the United States. The other two are heart attack and cancer. Stroke is the leading cause of disability in the U.S. It is for this reason that it is much wiser to focus on stroke prevention in the first place rather than trying to limit the damage with stroke treatment after event has occurred. High blood pressure (hypertension) is the single biggest, treatable risk factor for stroke. In the 1970s, there was a push by the medical community to aggressively treat high blood pressure to lower the risk of stroke, premature heart disease and kidney failure. One cannot feel that their blood pressure is elevated but the damage to major body organs (heart, brain, kidneys) continues on. It is only when these organs start to fail or a stoke occurs, will it become apparent that a given individual may have hypertension. On occasion, patients with untreated hypertension may have headaches. Fortunately checking one’s own blood pressure is easy. This can be done at your doctor’s office, pharmacies or the local fire department. If you have high blood pressure with the top number greater than 150 or the lower number greater than 85, you need to see a physician for treatment. Fortunately there are many different types of medication to treat high blood pressure. Many patients can be successfully treated with a single drug, for mild hypertension. Individuals with moderate to more severe hypertension, multiple drug therapy may be necessary. With the aggressive push to treat high blood pressure, the rate of stroke in the United States has dropped dramatically over the past two decades. There is a class of blood pressure medication, the ACE inhibitors, that have been shown in well designed clinical studies to significantly reduce the risk of stroke independent of their ability to lower blood pressure. Current evidence based medicine strongly suggests that addition of an ACE inhibitor should be done in patients with high blood pressure, even if their blood pressure is adequately controlled on other agents. Ideal blood pressure range should be with the upper number (systolic) being less than 130 and the lower number (diastolic) less than 80.

It has been well known for several decades that aspirin thins out the blood. Cardiologists have used aspirin extensively for 30 years to lower the risk of having a heart attack. Aspirin slows down the formation of clots by blocking the clumping of platelets to form blood clots. In 1994 a hallmark study, the Antiplatelet Trialists’ Collaboration, was published demonstrating the clear benefit of aspirin in the prevention of stroke and transient ischemic attacks (TIA, “mini strokes”.) In 1998, the FDA approved labeling of aspirin for the prevention of TIA and stroke. Dosage recommendations in the range of 81-325 mg daily should be used. Unfortunately aspirin does not entirely prevent stroke or TIA from occurring. Other blood thinning agents can be used in patients who fail aspirin therapy. The other two agents are Plavix and Aggrenox. Either agent can be used in patients who have had a TIA or stroke while taking aspirin. In patients who have no history of heart disease, Aggrenox is the preferred agent. Plavix is preferred in those patients who have known coronary artery disease.

Lastly, high cholesterol has been implicated in the development of accelerated atherosclerosis. There have been studies that have shown some correlation of high cholesterol with the increased risk of having a stroke. Multiple, double-blind, placebo controlled studies have shown that the use of cholesterol lowering statin drugs for cholesterol reduction results in an average of a 27% overall secondary risk decrease in stroke. Studies are ongoing to show if statins may help in primary prevention of stroke and TIA. At this time, it is prudent to be on a statin drug, for cholesterol reduction. The currently available statins include: Lipitor, Zocor, Pravachol, Crestor or Mevacor if you have a cholesterol over 200. The marked benefit of this class of drugs on the reduction of stroke and cardiac events (35%) is dramatic and strongly supports more aggressive treatment for high cholesterol (hyperlipidemia.) The objective is to have a total cholesterol less than 180, good cholesterol (HDL) of greater than 50 and bad cholesterol (LDL) less than 100. A recent study published in the journal Stroke reported that discontinuing statin therapy in the year after a stroke is associated with a significant increase in the risk for death, even in the absence of heart disease.

Medications are not the only treatment for stroke prevention. Smoking is associated with a 2-3 times greater risk of stroke and bleeding in the brain. Smoking also contributes to the accelerated development of heart disease, emphysema and peripheral artery disease. Chantix is a new medication that received FDA approval to help stop smoking. Exercise is important in maintaining overall body conditioning and weight control. This in turn leads to an overall lowering of blood pressure and cholesterol. In summary, stroke prevention is much easier and cost effective than fixing the problem after someone has a stroke. This approach to stroke reduces mortality and disability for the entire United States population. The cost saving are in the hundreds of billions of dollars over stroke treatment. If you feel that you are at risk for stroke, contact a neurologist for evaluation and treatment.

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One of the most frustrating neurological conditions is restless legs syndrome (RLS.) It is characterized by an intense overwhelming need to move your legs at night or when sitting or resting. This can be so severe that affected individuals have difficulty sitting through a movie or driving in a car for any distance. Occasionally RLS can be associated with abnormal sensation, particularly in the feet and lower legs. The abnormal sensory symptoms are a form of peripheral neuropathy that is associated with RLS. Symptoms can be so severe as to be an impairment to sleep and feeling of well being. RLS is consider to be a form of sleep disorder, even though individuals can have symptoms during the day, while awake. New research findings that were reported in the New England Journal of Medicine indicates that there is a genetic component to RLS. There are many who doubt the actual existence of RLS but those affected with this condition would disagree. As a movement disorder specialist, having seen many patients with this condition, there is no question that it is real. To ignore the medical literature and scientific evidence on the existence of RLS is foolish.

RLS can markedly impair the quality of life of affected individuals. They typically have chronic sleep deficit with a higher incidence of depression. The recent report on the genetic linkage of families with members affected with RLS is fascinating. Another common sleep condition, periodic limb movements of sleep, shows a stronger genetic correlation to run in families due to a specific genetic sequence variant at the 6p chromosome. Many of these individuals have RLS. If one isolates out the patients with RLS only, the genetic linkage becomes less clear. It is perhaps that RLS represents a subset of individuals with some chromosomal variation. This may serve as a marker for potential development of RLS in patients who have a history of RLS or periodic limb movements of sleep. These individuals can also have trouble with elevation in their blood pressure as well as other conditions associated with long standing sleep deprivation. There are several excellent treatment options for RLS including the dopamine agonists, Klonopin, low dose mild narcotics and other medications. If you are affected with this condition, it is important to get medical help as excellent treatment exists to control symptoms.

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