Archive for ◊ August, 2010 ◊

Author:
• Thursday, August 26th, 2010

Celebrity is one of these strange cultural things. People become famous, often for no particularly important reason except their ability to sing or play a sport well. It’s always been around. In ancient times, top warriors and “entertainers” would rule the cultural roost. Today, we seem less impressed by real soldiers, preferring the Hollywood version. Anyway, for better or worse, these people are able to use their fame to influence their fans – that’s one step away from fanatics whose intense enthusiasm leads them to dress and act in the same way. It becomes a kind of fame by association when you suddenly see people walking around wearing the latest styles shown on the pages of the influential magazines. Most of the time, this is fairly harmless. Manufacturers and distributors pay celebrities to endorse their products. The fans buy the products. If the products are good, everyone is happy. Sometimes the products are less than good and the celebrity’s name gets dragged through the mud. Although not quite on the same point, Paris Hilton is being sued again. This time, a hair extension company paid Hilton to wear its product but, remarkably, she turned up on red carpets wearing a competitor’s product. How sad for all involved given the names of the two competing products have now been trumpeted all over the news media for the last few weeks.

The most recent example is Justin Bieber. He’s the latest baby-faced, teen sensation to step out of YouTube. And, wherever you look, you see pictures of him. What great skin! But, like all sixteen year olds, he’s prone to the odd outburst of acne. So, moving with the cultural tide, one of the leading benzoyl peroxide products has recruited him as the new face of their anti-acne lotion. He follows in the tradition of Jessica Simpson, Alicia Keys, Katy Perry and others prepared to speak out in favor of this antibacterial. The marketing theory is solid like a rock. The target market buy his music and swoon over his picture. They will also want skin as smooth as his. They will buy this product. And, for the mild cases of acne, this will work out well. Benzoyl peroxide is a tried-and-tested way of dealing with skin problems. The addition of a moisturizer also leaves the skin feeling good.

But don’t get too carried away by endorsement. Justin Bieber may be the best new kid on the block, but the product will not deal with the more severe cases of acne. Indeed, if you use it for too long, moisturizers or not, it can cause the skin to dry and peel. For the really dramatic outbreaks that will not respond to any of the other treatments you need Accutane. Like benzoyl peroxide, there are side effects if you don’t follow the rules. But when you step up to the more powerful medications, you always take a risk to get the results. So, remember the name Accutane. It may not have the endorsement of Justin Bieber, but we think he would use it if he did get severe acne.

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Author:
• Thursday, August 26th, 2010

They may have barely mastered sitting up by themselves. But six-month-old babies become stressed out when they don’t get the attention they feel they deserve.

Levels of the stress hormone cortisol soar when they are ignored by their mother, and even a day later they are worried about the same thing happening again.

A baby who is deprived of its mother’s love for just two minutes is anxious about being ignored again the next day, a study found. Experts in child development said that repeated episodes of stress could have a huge effect on a youngster’s health and on his or her course in life.

To investigate whether six-month-olds are capable of anticipating trouble, the Canadian researchers invited 30 mothers and babies into their laboratory and divided them into two groups.

Babies were placed in car seats and their mothers played with them and talked to them as normal. The play was then interspersed with two-minute periods in which the mother simply stared over her child’s head, keeping her face free of emotion.

The next day, she took her child back to the laboratory. Levels of cortisol were measured several times on both days. Amounts of cortisol shot up when the babies were ignored.

They then fell off, before rising again when the youngsters were taken back into the laboratory, despite them not being ignored on the second day.  A second group of babies went through the same process, but without being ignored at any time, and their hormone levels barely changed.

The findings suggest that being taken back into the laboratory led the youngsters who had been ignored to anticipate there being more trouble ahead, the journal Biology Letters reports.

Researcher Dr David Haley, of the University of Toronto, said: ‘The results suggest that human infants have the capacity to produce an anticipatory stress response that is based on expectations about how their parents will treat them in a specific context.’

Professor Jay Belsky, of Birbeck College, University of London, said factors such as depression could affect a mother’s relationship with her baby and send cortisol levels soaring time and time again.

This could lower a baby’s immune system, while a troubled upbringing may also mean the child going on to become a less than perfect parent itself.

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Author:
• Wednesday, August 25th, 2010

When people sit down to write about dieting, there’s a terrible temptation to assume everyone is the same. Well, that’s never going to give you the best outcome. So here’s some advice just for women who have been through the menopause. This can be a difficult time as one part of your life closes and another opens. There may be both physical and emotional adjustments to make. When it comes to your weight, there’s one very important issue to think about. One of the longer-term risks to your health is losing bone density as you age. Unless you take care, this can turn into osteoporosis with the risk you can fracture bones very easily if you take a knock or fall. The latest research shows you are more at risk if you aim to lose weight eating a high protein diet.

The researcher took two groups of women aged between 43 and 80, lowering their daily intake by 750 calories a day over a period of 12 weeks. In the first group, half were given a diet without meat, relying on a vegetarian and diary diet (with eggs) to supply protein. The others ate higher amounts of protein in a diet containing lean meats like chicken and pork (the meat representing 40% of the food eaten). Interestingly, both groups an average of 19 pounds, but the meat-eaters lost bone density faster than those on a vegetarian diet. So, given there was no significant difference in the amount of weight lost, the vegetarian diet was safer over the longer term.

In the second group, the women all ate a diet of 1,250 calories per day for 9 weeks. Everyone had the same 1,000 calories as a vegetarian diet. One quarter took the additional 250 calories as chicken breast, the second as 250 calories of lean tenderloin beef, the third as shortbread cookies and sugar-coated chocolates, the remainder added 250 additional calories of vegetarian food. Again, all the women lost weight, but the three groups lost bone density against the low-protein vegetarian group.

Both studies suggest the need to look carefully at the source of the proteins you eat. This is not something you should aim to decide yourself. Discuss with a nutritionist how best to lose weight while maintaining the quality of muscle and bone. This is not to say this research is conclusive. In fact, it’s quite controversial. The problem with the studies is the short period of time and the small numbers of participants. The limit of twelve weeks does not give a reliable guide. All it shows is a trend that might not last and represent a danger. Equally, although it’s interesting a small number of women had this problem, it’s no guide the same will happen to large numbers of women. Nevertheless, safety first. Take supplements if you have a high meat content in your diet. If you feel hungry when you start reducing the calorie intake, Phentermine is the ideal partner in your weight loss program. It suppresses your appetite and keeps your motivation high while your body is adjusting to a lower food intake. Always remember never to take Phentermine for too long. Although it’s excellent moral support for short periods of time, you do not want to grow dependent. The price of losing weight should not be problems with Phentermine.

Category: Diet  | Tags: , , ,  | One Comment
Author:
• Wednesday, August 25th, 2010

You think the only errors in your diet are those that make you gain weight? Think again! Processed foods rich in sugar and fat do more than add a few inches on the waist and hips: they add extra years to your looks!

The next time someone wrong estimates your age (adding a few extra years), drop the pretzel or the cake you’re eating. Diet is the one that dictates the route of your body: everything from what your skin looks like, your bone density to how your brain functions. Thus, diet determines how fast the signs of aging appear.

Often, the solutions to “fix” a bad diet aren’t drastic, only measures that we might call “common sense”. Just get rid of some bad habits, among which the most dangerous ones are:

Number 1: Eating fast food

They call it fast food because it’s eaten on the run, when you’re out in the city, and you don’t need to prepare it. What you probably failed to notice is that the aging signs occur just as fast. Fat leads to inflammation and destruction of chromosomes: namely, aging rush to regenerate organs harder. In addition, they destroy the cell walls of folding, with serious effects on health and aging.

Although many restaurant chains and food manufacturers have been trying for years to stop using unhealthy fat when preparing their foods, it is best to be an informed consumer.

Eating at fast food should be avoided at all costs. When you’re at the restaurant, it is good to ask for a list of ingredients; read labels carefully before buying products at the supermarket. It is true that some ingredients have strange names, you do not know what to think of: usually you must avoid products containing “hydrogenated” or “partially hydrogenated fats.”

Number 2: Stress-food

Eating at the office, in the car, on the road or in any other serious stress conditions harms your digestion. Adrenaline and cortisol released under stress make your blood accumulate in the extremities of your body (feet, hands) and not in the stomach and intestines, and their ability to process and absorb food is affected.

In addition, the stress changes the acidity in your stomach, also affecting the ability to absorb nutrients such as vitamin B12.

Furthermore, stress makes you not pay attention to how much you eat: chances are that you eat unconsciously, without observing that you have exceeded your limit. In general it is good to take a lunch break at work or go home for lunch so you can take your time while eating.

Number 3: Sweets addiction

The body has a limited capacity to absorb sugar: you could say it isn’t so, as some would eat sweets without stopping. The truth is that eating sugar in excess, sometimes even without being aware of it (in sodas,processed foods and other foods in commerce contain serious amounts of sugar) only overtax the body.

Excess sugar remains in the blood and causes problems, leading to slower ability to regenerate the body and to aging skin.Wrinkles appear faster, skin elasticity is lost and it can’t regenerate efficiently after trauma. Basically, consumption of sugar is like hitting the fast forward button for aging.

Candy lovers should know that natural products such as honey, maple syrup or sugar in fruits don’t have the same destructive effect as processed sugar.

Author:
• Tuesday, August 24th, 2010

Imagine that your boss tells you to lose weight. Why might this happen? There are two possible causes. For people suffering from excessive weight it can be physically difficult to do some work. There may also be issues over appearance. Not everyone fits into a uniform and looks good. Since many customers tend to judge the employer by the way the staff are presented, there’s pressure on employers to police the way you look. The second reason is pressure coming from the health insurance industry. It’s a statistical fact that the overweight are more likely to claim on health plans for longer term illnesses. This is forcing up premiums to employers but, to “help” those in financial difficulty, insurers are offering discounts if employers run wellness programs to incentivize their employees to lose weight. Allowing for many states allowing termination at-will, there are no real laws at a federal or state level to prevent discrimination on body weight. Unlike an injury leaving you partly paralyzed, the lawmakers say how much you weigh is a lifestyle decision and not a disability.

This problem is not restricted only to the US. For example in England people are fanatical about soccer. Benni McCarthy who should play for West Ham is overweight and has been told to lose about 12 pounds. The club will fine him about $60,000 out of his pay for every week he fails to lose 2 pounds. The club sees him through training, controls what he eats while at “work”, and then waves goodbye to him in the evening. If he’s not losing weight, it’s because of what he does out of sight. If we go over to Turkey, the state-run Turkish Airlines has suspended 28 flight attendants for being overweight. If these attendants, 15 of whom are men, do not get down to their target weights, they will be given work in the back office. In the meantime, they have no pay which will restrict the amount they can afford to eat and speed their weight loss.

So what would you do if your boss told you to lose weight? How much is your job worth to you? The Turkish flight attendants have been told to lose 10% of their body weight. They are finding it difficult to move easily up and down the aisles of the planes. By a strange coincidence, the clinical trials show participants losing an average of 10% of their body weight when using Acomplia. Would you diet and use an appetite suppressant to meet your boss’s expectations, or would you think this an interference with your private life and fight for your rights? Except, of course, your rights under the anti-discrimination laws are very limited. Even in a state which some protections against unreasonable termination, you may struggle to hold on to your job. So, it all comes back to a diet and Acomplia or giving up your paid work. Life can be really unfair.

Author:
• Thursday, August 19th, 2010

Almost one million children in the United States are potentially misdiagnosed with Attention Deficit-Hyperactivity Disorder (ADHD) because they were the youngest and least mature in their kindergarten classes, a US study released Tuesday found. The Michigan State University study found that prescriptions for the misdiagnoses could represent spending of 320 to 500 million dollars a year, with 80 to 90 million of it paid by Medicaid, a public health insurance program for the poor.

The most commonly prescribed drug for ADHD is Ritalin (methylphenidate), a psychostimulant, and its long-term effects are not well known, wrote lead author Todd Elder, of Michigan State University, whose study will appear in the Journal of Health Economics. Elder studied some 12,000 young children.

He found that “the youngest kindergarteners were 60 percent more likely to be diagnosed with ADHD than the oldest children in the same grade. Similarly, when that group of classmates reached the fifth and eighth grades, the youngest were more than twice as likely to be prescribed stimulants” for ADHD.

Though only doctors diagnose the condition, “many ADHD diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a kindergarten classroom,” Edler wrote.

“But these ’symptoms’ may merely reflect emotional or intellectual immaturity among the youngest students.”

Author:
• Friday, August 06th, 2010

Dragging a teenager kicking and screaming out of bed too early on a Sunday morning could be bad for their health. Scientists have shown that a weekend lie-in is more than lazy indulgence and could be vital for well-being.

Tests on volunteers showed that the occasional sleep-in provides an invaluable antidote to the harmful effects of sleep deprivation. The findings will be welcome by all those lucky enough to be able to enjoy an extra hour or two of slumber on Saturdays and Sundays.

It came as another study warned of the dangers of persistently sleeping too much  -  and showed that people who regularly get more than seven hours every day are putting themselves at risk of heart disease.

Dr David Dinges, of the University of Pennsylvania School of Medicine in Philadelphia, who conducted the first study, said: ‘The additional hour or two of sleep in the morning after a period of chronic partial sleep loss has genuine benefits for continued recovery of behavioural alertness. The bottom line is that adequate recovery-sleep duration is important for coping with the effects of chronic sleep restriction on the brain.’

Inadequate sleep interferes with the way people think, handle stress and keep their emotions in check. It can also disrupt the immune system, increasing the risk of infection.

In the study, 142 adults with an average age of 30 were restricted to four hours in bed from 4am to 8am for five consecutive nights. At the end of the week, the volunteers were assigned to one of six ‘doses’ of a single night’s ‘recovery sleep’  -  ranging from zero to ten hours. Another 17 made up a comparison group who spent ten hours in bed nightly.

As expected, the test performance of the sleep deprived volunteers was consistently worse than that of the well-rested control group. But just one lie-in after a week of sleep deprivation improved mental faculties  -  and the longer the lie-in, the more alert they become.

However, even after ten hours in bed, sleep-restricted participants still had worse scores than the control group for attention lapses, poor reaction times, and fatigue.

Meanwhile, the second study showed that seven hours is the ‘perfect’ amount of sleep. Researchers at West Virginia University showed that sleeping fewer than five hours a day  -  including naps  -  doubles the risk of being diagnosed with angina, coronary heart disease, heart attack or stroke.

But sleeping more than seven hours increases the risks of cardiovascular disease too, the researchers found. Researcher Dr Anoop Shankar was unable to explain why length of sleep is linked to heart problems, but past studies have shown that sleep deprivation can increase blood pressure and diabetes.

Author:
• Wednesday, August 04th, 2010

The world’s first experiments using embryonic stem cells to treat humans have been given the go-ahead in America.

California-based bio-tech firm Geron will begin clinical trials on patients paralyzed by spinal cord injuries.

Scientists hope that injecting cells from discarded human embryos into the spines of volunteers will trigger regrowth of damaged nerve cells and eventually allow the patients to recover feeling and movement.

The Vatican condemned the controversial milestone as ‘ unacceptable’ and anti-abortion groups say they are planning protests across the country.

The study was cleared by President Obama a year ago, but was put on hold because some animals on which the company was testing the treatment developed cysts. Now Geron claims it has overcome the problem.

Dr Richard Fessler, a neurological surgeon at Northwestern University who will lead the research, said that if the treatment works on humans it would be ‘revolutionary’.

‘The therapy would provide a viable treatment option for thousands of patients who suffer severe spinal cord injuries each year,’ he said.

Geron has spent 15 years and more than £100million developing the treatment and hopes to begin the study within the next few months.

Adult stem cells, which typically produce a set variety of tissue types, have been tested on patients with limited success.

But researchers hope the use of highly versatile embryonic stem cells – which can turn into any cell in the body – will revolutionize medicine, from creating organs for transplants to helping to test drugs.

Stem cell trials are to be undertaken on patients with spinal cord injuries

The therapy also has the potential to help patients with Alzheimer’s disease and multiple sclerosis.

Until now, the ethical barrier of using discarded three- to five-day-old embryos has prevented any tests on humans.

The Bush administration, fearing a backlash from its many evangelical Christian supporters, kept embryonic stem cell research tightly shackled, but last year President Obama repealed the block.

The Roman Catholic Church remains fiercely opposed to the research. Vatican official Elio Dgreccia said: ‘Despite the efforts that are made to deny it, science continues to show us that the embryo is a human being in the making.’

One of Britain’s leading stem cell researchers, Dr Robin Lovell-Badge of the National Institute for Medical Research, said: ‘It is critical that the first steps to using human embryonic stem cell-derived cells for treatments are carried out with caution.

‘The last thing a field needs, especially one weighed down with so much ethical and political debate, is a disaster.

‘However, while it is right to proceed with care, at some point someone has to be brave. Many treatments that are today routine began with both the clinical teams and the patients taking a gamble, whether it was Christiaan Barnard and heart transplants or Edwards and Steptoe with IVF.’

Author:
• Tuesday, August 03rd, 2010

It’s one of the most infuriating things in the world.

Your best friend devours cream cakes by the plateful without putting on weight, but you gain 3lb by glancing at a chocolate bar. Now scientists think they know why.

A study suggests that the ‘propensity for obesity’ may be hardwired into the brain while we are in the womb.

Its findings will be welcomed by the millions of us who have struggled to lose weight despite sticking rigidly to calorie-controlled diets.

Dr Tamas Horvath, of Yale University School of Medicine in the U.S., said: ‘It appears that this wiring of the brain is a determinant of one’s vulnerability to develop obesity.

‘These observations add to the argument that it is less about personal will that makes a difference in becoming obese, and, it is more related to the connections that emerge in our brain during development.’

Britain, like most Western countries, is in the grips of an obesity epidemic with the number of fat people rising sharply since the 1960s.

Dr Horvath and colleagues studied a group of laboratory rats bred to be vulnerable to obesity.

They found that these naturally greedy animals were born with a major difference in the ‘feeding center of the brain’.

Neurons in the brain that are supposed to signal when enough has been eaten and when the body needs to burn off calories are far more sluggish in obese rats because they are inhibited by other cells, the researchers report in the journal Proceedings of the National Academy of Sciences.

However, in animals resistant to obesity, these same neurons are far more active – and quickly tell the rest of the brain and the body when enough food has been consumed.

The way the brain develops and whether it is vulnerable to obesity is influenced by genes and conditions in the womb, the researchers say.

Dr Horvath added: ‘Those who are vulnerable to diet-induced obesity also develop a brain inflammation, while those who are resistant, do not.

‘This emerging inflammatory response in the brain may also explain why those who once developed obesity have a harder time losing weight.’

In 1980, six per cent of men and eight per cent of women in Britain were obese.

Twenty years later, 22 per cent of men and 23 per cent of women are obese.

At least 20million people in this country are thought to be overweight, while 12million are clinically obese.

If the trends continue, one third of adults and half of all children will be obese by 2020.

Diet experts say the explanation for the wave of obesity is simple – that in an age of labor-saving devices and home entertainment, most people are doing too little exercise.

At the same time, high-fat, high-sugar foods are more widely available.

The new finding doesn’t explain why obesity is on the rise – but sheds light on why some people struggle to lose the extra pounds they get from a sedentary lifestyle.

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Author:
• Tuesday, August 03rd, 2010

Phases of healing

Early
Intermediate
Late
Terminal

Early wound healing events

Hemostasis
Platelet aggregation
Intrinsic and extrinsic coagulation cascade
Thrombin, fibrin
Vasoconstriction

Inflammation
Vasodilatation
Increase in vascular permeability
Chemotaxis
Cellular response

Intermediate wound healing events

Mesenchymal cell chemotaxis and proliferation
Angiogenesis
Epithelisation
2-4 days after injury
Mediated by cytokines

Fibroblasts- migration and proliferation
Smooth muscle

Angiogenesis- reconstruction of vasculature
Stimulate: High lactate, acidic Ph, low O2 tension
Endothelial cell migration and proliferation

Epithelisation
Partial thickness- Cells derived from wound edges and epithelial appendages.
Incisional wound: cellular migration over less then 1 mm. Wound sealed in 24-48h.

Cellular detachment
Migration
Proliferartion
differentiation

Late wound healing events

Collagen synthesis
3 helical polypeptide chains
Lysine and proline hydroxylation
Required for cross-linking

Wound contraction

Centripetal movement of the wound edges toward the center. ( 0.6-0.7 mm/day)
Begins at 4-5 days
Maximal contraction 12-15 days
Trivial component in closed incisional wounds, significant for closure of open wounds
Rate- depends on tissue
Circular wounds- slower closure but avoid stenosis

Mechanism- cell mediated processes, not requiring collagen synthesis
Myofibroblasts- fibroblasts with myofilaments in cytoplasm
Appear in wound day 3-21
Located in periphery- pull wound edges together.
Contractures- contraction across joint surface

Terminal wound healing events

Remodeling- turnover of collagen. Type 3 replaced by type 1
Day 21- net accumulation of wound collagen becomes stable
Wound bursting strength- 15% of normal.
Week 3-6- greatest rate of increase
6 weeks- 80-90% of eventual strength.
6 months maximum strength ( 90% ). Process continues for 12 months

Cytokines and growth factors

Primary mediators in wound healing.
Endo, para, auto, intracrine function
EGF
FGF
PDGF
TGF

Which of the following is primarily responsible for tensile strength in a healing wound 4 days after injury?

Collagen
Elastin
Fibrin
Fibronectin
Hyaluronic acid

Which of the following is primarily responsible for tensile strength in a healing wound 6 weeks after injury?

Myofibroblasts
Fibrin
Fibronectin
Collagen
Collagen cross linking

Infection
foreign body/ necrotic tissue, hematomas
local/ systemic factors
type of surgery

Hypoxia and smoking
O2 delivery necessary for cellular respiration and hydroxylation of proline and lysine
Smoking- vasoconstriction, atherosclerosis, carboxyhemoglobin.

Radiation
Collagen synthesized to abnormal degree- fibrosis
Fibrosis of vessels- (media)-occlusion
Thinned epidermis, pigmentation
Limited access of inflammatory cells and cytokines- impaired healing
Damage to fibrocytes and keratinocytes.

Systemic factors

Malnutrition
Limited AA supply for collagen synthesis
Consumption of proteins d/t CHD and fat deficiency.
Vit C deficiency- diminished hydroxylation of lysine and proline,
Vit D- impaired bone healing
Zinc- inhibition in cellular proliferation and defficient granulation tissur formation

Normal healing is accelerated by which of the following?
VitC
VitA
Zinc
Increased local oxygen tension
Scarlet red

Cancer
Cachexia, anorexia
Altered host metabolism.
Protein catabolism
Abnormal inflammatory cell response

Old Age

Diabetes
Impaired healing ( decreased chemotaxis and phagocyte function )
Risk of infection

Hypertrophic scars and kelloids

Excessive healing processes- increase in net collagen synthesis raised thickened scar
Keloid- Extension beyond wound margin, familial, may develop up to 1 year, rarely subside
Hypertrophic scar- Confined to wound margin, light skinned, early after injury, may subside, cause contractures
Tx- excision, steroid injection, pressure garments, radiation tx

Types of wound closure
Primary closure
Approximation of acutely disrupted tissue with sutures, staples or tape
Secondary wound closure
Open wound margins approximate by biologic contraction

If a patient requires reoperation 1 month after a midline abdominal incision which of the following promotes the most rapid gain in strength of the new incision
Separate transverse incision
Midline scar is excised with a 1 cm margin
Midline incision reopended without scar excision
Rate of strength ganed is not effected by incision technique