Healthy Live Tips

Teeth Whitening Treatments

noreply@blogger.com (Anonymous) — Mon, 10 Dec 2012 13:59:00 -0800

The teeth whitening product usually contains carbamide peroxide and hydrogen peroxide as the 'active ingredients'. When these ingredients break down, the oxygen enters the enamel of your teeth thus, making the color lighter. The entire treatment can be completed in three to four weeks time.

Bleaching. This is most common form of teeth whitening procedure. Your dentist will advice you if this is the best teeth whitening treatment suitable for you.
Bleaching is done by placing a gel or rubber to shield the soft tissue of your gums. Then, the whitening product will be applied on your teeth by using a special tray which shapes into your mouth like a gum shell.

For those who wish to undergo to this treatment, you will need at least three visits to the dentist. On your first visit, the dentist will create a mouth-guard and take a caricature or impressions of it. Once the treatment has started, it is recommended that you continue it at home. You have to regularly apply the teeth whitening product over four weeks, for at least 30 minutes at a time.

Most of the known and best teeth whitening products can be applied for up to several hours at a time. The treatment can be done even while you're sleeping. Ideally, a good result can be attained in as little as one week.Laser Whitening. This is also called the "power whitening". Though expensive, a lot of people especially artists consider it as the best teeth whitening method. During this process, a rubber dam is placed over your teeth to shield the gums, and the whitening product is then painted on your teeth. A laser will be used to stimulate the chemical. The light will help boost the chemical reaction of the bleaching product, thus the color change can be attained more rapidly.
Dentists believe that the result of laser whitening treatment is good. It can make your teeth up to six shades lighter.Unfortunately, not everyone can get a chance to undergo laser treatment. The dentist will have to check your teeth and ensure that you are fit for the treatment. The total procedure is usually done in an hour.
The effects of this power whitening is said to last up to three years depending on the person. The dentist still advice not to smoke, eat and drink products that may cause a stain in your teeth. Others may find their teeth vulnerable to cold after the treatment. But these symptoms usually vanish within a few days.
These are just two of the famous and best teeth whitening methods available. Despite the fact that they may cost a lot, the effect is still worth it. Through these methods, you'll surely flash everyone a perfect smile.

Modern Ways to Achieve the Perfect Smile

Everyone desires to have a great smile. For a killer smile, one should have sparkling, bright, and shiny teeth.

Today, a lot of people are spending more money just to have their teeth whiter. They make use of the best teeth whitening treatments and undergo procedures to achieve the brilliant white teeth.

Teeth whitening had been an effective procedure to lighten the color of the teeth, without taking away any of the tooth surface. It will not completely whiten the whole set of teeth; it will just lighten the existing color of the teeth.

Only a few are blessed with pearly white teeth, and our teeth normally become discolored as we grow up.

Our teeth can also be stained on the outer part because of the food and drink. Coffee, tea, blackcurrant and red wine have effect on the discoloration of our teeth. Smoking is another cause of teeth discoloration. Most people may encounter staining beneath the surface which is caused by tiny cracks in the teeth or certain antibiotics that absorb the stains.

Supplements of Natural Health

noreply@blogger.com (Anonymous) — Mon, 10 Dec 2012 03:49:00 -0800

Natural health supplements – which nutritional remedies work? Which don’t supplement your health? This Wonder Herb article shares the shocking truth. Natural Health Supplements and the Foods That Are Killing UsThe fact that you’re considering natural health supplements means you want to improve your health naturally. You probably know that cancer rates are higher than ever. That people are getting obscure diseases that didn’t even exist 50 years ago. That conventional medicine isn’t working.Why is this happening?Sure, it’s because the ever-increasing number of chemicals that we put on our skins and breathe in everyday but it also has a lot to do with our diets. More importantly, 50 years ago, even though we lacked education in nutrition, the health foods we did eat were rich in nutrients. We ate real apples that weren’t chemically altered - that were freshly picked - not the 6 month old, genetically modified ones we get in supermarkets today.

Then there’s the fact that today, people are busier than ever, so more and more families are turning to pre-packaged, frozen meals as their main source of nutrition, than ever before. Frozen pizzas, pasta, white breads, over-processed cereals, biscuits, coke, energy drinks, confectionary, pies, processed meats, tinned foods – many laced with chemicals, artificial colours and flavours and preservatives. Most families eat these regularly as part of their daily diets. The reality is they offer very few natural health benefits. The benefit of convenience is slowly killing us. We’re walking around overweight yet undernourished. We get more colds and flus than ever. There are more allergies in our schools than ever. And cancer rates are skyrocketing despite all the advancements in medicine.Today, health foods and natural health supplements are vital just so we can feed our bodies with the nutrition we need to live healthy lives – the nutrition that food gave us many years ago.The solution?Lay off the packaged, pre-processed foods and turn to fresh fruits, vegetables and unprocessed grains. And – supplement your diet with high potency natural health supplements. The right brands and the right type of health supplement and health foods, at the right potency are very powerful ways of boosting your health naturally - and in many cases, without the need to rely on conventional medicine.Which Nutritional and Vitamin Supplements Work Best For Your Health? Often, some of the most potent, natural (not synthesized) health remedies aren’t readily available commercially in supermarkets. Instead, they are available online so health food companies can provide you with the highest quality and highest dosage of active, natural ingredients without the high cost of being sold in-store.Ganoderma is one of them. For years, Chinese medical practitioners and herbalists have been hailing Ganoderma as the King of Herbs. The Ganoderma fungus is well known in Asia as being a master protector of the immune system. It has been known to do amazing things for cholesterol, blood pressure, inflammation, energy levels and dozens upon dozens of other health conditions.The revolutionary thing about Ganoderma is that it is a health food that is rich, not only in anti-oxidants, but it is also packed with organic Germanium, Adenosine, amino acids, Polysaccharides, Ganoderic acids, vitamins, proteins, enzymes and minerals. Uniquely, it is also classified as an adaptogen. In other words, it actually penetrates and cleans toxic cells.It’s little wonder then that natural health practitioners and Chinese herbalists rave about medicinal mushrooms. And with Ganoderma Lucidum being the richest in nutrients of all the medicinal mushrooms, it makes sense to add Ganoderma to your health arsenal.For more information on Ganoderma and other natural, high potency natural health supplements, just check out the Wonderherb online health store where you can research and buy some of the world’s greatest “wonder herbs” online.It’s little wonder then that natural health practitioners and Chinese herbalists rave about medicinal mushrooms. And with Ganoderma Lucidum being the richest in nutrients of all the medicinal mushrooms, it makes sense to add Ganoderma to your health arsenal.For more information on Ganoderma and other natural, high potency natural health supplements, just check out the Wonderherb online health store where you can research and buy some of the world’s greatest “wonder herbs” online.It’s little wonder then that natural health practitioners and Chinese herbalists rave about medicinal mushrooms. And with Ganoderma Lucidum being the richest in nutrients of all the medicinal mushrooms, it makes sense to add Ganoderma to your health arsenal.For more information on Ganoderma and other natural, high potency natural health supplements, just check out the Wonderherb online health store where you can research and buy some of the world’s greatest “wonder herbs” online.It’s little wonder then that natural health practitioners and Chinese herbalists rave about medicinal mushrooms. And with Ganoderma Lucidum being the richest in nutrients of all the medicinal mushrooms, it makes sense to add Ganoderma to your health arsenal.For more information on Ganoderma and other natural, high potency natural health supplements, just check out the Wonderherb online health store where you can research and buy some of the world’s greatest “wonder herbs” online.It’s little wonder then that natural health practitioners and Chinese herbalists rave about medicinal mushrooms. And with Ganoderma Lucidum being the richest in nutrients of all the medicinal mushrooms, it makes sense to add Ganoderma to your health arsenal.For more information on Ganoderma and other natural, high potency natural health supplements, just check out the Wonderherb online health store where you can research and buy some of the world’s greatest “wonder herbs” online.

Sex Hormones Are Not Just for Baby-Making

noreply@blogger.com (Anonymous) — Sun, 16 May 2010 09:58:00 -0700

The preceding discussion notwithstanding, the ovary is more than just a storehouse for eggs. The bioidentical hormones that it produces ensure that our bodies will function properly throughout our lives, not just during our reproductive years.
I mentioned earlier that bioidentical hormones travel in the bloodstream to cells and tissues throughout the body, powerfully affecting our health. But once hormones reach their intended destinations, you may wonder, how do they actually exert their effects? Cells that depend on hormones to function properly have protein molecules called hormone receptors that act like tiny ignition starters. And the hormones, logically enough, act like tiny keys. When a hormone—say estrogen— encounters a cell that has a receptor for estrogen, it’s like when you put your key into your car’s ignition and turn it on to start the engine. When estrogen binds to and turns on the estrogen receptor, it stimulates the cell to produce a cascade of proteins that influence its behavior.
Estrogen receptors are found not only in the cells of reproductive organs, such as the uterus and breast, but also in the cells of the liver, digestive system, urinary tract, heart, blood vessels, bone, skin, and the brain.
The exact effect of estrogen depends on the type of cell that it encounters. For example, in the uterus and breast, estrogen’s main effect is to cause the cells that line the uterus and the milk ducts to grow and divide in preparation for pregnancy. In the liver, estrogen acts to control the production of cholesterol in ways that influence the buildup of harmful fatty deposits in the arteries. In the skeleton, estrogen preserves bone strength by helping to maintain the proper balance between bone buildup and bone breakdown. And in other parts of the body, estrogen appears to play a role in the regulation of body temperature, the ability to recall information from memory, and the elasticity of arteries and skin. This is only a partial list of estrogen’s effects.
When estrogen levels drop, the rate of bone loss accelerates rapidly. Indeed, the average woman loses 2 to 3 percent of bone mass a year for the first three years after menopause. As a result, osteoporosis is much more common in the decades after menopause. A woman’s risk of heart disease also increases sharply after menopause, but estrogen’s role in this process is still under study.
Two types of estrogen receptors—alpha and beta—have been identified. Scientists have known about the alpha receptor since the 1950s, but the beta receptor was identified only in 1996. In general, there are more alpha receptors in the reproductive organs (e.g., uterus and breast) and the liver, while beta receptors are more abundant in other tissues, such as bone and blood vessels. Estradiol appears to bind equally well to both types of receptors, while estrone binds preferentially to the alpha receptor and estriol to the beta receptor. We do not fully understand the role of the two types of estrogen receptors, their exact functions, or how they relate to the benefits and risks of our natural estrogen or the estrogen in traditional hormone therapies for menopause.
Nevertheless, recognition of differences in receptors has allowed pharmaceutical companies to manufacture a new class of medicines called selective estrogen receptor modulators (SERMs)—or, to use the more glamorous name, “designer hormones”—that act on one or the other of these receptors to selectively block or stimulate estrogen-like action in various tissues.
One of the first SERMs to be developed was tamoxifen. Known by its trade name Nolvadex and also available as a generic, tamoxifen is prescribed to treat breast cancer and prevent its recurrence in women with a history of the disease and to prevent its development in women at high risk. In the breast, tamoxifen acts as an antiestrogen by binding to the alpha receptor, thus preventing estrogen from accessing it. In other parts of the body, however, tamoxifen acts like estrogen. Another SERM, raloxifene, known by its trade name Evista, is approved for prevention of bone thinning in women after menopause and is being studied as a way to prevent breast cancer. In a recent “head-to-head” trial, raloxifene and tamoxifen provided similar protection against breast cancer but raloxifene had fewer risks. Both of theseSERMs increase hot flashes and the risk of blood clots, however. In the future, watch for additional developments with SERMs, which could eventually be designed to ease symptoms of menopause and protect bone and heart health without adding to the risk of breast cancer.
As with estrogen, receptors for progesterone also come in at least two forms. However, even less is known about their precise roles and functions, or how this information could be used to develop safer or more effective forms of hormone replacement therapy.
In addition to estrogen and progesterone, generally known as the female sex hormones, the ovaries, along with the adrenal glands, produce small amounts of male sex hormones known as androgens, including testosterone. Testosterone levels in women are only one-tenth as high as in men. Androgens are thought to work in concert with estrogen to maintain a woman’s sex drive, bone and muscle health, energy level, and psychological well-being. Indeed, androgen receptors are found in many of the same cells that have estrogen receptors.
Interestingly, a large proportion of the androgens produced by the ovary and adrenal gland are converted to estrogen by an enzyme called aromatase found in fat and muscle. (Other organs that contain aromatase include the brain, hair, skin, and bone marrow.) After menopause, this conversion actually represents the main source of estrogen in women. Because aromatase is found in fat cells, women who are overweight or obese tend to have higher levels of estrogen than thinner women.
At the same time, because muscle cells are also rich in aromatase, women with more muscle mass are more likely to have higher estrogen levels than their scrawnier counterparts. This is thought to be why heavier women, and women who keep their muscles active with physical activity, may be less likely to suffer from certain symptoms of menopause.
In recent years, medicines called aromatase inhibitors—anastrozole (Arimidex) and letrozole (Femara)—have been approved to treat women with early-stage breast cancer. These medicines work by blocking the aromatase enzyme, thus preventing the conversion of androgens to estrogen in fat, muscle, and other tissues. Together with tamoxifen, aromatase inhibitors form a powerful new arsenal to fight breast cancer. (Not all breast cancer cells have estrogen receptors, though. These medicines stifle the growth of breast cancer cells that have estrogen receptors but do not affect the growth of breast cancers that lack estrogen receptors.)

PROBLEMS IN EARLY PREGNANCY

noreply@blogger.com (Anonymous) — Tue, 18 Nov 2008 14:26:00 -0800

One of the earliest predicaments to confront a woman who has missed one or two periods, involves this all absorbing question, “Am I pregnant?” There are several simple techniques to determine pregnancy with reasonable certainty, right within one’s own home. A suspicion arises when there is a miss of the normal menstrual period. If menses have been regular for several months, then the intuition heightens. Many women have months when they skip the cycle normally. Others have periods too scant to notice. Then the diagnosis of pregnancy becomes more difficult.
Symptoms of pregnancy may be present. You may experience a feeling of nausea, typically in the morning. This is occasionally associated with prolonged vomiting lasting throughout the day. The breasts may swell and become more tender than is usually associated with the premenstrual state. A slight change may occur in the vaginal discharge. Occasionally, a woman who has had previous children just “feels pregnant.” In pregnancy after three to four months, a “lump” may actually be felt above the pubic bone, located in the lower abdomen. This is probably the enlarging womb. By five months gestation it will usually reach to the navel, with an obvious rounded prominence in the lower abdomen. Fetal movements may be sensed at four to four and a half months, though they are sometimes detected earlier by experienced mothers carrying their second or third child.
In most pharmacies today, you can purchase a urine pregnancy test kit. This analysis very simply measures the amount of HCG (Human Chorionic Gonadotropin), a hormone secreted by the developing placenta. A positive test for pregnancy develops within three to six weeks after conception. Use a concentrated morning urine sample for best reliability. If performed according
to directions, these tests are quite dependable in confirming the suspicion of pregnancy.
Vague abdominal pains are sometimes felt in early pregnancy. Pelvic pain may occur from pressure on an enlarged ovary, or from a “tilted” uterus. As it enlarges, the organs become tighter in the pelvis, while the womb has not yet risen into the abdominal cavity. Pain could be related to constipation, or to cystitis. Usually, a bladder infection is characterized by burning combined with a frequent urge to urinate. Stretching of the ligaments that support the uterus may produce pain. In later months, the pressure of a fetal part on a pelvic nerve or a sudden shifting of the baby within the womb may give rise to such symptoms. Usually reassurance is all the patient needs. Severe pain or sudden changes in health status should be called to the attention of a physician immediately, however, since it could be an ectopic (tubal) pregnancy. If this goes unrecognized it could rupture, with internal hemorrhage and potential disaster. Appendicitis may occasionally be superimposed upon pregnancy, requiring early diagnosis and prompt surgical treatment as usual.
Vaginal bleeding sometimes occurs, even after pregnancy begins. Usually this appears scant and transient, but at times it may be profuse. When an actual hemorrhage develops after pregnancy has established, this constitutes an obvious threat of miscarriage. The presence of regular contractions and pelvic pain, combined with vaginal bleeding, should alert to this possibility. At times a miscarriage may occur with the complete passage of the placenta and the subsequent stoppage of bleeding. If incomplete expulsion of the placenta or fetal tissue occurs, a simple operation, called a D and C (dilation and curettage), should be performed, so the bleeding will stop and the uterus can return to its normal size. Fever in the presence of a miscarriage is a more ominous sign, as it probably indicates the presence of pelvic infection.
For treatment of threatened miscarriage, bed rest is always advisable. The absence of straining, standing, or moving about lessens the flow and usually decreases the likelihood of a miscarriage. Sexual intercourse should be avoided in early pregnancy, particularly near the times when a menstrual period would otherwise occur. Uterine cramping and the likelihood of miscarriage is greater at these cycles, for reasons yet unknown. Hormones are no longer given routinely to mothers threatened with miscarriage. They are powerless to stop the inevitable. Furthermore, progesterone concentrates may cause damage to the fetus, if it is carried to term. Scientists believe that many spontaneous miscarriages are the result of some chromosomal defect, which
otherwise would have led to congenital deformity. They are eliminated by nature before the pregnancy goes too far. This is of considerable consolation to parents, suddenly disappointed by the premature loss of a long-looked-for baby. Most couples can wait a few months, then try again.
One of the more troublesome conditions of early pregnancy, sometimes lasting for months, is an upset stomach. Called “morning sickness,” for obvious reasons, nausea and vomiting tends to herald the onset of pregnancy. Although only a few ladies find it incapacitating, these symptoms tend to hinder proper nourishment, so important in the early months of pregnancy. This nausea may last throughout the day. On the other hand, it may be relieved by eating some crackers or other form of dry food. Frequently, the appetite completely changes, and the “lady-in-waiting” craves foods that were formerly disliked. In extreme cases this so-called pica (abnormal craving) is manifested by the “clay eating” habit of southerners, or the strange love for “pickles and ice cream” that ordinarily seems like a repulsive combination.
Mothers need to be careful that their appetites are controlled by reason when such cravings become abnormal. Where vomiting in pregnancy becomes persistent, hospitalization may prove necessary. One or two days of intravenous feedings is normally sufficient to bring back a normal digestion once again. Emotional contributions to this gastric problem are frequent. These can be related to ambivalence about being pregnant, or an underlying temperament of nervousness manifested in an unusually sensitive stomach. Nevertheless, the physiologic and hormonal changes that occur are profound. Such endocrine considerations may well explain these early digestive symptoms. A tolerance for food usually emerges by the fourth month, enabling a normal digestive tone to continue for the remainder of pregnancy.
Adequate fluid intake is vitally important from the start. It is suspected that the common, insufficient intake of water is one principal cause of persistent nausea and vomiting. Drink at least six to eight glasses of water per day, at whatever temperature is best tolerated by the sensitive stomach. If the mother avoids soups and creamed mixtures, and chews thoroughly a rather dry meal of whole grain crackers, breakfast cereals, or raw vegetables, her food will stay down better and permit the best nutrition at this critical stage. Vaginal discharge is often troublesome during the latter months of pregnancy. This may be due to the parasite Trichomonas, but is more commonly caused by a buildup of yeast or Monilia (Candida albicans).
Hormone changes combined with increased perineal moisture and warmth, create an environment favorable to the growth of these organisms. Diabetes mellitus, particularly aggravates the tendency to develop yeast infections.
Administration of hormones such as the birth control pill may produce a diabetes-like state in non-pregnant women. However, pregnancy increases this trend. Nylon underwear, panty hose, and tight slacks tend to increase the propensity for vaginitis. This is because greater warmth and moisture are produced in the perineum when one wears those synthetic fabric materials. Air circulation around the body and “breathing” of the skin is impeded. Then it leads to the rapid multiplication of yeast germs with such unpleasant symptoms as discharge, burning, itching, and skin rash. Gentle vaginal douches, with a dilute vinegar solution (one tablespoon of white vinegar to one quart of warm water) can help decrease the discharge and restore normal acidity to the birth canal. Specific agents are available to help in acute stages (such as Massingill products). However, the intestinal tract always harbors these germs, so it is impossible to completely escape from them. Therefore,you will find it preferable to build up resistance and let improved health of the body create its own defense. Marital relations should be avoided, not only when discharge or infection is present, but during any time of spotting or uterine cramping. Moreover, for at least four to six weeks prior to the birth of the baby, intimate relations should likewise be curtailed, since a significantly increased risk of infection in the amniotic fluid surrounding the baby has been linked to intercourse at this stage. Sexual continence at this critical time will be rewarded with better health, as well as peace of mind.

Anesthesia

noreply@blogger.com (Anonymous) — Fri, 12 Sep 2008 23:53:00 -0700

One of the oldest forms of medical treatment is described in Genesis 2:18, 21-23, where the Creator Himself “caused a deep sleep” to come upon Adam while He took out the rib, closed up the incision, and made a “help meet for him.” Relief of pain is intimately associated with the rendering of needful medical care. This is one of the physician’s cardinal responsibilities.
For certain patients, some forms of severe pain may be life threatening. However, in the case of most effective pain relieving medications, addiction can occur, with distortion of mental imagery to the point of serious impairment. Thus, it is wise to look for the simplest methods of relieving pain when attempting to perform surgery.
Probably the oldest form of pain relief is refrigeration anesthesia. Extremities can be rendered pain free with ice packs. This is particularly valuable in the case of vascular disease where cardiac and circulatory impairment makes general anesthesia risky. During the World War II, army medics discovered that troops suffering from frostbite might save their limbs if the extremity remained frozen until medical care could be secured. This observation influenced all currently accepted first aid for frostbite used in our country.
In order to properly administer refrigeration anesthesia, the extremity needs to be cooled to the point of numbness, while keeping the remainder of the body warm to avoid a general drop in emperature, chilling, or agitation. Ice packs or snow can be used to progressively cool an xtremity, either a hand or foot. If the surgery is to be localized to the arm or leg, place the pack
just above the site of amputation. This reduces blood loss and allows for a careful, meticulous dissection of the tissue. Broken bones can be set with refrigeration. In the case of a simple fracture of the hand or wrist, immerse the extremity in ice water for one-half hour or more. This will allow manipulation and bone setting to be done quite painlessly.
Refrigeration can also be used topically in the removal of warts, moles, and other skin lesions. Dry ice or liquid nitrogen can be applied with a cotton applicator to freeze a small area and render it numb to pin prick.
A second method of anesthesia is the application of gradual pressure on a nerve. The ulnar nerve at the elbow (funny bone) is quite amenable to pressure. Quite often in certain positions a foot or a hand has been known to “go to sleep” due to stretching or pressure on an affected nerve. nowledge of neuroanatomy can utilize this principle favorably for surgery to an extremity.
Counterirritation can also be applied with electric stimulation near the point of incision. This can utilize DC current, but it is more effective with a pulsed generator, such as rehabilitation centers employ in treatment of chronic pain. Desensitization can be obtained with liniments and ointments, mustard packs or plasters. Even animal surgery has been performed using
counterirritation, e.g., the “twitch” on the nose of horses. Finally, it is helpful to understand some of the common injectable anesthetics that are used locally for the relief of pain. These are used both in dental and surgical care. But they have some side effects and potential allergic reactions. Injectable narcotics should always be avoided, as they leave behind serious effects on the brain. They are not only difficult to metabolize, but because of their tendency to produce euphoria can become rapidly addicting. On rare occasions for major procedures, general anesthesia may be necessary. The gaseous agent used in these cases should be that which is most rapidly metabolized and least toxic to the system. Nitrous oxide and oxygen are commonly employed together to relieve mild pain. Although ether is quite flammable, it still remains the safest form of general anesthesia, due to its rapid clearing from the blood by the way of the lungs and relatively low toxicity to the liver and other organs. Open drop techniques in a well ventilated area can be used, but for safety reasons general anesthesia ideally should be performed in a hospital. Newer anesthetic agents (Halothane, Ethrane, etc.), although more likely to cause toxicity, are less dangerous to the heart and usually nonflammable. Regional blocks, local nerve blocks, and spinal anesthesia have their places in hospital settings but it is beyond the scope of this book to detail their applications.

Suturing

noreply@blogger.com (Anonymous) — Thu, 11 Sep 2008 22:46:00 -0700

Considerable practice is required to suture incisions and lacerations quickly and accurately. Yet these skills are not beyond the reach of the average layman gifted with manual dexterity or an interest in mastering the art. If possible, practice your suturing techniques on a piece of sponge rubber, upholstery, or even a pillow. Some surgeons become skilled in knot tying, practicing on door handles or in the automobile while traveling. The accompanying diagrams, located on pages 178 to 189, help demonstrate the principles of the three basic methods of surgical knot tying. The one described as an “instrument tie” utilizes a hemostat or needle holder, while the others require only skillful fingers for proper use. I would suggest that a novice begin with the two-handed tie and instrument tie, adding more complex forms as skill is gained.
Avoid tying the sutures so tightly that insufficient blood flow to the skin edges results. This would cause delayed and incomplete healing of the wound.
“Approximate, don’t strangulate” is the watch word for closure of lacerations with sutures. Human bites, animal bites, and lacerations opened longer than 12 hours, or those grossly contaminated are not sutured, but allowed to granulate and heal by secondary intention.
The placement of sutures and selection of suture material will be described in the following sections, as the various types of lacerations and their special care are considered. In a home-like setting it is possible to make the appropriate needles, like bending a sewing needle, sharpening the point in a chisel fashion to better penetrate the skin. Silk or cotton can be boiled along with the needle, thus sterilizing it for use in suturing. Prepared packages, that come already sterile, are available from suture manufacturing companies and can be obtained in various sizes and needle styles. Remember to consult the suture use manual for aid in selecting the appropriate sutures.

Wound Care

noreply@blogger.com (Anonymous) — Wed, 10 Sep 2008 22:42:00 -0700

There are three basic methods by which a wound heals itself. Primary Intention is the usual type of healing when an incision or laceration is closed immediately to allow close adherence of the opposing skin edges and subcutaneous layers. This permits healing from side to side with the east amount of scarring and pain. The rate of healing of our skin depends on its blood supply and the presence or absence of pressure, tension, and infection. The facial skin, with its rich blood supply, can heal in 3-5 days, while a thickened area of skin with less nutritive potential, such as the back or feet, may require two weeks or more. If sutures are placed, it is important to know how long healing will require to avoid too early removal and wound separation.
Secondary healing of a wound occurs when the laceration is too large to be closed or is infected and must be left open. A general principle of laceration treatment is this. A wound that has been open more than 8-12 hours is never sutured, since infection may already have developed. In uch case, granulation occurs with the formation of a specialized tissue across the wound, and later coverage with new skin. Some deformity and scarring usually occurs. Nevertheless, with the exception of very large ulcers, the skin healing is usually complete. Understandably, this akes longer. Proper care of the wound to prevent or treat infection will serve to hasten the healing process.
The third method involves the initial formation of granulation tissue, then a secondary closure of the wound with sutures. This accelerates the healing in large open lesions and is usually used hen a surgical wound, for some reason, separates and must be closed again. Even more scarring takes place as a rule, but the healing is usually complete.
Some essential factors in wound healing are the presence of adequate protein, vitamins, oxygen, and the prevention of infection. It is generally recognized that the normal rate of healing in a perfectly healthy patient is the optimum rate that can be obtained. Wounds do not heal as well in anemic patients. With a normal complement of white blood cells the healing of a sterile wound is not impaired. However, when infection is present delayed healing does occur. Swelling (edema), whether local or general, appears to interfere with the healing process. Older individuals take onger to heal than the young. Endocrine factors, such as the possible deficiency of thyroid or growth hormone, or adrenal dysfunction, may retard or interfere with the healing process.
Local factors are important. According to Van’t Hoff’s law, reactions occur more rapidly when the temperature is increased. Conversely, hypothermia will delay wound healing in most areas, lthough cold is sometimes used for pain control. The areas of the skin which have the best blood supply, such as the face and neck, normally heal the fastest. Fat persons tend to heal more slowly, and their wounds tend to separate more often than in people of normal weight. Skin utures are usually left in longer. Cleanly incised wounds will heal more rapidly than irregular jagged lacerations. The presence of a blood clot or hematoma may interfere with proper wound healing by preventing close contact of the walls of the wound, and thus there forms a pocket, called “dead space.” Infected fluids, pus, and foreign bodies will all retard the healing of these wounds. It is critical to cleanse the wound of all foreign debris, irrigating it thoroughly before any suturing is attempted. Suture material is also important in the care of wounds. Although stainless steel is the least reactive, it is difficult to handle and remove. The absorption of foreign material, such as gut, silk, cotton, and nylon will occur slowly, in the order that they are here
mentioned. Newer sutures of nylon, Dacron, and Teflon last longer and cause less reaction, but are not suitable everywhere. A suture use manual may be consulted to aid in selecting ppropriate materials. The suture manufacturer’s suggestion of needle size, type, and techniques should also be consulted.

Caries

noreply@blogger.com (Anonymous) — Tue, 9 Sep 2008 23:07:00 -0700

Tooth decay (dental caries) starts with the destruction of the enamel cap by micro-organisms
present in the oral cavity and adherent to the tooth surface. This leads to exposure of the underlying dentin to the oral environment and to its destruction by bacterial proteolytic enzymes. The dental management is the way of teeth manage. Caries will not occur that somebody have a good dental management.
Enamel caries will not be visible in routinely prepared histologic sections as this tissue dissolves
completely during decalcification. In ground sections made from undecalcified teeth, microscopic
examination under transmitted light will reveal optical alterations related to decreased mineral content of a still-intact crystalline structure.
These alterations tend to occur over a coneshaped area having its base on the surface and its point towards the amelo-dentinal junction. With increasing loss of minerals from the enamel structure, this tissue will disintegrate. The dental consultant can make some suggestion about the caries.
Sometimes, this destroyed enamel will contain so much organic material that it is still present in decalcified sections where it is visible as a basophilic amorphous mass.
The initial carious lesion in dentin afflicts the tubuli that serve as a highway for bacteria to spread into the dentin. As the tubules of the carious dentin become more distended due to breakdown of their walls by the proteolytic enzymes excreted by the invading bacteria, they may fuse and form spindle-shaped cavities perpendicular to the tubules. Fusion of afflicted tubules over a longer distance may also create spindle-shaped cavities in the same direction as the tubuli run. Through the continued loss of dentin between the tubules, its inner structure crumbles away .
When caries is not halted by dental treatment, bacteria and their toxic products will reach the
soft inner part of the tooth, the dental pulp, and evoke an inflammatory response . Subsequently,
the pulp dies and toxic substances from the pulp space diffuse through the apical foramen into
the adjacent periapical part of the periodontal ligament and surrounding jaw bone. Periapical
disease will now ensue. If the root surface of a tooth is exposed due to periodontal disease, the root-covering caries may also be the victim of carious decay. At this site, the bacteria penetrate into the cementum using the collagen fibres that once anchored the tooth in its tooth socket as pathways. The dental consultants can make solution about it.

Antisepsis

noreply@blogger.com (Anonymous) — Tue, 9 Sep 2008 22:39:00 -0700

One of the outstanding advances that medical science has made in the past hundred years is the establishment of antiseptic principles in the practice of surgery. Milestone discoveries were the germ theory by Pasteur and Koch, the emphasis on hand washing by Semmelweis, and the principles of antisepsis by Lister. To understand the relationship between infective agents and disease has allowed the art and science of surgery to develop many new techniques, as well as life-saving procedures.
Fundamentally, the principles of antisepsis deal not only with the presence or absence of germs, but also with the resistance of the person (host) to their invasion. The acid mantle of the skin and our body’s resident normal flora constitute an important barrier to the growth of disease-producing germs. Enzymatic protection by lysozyme in the nasal secretions, tears, saliva, and other mucous membranes affords a defense of marvelous significance and complexity.
From simple wound care to most complicated surgery, every individual should know how to avoid contamination by harmful germs. During the 19th century in Austria, Doctor Semmelweis began to encourage hand washing, requiring this of his residents after each post-mortem examination and before contact with maternity patients. The death rate from infection dropped
precipitously. Although this brilliant physician was persecuted by his own profession for these “strange” doctrines, decades later he was acclaimed a medical trailblazer. Without doubt, the washing of hands is as important to safe surgery, as the use of water internally is to fighting fever.
It is especially important to know how to wash the hands and prepare them to handle diseased or injured tissues. Usually before surgery, a soft disinfected bristle brush is used to scrub the hands starting first around each finger, the ends and sides of the fingernails, the palm and backside of the hand, the wrist, and then the forearm. To prepare for a delicate operation, ten minutes of this type of scrubbing is required, typically with an antibacterial soap. Sterile rubber or latex gloves should then be worn. Disinfectants such as organic iodine (Betadine), hexachlorophene (Phisohex), or other antibacterial soaps are used to prepare the patient’s skin for the incision. Where this is not available, soap and water are employed, however the scrubbing must be prolonged. It is well to remember, moreover, that the mere washing of the hands with any substance does not guarantee a totally germ-free skin.
Sweating is especially common under rubber or latex gloves, with the natural bacteria present in hair follicles and around the nails. Thus the bacterial count is only transiently suppressed, while our real line of defense is our body’ sresistance. Several routines and techniques of skin preparation will be described in the accompanying table.
In the treatment of skin wounds, copious irrigation with water is essential, With some force, the stream of water is directed at the contaminated areas. The wound is thereby cleansed, allowing germs, foreign debris, and blood clots to be washed away, making the area clean for closure or suturing. Preparation of the skin with appropriate antiseptics is also helpful. Proper nutrition to the injured area includes abundant oxygen and vitamin C to aid wound healing. Elimination of refined sugar assists in fighting infection. These measures, together with the avoidance of tobacco and other harmful substances that impair oxygen supply, will enable healing to occur rapidly.

The Inflammation Theory of Aging

noreply@blogger.com (Anonymous) — Thu, 24 Jul 2008 19:32:00 -0700

The majority of the free radicals are derived from oxygen. Thus, theb damage being done by these free radicals is known as oxidative damage. When a cell has a high level of free radicals present, we call this oxidative stress, and oxidative stress leads to the production of chemicals that create inflammation within the cell. This process is a vicious cycle, as free radicals can initiate inflammation and inflammation can initiate the production of free radicals.The scientists who argue in favor of the free-radical theory of aging must now go beyond this premise if we are to stop and help reverse cellular degeneration. Free radicals exist only for a nanosecond and therefore do very little direct damage to cellular molecules. However, what they do accomplish, in their very brief life, is the initiation of an inflammatory cascade, which can continue for hours or even days.The long life of the inflammatory cascade results in most of the cellular damage that leads to aging and age-related diseases. Fortunately for us, our bodies already contain certain defenses against free radicals and inflammation. Our bodies can actually make a variety of enzyme antioxidants that suppress or alter free radicals. (An enzyme is a protein that accelerates the rate of chemical reactions.) They are referred to as endogenous antioxidants because they are made internally by the body. Another way of obtaining antioxidants is through our diet or by taking nutritional supplements. We call these exogenous antioxidants because they come from outside of the body.We are all familiar with many of these antioxidants, such as vitamins C and E, as well as the multitude of phytonutrients that are available in fresh fruits and vegetables.Antioxidants are critical in anti-aging medicine because they act as natural anti-inflammatories, giving us protection against the inflammation initiated by free radicals that causes cellular damage. When this damage occurs internally to our vital organs, such as the brain, it results in problems such as Parkinson’s disease, Alzheimer’s, and dementia. It can also damage the lungs, resulting in decreased respiratory function, as well as the heart and the kidneys.And it is not just our internal organs that suffer. Free-radical damage and inflammation is apparent in our appearance with each passing year. It manifests in very visible damage to skin, resulting in the thinning of the skin, deep lines, wrinkles, sagging, and loss of tone, texture, and radiance. Negative changes in our muscle mass, known as sarcopenia, along with the loss of critical bone mass (osteopenia and osteoporosis), also occur. Each of these changes, whether external or internal, is the initial result of damage on a molecular and cellular level.

Disorders of the Augmented Breast

noreply@blogger.com (Anonymous) — Thu, 24 Jul 2008 10:36:00 -0700

At least 4 million American women have had breast implants. Breast augmentation is performed by placing implants under the pectoralis muscle or, less desirably, in the subcutaneous tissue of the breast. Most implants are made of an outer silicone shell filled with a silicone gel, saline, or some combination of the two. Capsule contraction or scarring around the implant develops in about 15–25% of patients, leading to a firmness and distortion of the breast that can be painful. Some require removal of the implant and surrounding capsule. The FDA has reapproved silicone implants for augmentation cosmetic surgery.
mplant rupture may occur in as many as 5–10% of women, and bleeding of gel through the capsule is noted even more commonly. Although silicone gel may be an immunologic stimulant, there is no increase in autoimmune disorders in patients with such implants. The FDA has advised symptomatic women with ruptured implants to discuss possible surgical removal with their physicians. However, women who are asymptomatic and have no evidence of rupture of a silicone gel prosthesis should probably not undergo removal of the implant. Women with symptoms of autoimmune illnesses should address the possibility of removal with their practitioner.
Studies have failed to show any association between implants and an increased incidence of breast cancer. However, breast cancer may develop in a patient with a silicone gel prosthesis, as it does in women without them. Detection in patients with implants is more difficult because mammography is less able to detect early lesions. However, after a woman who had mastectomy undergoes breast reconstruction with implants, the prosthesis should be placed retropectorally. Local recurrence of cancer is usually cutaneous or subcutaneous and is easily detected by palpation.
If a cancer develops in a patient with implants, it should be treated in the same manner as in women without implants. Such women should be offered the option of mastectomy or breast-conserving therapy, which may require removal or replacement of the implant. Radiotherapy of the augmented breast often results in marked capsular contracture. Adjuvant treatments should be given for the same indications as for women who have no implants.

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Hair Treatments

noreply@blogger.com (Anonymous) — Wed, 23 Jul 2008 10:16:00 -0700

Hair treatments can consist of methods to curl, straighten, bleach, hair loss and dye the hair. These treatments may or may not cause damage to the hair cuticle and shaft. The variates for hair treatments include Absent/Not Apparent, Dyed, Bleached, Permed, Combination, and Other. The variate Absent/Not Apparent refers to hairs that appear to have had no treatment with regard to color and curl. The variate Dyed refers to hairs that show evidence of artificial coloring. The variate Bleached refers to hairs that have been treated to remove the natural hair color. The variate Permed refers to hairs that have been treated to alter the natural curl. The variate Combination refers to hairs that have been treated using more than one of the previously discussed hair loss treatment methods (e.g., some hairs may have been bleached and subsequently dyed during the same treatment process).
The variate Other refers to hairs that appear to be treated, but the observed treatment cannot be categorized as dyed, bleached, or permed.
The result of some treatments may be apparent using light microscopy, while others are not as easily detected. A hair that has been dyed may be apparent by the presence of a demarcation line, or a sharp boundary between the treated portion of the hair and the naturally pigmented newly grown portion. A dyed hair may also exhibit the dye color in the cuticle. A dyed hair also will be apparent by the uniformity of the color distribution. Some hair examiners may recognize a dyed hair based on their observation that the color of the subject hair is not typical of naturally colored hair.
The bleaching of hair may result from an artificial bleaching process, or it may result from natural exposure to the sun. A hair that has been bleached from exposure to sun is often referred to as a solar-bleached hair. A bleached hair may be recognized by the presence of a demarcation line between the treated portion and the naturally pigmented newly grown portion. The bleached portion may contain no pigment granules, or it may contain significantly fewer pigment granules than the natural portion. The demarcation line of solar-bleached hair typically is not as distinct as the demarcation line of artificially bleached hair. Repeated dyeing and bleaching of a hair may result in several lines of demarcation that might render a hair as being
unusual, resulting in a hair comparison that might have greater significance.
Hair Loss Product help the damage to the hair cuticle and shaft.The observation that a questioned hair and known hairs have received the same treatment may add to the strength of a hair comparison, but the widespread use of hair treatments may also limit the significance of the correspondence.
Permanent waved hairs sometimes may have buckles or bends in the hair shaft due to the use of perm curlers. These buckles may present themselves at roughly even intervals along the hair shaft due to the manner in which the hair is wrapped around the curler. Artificially straightened hairs sometimes may be recognized by the simple observation that a straight hair has
a cross-sectional shape (e.g., oval, flat) that is more consistent with curly hair.

Regional Human Hair Characteristic Variates

noreply@blogger.com (Anonymous) — Wed, 23 Jul 2008 10:08:00 -0700

The older terms “Mongoloid,” “Caucasoid,” and “Negroid” used to describe the major population groups of humankind are replaced in this atlas with the more modern terms East Asian, European, and African (meaning sub-Saharan African), respectively. These terms were adapted from Brace.
The populations of the Indian subcontinent are allied with the European populations in terms of anthropological kinship.However, the scalp hair of the Indian subcontinent populations is more closely allied with the hair type of the East Asian populations, as is the scalp hair of the native populations of North, Central, and South America. Although the native populations of the Americas are allied with the East Asians anthropologically, many of the populations of Mexico and the other countries of Central and South America are of mixed heritage, so the scalp hair of these populations may represent characteristics consistent with those of a mixed heritage.
Forensic anthropologists rely primarily on skeletal analysis for an accurate estimate of original geographic origins. The depth of skin pigmentation has considerable overlap between individuals of African, European, and East Asian geographical origin, as does hair form among individuals of European, African and East Asian populations. Hair color, form, and degree of curl, however, can provide an indication of the geographical ancestry of the individual from whom a questioned hair originated. Those indications of the geographical heritage of an individual who is the source of a questioned hair can be of considerable value in the forensic examination of human hair, particularly with regard to providing investigative leads as to the possible regional ancestry of the individual from whom a questioned hair originated.

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General Dentist : Patient Evaluation and Medical History

noreply@blogger.com (Anonymous) — Tue, 22 Jul 2008 09:28:00 -0700

To provide the general dentist with specific information about oral surgery procedures that are performed daily in general dentists’ offices. Some advanced information is also given to provide the more experienced general dentist the opportunity to further his or her skills and knowledge. The ability of a general dentist to perform these procedures is based on a number of factors. Some dentists have a great interest in surgery, while others have very little interest. Some dentists have had a general practice residency or other postgraduate training or experience; others may not have had the opportunity.
Some are in areas that have little or no support from a specialist, which makes some surgery mandatory in their practices. Currently, it is accepted that regardless of who performs dental procedures, be they a generalist or a specialist, the standards of care are the same. If a general dentist wants to include the removal of third molars in his or her practice, he or she will usually need more training than that provided in Dental Management.
Just having the desire to do this procedure will not, in and of itself, qualify a person. The best thing a general dentist can do is to first obtain additional training. Surgical expertise is improved by taking postgraduate courses. The Dental Consultant then learns to diagnose the less complicated procedures and does them with supervision until they are performed well. State laws do not discriminate between a general dentist and a specialist. A license gives the same perogative to a generalist that an oral surgeon has to extract teeth.
Therefore, the generalist has a greater responsibility to acquire training and knowledge if he or she expects to do more complex procedures. This responsibility includes not only receiving instruction in step-by-step surgical techniques, but also the medical management of such patients and any complications that might arise. Surgical skill is only part of the equation.
The judgment of the practitioner in making appropriate decisions regarding the patient’s total condition is vital when doing surgical procedures. Anxiety management should be addressed before the surgical procedure is started. Will sedation be needed to accomplish the treatment? Some patients require sedation in order to make them feel comfortable about the surgery. The dentist who doesn’t fully understand the many facets of treating an extremely anxious and medically compromised patient should find an appropriate network of specialists in medicine
and/or dentistry and then use a multidisciplinary team approach.
Dental Consultant must never forget the human elements of kindness, compassion, and caring.
The patient wants to be treated just like any person would want to be treated. Dentists need to have enough insight into the patients’ fears and concerns to be able to calm and reassure them that they can handle any and all contingencies with competence. A little compassion and empathy go a long way in today’s “rushed” society.

Persistent Pulmonary Hypertension of the Newborn

noreply@blogger.com (Anonymous) — Tue, 22 Jul 2008 07:34:00 -0700

Persistent pulmonary hypertension of the newborn (PPHN) occurs in an estimated 1 or 2 infants per 1000 live births and is associated with substantial morbidity and mortality. Despite treatment, 10 to 20 percent of affected infants will not survive. Newborns with PPHN are typically full-term or near-term infants without associated congenital anomalies who present shortly after birth with severe respiratory failure requiring intubation and mechanical ventilation. This disruption of the normal fetal-to-neonatal circulatory transition is characterized by postnatal persistence of elevated pulmonary vascular resistance, resulting in right-toleft shunting of blood through fetal channels (the patent ductus arteriosus, foramen ovale, or both), diminished pulmonary blood flow, and profound hypoxemia.
Paxil is a popular antidepressant that has a number of distressing and dangerous side effect, birth defect, pregnancy risks, birth injuries, and may even cause death. Dangers of persistent primary hypertension in newborns also called PPHN.
Even though Paxil is used mainly to treat depression, many doctors use it to treat panic disorders, anxiety, and post traumatic stress disorder in almost 17 million people around the world. Unfortunately, the Food and Drug Administration advised doctors that prescribing Paxil to children and teenagers could significantly increase the likelihood of violence and suicidal tendencies.Paxil Attorneys California is one of legal specialist about that.
It is important to replicate these findings in other studies. In addition, further research should
assess the relationship of different types and dosages of SSRIs with PPHN and with milder respiratory complications in newborns. Studies should also be undertaken to investigate whether there is any association between SSRIs and PPHN in the offspring of women who discontinue SSRI use late in pregnancy. Furthermore, to better identify patients who may be at risk, investigations should explore interactions between environmental and genetic factors, the latter including polymorphisms affecting the production or regulation of enzymes involved in the metabolism of SSRIs, as well as mutations related to PPHN.http://www.pphnlawyers.com/

The Impact of Alcohol : The heart and the circulatory system

noreply@blogger.com (Anonymous) — Tue, 15 Jul 2008 09:42:00 -0700

Lichtenstein (2003) states that 15 million deaths in the late 1990s could be attributed to cardiovascular disease. The American Heart Association has pointed out that coronary heart disease and the related cardiovascular disease is the number-one killer in the US, accounting for almost one in two deaths among Americans and more deaths than are caused by all the forms of cancer combined. The impact on disability and the attendant economic loss are enormous.
Atherosclerosis (‘hardening of the arteries’) is the term used to describe a number of pathological events occurring in arteries and which are responsible for coronary heart disease, stroke and diseases of the peripheral circulatory system (Fisher 1991). Atheroma (from the Greek ather = porridge) comprises deposits of fatty material on the walls of arteries – a material comprising cholesterol, triglycerides, brous tissue and red blood cells. As it builds it restricts blood ow and if this is in the coronary artery then heart attack and death may follow, as the heart muscle does not receive suf cient oxygen. Atheroma has also been associated with the development of cataracts, macular degeneration in the retina and the development of cancers (Emerit et al. 1991; Tunick et al. 1994). If the atheroma accumulation (plaque) is ruptured a blood clot may form which not only can accelerate the blockage of the artery concerned but also may break loose and plug another artery, increasing the risk of heart attack or, if the newly blocked artery is in the brain, a stroke.
Plainly, the intake of saturated fats and cholesterol increases the risk, although it must be realised that four- fths of the cholesterol is made in our bodies and does not come through the diet. The quantity of cholesterol produced is increased in proportion to the level of saturated fatty acids in the diet (polyunsaturated fatty acids reduce blood cholesterol), and also the trans saturated fatty acids, i.e. those that are produced industrially by catalytic hydrogenation (Krisetherton 1995). High sugar intake can lead to high formation of saturated fats in the body. Indeed, any imbalance in metabolism such that there is an excess of calories over those needed to sustain the body will lead to an accumulation of fat. Obesity, hypertension, diabetes, sedentary living and the use of cigarettes all increase the risk of atherosclerosis.
As cholesterol and other lipids such as the triglycerides are insoluble in aqueous systems, they are transported through the body by combination with proteins, as lipoproteins. The principal carrier of cholesterol is low-density lipoprotein (LDL) and there is a strong positive correlation between its level and the risk of atherosclerosis. Hence LDL is frequently referred to as ‘bad cholesterol’. A lower percentage (20–30%) of the blood cholesterol is in the form of high-density
lipoprotein (HDL), which is responsible for transporting cholesterol away from the arteries to the liver where it is metabolised. This role has caused HDL to be named ‘good cholesterol’, such that high levels of HDL appear to afford protection against heart attack. Thus there is an inverse correlation between levels of HDL and atherosclerosis.

Alcohol : Direct and indirect impacts on body health

noreply@blogger.com (Anonymous) — Mon, 14 Jul 2008 09:34:00 -0700

There are at least two ways in which an alcoholic beverage such as beer might impact bene cially on the body: rst, through a direct physiological impact on bodily tissues and functions (which will be focused upon here); second, through indirect impact, but founded equally on a physiological interaction. The mellowing in uence that moderate consumption of alcohol has, with its calming and relaxing impact, will of itself have a sparing effect on stress-related illnesses (Morrell 2000). Cleophas (1999) concludes that there is a signi cant psychological component in the bene cial relationship between moderate alcohol consumption and mortality.
In either instance it will be recognised that excessive alcohol consumption will shift the status quo in a negative direction. We will address the incontrovertible direct damage to body organs that can be caused by overconsumption, and there is no denying the antisocial impact of excessive alcohol consumption in terms of behavioural changes and drink driving. One problem emphasised by many writers is the impact of underreporting alcohol consumption.
Dr Thomas Stuttaford (who for years has written a most engaging column in The Times) presents a fascinating experiential account of the likely reasons why his patients in rural Norfolk enjoyed a lesser incidence of cardiovascular problems and tended to live longer than did their counterparts in London (Stuttaford 1997). First, they had enjoyed less sedentary lives, with less dependence on the automobile. Second, they took aspirin daily to counter the osteoarthritis brought on by working in soggy agricultural conditions. Third, they weren’t teetotallers. And their chosen drink was beer, with the occasional celebratory whisky. It is of course not possible to con rm with any certainty that there was a causal link between any of those three factors and Stuttaford’s observations on mortality. Indeed, the reader will recognise the dif culty of pursuing robust research in this entire area, for the simple reason that studies relating health to any type of food intake must inherently try to remove as many interfering factors as possible and this is not easy:

Additional methodological problems are presented by a number of ‘confounding
factors’ such as age, sex, body mass index, diet, physical activity, smoking, coffee
consumption, educational attainment, type A/B behaviour, socio-economic status,
and medical history, that may be factors in particular health problems in persons who have been the subjects of the reported studies. For example, a generally
poor nutritional condition could possibly play a signi cant role in various health
problems associated with heavy drinkers.
Butterworth (1993)

Studies based on individuals’ reporting of their dietary intake are not as controlled as those in which feeding trials are performed with laboratory rats with de ned diets. Yet, of course, what is observed with a rat does not necessarily extrapolate to the human. We must critically evaluate the breadth of evidence that is presented. Most assume that if suf cient evidence of diverse origin is offered then ‘there must be something in it’. Much of the attention that has been paid to the impact of alcohol on the body has been for its negative effect on those who abuse it. These effects are amply described in the Oxford Textbook of Medicine (Weatherall et al. 1996) and, in more prosaic form, by Stuttaford (1997). In the discussions that follow I refer to these impacts and the reader is referred to those texts for more information.

The Impact of Alcohol on Health

noreply@blogger.com (Anonymous) — Sun, 13 Jul 2008 09:18:00 -0700

The effect alcohol, including in the form of beer, might have on the overall state of healthfulness of the body. What harm might it do and might it actually do some good? And let us start from a baseline statement that alcohol is relatively non-toxic, with an oral LD50 for the rat of 13.7 g/kg (i.e. the amount of ethanol which will kill half of the animals in an experimental population) (Bakalinsky and Penner 2003) Increasingly the evidence is that there appear to be bene ts in drinking beer (and other types of alcoholic beverage). Guallar-Castillon et al. (2001) concluded that the consumption of total alcohol (wine and beer) was associated with a lower prevalence of sub- optimal health. Hospitalisation is less acute for daily moderate drinkers (Longnecker & McMahon 1988), especially for women who had consumed between 29 and 42 alcoholic beverages in the fortnight prior to lling in the questionnaire. Artalejo et al.
(2000) found that moderate drinkers in Spain were less likely than abstainers to use healthcare services. Meanwhile Wiley and Camacho (1980) showed that moderate alcohol consumption (17–45 drinks per month) was associated with the most favourable adjusted health scores.
Beer drinkers were shown by Richman and Warren (1985) to have signi cantly lower rates of morbidity (sickness) than expected – one drink per day giving 15% less disability than was the case for the general population. There will be those reading this who will not be able to countenance such ndings.
If these people nd it hard to swallow that drinkers, imbibing in moderation, could be less ill, then they might note that they have certainly not been shown to be more sick. However, we must stress always that many of these studies are dealing with correlation, not necessarily causality. Some will argue that there may be other confounding factors not explored in the studies, and that those who tend to drink in moderation may have other lifestyle attributes that are the true reason for their enhanced healthiness. However, the sheer frequency of studies that have demonstrated the bene ts of restricted alcohol intake, weigh heavily in support of the merits of sensible drinking.
In the mid-1990s, the Department of Health within the British government addressed the matter of recommended safe limits for drinking. After (we presume) careful consideration of the scienti c and medical evidence available up to that stage, they increased the recommended limit for men from 21 units to 28 units per week, with the advice to
women being to drink no more than 21 units per week (previously it had been 14). They stressed that the daily maximum should be 4 units and that binge drinking (the equivalent of taking all of the weekly allocation at one sitting) is absolutely undesirable.
Individuals differ substantially in their bodily response to alcohol. Various factors will play a role, including body weight, general state of health, amount of activity, and whether the alcohol is being consumed on its own or alongside food. The UK guidelines are precisely that: blueprints to give some guidance to people to judge sensibly what is and what is not an advisable amount of alcohol to consume. They are not recommendations to drink: they are certainly not instructions. Rather they are a common-sense judgement on what is likely to be healthful for a sensible and healthy adult. And the fact that the levels were increased is testimony to the burgeoning evidence that there is real merit in moderate consumption of alcohol.
The author of a newspaper article in California once highlighted the number of times I had invoked the word ‘moderation’ when she interviewed me. I make no apology for using the word again here (particularly as a glance at the thesaurus in my computer offers the word temperance as a suggested alternative!). As the reader should surmise from what follows, there is more than ample evidence for the harmful effects of sustained, heavy intake of alcohol in all its forms. However, it will be noted that the serious ailments are primarily associated with extreme alcoholism, and a consequence of vastly more alcohol ingestion than is the norm for the great majority of adults.

Beer: a vice or a staple part of the diet?

noreply@blogger.com (Anonymous) — Sat, 12 Jul 2008 09:11:00 -0700

Were we able to transport ourselves back to the Middle Ages and enquire in England, Flanders, Bavaria or Bohemia about the key features of the popular diet, ale or beer would unquestioningly and unhesitatingly be listed alongside meat, bread, milk and vegetables. The questioner would be regarded as being mightily peculiar if he or she were to question ale’s legitimate place on the table. It was neither a comfort food nor an extravagance. It was an integral part of the food intake in all walks of society. In eighth-century England a monk might consume eight pints of ale a day. Beer in Britain has long been considered to be a key part of the diet, as much so as wine in France. Henry Brougham MP (Brougham 1830) said that ‘To the poor the beer is next to a necessity of life.’
Over 50 years ago the nutritive value of beer was emphasised. An admittedly weakish beer [3% alcohol by volume (ABV) in the austere early post-war years] was claimed to provide 200 calories and a fth of a working man’s requirement for calcium, phosphorus,nicotinic acid and ribo avin (Bunker 1947). The satisfaction of having at least part of one’s dietary intake in a pleasurable form was not sneered at then.
Perhaps the rst person to conduct a serious study of the impact of abstinence, moderation and excessive drinking on health was statistician Raymond Pearl. On the basis of interviews with over 2000 workers in Baltimore, he concluded almost 80 years ago that on average moderate drinkers lived longer than abstainers and much longer than those who were heavy drinkers (Pearl 1926).
Yet now, at the dawn of the twenty- rst century, beer-drinking is regarded in many societies as a vice. It is surely astonishing that in the United States it is possible to buy cigarettes at the age of 18, but it is not legal to purchase alcohol until the age of 21. It would be a struggle to identify any merit associated with smoking, with the possible exception of its role as an anxiety relaxant. By contrast there is accumulating evidence that alcohol, including beer, in moderation can have a bene cial impact on health and wellbeing.
In passing, let us consider the legal age at which, in the US, it is possible to partake of other activities that surely might be considered a genuine risk to health and wellbeing, not only for the partaker but also for those around them. A child may legally drive a car, with relatively few restrictions, at the age of 16. More alarmingly, 35 states in the US have no licensing or registration requirements for guns (www.soros.org/crime/ higlights.htm). Seven states lack a legal minimum age for buying a ri e or shotgun from an unlicensed dealer, while six states have no legal minimum age for a child to possess a handgun. In ve states there is a minimum age – 16 in New York, Georgia, Vermont and Alaska, and just 14 in Montana. But the minimum legal age for drinking alcohol in all 50 states is 21!
Opinions about the relative merits and de-merits of smoking, driving, guns and alcohol will of course differ between individuals. Certainly if we consider the respective virtues of smoking, weapon use and alcohol (in restraint), then it seems to this author that there may be a warped set of priorities in one country at least. Nonetheless beer is the second most popular drink in the United States, with annual average per capita consumption at 357 8-ounce servings, after sodas and other soft drinks (861) (Beverage Digest 1998). Worldwide production of beer in 1999 ran at 0.13 billion litres.

Several drugs and hormones have an effect on body weight.

noreply@blogger.com (Anonymous) — Tue, 8 Jul 2008 22:11:00 -0700

Some hormones cause weight gain and others cause weight loss. Hormones that cause weight gain are of particular interest, because if researchers can study and understand how they work, they may be able to develop drugs that can interact with these hormones in a way that makes it easier for people to lose weight. Insulin is a hormone that helps turn glucose (the sugar found in food) into energy the body can use. High levels of insulin lead to weight gain, although the reason why is not fully understood. Drugs used to treat diabetes, such as insulin and medications that make the body produce more insulin, cause weight gain. Obese people often have higher levels of naturally occurring insulin than their leaner counterparts.
Female hormones, like progesterone and estrogen, are associated with weight gain. Obese women most commonly begin to gain weight after puberty, when their bodies begin to produce these hormones. Birth control pills contain estrogen and progesterone, and are associated with weight gain. Today, birth control pills cause less weight gain than in previous years because they contain lower levels of estrogen. Some women may gain more weight than usual during pregnancy, up to 110 pounds (50 kg), which may be related to differences in their hormone levels during pregnancy, as compared to other pregnant women. Women who gain excessive weight during pregnancy may never fully lose this weight. Changes in hormone levels also occur during menopause. These hormone changes lead to a change in fat distribution, including increased central obesity (fat around the midsection or waist). This fat distribution is associated with increased health risks, especially heart disease.
Thyroid hormones increase metabolism and cause weight loss. People with the disease hypothyroidism (underactivity of the thyroid gland) have a smaller amount of thyroid hormone. People with hypothyroidism are predisposed to weight gain.When these individuals are treated with a drug that contains thyroid hormones, they lose weight. Thyroid hormones are dangerous in very high levels and must be monitored closely when taken. An excess of thyroid hormones in the blood can lead to several health problems, including high blood pressure, nervousness, insomnia (trouble sleeping), menstrual cycle changes, heart palpitations (the feeling that the heart is pounding), and fever. Several hormones that may play a role in weight gain have recently been discovered. One of these is leptin, a newly discovered hormone produced in fatty tissue. Increased leptin decreases food intake and increases metabolism in rats and, according to some early studies, in humans as well. Other hormones released by the stomach—including neuropeptide Y, cholecystokinin (CCK), enterostatin, and polypeptide Y 3-36— tell the body it has consumed enough food and should stop eating. Another hormone, ghrelin, is produced by the
stomach. Ghrelin signals hunger and increases appetite.
Ghrelin concentrations increase in response to weight loss. This may make ghrelin partly responsible for people gaining weight back after a successful diet. Table 2.2 lists some of the hormones that influence body weight. Clearly, many hormones affect body weight. Some of these hormones are known, and some have not yet been discovered. By studying these hormones researchers can better understand what causes people to gain and lose weight. Eventually, researchers may be able to develop drugs that can change levels of these hormones in the body, thus giving people who are overweight or obese another weapon in the weight loss battle. Intensive study is required to identify the possible negative effects of increasing or decreasing the level of hormones in the body.

HEALTH RISKS ASSOCIATED WITH OBESITY

noreply@blogger.com (Anonymous) — Mon, 7 Jul 2008 21:27:00 -0700

Obesity is currently the second leading cause of preventable death in the United States.1 Being overweight and obese can contribute to death by causing or worsening many different diseases, including but not limited to:

High blood pressure;
High cholesterol (overweight individuals often have higher levels of “bad” cholesterol and lower levels of “good” cholesterol);
Obstructive sleep apnea (a condition where a person may stop breathing for a period of time while sleeping);
Rheumatoid arthritis and osteoarthritis;
Certain types of cancer, including breast, esophageal, stomach, colorectal, endometrial, and kidney cancer;
In women: menstrual disturbances, infertility problems, and an increased incidence of birth defects in children;
Increased daytime sleepiness and heat intolerance;
Obesity may also contribute to gallbladder disease, gout, breathing problems, increased incidence of infections, liver diseases, and increased pain, especially in the lower back and knees.

Two of the biggest health problems that overweight individuals face are a greatly elevated risk of heart disease and stroke. The American Heart Association (AHA) has found a direct link between these health conditions and being overweight. Heart disease is now the number-one killer of women in the United States, and the rise of overweight and obesity can be directly correlated to it.
A person’s risk of developing these health conditions increases as his or her BMI increases, so obese individuals are at higher risk than overweight individuals. Weight loss of even 10 to 15 pounds (4.5 to 6.8 kg) in adults and children can decrease the risk of developing health problems such as diabetes and hypertension. This weight loss can also help to control or lessen the severity of these conditions in patients already afflicted with these conditions. As previously noted, adults with central obesity are at higher risk of developing many of these conditions than are people with evenly distributed body fat.
Obese children also have an increased incidence of health problems.As the prevalence of obesity has increased in children, there has been a similar rise in diseases that were previously rare in children, including type II diabetes and hypertension (high blood pressure). There is a high incidence of obesity among children with asthma, which may indicate a link between the two conditions. There is also an increase in bone and joint complications in obese children. During childhood, bone and cartilage is still growing and developing, and is not strong enough to bear excess weight.

The Link between Weight and Health

noreply@blogger.com (Anonymous) — Sun, 6 Jul 2008 21:19:00 -0700

Weight and health are strongly related to each other. Disease risk goes up slowly as weight gain pushes you out of the healthy weight range and into the overweight range.Your risk of disease and death increase significantly if extra weight puts you in the obese range. One study reported that obesity in middle age reduces life expectancy by seven years.
The list of weight-related diseases continues to grow. Increased weight raises blood lipids (cholesterol and triglycerides) and blood pressure, which are heart disease risk factors.Weight gain impairs the body’s ability to handle glucose (blood sugar) and contributes to a prediabetic condition called insulin resistance. Other medical conditions that are associated with increased weight include certain cancers, osteoarthritis of the knees and other weight-bearing joints, gastrointestinal tract disturbances, interrupted sleep and sleep apnea, and reduced fertility.To date, obesity has been linked with more than thirty medical conditions.
As weight goes out of the healthy range, risk increases for
• Heart disease
• High blood pressure
• Stroke
• Diabetes
• Several forms of cancer
• Metabolic syndrome (Syndrome X)
• Gallbladder disease
• Gout

It is not just big gains that carry ill health effects—the consequences of gradual or modest weight gain add up quickly. Even 10 or 20 extra pounds increases the risk of death among adults, as shown in a large study published in the New England Journal of Medicine.A recently published study found that just a 5% increase in the BMI over time had a negative impact on simple body functions like walking. Research on women, weight gain, and cancer found that women who gained 21 to 30 pounds since age 18 and were not on hormone replacement therapy were 40% more likely to get breast cancer than women who had gained no more than 5 pounds. The risk increased as the women’s weight increased. Similarly, another study found an 8% increase in the
risk of postmenopausal breast cancer for every 11 pounds gained.

Developing a Good Relationship with Your Doctor

noreply@blogger.com (Anonymous) — Thu, 3 Jul 2008 22:50:00 -0700

In the past, many people saw the same doctor for years—sometimes for most of their lives. Today, people are much more mobile, making a long-standing patient-doctor relationship more difficult. People move to new locations, accept new jobs, and change healthcare coverage. Any of these situations may require a change of doctors. Some health plans restrict your choice of doctors to those who participate in their plans. Seeing a specialist may entail getting a referral from your primary care doctor. Choosing a new doctor takes more than just a word-of-mouth recommendation from a friend. You need to think carefully about what you are looking for when changing doctors. The area of medicine in which a doctor specializes is an important consideration. If you have a particular medical problem, such as heart disease, you will probably want to see a cardiologist (a doctor who specializes in diseases of the heart). If you are generally healthy, an internist (a doctor who specializes in the care of adults) or a family physician is probably the best choice. You may also prefer a male doctor over a female doctor. Some people choose medical assistant which he or she admits patients. The location of the doctor’s office also is a factor. It should be easy to reach from your home or workplace, especially if you rely on public transportation.
Once you have narrowed your choices, find out more about the medical assistant school you are considering. Important information includes where they trained, how long they have been practicing, and their specialty area and whether they have been certified by the board in that specialty.
medical assistant schools needs to communicate well with you by fully answering all of your questions and explaining medical terms and procedures in language you can understand. they also needs to treat you with respect and keep waiting times to a minimum. If you feel that you are not getting all the information you need to follow medical assistant instructions or that your appointment times are too rushed to address all of your medical concerns, Keeping an established relationshipis much easier and more valuable than starting all over again.

Environmental Factors,Causes of Obesity

noreply@blogger.com (Anonymous) — Thu, 3 Jul 2008 21:13:00 -0700

Along with genetics, environmental factors have been found to contribute to obesity. In particular, increased food consumption and an inactive (sedentary) lifestyle are environmental factors that very closely correlate with an increased risk of obesity. Americans have an ever-increasing number of energydense foods, packaged in enormous portions, conveniently available at low cost. Energy-dense foods contain large numbers of calories in very small portions. These foods promote the overconsumption of calories. Americans also consume 40% of their calories from fats, which is well above the level recommended by the American Heart Association (AHA). Fats are an extremely energy-dense form of nutrition. The AHA recommends that adults obtain less than 30% of their daily calories from fat. In the United States and in other developed countries, modern technology allows people to be less active in their daily tasks, since many things today are automated and do not require manual labor. For example, years ago people walked to most places. Today, people have access to cars and public transportation to take them to these same places, thus limiting the need for physical activity.
Decreases in physical activity can lead to weight gain. Ultimately, all the calories you eat are not utilized, or burned off. Calories that are not utilized are stored as fat tissue, which can lead to weight gain. Sedentary behavior is on the rise now that technology and automation are so widely available. All of the modern conveniences we now have accessible to us have eliminated the need for individuals to perform much of the physical activity that was once required for daily tasks at work and home (Table 2.1). Computers, cable and satellite television, movies on demand, and high-tech toys like video game systems have led to a decrease in physical activity in people of all ages. Reduced physical education requirements in schools across the nation have also caused physical activity to decline among adolescents. The CDC estimates that 70% of adults in the United States fail to meet minimal recommendations for physical activity. It also estimates that
about one-third of people over the age of 18 get no leisuretime physical activity at all.
Other environmental factors that have been linked to obesity are lower economic class, lower education level, and cessation (quitting) of smoking. The link between economic level, educational background, and obesity is not clear. One theory is that a person who is illiterate may not be able to read labels on food and may not be aware he or she is consuming high-fat, high-calorie foods that can lead to obesity.High-fat, high-calorie foods, such as the food served at most fast-food restaurants, are formulated to be cheap and great tasting. This food is readily available and affordable for people with lower incomes and it is speculated that these people may consume more of this type of food, which can lead to obesity.
People who quit smoking are also likely to gain weight and potentially become obese. It is believed that the nicotine withdrawal a person experiences when he or she quits smoking causes an increase in appetite that leads to an increased intake of calories and, thus, weight gain. This trade-off is not an easy one to handle. The harmful effects of smoking are many and include lung cancer, bronchitis (an infection of the tube that brings air to the lungs), and emphysema (a condition that results in labored breathing and increased risk of infections). Many people who quit smoking trade one health risk (smoking) for another (obesity) because they gain weight.

Genetics,Causes of Obesity

noreply@blogger.com (Anonymous) — Thu, 3 Jul 2008 21:11:00 -0700

Genetics clearly play a role in obesity. It has been noted that an
adopted child’s body weight is usually more similar to the body
weight of his or her biological parents than that of his or her
adopted parents. Identical twins usually have similar occurrences
of obesity. Studies have also shown that fraternal twins
do not show this same likelihood of obesity; when one twin is
overweight, the other is very often not. These examples help
demonstrate that genetics play a significant role in obesity.
Researchers participating in the Human Obesity Gene
Map project are in the early stages of determining which genes
contribute to obesity in people. Several alterations in normal
genes have been discovered in laboratory rodents and linked to
obesity in these animals. These genes include the ob or lep gene
and the Agouti gene. Researchers are working to find out if
these same genes contribute to obesity in humans.
Not all people who have obesity genes will be overweight.
Conversely, some people who are overweight will not have
these genes. This is because environmental factors also play
a major role in causing overweight and obesity.